Carey Fishe

Ideal Tips Concerning Your Feet

Addressing Mortons Neuroma

Overview

Morton neuromaPatients with Morton?s neuroma present with pain in the forefoot, particularly in the ?ball? of the foot. However, not all pain in the forefoot is a Morton?s neuroma. In fact, most chronic pain in the forefoot is NOT the result of a Morton?s neuroma, but rather is from metatarsalgia - inflammation (synovitis) of the ?toe/foot? joints. The symptoms from Morton?s neuroma are due to irritation to the small digital nerves, as they pass across the sole of the foot and into the toes. Therefore, with a true Morton?s neuroma, it is not uncommon to have nerve-type symptoms, which can include numbness or a burning sensation extending into the toes. There are several interdigital nerves in the forefoot. The most common nerve to develop into a neuroma is between the 3rd and 4th toes. With a true neuroma, the pain should be isolated to just one or two toes.

Causes

Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma. Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition. Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve. Improper footwear that causes the toes to be squeezed together is problematic. Avoid high-heeled shoes higher than two inches. Shoes at this height can increase pressure on the forefoot area. Repeated stress, common to many occupations, can create or aggravate a neuroma.

Symptoms

A Morton's neuroma causes a "burning" sharp pain and numbness on the bottom of the foot in the involved area, and this pain and numbness can radiate to the nearby toes. The pain is usually increased by walking or when the ball of the foot is squeezed together and decreased with massaging. It may force a person to stop walking or to limp from the pain.

Diagnosis

An MRI scan (magnetic resonance imaging) is used to ensure that the compression is not caused by a tumor in the foot. An MRI also determines the size of the neuroma and whether the syndrome should be treated conservatively or aggressively. If surgery is indicated, the podiatrist can determine how much of the nerve must be resected. This is important, because different surgical techniques can be used, depending on the size and the position of the neuroma. Because MRIs are expensive, some insurance companies are reluctant to pay for them. If the podiatrist believes an MRI is necessary, he or she can persuade the insurance company to pay for it by presenting data to support the recommendation.

Non Surgical Treatment

Initial treatment for Morton?s Neuroma may include non-prescription anti-inflammatory medications to reduce pain and swelling. These may consist of standard analgesics such as aspirin and ibuprofen (Advil, Motrin, others). Massaging the painful region three times daily with ice. Change of footwear. Avoid tight shoes, high heels or any footwear that seems to irritate the condition. Low heeled shoes with softer soles are preferable. Arch supports and foot pads to help reduce pressure on the nerve. In some cases, a physician may prescribe a customized shoe insert, molded to fit the contours of the patient?s foot. Reducing activities causing stress to the foot, including jogging, dancing, aerobic activity or any high impact movements of the foot. Injections of a corticosteroid medication to reduce the swelling and inflammation of the nerve and reduce pain. Occasionally other substances may be injected in order to ?ablate? the Neuroma. (The overuse of injected steroids is to be avoided however, as side effects, including weight gain and high blood pressure can result.)Morton

Surgical Treatment

Patients are commonly offered surgery known as neurectomy, which involves removing the affected piece of nerve tissue. Postoperative scar tissue formation (known as stump neuroma) can occur in approximately 20%-30% of cases, causing a return of neuroma symptoms. Neurectomy can be performed using one of two general methods. Making the incision from the dorsal side (the top of the foot) is the more common method but requires cutting the deep transverse metatarsal ligament that connects the 3rd and 4th metatarsals in order to access the nerve beneath it. This results in exaggerated postoperative splaying of the 3rd and 4th digits (toes) due to the loss of the supporting ligamentous structure. This has aesthetic concerns for some patients and possible though unquantified long-term implications for foot structure and health. Alternatively, making the incision from the ventral side (the sole of the foot) allows more direct access to the affected nerve without cutting other structures. However, this approach requires a greater post-operative recovery time where the patient must avoid weight bearing on the affected foot because the ventral aspect of the foot is more highly enervated and impacted by pressure when standing. It also has an increased risk that scar tissue will form in a location that causes ongoing pain.
Remove all ads

Podiatrists Choose Shoe Lifts For Leg Length Imbalances

There are two unique variations of leg length discrepancies, congenital and acquired. Congenital means that you are born with it. One leg is structurally shorter compared to the other. Through developmental phases of aging, the brain picks up on the step pattern and identifies some variation. The entire body typically adapts by tilting one shoulder over to the "short" side. A difference of less than a quarter inch isn't really uncommon, doesn't need Shoe Lifts to compensate and normally won't have a serious effect over a lifetime.

Shoe Lift

Leg length inequality goes typically undiscovered on a daily basis, yet this problem is simply fixed, and can eradicate many instances of back problems.

