Does A Heel Spur Hurt?

Heel Spur


Overview


A heel spur is a projection or growth of bone where certain muscles and soft tissue structures of the foot attach to the bottom of the heel. Most commonly, the plantar fascia, a broad, ligament-like structure extending from the heel bone to the base of the toes becomes inflamed, and symptoms of heel pain begin. As this inflammation continues over a period of time, with or without treatment, a heel spur is likely to form. If heel pain is treated early, conservative therapy is often successful, and surgery is usually avoided.


Causes


Generally caused by lack of flexibility in the calf muscles and/or excess weight, heel spurs occur when the foot bone is exposed to constant stress and calcium deposit build-up on the bottom of the heel bone. Repeated damage can cause these deposits to pile up on each other, presenting a spur-shaped deformity.


Inferior Calcaneal Spur


Symptoms


You'll typically first notice early heel spur pain under your heel in the morning or after resting. Your heel pain will be worse with the first steps and improves with activity as it warms up. When you palpate the tender area you may feel a tender bony lump. As your plantar fasciitis deteriorates and your heel spur grows, the pain will be present more often.


Diagnosis


Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.


Non Surgical Treatment


Common and effective treatments for Heel Spurs include: Stretching exercises, changing to specific shoes, taping or strapping to rest stressed muscles and tendons, custom orthotic devices and physiotherapy. There are many things you can do to treat heel spurs. You should stretch the muscles and ligaments around the area regularly and ensure you are wearing the right footwear for your feet. There are also tapes and straps that you can apply to the muscles and tendons around the area. For more severe cases, custom orthotics may be the way to go along with aggressive physiotherapy. To treat the pain, over the counter NSAIDs (anti-inflammatory medications) is recommended, but use with caution as prolonged use can lead to the development of ulcers. It is therefore best to apply a topical treatment such as Zax?s Original Heelspur Cream, which contains natural ingredients proven to reduce pain and inflammation. More severe forms of the condition may require corticosteroid injections or surgical procedures, but these are very rare cases. Still, should pain become worse and persist, you should consult with your doctor.


Surgical Treatment


Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.


Prevention


Choose new shoes that are the right size. Have your foot measured when you go to the shoe store instead of taking a guess about the size. Also, try on shoes at the end of the day or after a workout, when your feet are at their largest. To ensure a good fit, wear the same type of socks or nylons that you would normally wear with the type of shoe that you are trying on.

Tips On How To Protect Against Inferior Calcaneal Spur

Calcaneal Spur


Overview


A heel spur also known as a calcaneal spur, is a pointed bony outgrowth of the heel bone (calcaneus). Heel spurs do not always cause pain and often are discovered incidentally on X-rays taken for other problems. Heel spurs can occur at the back of the heel and also under the heel bone on the sole of the foot, where they may be associated with the painful foot condition plantar fasciitis.


Causes


Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.


Calcaneal Spur


Symptoms


If your body has created calcium build-ups in an effort to support your plantar fascia ligament, each time you step down with your foot, the heel spur is being driven into the soft, fatty tissue which lines the bottom of your heel. Heel spur sufferers experience stabbing sensations because the hard protrusion is literally being jabbed into the heel pad. If left untreated, Plantar Fasciitis and heel spurs can erode the fatty pad of the heel and cause permanent damage to the foot. Fortunately, most cases can be resolved without medications or surgeries.


Diagnosis


A Diagnosis of Heel Spur Syndrome is a very common reason for having heel pain. Heel pain may be due to other types of conditions such as tendonitis, Haglund's Deformity, Stress Fracture, Tarsal Tunnel Syndrome, or low back problems. A more common condition in children is Sever's Disease. The diagnosis is usually made with a combination of x-ray examination and symptoms.


Non Surgical Treatment


There are many temporary solutions to resolve the pain associated with irritation to the plantar ligaments. Common recommendations are ice and anti-inflammatory medications or even cortisone injections, however none of these solve the fundamental problem. To permanently resolve heel spurs you need to support and restrict the movement of the plantar ligaments. Flexible shoes will aggravate and often contribute to heel spurs. We recommend a RIGID orthotic that extends from the metatarsal heads to the heel to resolve heel spurs.


