Does A Calcaneal Spur Hurt?

Heel Spur


Overview


Heel spurs, or abnormal growths of the heel bone, can cause sharp pains in the heel, especially first thing in the morning and after long periods of rest. In many cases, a heel spur develops as a result of plantar fasciitis, which is the inflammation of the ligament that stretches along the bottom of the foot, from the base of the toes to the heel. In individuals who suffer from plantar fasciitis, the ligament pulls away from the heel as the foot bears weight. In an effort to stabilize the ligament, the body may produce calcium deposits, which can then develop into heel spurs.


Causes


Bone spurs can occur all over the body including the spine, shoulders, hands, hips and feet. The feet are a common place to find them. A heel spur happens when the body tries to mend itself. Building extra bone is one way your body tries to correct a weakness. Wearing shoes that are too tight in the heel can cause bone spurs. More women than men get heel spurs because of the kinds of shoes they wear. Athletes who stress their feet and legs routinely are also prone to heel spurs. Being overweight can also indirectly cause heel spurs by over-exerting the plantar fascia. Some heel spurs are caused by the aging process, in which the cartilage covering the ends of bones wears away. This process can lead to pain, swelling and spur formation. Stress-related problems with the plantar fascia frequently lead to heel spurs.


Inferior Calcaneal Spur


Symptoms


With heel spurs, people often talk about a dull ache which is felt most of the time with episodes of a sharp pain in the center of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the morning and after rest and is aggravated by prolonged weight bearing and thin-soled shoes.


Diagnosis


Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.


Non Surgical Treatment


Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.


Surgical Treatment


More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it's important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.

What Can Induce Inferior Calcaneal Spur

Inferior Calcaneal Spur


Overview


A heel spur is a calcium deposit on the underside of the heel bone, often caused by strain on foot muscles and ligaments. Heel spurs are common among athletes but also tend to develop as we age, as flexibility decreases. Heel spurs can be painful when associated with plantar fasciitis, an inflammation of the connective tissue that runs along the bottom of the foot and connects the heel bone to the ball of the foot.


If left untreated, the mild aches associated with this condition can evolve into chronic pain. And as you try to compensate for the pain, your gait may change, which could impact your knee, hip and back.


Causes


This condition is a constellation of many causes; overweight, ill fitting shoes, bio-mechanical problems (mal-alignment of the heel), gout, pronation (a complex motion including outward rotation of the heel and inward rotation of the ankle) and rheumatoid arthritis are some of the causes of heel pain.


Inferior Calcaneal Spur


Symptoms


Most bone spurs cause no signs or symptoms. You might not realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints.


Diagnosis


Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.


Non Surgical Treatment


Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.


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.

The Cause Of Bursitis Of The Feet?

Overview


In the ankle, 2 bursae are found at the level of insertion of the Achilles tendon. The superficial one is located between the skin and the tendon, and the deep one is located between the calcaneus and the tendon. The latter is the one more commonly affected by bursitis.


Causes


The most common cause of bursitis is repeated physical activity, but it can flare up for no known reason. It can also be caused by trauma, rheumatoid arthritis, gout, and acute or chronic infection.


Symptoms


Pain when activating the Achilles tendon (running and jumping) and when applying pressure at the point of attachment of the tendon on the heel bone. Contrary to the tenderness occurring with inflammation of the Achilles tendon, the tenderness is localised to the point of attachment to the heel bone.


Diagnosis


Obtaining a detailed history from the patient is important in diagnosing calcaneal bursitis. The following complaints (which the physician should ask about during the subjective examination) are commonly reported by patients.


Other inquiries that the physician should make include the following. The clinician should ask about the patient's customary footwear (whether, for example, it includes high-heeled shoes or tight-fitting athletic shoes). The patient should be asked specifically about any recent change in footwear, such as whether he/she is wearing new athletic shoes or whether the patient has made a transition from flat shoes to high heels or vice versa. Individuals who have been accustomed to wearing high-heeled shoes on a long-term basis may find that switching to flat shoes causes increased stretch and irritation of the Achilles tendon and the associated bursae. The specifics of a patient's activity level should be ascertained, including how far the patient runs and, in particular, whether the individual is running with greater intensity than before or has increased the distance being run. The history of any known or suspected underlying rheumatologic conditions, such as gout, rheumatoid arthritis, or seronegative spondyloarthropathies, should be obtained.


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


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.

What Is The Treatment For Hammer Toes

HammertoeOverview


A Hammer toe is a contracture, or bending, of the toe at the first joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down V when looked at from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammer toes are more common in females than males.