Therapy for leg length inequality typically consists of Shoe Lifts. Many are economical, regularly being below twenty dollars, in comparison to a custom orthotic of $200 plus. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Mid back pain is easily the most widespread health problem afflicting men and women today. Over 80 million men and women are affected by back pain at some stage in their life. It is a problem which costs companies millions of dollars year after year because of time lost and output. Innovative and superior treatment methods are continually sought after in the hope of lowering economic impact this issue causes.

Leg Length Discrepancy Shoe Lift

Men and women from all corners of the earth experience foot ache due to leg length discrepancy. In a lot of these cases Shoe Lifts are usually of very useful. The lifts are capable of eliminating any discomfort in the feet. Shoe Lifts are recommended by countless expert orthopaedic orthopedists.

In order to support the human body in a balanced fashion, feet have a significant job to play. Despite that, it can be the most overlooked region in the human body. Some people have flat-feet which means there may be unequal force exerted on the feet. This causes other body parts like knees, ankles and backs to be affected too. Shoe Lifts guarantee that proper posture and balance are restored.

How To Treat Hammertoes Without Surgery

Hammer ToeOverview

The 2nd toe is the most common digit to develop a Hammer toe deformity. Second toe hammer toes commonly result from an elongated Hammer toe 2nd metatarsal and from pressure due to an excessively abducted great toe (hallux valgus deformity) causing a bunion. Unusually long toes often develop hammer toe deformities. Painful corns often develop in hammer toe deformity, particularly of the 5th toe. Reactive adventitial bursas often develop beneath corns, which may become inflamed.

Causes

Some causes of hammertoe are shoes that are too tight or short, shoes with high heels, injury, Diseases that affect the nerves and muscles, such as arthritis and diabetes. When shoes do not fit well, over time the pressure of the shoes pushes the toes into a bent position. After a while, the muscles become unable to straighten the toe, even when you are not wearing shoes. Similarly, when there is damage or disease of the nerves or muscles in the toes, the toe may rest in the bent position until the tendons become permanently shortened and the toe becomes a rigid hammertoe. The risk of developing a hammertoe increases with age. Women are much more likely to develop a hammertoe than men.

HammertoeSymptoms

The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe is usually flexible, but when longstanding it becomes more rigid.

Diagnosis

Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Non Surgical Treatment

Prescription strength medicines to decrease pain and inflammation. Physical Therapy. To strengthen poorly functioning muscles and stretch tight muscles that may be exacerbating the toes. Special ultrasound techniques may reduce inflammation. Custom Foot Orthotics. An orthotic with an exact mold of your foot to better align and support the foot to ease current discomfort and prevent future progression. Toe Splints or Pads. Specific pads may prevent pressure and physical irritation in shoes. Toe splints and toe spacers physically realign the toes and can lessen pain and halt or stall hammer toe progression. Cortisone injections are strong anti-inflammatory agents to decrease pain, and swelling directly at the toe region. Injections only treat the symptoms, and in some cases used in caution (and sparingly) they can weaken supporting ligaments of the toe(s).

Surgical Treatment

Sometimes, if the deformity is severe enough or surgical modification is needed, the toe bones may be fused so that the toe does not bend. Buried wires are used to allow for the fusion to heal, and they remain in place after healing. Your skin is closed with fine sutures, which are typically removed seven to ten days after surgery. A dressing is used to help keep your toes in their new position. Dressings should not get wet or be removed. After surgery, your doctor may prescribe pain relievers, typically for the initial four to seven days. Most people heal completely within one month of surgery, with few complications, if any. Crutches or a cane may be needed to help you keep weight off your affected foot, depending on the procedure. Occasionally, patients receive a special post-op shoe or a walking boot that is to be worn during the healing process. Most people are able to shower normally after surgery, but must protect the dressing from getting wet. Many patients are allowed to resume driving within one week after the procedure, but care needs to be taken.

HammertoePrevention

Avoid wearing shoes that are too short or narrow. Check children's shoe sizes often, especially during periods of fast growth. If you have hammer toe, call for an appointment with your health care provider. If you develop thick blisters or corns on your toes, if your pain gets worse, if you have difficulty walking call for an appointment with your health care provider.
Remove all ads

Hammer Toe Surgery Procedure

HammertoeOverview
Hammertoe is caused when the middle joint (PIP) bends down towards the floor (flexion). To compensate, the joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser toes (i.e. not the big toe). It tends to only affect one toe, most commonly the second.

Causes
Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joint curling downward. Arthritis can also lead to many different forefoot deformities, including hammer toes. Hammertoe

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
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Non Surgical Treatment
If you have hammer toe, avoiding tight shoes and high heels may provide relief. Initial (non-surgical) treatment for hammer toe involves wearing shoes with plenty of room in the toe area. Shoes should be at least one-half inch longer than the longest toe. Stretching and strengthening exercises for the toes (such as picking up items with the toes or stretching the toes by hand) are also recommended. Sometimes orthopedists recommend special pads, cushions, or slings to help relieve the pain of hammer toe.

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.

Remove all ads