Mortons Neuroma Symptoms

Overview

intermetatarsal neuromaMorton’s neuroma is named after Dr Morton who first described this condition in 1876. It is sometimes called Morton’s metatarsalgia or interdigital neuroma. It is a condition that affects one of the common plantar digital nerves that run between the long bones (metatarsals) in the foot. It most commonly affects the nerve between the third and fourth metatarsal bones, causing pain and numbness in the third and fourth toes. It can also affect the nerve between the second and third metatarsal bones, causing symptoms in the second and third toes. Morton’s neuroma rarely affects the nerve between the first and second, or between the fourth and fifth, metatarsal bones. It tends to affect only one foot. It is rare to get two neuromas at the same time in the same foot.

Causes

Some say that this condition should not be called Morton’s neuroma as, in fact, it is not actually a neuroma. A neuroma is a non-cancerous (benign) tumour that grows from the fibrous coverings of a nerve. There is no tumour formation in Morton’s neuroma. The anatomy of the bones of the foot is also thought to contribute to the development of Morton’s neuroma. For example, the space between the long bones (metatarsals) in the foot is narrower between the second and third, and between the third and fourth metatarsals. This means that the nerves that run between these metatarsals are more likely to be compressed and irritated. Wearing narrow shoes can make this compression worse.

Symptoms

If you have a Morton’s neuroma, you will probably have one or more of these symptoms. Tingling, burning, or numbness. A feeling that something is inside the ball of the foot, or your sock is bunched up. Pain that is relieved by removing your shoes. A Morton’s Neuroma often develops gradually. At first the symptoms may occur only occasionally, when wearing narrower shoes or performing certain activities. The symptoms may go away temporarily by massaging the foot or by avoiding aggravating shoes or activities. Over time the symptoms progressively worsen and may persist for several days or weeks. The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.

Diagnosis

Metatarsal bones will be examined clinically, and often an x-ray will be taken to assess the particular case and ensure against other conditions, including fracture. When the foot is examined by a doctor, he may feel a characteristic ?click,? referred to as Mulder?s sign, and the interspaces between toe bones will often be tender. The doctor may put pressure on these areas to localize the site of pain and test for other conditions, including calluses or stress fractures. Range of motion tests will also be applied to rule out arthritis or joint inflammations. X-rays may be required to ensure there are no stress fractures or arthritis within the joints that join the toes to the foot. Tenderness in one or more metatarsal bones may imply a pre-stress fracture or stress-fracture. An ultrasound scan may be used to confirm diagnosis of Morton?s Neuroma, as x-ray will not detect the condition, (but can confirm that the bones are uninjured).

Non Surgical Treatment

You may need a metatarsal pad if wider shoes do not help relieve your Morton?s neuroma symptoms. A metatarsal pad will help spread your metatarsal bones and reduce pressure on your affected nerve as it travels under the ball of your foot. The placement of your metatarsal pad is important, and it is best placed by a foot care professional who has experience in the anatomy of the forefoot and Morton?s neuroma treatment.intermetatarsal neuroma

Surgical Treatment

The ultimate success of a Morton?s neuroma treated surgically can be variable. In cases where the underlying problem is only an irritated nerve (a true Morton?s neuroma), then surgery will probably be curative (although it may take a few months for the foot to fully heal). But in many cases, forefoot pain is more complex. There may be an irritated nerve or two causing pain, but the real problem is often excessive loading of the lesser metatarsals. The generic term for this condition is metatarsalgia. When considering surgery, identifying and addressing these problems may lead to a better end result.

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What Can Lead To Posterior Calcaneal Spur

Posterior Calcaneal Spur

Overview

A heel spur is a hook of bone that can form on the heel bone of the foot. Heel spurs are associated with plantar fasciitis. Heel spurs can cause extreme pain in the rearfoot. The pain is most intense while standing or walking. What Causes Heel Spurs? Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia stretches and pulls away from the heel. The plantar fascia is a ligament located at the bottom of your foot. This stretching of the plantar fascia is usually the result of flat feet or unusually high arches.

Causes

When the Plantar Fascia is allowed to rest during sleep or long periods of inactivity, the fascia tightens and shortens. When you first stand up after resting, the fascia is forced to stretch very quickly causing micro-tears in the tissue. This is why the first steps in the morning are so exquisitely painful. Heel spurs are more likely to happen if you suffer from over-pronation (walking with a rolling gait) you stand or walk on rigid surfaces for long periods, you are above ideal weight or during pregnancy, you have stiff muscles in your calves.

Inferior 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

Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).

Non Surgical Treatment

Get some rest. You need to stay off of your aching foot as much as possible for at least a week. Think about possible causes of the problem while you’re resting and figure out how you can make some changes. Some actions that can contribute to heel spurs include running too often or running on hard surfaces such as concrete, tight calf muscles, shoes with poor shock absorption. Ease back into your activities. In many cases, you’ll be in too much pain to go ahead with a strenuous exercise routine that puts pressure or impact on your heel. Listen to your body and switch to different activities such as swimming or riding a bike until your heel spurs improve.

