The Diagnosis Of Inferior Calcaneal Spur

posted on 28 Sep 2015 08:13 by aberrantquagmir17
Inferior Calcaneal Spur

Overview

A calcaneal spur (or heel spur) is a small osteophyte (bone spur) located on the calcaneus (heel bone). Calcaneal spurs are typically detected by a radiological examination (X-ray). When a foot bone is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to pile up on each other,causing a spur-shaped deformity, called a calcaneal (or heel) spur. Obese people, flatfooted people, and women who constantly wear high-heeled shoes are most susceptible to heel spurs. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing spondylitis (typically in children). A posterior calcaneal spur develops on the back of the heel at the insertion of the Achilles tendon. An inferior calcaneal spur consists of a calcification of the calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. A posterior calcaneal spur is often large and palpable through the skin and may need to be removed as part of the treatment of insertional Achilles tendonitis. These are also generally visible to the naked eye.

Causes

Each time we take a step forward, all of our body weight first rests on the heel of one foot. As our weight moves forward, the entire foot begins to bear the body's weight, and the foot flattens and this places a great deal of pressure and strain on the plantar fascia. There is very little ?give? to the plantar fascia, so as it stretches only slightly, it pulls on its attachment to the heel. If the foot is properly aligned this pull causes no problems. However, if the foot is ?pronated?(the foot rolls outward at the ankle, causing a break down of the inner side of the shoe), the arch falls excessively, and this causes an abnormal stretching of the relatively inflexible plantar fascia, which in turn pulls abnormally hard on the heel. The same pathology occurs with ?supination? (the rolling inward of the foot, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible; usually have a high arch, and a short or tight plantar fascia. Thus as weight is transferred from the heel to the remainder of the foot, the tight plantar fascia hardly stretches at all, and pulls with great force on its attachment to the heel. In both cases, the abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain, inflammation, and possibly swelling. If this process continues, the plantar fascia partially tears away from the heel. The body will fill in this torn area with calcium; eventually it becomes bone, and a heel spur results.

Inferior Calcaneal Spur

Symptoms

The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at approximately ankle height.

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

To aid in the reduction of inflammation, applying ice for 10-15 minutes after activities and the use of anti-inflammatory medications, such as aspirin or ibuprofen, can be helpful. Corticosteroid injections may also be used to reduce pain and inflammation. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound, that create a deep heat and reduce inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with a bandage will help. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.

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.

Solution For Bursitis In Ball Of Foot

posted on 29 Aug 2015 05:45 by aberrantquagmir17
Overview

People suffering from heel bursitis may experience pain and tenderness around the affected soft tissue, pain that worsens with movement or pressure, and visible swelling or skin redness in the area of the inflamed bursa at the back of the heel, which may restrict movement and affect your daily activities. Bursitis is in the heel area is also called Retrocalcaneal Bursitis or Calcaneal Bursitis. The calf comprises of two major muscle groups, both of which insert into the heel bone via the Achilles Tendons. Between the Achilles tendon and the heel bone lies a bursa known as the retrocalcaneal bursa. During contraction of the calf, tension is placed through the Achilles tendon and this rubs against the retrocalcaneal bursa. Treatment of Bursitis is similar to the treatment options for normal heel pain, in particular ice, anti-inflammatories, exercises and orthotics can be beneficial for heel bursitis.

Causes

The swelling is the result of the blockage of blood, tissue fluids and circulation in the heel because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating, blood and fluids back up behind the injured heel, causing pain, inflammation, lumps and swelling.

Symptoms

Your feet are extremely resilient and are designed to stand up to the pressures of day-to-day living. In some cases, though, foot structures may break down when subjected to chronic stress associated with prolonged periods of weight-bearing activity on concrete, asphalt, or other hard surfaces (especially when your footwear does not allow for appropriate weight distribution). Foot problems, including infracalcaneal bursitis, are often exacerbated by poorly designed footwear, and pressure, impact, and shear forces can damage your feet over time. Bursal sacs are intended to minimize this damage, but sometimes the bursa itself becomes inflamed.

