Foot Pain - Foot Pain Symptoms




Foot Pain - Foot Pain Symptoms

Foot Pain


We're sorry to hear you have foot pain!

Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The goal of this guide is to provide information while awaiting evaluation with your doctor or additional information after you have seen him or her.

Foot pain may develop for a number of reasons -- fracture and infection are among the most serious while sprains and arthritis are among the most common.There are rare causes of symptoms that will not be included here and would require more detailed evaluation than this guide can provide.

Severe pain, swelling, bruising, or inability to bear weight are "alert" symptoms that could indicate serious injury to a bone or ligaments. When accompanied by fever, an infection becomes a major concern. However, most people with foot pain have no serious or dangerous cause. In fact, many have pain due to poorly fitting or tight shoes; for women, high heels only make a tight shoe more uncomfortable. Try changing your footwear to something with more cushion, support and room for your feet -- and read on to learn more about the causes of foot pain.

Certain symptoms suggest a serious cause of foot pain that requires prompt attention. It's important to ask questions about these symptoms first.

Did your pain begin after a significant injury, such as a fall or car accident?
dash Yes, my pain began just after a significant injury.dash No, my pain did not occur after a severe blow or injury.
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Related InformationBunionCorns and CallusesDiabetic NeuropathiesFallen ArchGoutHammertoeHeel PainInfectious ArthritisMorton's NeuromaMuscle StrainOsteoarthritisPeripheral Vascular DiseasePlantar FasciitisRheumatoid ArthritisSprain (Overview)Warts

Bunion Surgery - Metatarsal Osteotomy




Bunion Surgery - Metatarsal Osteotomy

Bunion Surgery - Metatarsal Osteotomy
What is a bunion?
A bunion is a lump at the base of the big toe, caused by sideways drifting and angulation of the big toe. A bunion is not a 'bump' on the bone, it is caused by angulation of the bones in the foot. Sometimes it is painful in itself, but more commonly it causes symptoms by pressure on shoe-wear or, on occasions, by crowding or crossing the smaller (lesser) toes. The second toe can become so crowded that it becomes 'clawed,' and crosses over the big toe.


Is surgery the only way to treat bunions?
Early and mild bunions may respond to the application of splints or braces, although the effects are often short-lived. Wearing 'corn plasters' or 'pads' may relieve local pressure symptoms. Shoes may be made or adapted to accommodate the bunion within a broad front (toe-box).

Some bunions are caused by flat foot and collapse of the arches. These can be helped by arch supports.

More severe bunions can only be corrected by surgery. Surgery should only be undertaken if the symptoms are significant and appropriate non-operative management has been considered. The surgery is usually carried out under a general anaesthetic, with local anaesthetic being used to reduce the amount of general anaesthetic required. Surgery is usually performed either as a day-case (where you do not have to stay in hospital over night at all), or with an overnight stay in hospital.

ShortscarfWhat is an osteotomy?
An 'osteotomy' is an operation when the bone at the base of the toe (the metatarsal bone) is divided and 'displaced' into the correct position. The bony bump is usually trimmed at the same time. The operation aims to strengthen the great toe, and narrow the forefoot. Because the operation involves dividing the bone, it has to be held in position while the bone heals together again. In the majority of cases small screws, wires or staples are used. The foot is usually protected in a special post-operative shoe during this time.

Occasionally the big toe is osteotomised as well, a procedure known as an 'Akin'. The fracture in the bone allows the bones to be repositioned, so that the bunion disappears.



Darco ShoeWhat can I expect after the operation?
After the operation, you will wake up with your foot in a bandage.
The foot is always painful, but painkilling tablets usually control this.
In order to minimise swelling, you will need to keep your foot up after the operation. You will be given a special shoe to wear after surgery. This should be worn at all times, including in bed at night.

What can I do once I am discharged?
To start with you will need to rest your foot up (above heart level) most of the time. When the foot is lowered it will throb and swell. This should be avoided. With time, the period you can keep the foot down will increase. After two to three weeks after the operation you should be able to keep it down most of the time.

At around two weeks after surgery, you will return to the clinic for removal of stitches. It is important to exercise, or mobilise the toe. This can be started after surgery, and you will be advised of the exercises. Failure to undertake these exercises increases the risk of developing stiffness of the toe after surgery.

On average, you should expect to spend six weeks in the post-operative shoe. After this you will need an open toed sandal, preferably with adjustable straps. It will be a further six - eight weeks before you can wear a shoe for a working day, and it is usually three to six months from the operation before you can hope to resume recreational walking or light sporting activities.