Surgical Treatment

Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the plantar fascia. This surgery is commonly paired with tarsal tunnel release surgery. Surgery is successful for the majority of people.

Protecting Against Calcaneal Spur

Posterior Calcaneal Spur

Overview

Patients and doctors often confuse the terms heel spur and plantar fasciitis. While these two diagnoses are related, they are not the same. Plantar fasciitis refers to the inflammation of the plantar fascia–the tissue that forms the arch of the foot. A heel spur is a hook of bone that can form on the heel bone (calcaneus) and is associated with plantar fasciitis. About 70 percent of patients with plantar fasciitis have a heel spur that can be seen on an X-ray. However, many patients without symptoms of pain can have a heel spur. The exact relationship between plantar fasciitis and heel spurs is not entirely understood.

Causes

When a bone is subjected to pressure, rubbing, or other stress over long periods, it tries to repair itself by building extra bone. This extra bone is what is referred to as a ?spur?. Many form as part of the aging process when cartilage breaks down in the joints.

Heel Spur

Symptoms

Heel spurs are most noticeable in the morning when stepping out of bed. It can be described as sharp isolated pain directly below the heel. If left untreated heel spurs can grow and become problematic long-term.

Diagnosis

Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.

Non Surgical Treatment

Ice and use arch support . If you can localize the spur, cut a hole in a pad of felt and lay the hole over the spur. This supports the area around the spur and reduces pressure on it. Massage the spur. Start gently with your thumb and gradually increase the pressure until you?re pushing hard directly on the spur with your knuckle or another firm object. Even it if hurts, it should help. Arch support. Build up an arch support system in your shoes. Try to equalize the pressure of your body weight throughout your arch and away from the plantar area. Use a ?cobra pad? or other device that supports the arch but releases pressure on the painful area. If homemade supports do not work, see a podiatrist about custom orthotics.

Surgical Treatment

In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.

Prevention

You can prevent heel spurs by wearing well-fitting shoes with shock-absorbent soles, rigid shanks, and supportive heel counters; choosing appropriate shoes for each physical activity; warming up and doing stretching exercises before each activity; and pacing yourself during the activities. Avoid wearing shoes with excessive wear on the heels and soles. If you are overweight, losing weight may also help prevent heel spurs.

Bursitis Foot Pad

Overview

The calf muscle (M Gastrocnemicus) is comprised of two muscle heads which gather in a wide tendinous ligament and continue in to the Achilles tendon. Another of the larger calf muscles (M Soleus) is attached to the front side of the Achilles tendon and thus forms a part of the Achilles tendon. The Achilles is attached to the heel bone (calcaneus). At the heel bone there is a bursa in front of the Achilles anchor point (bursae tendinis Achilles), as well as behind (bursae subcutanea calcanei). The bursa reduce the pressure against the heel bone.

Causes

Bursitis has many causes, including autoimmune disorders, crystal deposition (gout and pseudogout), infectious diseases, traumatic events, and hemorrhagic disorders, as well as being secondary to overuse. Repetitive injury within the bursa results in local vasodilatation and increased vascular permeability, which stimulate the inflammatory cascade.

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

Magnetic resonance imaging (MRI) may demonstrate bursal inflammation, but this modality probably does not offer much more information than that found by careful physical examination. Theoretically, MRI could help the physician to determine whether the inflammation is within the subcutaneous bursa, the subtendinous bursa, or even within the tendon itself, however, such testing is generally not necessary. Ultrasonography may be a potentially useful tool for diagnosing pathologies of the Achilles tendon.

Non Surgical Treatment

For non-infectious bursitis, the preliminary treatment starts with non-operative options such as cold compression therapy and Blood Flow Stimulation Therapy. Surgery to remove the inflamed bursa is normally not required for bursitis, however if you fail to see improvement with the conservative treatments, your physician may recommend surgery to remove the bursa completely. Although this removes the problem of an inflamed bursa, you are left with less cushioning in your joint which can lead to a host of other conditions.

Surgical Treatment

Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to remove the inflamed bursa.

Hammer Toe Causes And Cures

Hammer ToeOverview

A Hammer toe is a toe that tends to remain bent at the middle joint in a claw-like position. There are 2 types of hammer toe. Flexible hammer toe, can be straightened by hand. Rigid hammer toe, cannot be pulled straight and can be extremely painful. The position of the toe can also lead to corns or calluses. These may also be painful. Hammer toe may be present at birth or develop later in life due to tendons that have tightened, causing the toe’s joints to curl downward. Occasionally, all toes may be bent. This may be due to problems with the peripheral nerves or the spinal cord.