Causes


Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to hammertoes this positioning, causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in footwear is also problematic, as it causes your toes to be pushed into the shoe?s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles tendon-the tendon at the back of your leg that attaches your calf muscles to your heel bone-is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and hold your toes in an unnatural, elevated position.


Hammer ToeSymptoms


Signs and symptoms of hammertoe and mallet toe may include a hammer-like or claw-like appearance of a toe. In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance. Pain and difficulty moving the toe. Corns and calluses resulting from the toe rubbing against the inside of your footwear. Both hammertoe and mallet toe can cause pain with walking and other foot movements.


Diagnosis


The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.


Non Surgical Treatment


Hammer toes may be effectively corrected in different ways. Treatments can be non-invasive and involve physical therapy along with the advice that the person not wear any more shoes that restrict appropriate space for their toes. Appropriate shoes for people who want to avoid hammer toes, or for people who already have them, should be at least half an inch longer than the person's longest toe. High-heeled shoes are something to definitely avoid.


Surgical Treatment


In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed. Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

How To Prevent Bunions From Growing


Overview
Bunions Hard Skin
Bunions are one of the more serious conditions that can affect foot health. A bunion is actually a bone deformity of the big toe, where the joint at the base and side of the toe is enlarged, forcing the toe out of place. Left untreated, bunions worsen over time. The big toe angles in toward the rest of the toe, and can overlap the third toe (a condition known as Hallux Valgus). Or, it may move toward the second toe and twist or rotate (Hallus Abducto Valgus). Bunions can also lead to deformities like hammertoes. Bunions cause discomfort and pain, because the enlargement constantly rubs against footwear. The skin of the toe becomes red and tender. The larger a bunion grows, the more painful it is to walk. People with bunions can develop thickening skin on the bottom of the foot, bursitis or arthritis, and chronic pain.

Causes
Bunions are a common problem that can cause foot pain and difficulty wearing shoes. Bunions occur in about 30% of the population of most Western countries. They are seen most commonly in women and become more common as people get older. Patients with bunions generally have one of two problems that can cause pain. As the big toe becomes more and more angled (pointing toward the other toes), the base of the toe becomes more and more prominent, forming the bunion. The bunion forms in part because of the new angle of the toe, and in part due to inflammation over the bunion surface. As the inflammation worsens, people can experience pain with shoe wear and walking. The big toe may eventually come to lie over, or more commonly under, the second toe. This may cause further irritation while wearing shoes and more pain. The second toe of patients who have bunions commonly forms a hammer toe.
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
Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight. X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout , rheumatoid arthritis , or joint infection.

Non Surgical Treatment
Long-term treatment of bunions must be directed towards re-balancing the foot, so that we no longer walk with our weight forced on to the inner border of the foot. This is accomplished by controlling and reducing pronation with the use of a high quality arch support or custom made orthotics. These devices comfortably re-balance the feet and overcome pronation. This reduces the abnormal weight forces on the big toe and its metatarsal head, allowing the feet to function normally. As a result, the deformity should not worsen, and the pain should gradually subside. If the foot is not re-balanced, the deformity and pain will become worse.
Bunions

Surgical Treatment
Procedures can range from shaving off excess bone to restructuring and fusing the big toe. For mild conditions, you may simply need the connective tissues holding your big toe to be tightened so they hold the digit in the correct position. More advanced bunions will need more manipulation and involved remedies. Cuts in the bone tissue can help our specialists realign the toe. You may need to have the damaged portion of the joint removed. In severe cases, the joint may be fused to prevent it from moving out of position again. If your bunion created other foot complications, like hammertoes, our specialists may correct those during the procedure as well.

Prevention
Make better shoe choices. If you?re a woman, avoid high-heeled footwear whenever possible (at the very least, choose shoes with heels lower than two inches), and make sure all your footwear has a wide, deep toe box. Whether man or woman, if you?re trying on shoes and your toes feel ?squished? or crowded by a particular shoe, reject that style and try another, or go for a larger size. You don?t need to invite trouble. In general, shoes that come to a point at the toe are bad news, as they tend to push the toes together into an overlapping pattern. Shoes with rocker soles will unload pressure on the bunion area. Examine your feet regularly. Note any redness, swelling or discoloration. Flex your toes and check for any stiffness. If there is any, think back to what you?ve worn or done in the past few days. If the condition persists more than a few days, or worsens, a visit to the podiatric physician is in order.
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