If you are slower than these times do not panic, they are only averages, but let your surgeon know when you attend the clinic.

Are there any risks or complications?
Although the operation produces good results in most cases, complications do occur. Although great care is taken with the operation and aftercare, a small number of people (up to 10%) may have a less than perfect results due to problems such as:

1. Recurrence of the bunion
2. Over-correction of the bunion, so that the big toe points inwards.
3. Sensitisation and pain in the foot due to damage to the small nerves or blood vessels in the foot.
4. Non-healing of the bone.
5. Stiffness of the big toe.
6. The screws become prominent and require removal at a later date.
7. Weight transfer to the second toe (a corn under the second toe).
8. Infection of the skin, and rarely of the bone.
9. The complications of any surgery such as thrombosis (a blood clot) and anaesthetic problems.


Most problems can be treated by medications, therapy and on occasions by further surgery, but even allowing for these, sometimes a poor result ensues. For this reason we do not advise surgery for cosmetic reasons. The level of symptoms before surgery must worth the risk of these complications. We also advise against prophylactic surgery (surgery to avoid problems that are not yet present).

You can reduce the risk of complications by preparing yourself and your foot, as described in our handout 'preparing for foot surgery'

If you are at particular risk of complication, this will be discussed with you. If you have any general or specific worries, you should ask the doctor treating you who will explain it to you.

How do I know if I have a complication?
Some problems such as recurrence of the bunion, or corn formation become obvious with time.

It is important that you notify a doctor if you get an increase in pain after you go home, and particularly if the pain does not settle with elevation and mild painkillers, as this may indicate early infection.

Similarly if you get swelling of the leg or foot which does not settle when the foot is elevated above heart level you should seek medical advice.

Special Note
These guidelines are intended to help you understand your operation, and to help you to prepare yourself and your foot for it.

Some patients will want to know more details. Please ask, and we will be happy to add additional notes or comments for your assistance. Above all else please do not proceed with surgery unless you are satisfied you understand all that you want to about the operation.

Finally, this level of detail may cause some patients worry, concern, or uncertainty. Please let your doctor or nurse know if this is the case, so we can address the matters of concern.



Bunions | Bupa UK

Bunions | Bupa UK

Treatment of bunions
Wearing the right shoes, using shoe inserts (orthoses) and padding, and taking painkillers can all help to ease your symptoms of a bunion. However, these treatments can't cure a bunion or stop it getting worse. If you have severe pain or discomfort from a bunion, you may be advised to have an operation to correct it.


Self-help

One of the most important things you can do is to wear the right footwear. You should try to wear flat, wide-fitting shoes with laces or an adjustable strap that fits you properly. You may also want to place a bunion pad over your bunion to give it some protection from the pressure of your shoes. You can usually buy these pads from a pharmacy, or get them from your podiatrist or chiropodist. He or she may also recommend a shoe insert, which can be moulded specifically to your foot. Shoe inserts aim to reduce the pain of your bunion by improving how you walk.


Medicines

You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to help relieve the pain and inflammation of your bunion. Always follow the instructions in the patient information leaflet that comes with your medicine. Medicines give temporary relief but they won't be able to cure your bunion or prevent it from getting worse.


If you have a bunion as a result of underlying arthritis, your GP may prescribe specific medicines to treat this.


Surgery

If other treatments don't help and your bunion is very painful, you may be referred to an orthopaedic or a podiatric surgeon for assessment. There are over 130 different operations that can be carried out to treat bunions. The simplest operations are called bunionectomies.


The majority of the operations aim to correct the alignment of your big toe. This will narrow your foot and straighten out your big toe joint as much as possible. An operation won't return your foot back to normal, but most people find that surgery reduces their symptoms and improves the shape of their foot. The operation your surgeon will advise you to have will depend on how severe your bunion is and whether or not you have arthritis.


For more information on bunion surgery, see Related topics.

Shooting/stabbing pain in achilles tendon...what is this? - Exercise & Fitness Message Board - HealthBoards




Shooting/stabbing pain in achilles tendon...what is this? - Exercise & Fitness Message Board - HealthBoards



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Foot Pain - Introduction




Foot Pain - Introduction

Table of ContentsHighlightsIntroductionCausesRisk FactorsCorns and CallusesBunionsHammertoesIngrown ToenailsForefoot PainHeel PainFlat FeetAbnormally High ArchesTarsal Tunnel SyndromeFoot InjuryPreventionShoesInsolesOrthoticsResourcesReferences
Introduction

Foot pain is very common. About 75% of people in the United States have foot pain at some time in their lives. Most foot pain is caused by shoes that do not fit properly or that force the feet into unnatural shapes (such as pointed-toe, high-heeled shoes).