Causes

More often than not, wearing shoes that do not fit a person well for hammertoe 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.

HammertoeSymptoms

A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.

Diagnosis

Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.

Non Surgical Treatment

Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Or, a shoe repair shop may be able to stretch the toe box so that it bulges out around the toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.

Surgical Treatment

Your podiatrist may recommend a surgical procedure if your hammertoes are not helped by the conservative care methods listed above. Surgery for hammertoes is performed to help straighten your crooked toe. Your surgery will be performed in your podiatrist?s office or at a hospital, depending on the severity of your hammertoe. A metal pin is sometimes used to help your affected toe maintain its straight position during your recovery.

Over-Pronation Of The Foot What Are The Symptoms

Overview

As with the “normal pronation” sequence, the outside of the heel makes the initial ground contact. However, the foot rolls inward more than the ideal fifteen percent, which is called “overpronation.” This means the foot and ankle have problems stabilizing the body, and shock isn’t absorbed as efficiently. At the end of the gait cycle, the front of the foot pushes off the ground using mainly the big toe and second toe, which then must do all the work.Overpronation

Causes

Over-pronation may happen because the tissue that attaches to your foot bones is loose. You may be born with this problem or it may result from injuries or overuse, like from too much running.

Symptoms

If you overpronate, your symptoms may include discomfort in the arch and sole of foot. Your foot may appear to turn outward at the ankle. Your shoes wear down faster on the medial (inner) side of your shoes. Pain in ankle, shins, knees, or hips, especially when walking or running.Unfortunately, overpronation can lead to additional problems with your feet, ankles, and knees. Runners in particular find that overpronation can lead to shin splints, tarsal tunnel syndrome, plantar fasciitis, compartment syndrome, achilles tendonitis, bunions (hallux valgus) patello femoral pain syndrome, heel spurs, metatarsalgia. You do not have to be a runner or athlete to suffer from overpronation. Flat feet can be inherited, and many people suffer from pain on a day-to-day basis. Flat feet can also be traumatic in nature and result from tendon damage over time. Wearing shoes that do not offer enough arch support can also contribute to overpronation.

Diagnosis

Your healthcare provider will ask about your symptoms, medical history, and activities and examine your feet. Your provider may watch you walk or run. Check the motion of your feet when they strike the ground. Look at your athletic shoes to see if they show an abnormal pattern of wear.Pronation

Non Surgical Treatment

Flat feet and fallen arches can be treated effectively by wearing an orthotic insert in your shoes. Orthotics can be custom-made and prescribed by your foot specialist (podiatrist), or you can use a so called pre-made foot orthotic. Most people do not require expensive custom-made orthotics to combat excess pronation, unless they have a specific medical foot condition. Footlogics orthotic insoles were developed to correct excess pronation, thereby providing sustainable, long-lasting pain relief to many aches and pains in a natural way. Footlogics Comfort, Casual and Sports are products which promote excellent biomechanical control of the foot.

Surgical Treatment

HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.

What Is Severs Disease?

Overview

Foot pain is not only limited to grown-ups. Often, healthy and active children will complain of pain in one or both heels shortly after running, engaging in sports or even walking. The pain is centered at the back of, or under the heel. The cause of heel pain in children is usually a condition called calcaneal apophysitis, normally reported by 8 to 14 year olds.

Causes

The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever?s disease occurs as a result of repetitive stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation. Such stress and pressure can result from sports that involve running and jumping on hard surfaces (track, basketball and gymnastics). Standing too long, which puts constant pressure on the heel. Poor-fitting shoes that don?t provide enough support or padding for the feet. Overuse or exercising too much can also cause Sever?s disease.

Symptoms

Some of the most common signs and symptoms associated with Sever?s disease include. Heel pain or tenderness in one or both heels, usually at the back of the heel. Pain or discomfort upon waking, or when the heel is squeezed. Heel pain that is worse during or following activity. Limping. Heel swelling or redness. Tight calf muscles. Decreased ankle range of motion.

Diagnosis

Low-grade inflammation of the calcaneal apophysis cannot be seen on x-ray. Therefore, although x-rays are often done to rule out bony injuries in children with Sever’s disease these x-rays are usually normal. Advanced Sever’s disease can be seen on x-ray but usually the problem is treated before it reaches this point. Other diagnostic tests, such as bone scans or MRI’s, are not usually required in typical cases of Sever’s disease. These, or other tests, may be required to rule out other conditions, such as stress fractures of the calcaneus or other bony abnormalities that can mimic Severs disease.

Non Surgical Treatment

A physiotherapist will assess your pain, presentation and biomechanics. They can then treat your sever?s disease with hands on techniques which may include massage, manual therapy and taping. Your physiotherapist can then provide advice on what you can do at home to further progress your treatment, this may include stretching, strengthening and activity modification. In some cases orthotic prescription may be of benefit.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.