HEEL PAIN/ PLANTAR FASCITIS

Symptoms;
                   Heel pain is one of the most common medical conditions that a Podiatrist treats. Heel pain is commonly due to an inflammation of a thick ligament on the bottom of the foot which runs from the heel bone to the bottom aspect of the toes. Symptoms of plantar fascitis typically include pain with the first few steps in the morning or after a period of sitting. This occurs because the plantar fascial band is relaxed (shortened) and heals during rest. When the first few steps are taken, the ligament becomes strained and tears internally which may cause a bone spur.

Evaluation;
                   Your Podiatrist will discuss your symptoms and activity as it relates to your condition. The Podiatrist will then examine, palpate and perform range of motion excercises to determine the extent of the deformity. He or she will probably perform gait analysis or observe your feet and legs throughout the walking cycle. Standing x-rays are taken to evaluate the bone structure, mechanics and deformity as it appears with weight on the foot. Arthritis, stress fractures, a pinched nerve and tumors can also cause pain in the heel or arch which may be similar to symptoms of plantar fascitis.

Treatment;
                   Conservative treatment for plantar fasciitis includes nonsteroidal anti-inflammatory medication, podiatric taping & strapping, a series of cortisone injections, proper shoe gear, weight loss, stretching exercises and custom functional foot orthoses. In most cases, these conservative treatments provide success.

 

Back

NEUROMA

Symptoms;
                   A neuroma was once thought to be a benign tumor, now it is understood that a neuroma is actually an inflammation of nerve tissue usually located in the ball of the foot and occasionally into the toes. This inflammation is caused by two metatarsal bones that rub and pinch the nerve. The feeling of a neuroma is sometimes equated to a bunched up sock or stepping on a pebble. Symptoms may include tingling, burning, cramping and/or aching in and across the ball of the foot or toes. The individual may also experience periods of numbness. Over time, the top of the foot may become painful because these tendons work harder to alleviate the discomfort caused by the neuroma. In general, the longer a neuroma is present, the more difficult it is to treat. Nerve problems due to a pinched nerve in the spine, diabetes, alcoholism, chemotherapy, some medications and vitamin B deficiency may also cause symptoms like a neuroma. Enlarged veins, ganglions and stress fractures have also caused similar symptoms and should be evaluated by your Podiatrist.

Evaluation;
                   Your Podiatrist will discuss your symptoms and activity as it relates to your condition. The Podiatrist will then examine, palpate and perform specific maneuvers on the foot to determine the deformity and or other related conditions. He or she will probably perform gait analysis or observe your feet and legs throughout the walking cycle. Standing x-rays may be taken to evaluate the bone structure, mechanics and deformity as it appears with weight on the foot. Nerve Conduction Velocity (NCV), Ultrasound, Magnetic Resonance Imaging (MRI) and CT scanning may be helpful, but the diagnosis is primarily made clinically by your Podiatrist.

Treatment;
                  Conservative treatment may include a series of cortisone injections, padding, proper shoe gear and custom functional foot orthoses. If conservative measures are not successful, an outpatient surgical procedure known as a neurectomy can be performed to correct the problem.

 

Back

STRESS FRACTURES

Symptoms;
                   Stress fractures or "fatigue" fractures commonly occur in the foot and leg. A stress fracture usually presents itself in an individual who is new to exercise or has increased his/her exercise regiment, has started wearing new or different shoes, has started walking on a different flooring as in a new or different job and/or has had an increase in body weight. The patient usually cannot recall the specific conditions leading up to the stress fracture. Usually a stress fracture is accompanied by a local or diffuse area of pain that may or may not be swollen. Most patients do not bring themselves to the Podiatrist until a week or more of discomfort/pain. Certain types of arthritis, diseases and other types of injury can cause similar symptoms.


Evaluation;
                   Your Podiatrist will discuss your symptoms and activity as it relates to your condition. The Podiatrist will then examine, palpate and perform specific maneuvers on the foot to determine the deformity and or other related conditions. He or she will probably perform gait analysis or observe your feet and legs throughout the walking cycle. Standing x-rays are taken to evaluate the bone structure, mechanics and deformity as it appears with weight on the foot. An inflammation of the bone, called periostitis, can cause similar complaints and is usually treated the same. A stress fracture may not show itself on an x-ray for one to four weeks. Your Podiatrist may order a bone scan to determine the injury. Your Podiatrist may take x-rays, at various times, to determine the injury and extent of bone involved as it progresses or heals.

Treatment;
                   Early diagnosis and treatment of the stress fracture or bone inflammation is important, because the fissure may slowly expand across the entire bone. Treatment consists of decreasing activity, wearing a metatarsal shoe, compression dressing, icing, anti-inflammatories, off-weightbearing excercises and in some cases casting. In mild situations or when the stress fracture starts to heal, it is important to be fitted for custom functional foot orthoses. These devices will help to control the abnormal mechanics of the foot that may have predisposed the patient to getting the fracture in the first place. Proper shoe gear should also be discussed with the Podiatrist. Any other factors such as osteoporosis, oral steroid use and other diseases must also be addressed.

 

Back