The foot is a complex structure of 26 bones and 33 joints, layered with an intertwining web of more than 120 muscles, ligaments, and nerves. It serves the following functions:
Supports weightActs as a shock absorberServes as a lever to propel the leg forwardHelps maintain balance by adjusting the body to uneven surfaces
Because the feet are very small compared with the rest of the body, the impact of each step exerts tremendous force upon them. This force is about 50% greater than the person's body weight. During a typical day, people spend about 4 hours on their feet and take 8,000 - 10,000 steps. This means that the feet support a combined force equivalent to several hundred tons every day.

Foot Problems and Their Locations
Foot pain generally starts in one of three places: the toes, the forefoot, or the hindfoot.

The Toes. Toe problems most often occur because of the pressure imposed by ill-fitting shoes.

The Forefoot. The forefoot is the front of the foot. Pain originating here usually involves one of the following bone groups:
The metatarsal bones (five long bones that extend from the front of the arch to the bones in the toe)The sesamoid bones (two small bones embedded at the top of the first metatarsal bone, which connects to the big toe)
The Hindfoot. The hindfoot is the back of the foot. Pain originating here can extend from the heel, across the sole (known as the plantar surface), to the ball of the foot (the metatarsophalangeal joint).

Summary of Foot Problems
Condition

Location

Symptoms

Recommended Footwear

Toe Pain

Corns and calluses

Around toes, usually little toe, bottom of feet or areas exposed to friction.

Hard, dead, yellowish skin.

Wide (box-toed) shoes; soft cushions under heel or ball of foot, or customized or gel insoles for calluses. Doughnut-shaped pads for corns.

Ingrown toenails

Toenails.

Nail curling into skin causes pain, swelling, and, in extreme cases, infection.

Sandals, open-toed shoes.

Bunions and bunionettes (tailor's bunion)

Big toe (bunions) or little toe (bunionettes).

The following can occur alone or in combination:

Metatarsus primus varus. The first (big toe) metatarsal bone shifts away from the second, and the big toe points inward.

Medial exostosis. This is a bony bump at the base of the big toe, which protrudes outward. Area next to bony bump is red, tender, and occasionally filled with fluid. Toe joint may be inflamed.

Hallux valgus. This is a deformity in which the bone and joint of the big toe shift and grow inward, so that the second toe crosses over the big toe.

Soft, wide-toed shoes or sandals. Bunion shields or splints. Thick doughnut-shaped moleskin pads, custom-made orthotics or foot slings, if necessary. Avoid shoes with stitching along the side of the "bump."

Morton's neuroma (also called interdigital neuroma)

Inflammation of the nerve, usually between the third and fourth toes and bottom of the foot near these toes.

Cramping and burning pain, or electric-shock sensation. The condition may produce a thick protective sheath around the nerve that feels like a ball. This may be detected by pressing top to bottom on the top of the foot using one hand and moving the other hand from side to side. Morton's neuroma is aggravated by prolonged standing and relieved by removal of the shoes and forefoot massage.

Wide (box-toed) shoes. Orthotic or insole with pad that reduces stress on the painful area.

Hammertoe or claw toe

Usually second toe, but may develop in any or all of the three middle toes.

Toes form hammer or claw shape. In hammertoe, the first knuckle of the toe is mainly affected. In claw toe the entire toe is deformed. No pain at first, but pain increases as tendon becomes tighter and toes stiffen.

Wide (box-toed) shoes. Toe pads or specially designed shields, splints, caps, or slings. (Splints or slings are not for people with diabetes.)

Front-of-the-Foot Pain

Metatarsalgia

Ball of the foot.

Acute, recurrent, or chronic pain without a known cause.

Wide (box-toed) shoes. Orthotic with pad that reduces metatarsal pressure. Gel cushions. Metatarsal bandage.

Stress fracture

Most often in the area beneath the second or third toe.

Sudden pain (which persists) when injury occurs.

Low-heeled shoes with stiff soles.

Sesamoiditis

Ball of foot beneath big toe.

Pain and swelling.

Low-heeled shoe with stiff sole and soft padding inside.

Heel and Back-of-the-Foot Pain

Plantar fasciitis or heel spurs

Back of the arch right in front of heel.