Diagnosis

Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.

Non Surgical Treatment

Long Term Treatment must be directed towards eliminating the abnormal tilting of the heel, regardless of its cause. If this is delayed, the usual results are the pain and swelling becomes worse, chronic, and debilitating. Eventually, painful calcifications and bone spur formations may occur on the back of the heel, along with tears in the Achilles Tendon. These are serious problems that may require surgical intervention. In order to eliminate abnormal heel tilt, the foot must be re-balanced. Controlling and reducing the biomechanical foot defects that are causing the heel to tilt best accomplish this. The "Gold Standard" of medical care (that treatment most used by doctors and therapists) to help eliminate pain, inflammation, and swelling at the back of the heel is orthotics.

Surgical Treatment

Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

Prevention

It isn't always possible to avoid the sudden blow, bump, or fall that may produce bursitis. But you can protect your body with measures similar to those that protect you from other kinds of overuse injuries, such as tendinitis. Keep yourself in good shape. Strengthening and flexibility exercises tone muscles that support joints and help increase joint mobility. Don?t push yourself too hard (or too long). If you?re engaged in physical labor, pace yourself and take frequent breaks. If you?re beginning a new exercise program or a new sport, work up gradually to higher levels of fitness. And anytime you?re in pain, stop. Work on technique. Make sure your technique is correct if you play tennis, golf, or any sport that may strain your shoulder. Watch out for ?elbow-itis.? If you habitually lean on your elbow at your work desk, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you don?t have to lean on your elbow to read, write, or view your computer screen. Take knee precautions. If you have a task that calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change position frequently, and take breaks. Wear the right shoes. High-heeled or ill-fitting shoes cause bunions, and tight shoes can also cause bursitis in the heel. Problems in the feet can also affect the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that?s too short or narrow. Women should save their high heels for special occasions only. Avoid staying in only one position for too long. Get up and walk around for a while or change positions frequently.

Do Hammer Toe Straighteners Do The Job

posted on 23 Jun 2015 07:35 by aberrantquagmir17
HammertoeOverview

A Hammer toes is a misshapen toe. The middle joint of the toe bends up in a way that makes the toe look like it is forming an upside-down V. The bent joint may rub the top of your shoe. Hammertoes can develop on any toe, but they usually happen in the second toe. Claw toes or mallet toes look a lot like hammertoes, but a different joint in the toe is bent. Hammertoes usually are not painful at first. When they begin, they can be pushed down to the correct position. These are called flexible hammertoes. After a while, they will not go back to their normal position, even if pushed with the fingers. These are called rigid hammertoes.

Causes

The cause of hammertoes varies, but causes include genetics, arthritis and injury to the toe. Treatment for hammertoes depends on the severity and can include anti-inflammatory medication, metatarsal pads, foot exercises and better-fitting shoes. If the pain caused by a hammertoe is so severe that wearing a shoe is uncomfortable, surgery may be necessary. Typically this surgery is an outpatient procedure that doesn?t require general anesthesia, though it is an option. Recovery from surgery usually takes a few weeks, and patients are given special shoes to wear.

Hammer ToeSymptoms

A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of Hammer toe bone possibly due to your foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.

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. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).

Non Surgical Treatment

To keep your hammertoes more comfortable, start by replacing your tight, narrow, pointy shoes with those that have plenty of room in the toes. Skip the high heels in favor of low-heeled shoes to take the pressure off your toes. You should have at least one-half inch between your longest toe and the tip of your shoe. If you don't want to go out and buy new shoes, see if your local shoe repair shop can stretch your shoes to make the toe area more accommodating to your hammertoe.

Surgical Treatment

Surgery to straighten the toe may be needed if an ulcer has formed on either the end or the top surface of the toe. Surgery sometimes involves cutting the tendons that support movement in the toe so that the toe can be straightened. Cutting the tendons, however, takes away the ability to bend the very end of the toe. Another type of surgery combines temporary insertion of a pin or rod into the toe and alteration or repair of the tendons, so that the toe is straightened. After surgery, the deformity rarely recurs.