Surgical Treatment


Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be considered.

Bursitis Following Foot Surgery

Overview


Swelling and inflammation near a joint may be a sign of bursitis, a condition that involves buildup of liquid and inflammation in a bursa sac that cushions a joint. This condition has earned some interesting names over the years: housemaid?s knee, student?s elbow, and tailor?s bottom, to name a few. Simply put, bursitis is the inflammation of a bursa and buildup of fluid in the bursa sac. A bursa is a thin, slippery sac found around a joint that serves to reduce friction between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons. A bursa sac is made up of a synovial membrane, or synovium, that produces and contains synovial fluid. Excessive friction, a trauma, or other condition can irritate the synovium and cause it to become inflamed. The inflamed synovium will thicken and produce excess synovial fluid, and can cause symptoms such as localized swelling, skin redness and warmth, tenderness and pain. Of the approximately 160 bursae in the body, only a handful of them usually cause bursitis. These usual suspects are found in the knee, shoulder, elbow, and hip. Less frequently, bursitis may also occur in the heel, wrist, buttocks and big toe.


Causes


Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.


Symptoms


You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts worse when you run, walk up hill or wear high heels.


Diagnosis


On physical examination, patients have tenderness at the site of the inflamed bursa. If the bursa is superficial, physical examination findings are significant for localized tenderness, warmth, edema, and erythema of the skin. Reduced active range of motion with preserved passive range of motion is suggestive of bursitis, but the differential diagnosis includes tendinitis and muscle injury. A decrease in both active and passive range of motion is more suggestive of other musculoskeletal disorders. In patients with chronic bursitis, the affected limb may show disuse atrophy and weakness. Tendons may also be weakened and tender.


Non Surgical Treatment


Treatment consists of anti-inflammatory therapy with the use of ice, short term non steroidal therapy including ibuprofen and naproxen and selective use of cortisone injections. Cortisone injections have been shown to be a highly effective anti-inflammatory measure for relieving foot and ankle pain. Care must always be taken by the physician to insure that the injection is administered into the bursal sac and not the Achilles tendon which can cause tendon injury. Treatment also consists of the use of heel lifts or the temporary use of a shoe with a low heel. The heel lift decreases the mechanical load on the Achilles tendon. Gentle stretching of the Achilles tendon, the possible use of a splint that is worn at night as well as physical therapy as directed by your physician can be employed. Temporary activity limitations for fitness must be incorporated into the treatment plan. Any weight bearing activity for exercise that actively lifts your heel off of the ground including running, walking stair stepper will interfere with effective conservative care. Low impact activity including biking and pool tend to be safe exercises during your recovery.


Surgical Treatment


Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.


Prevention


Do not run if you have pain. When you begin running again, avoid running fast uphill or downhill until the tendon is fully healed. Start exercising when caregivers say that it is OK. Slowly start exercise such as bicycling when caregivers say it is OK. When doing exercises that put pressure on the ankles, such as running or walking, exercise on flat, even surfaces. Avoid doing these exercises on very hard surfaces such as asphalt or concrete. Stretch before exercising. Always warm up your muscles and stretch gently before exercising. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your heel. Wear heel protectors. Use soft foam or felt heel pads (wedges or cups) to help decrease pressure against your heel. Ask your caregiver which heel pads are the best for you. Wear well-fitting shoes. Buy running or exercise shoes that support and fit your feet well. Do not wear low-cut shoes. Talk to your caregiver or go to a special exercise footwear store to get well-fitting athletic shoes. Ask your caregiver if you should wear specially-made shoe inserts called orthotics (or-THOT-iks). Orthotics can line up your feet in your shoes to help you run, walk and exercise correctly.

What Causes Hammertoe Pain

Hammer ToeOverview


A hammertoe is a deformity of the second, third or fourth toes in which the main toe joint is bent upward like a claw. Initially, hammertoes are flexible and can be corrected with simple measures. Left untreated, they can become fixed and require surgery. Hammertoe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and can?t stretch out.


