Sheilah Crosbie

Helpful Knowledge In Relation To Foot Care

Mortons Neuroma Treatments

Overview

interdigital 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

Morton's neuroma may be the result of irritation, pressure or injury. In some cases its cause is unknown. In the majority of cases only one nerve is affected. Having both feet affected is extremely rare. A high percentage of patients with Morton's neuroma are women who wear high-heeled or narrow shoes. Patients with Morton's neuroma may need to change their footwear, take painkillers or steroid injections, while others may require surgery to either remove the affected nerve or release the pressure on it.

Symptoms

Symptoms typically include pain, often with pins and needles on one side of a toe and the adjacent side of the next toe. Pain is made worse by forefoot weight bearing and can also be reproduced by squeezing the forefoot to further compress the nerve. Pressing in between the third and forth metatarsals for example with a pen can also trigger symptoms.

Diagnosis

To confirm the diagnosis, your doctor will examine your feet. He or she will look for areas of tenderness, swelling, calluses, numbness, muscle weakness and limited motion. To check for a Morton's neuroma, your doctor will squeeze the sides of your foot. Squeezing should compress the neuroma and trigger your typical pain. In some cases, your doctor will find numbness in the webbed area between the affected toes. Pain in two or more locations on one foot, such as between both the second and third toes and the third and fourth toes, more likely indicates that the toe joints are inflamed rather than a Morton' neuroma.

Non Surgical Treatment

In developing a treatment plan, your foot and ankle surgeon will first determine how long you?ve had the neuroma and evaluate its stage of development. Treatment approaches vary according to the severity of the problem. For mild to moderate neuromas, treatment options may include Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking. Placing an icepack on the affected area helps reduce swelling. Custom orthotic devices provided by your foot and ankle surgeon provide the support needed to reduce pressure and compression on the nerve. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves. Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Treatment may include injections of cortisone, local anesthetics or other agents.plantar neuroma

Surgical Treatment

If symptoms do not respond to any of the above measures then surgery may be suggested. This involves a short 30 minute operation to either remove tissue to take pressure off the nerve or to remove the nerve causing the pain. The surgery can be done as a day case but it will be two or three weeks before you can be fully active on your feet. There may be some lingering numbness afterwards if the nerve is removed. But surgery is successful in around 80% of cases. There is a small risk of complications such as infection and thickening of the skin on the soles of the feet.
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Chiropodists Favor Shoe Lifts For Leg Length Difference

There are actually not one but two different kinds of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter compared to the other. Through developmental periods of aging, the brain senses the stride pattern and identifies some difference. The entire body typically adapts by tilting one shoulder over to the "short" side. A difference of under a quarter inch is not really excessive, demand Shoe Lifts to compensate and commonly doesn't have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lifts

Leg length inequality goes largely undiagnosed on a daily basis, yet this problem is very easily corrected, and can eradicate many incidents of back problems.

Treatment for leg length inequality usually consists of Shoe Lifts. These are generally economical, commonly priced at less than twenty dollars, compared to a custom orthotic of $200 or higher. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Mid back pain is the most prevalent condition afflicting men and women today. Around 80 million men and women experience back pain at some stage in their life. It is a problem that costs companies millions of dollars annually due to time lost and production. Innovative and superior treatment solutions are always sought after in the hope of lowering economic influence this issue causes.

Shoe Lift

People from all corners of the world suffer the pain of foot ache due to leg length discrepancy. In a lot of these situations Shoe Lifts might be of beneficial. The lifts are capable of eliminating any pain in the feet. Shoe Lifts are recommended by numerous certified orthopaedic practitioners".

So that you can support the body in a nicely balanced manner, your feet have got a critical function to play. In spite of that, it can be the most neglected zone of the body. Some people have flat-feet meaning there is unequal force exerted on the feet. This will cause other areas of the body such as knees, ankles and backs to be affected too. Shoe Lifts ensure that proper posture and balance are restored.

Hammer Toe Surgery Procedures

HammertoeOverview

There are two types of hammertoe. Flexible hammer hammertoes toes. If the toe can still be moved at the joint, it's a flexible hammer toe. That's good, because this is an earlier, less-severe form of the problem. There may be several treatment options. Rigid hammer toes. If the tendons in the toe become rigid, they press the joint out of alignment. At this stage, the toe can't be moved. This usually means surgery is required to correct the problem.

Causes

Hammer toe 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 cannot stretch out. Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when there is no confining shoe.

HammertoeSymptoms

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 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

The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.

Non Surgical Treatment

In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases podiatric surgery may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.

Surgical Treatment

If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the toe. The procedures used vary greatly, depending upon the reasons for the hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint capsule repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the toe to straighten. The temporary use of pins or K-wires may be necessary to keep the toe straight during the healing period. Joint implants are sometimes used to allow for a better range of motion in the toe following surgery. Digital arthrodesis involves the removal of bone from the bent joint and fusing the toe in a straight position. If the corn is due to a bone spur, the most common procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.

Hammer ToePrevention

To help prevent hammer toes from developing, wear shoes or boots that provide sufficient width in the toe box to ensure minimal compression. Use inserts that help the toes flatten out and spread and give sufficient support to the metatarsal arch in the forefoot. If hammer toes have already formed, padded socks help protect the tops and the tips of the hammer toes and may reduce pain from rubbing and chafing.
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Hammer Toe Caused By Bunion

Hammer ToeOverview
The term Hammertoes refers to a common deformity of the foot in which either the second, third, or fourth toe is bent at the middle joint, so that the tip of the toe is bent downward while the middle of the toe is cocked upward resembling a hammer. The hammer toe deformity is the most common deformity of the small toes. When a hammer toe first develops, it can be bent back into its normal position. If not treated, a hammer toe may become rigid and require surgical correction in order to correct the deformity. Symptoms and signs associated with hammer toe include corns or calluses on the affected toe and pain in the affected area. It may be difficult for people suffering from hammer toe to find comfortable shoes.

Causes
Hammer toe 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 cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma. Hammer Toe

Symptoms
Common symptoms of hammertoes include pain or irritation of the affected toe when wearing shoes. corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location. Inflammation, redness, or a burning sensation. Contracture of the toe. In more severe cases of hammertoe, open sores may form.

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
Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include splinting the toe to keep it straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.

Surgical Treatment
Laser surgery is popular for cosmetic procedures, however, for hammer toe surgery it does not offer any advantage to traditional methods. Laser is useful for soft tissues (not bone), and because hammer toe surgery involves bone procedures, it is not effective. For cosmetic hammer toe surgery, patients should look for surgeons experienced in aesthetic foot surgery. Hammer Toe

Prevention
In addition to wearing proper shoes and socks, walking often and properly can prevent foot injury and pain. The head should be erect, the back straight, and the arms relaxed and swinging freely at the side. Step out on the heel, move forward with the weight on the outside of the foot, and complete the step by pushing off the big toe. Exercises specifically for the toe and feet are easy to perform and help strengthen them and keep them flexible. Helpful exercises include the following. Raise and curl the toes 10 times, holding each position for a count of five. Put a rubber band around both big toes and pull the feet away from each other. Count to five. Repeat 10 times. Pick up a towel with the toes. Repeat five times. Pump the foot up and down to stretch the calf and shin muscles. Perform for 2 or 3 minutes.

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