September Articles 2013

Plantar Fasciitis Treatment Relieves Heel Pain

A new treatment option which combines ultrasound waves and steroid injections was found to be 95% effective in patients suffering from plantar fasciitis, according to a groundbreaking study from the University of Genoa in Italy.

The plantar fascia is a connective tissue in the heel that stretches the bottom length of your foot. Plantar fasciitis is the inflammation of this connective band, causing heel pain and overall discomfort while walking or standing. Although the condition is completely treatable, traditional methods can take up to a year to start being effective.

These conventional treatments include arch support, night splints, certain exercises, and overall rest and staying off your feet.  The previous effective method for curing plantar fasciitis was shockwave therapy, in which sound waves are directed to the area where the pain is being experienced, often the heel. Despite the success of shockwave therapy, it could be considered somewhat painful, requires several sessions before any results are noticed, and is comparably expensive. However, even shockwave therapy does not cure the pain caused by plantar fasciitis in every patient.

The study, conducted by Luca M. Sconfienza, M.D., examined the effects of a new technique that combined ultrasound-guided methods, similar to shockwave therapy, with a steroid injection directly the plantar fascia. Because of the added steroid injection, the method becomes a one-time outpatient procedure involving a small amount of local anesthesia, in which a needle punctures the affected area and causes a small amount of bleeding that aids in the heeling of the fascia. This technique is referred to as dry-needling.

Dr. Sconfienza determined that 42 of the 44 patients involved in the new procedure had their symptoms, including pain, disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”


Effect of High-Heels on the Feet

Women have been wearing various kinds of high-heels for hundreds of years, mostly for aesthetic reasons. Shoes with heels make their wearer appear to be taller and to have longer and thinner legs, and change the wearer’s gait and posture. High-heels’ association with femininity have kept them popular over the years, but there are definite health problems caused by wearing high-heels too frequently.

High heels also limit the motion of the ankle joints as well when they are worn. The ankle is a very important joint in the body when it comes to walking. These joints have a great deal of weight put on them because of their location. This is why it is so important to keep them as healthy as possible. The main tendon in the ankle is the Achilles tendon. Studies have shown that wearing high heels often causes the calf muscle and Achilles tendon to shorten, and stiffens the Achilles tendon as well, which can cause problems when shoes without heels are worn.

By forcing the toes into a small toe box, and putting a great deal of pressure on the ball of the foot, high-heels can cause or worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis. 

Wearing high-heels regularly, especially very high ones, can have long term negative effects on many other parts of the body, as well as the feet. One of the most important joints in the entire body, the knees, can be affected by wearing high heels. Wearing high heels causes the knees to stay bent at all times. It also causes them to bend slightly inward as well. Many doctors believe that constantly walking like this is the reason that women are so much more likely to suffer from osteoarthritis later in life. High-heels also cause increased stress on the knees by limiting the natural motion of the foot during walking.

The back may also be negatively affected by high heels because this shoe style causes the back to go out of alignment. This affects the spine’s ability to absorb shock, and can cause continued pain in the back if high heels are worn constantly. High-heels also compress the vertebrae of the lower back, and can cause overuse of the muscles in the lower back.

This is not to say that high heels should never be worn. They will not cause serious problems if they are worn only occasionally. However, they should not be worn every day in order to avoid long term physical health problems to the feet, knees, ankles and back.


Dealing with Stress Fractures of the Foot and Ankle

Stress fractures occur in the foot and ankle when muscles in those areas are weakened from too much or too little use. When this happens, they stop cushioning the foot and ankles from the impact of hitting the ground. Because there is nothing to protect them, the bones of the foot begin to absorb the full impact of each step someone takes. The added stress causes little cracks to form in the bones that are under the most pressure. These cracks are called stress fractures.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Individuals who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intensive high impact work out may get stress fractures. This is because their muscles are not strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

The pain from these fractures will occur in the general area of the fracture. It may be intermittent or constant, and will cause sharp or dull pain along with swelling and tenderness. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture. This is a much more serious problem, and will probably prevent you from applying any pressure on the foot at all.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

In order to avoid getting stress fractures, make sure to get plenty of calcium and Vitamin-D. They will help to keep your bones strong, and make them less likely to break under pressure. If your new exercise regimen is running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. For example, if you plan to walk every day, you could ride a bike on some days to take the stress off of your feet. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms do not go away, see an orthopedic specialist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.


Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.


Broken Foot Causes, Symptoms, and Treatment

A broken foot is when one of the bones located in the foot fractures, or breaks. About 10% of broken bones occur in the foot.

Bones typically break when an object crushes, bends, or stretches the bone. In the foot, the location of the broken bone is usually indicative of how the break occurred. Toes usually break when something hard and solid is kicked with great force. Broken Heels are usually a result of falling from a great height and landing on the feet. Other broken bones in the feet can occur because of a twisted or sprained ankle. Most of the time, a broken foot results from a sudden accident or injury. Sometimes small cracks can form over time in the bones of the feet from repeated stress. These cracks are called stress fractures and usually only occur in athletes that put a lot of pressure on their feet, like runners, dancers, and gymnasts.

Symptoms of a broken foot typically include pain, swelling, bruising, and redness. Occasionally the pain of a broken foot may be so severe that walking is not an option. However, this depends on the location of the broken bone within the foot. Broken toes are usually less painful than broken heels or other bones within the foot. A foot that is blue, numb, cold, misshapen, cut or deformed can occur in more serious cases of broken feet. Those who are experiencing any of these symptoms, or suspect that they have a broken foot, should seek medical attention in a center where x-rays can be performed. 

Prior to seeking the attention of a doctor, several steps can be taken at home in order to reduce pain and swelling. Stabilization and elevation of the broken foot should be the number one priority. It is important not to move the foot, so any type of homemade splint will work well. However, any splint that causes the foot to become more painful, or cut off blood circulation should be removed. Ice can also decrease swelling and alleviate some of the pain that a broken foot can cause.

In a medical center, treatment for a broken bone will differ depending on which bone in the foot is fractured and depending on what caused the break. Some broken feet will require the patient to use crutches, while others will require splits or casts. More severe cases may require surgery on the foot to repair the broken bone or bones.

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