Causes


More often than not, wearing shoes that do not fit a person well for too long may actually cause hammer toes. Wearing shoes that are too narrow or too tight for the person for extended periods of time may eventually take a toll on the person's feet. The same is true for women who like wearing high-heeled shoes with narrow toe boxes.


Hammer ToeSymptoms


People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.


Diagnosis


Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.


Non Surgical Treatment


Your doctor may prescribe some toe exercises that you can do at home to stretch and strengthen the muscles. For example, you can gently stretch the toes manually. You can use your toes to pick things up off the floor. While you watch television or read, you can put a towel flat under your feet and use your toes to crumple it. Finally, your doctor may recommend that you use commercially available straps, cushions or nonmedicated corn pads to relieve symptoms. If you have diabetes, poor circulation or a lack of feeling in your feet, talk to your doctor before attempting any self-treatment.


Surgical Treatment


The deformity is corrected in a variety of ways. There are actually a large number of procedures. The simplest procedure would involve a Tenotomy, the cutting of the tendon causing the deformity or a Tendon Lengthening procedure. These procedures are infrequently done, though, as the structural deformity (the arthritis and joint adaptation) is not addressed with these surgeries. Other soft-tissue procedures involve rebalancing the tendons around the joint. There are Hammer toe several techniques to do this, but the most common is probably the Girdlestone-Taylor procedure, which involves rerouting the tendons on the bottom of the toe up and over the toe where it sticks up, so that the tendon helps pull the toe downwards into proper alignment.


Hammer ToePrevention


elect and wear the right shoe for specific activities (such as running shoes for running). Alternate shoes. Don't wear the same pair of shoes every day. Avoid walking barefoot, which increases the risk for injury and infection. At the beach or when wearing sandals, always use sunblock on your feet, as you would on the rest of your body. Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one. It is critical that people with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they are more prone to infection.

Bunions Symptoms


Overview
Bunions Hard Skin
When your big toe is angled towards the second toe, the deformity is called a bunion (hallux valgus). This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. Sometimes a fluid-filled sac (bursa) develops over the joint.

Causes
Bunions are sometimes genetic and consist of certain tendons, ligaments, and supportive structures of the first metatarsal that are positioned differently. This bio-mechanical anomaly may be caused by a variety of conditions intrinsic to the structure of the foot, such as flat feet, excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although some experts are convinced that poor-fitting footwear is the main cause of bunion formation, other sources concede that footwear only exacerbates the problem caused by the original genetic structure. Bunions are commonly associated with a deviated position of the big toe toward the second toe, and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal (which help the flexor tendon bend the big toe downwards) may also become deviated over time as the first metatarsal bone drifts away from its normal position. Arthritis of the big toe joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development. Atop of the first metatarsal head either medially or dorso-medially, there can also arise a bursa that when inflamed (bursitis), can be the most painful aspect of the process.
SymptomsRed, thickened skin along the inside edge of the big toe. A bony bump at this site. Pain over the joint, which pressure from shoes makes worse. Big toe turned toward the other toes and may cross over the second toe.

Diagnosis
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.

Non Surgical Treatment
The treatment of a bunion depends entirely on how uncomfortable it is. Realistically, there are only two ways to treat a bunion: either change the size and shape of the shoe or change the size and shape of the foot. Once a bunion gets to be irritating or painful and shoe wear is uncomfortable, surgery may be recommended.
Bunions Callous

Surgical Treatment
According to the NHS, 85 per cent of operations are successful, but there?s no guarantee that the problem won?t recur, that the pain will go away, or that your movement won?t become limited. Ask yourself if the affront to your vanity and discomfort caused by your bunion is worth the post-op suffering, and if you can cope with the inevitable restriction on your movement that means no driving and time off work, even if only for a few weeks.

Prevention
The best way to reduce your chances of developing bunions is to wear shoes that fit properly. Shoes that are too tight or have high heels can force your toes together. Bunions are rare in populations that don?t wear shoes. Make sure your shoes are the correct size and that there's enough room to move your toes freely. It's best to avoid wearing shoes with high heels or pointed toes.
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