At onset, some people report a tearing or popping sound. Pain is most severe with first steps after getting out of bed. Pain decreases after stretching, returns after inactivity.

Over-the-counter foot insole (cut quarter-size hole surrounding painful area). Possible night splints. Orthotics if necessary.

Bursitis of the heel

Center of the heel.

Pain, with warmth and swelling. Increases during the day.

Heel cup.

Haglund's deformity ("pump bump")

Fleshy area on the back of the heel.

Tender swelling aggravated by shoes with stiff backs.

Soft shoes. Heel pads. Possible orthotic to support heel.

Achilles tendinitis

Achilles tendon: area along the back between calf muscles and heel.

Pain worsens during physical activities (particularly running), after which the tendon usually swells and stiffens. If it ruptures, popping sound may occur followed by acute pain similar to a blow at the back of the leg.

Insoles, tendon strap, heel cups.

Arch and Bottom-of-the Foot Pain

Tarsal tunnel syndrome

Anywhere along the bottom of the foot.

Numbness, tingling, or burning sensations, pain, most commonly felt at night.

Specially designed orthotics to relieve pressure.

"Flat feet" or posterior tibial tendon dysfunction (PTTD)

The arch.

No arch. Often no pain or discomfort. Three stages in PTTD:

Pain and weakness in the tendon.

The arch flattens but is still flexible.

The foot becomes rigid and possibly painful at the ankle. Sometimes people report fatigue, pain, or stiffness in the feet, legs, and lower back.

For children, possible custom-made insoles.

High arches ("hollow feet")

The arch.

High arches. Lower back pain, possible tendency to lower limb injuries.

Foot PainHighlightsFoot PainCauses
Review Date: 01/30/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,Harvard Medical School; Physician, Massachusetts General Hospital.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)




Walking Shoes For Plantar Fasciitis


The best bet, if the pain has not subsided after a few days of rest, is to visit your doctor for an accurate diagnosis and to determine the severity of the condition. Your doctor should complete an examination of your foot, and will take a case history to help diagnose the condition. Since plantar fasciitis is not always directly diagnosable, a history is often one of the most reliable ways to get an accurate diagnosis. Plantar fasciitis does not show up on an x-ray, and whilst accompanying heel spurs do, these can be difficult to spot even for a trained professional.

Plantar fasciitis is inflammation of the plantar fascia. It is one of the commonest causes of heel pain and can be quite debilitating. It is commonly caused by over pronation, or rolling inwards of the foot during motion. Whilst some degree of pronation is perfectly normal during walking, and most people do it to some extent, a few people over pronate during motion. This action puts excessive stress on the plantar fascia, the long foot ligament running underneath the arch, causes minute tears or rips to develop in the plantar fascia, which become inflamed and painful as the foot is used

Arch plantar fasciitis taping does not stretch out the plantar ligament, but supports it as it runs underneath the foot arch. This treatment for plantar fasciitis can be a little tricky to do for yourself because you tape from the outside of the foot towards the inside flexing the big toe joint to create a high arch as you do so. Full foot plantar fasciitis taping is done by separately covering the ball of the foot and the heel with tape and then connecting the heel to the toes using a criss-cross taping pattern until the whole sole of the foot is covered.

Splints are particularly effective at preventing morning foot pain, and are strapped to the foot at bedtime and keep the tissue in its stretched state. Without the contraction the foot is prepared for the first few steps, and the devices can eradicate morning foot pain. Heel seats on the other hand are devices which are placed under the heel and fit easily into most shoes. By elevating the heel the plantar fascia is not required to stretch and flex as much when walking which eases the pain and prevents further damage. They are also particularly effective at easing the pain from heel spurs by cushioning the heel.

For runners, the plantar fascia may become inflamed after a period of running hilly courses or running in excessively worn shoes or the wrong type of shoe for your foot type. Once this happens, a cycle of inflammation ensues. There is a nerve (called the medial calcaneal nerve) that runs along on the inside of the heel bone and actually curves down around the bottom of the heel between the bone and the plantar fascia. As you walk and place stress on the plantar fascia, the tugging of this ligament where it attaches to the heel bone stimulates inflammation. This causes the sharp pain. plantar fasciitis sock

Originally is was assumed that Plantar Fasciitis was just an inflammatory condition, however inflammation is only rarely the cause. Individuals with flat feet/no arches or very high arches are more prone to plantar fasciitis than individuals with normal arches. Other causes or risk factors for plantar fasciitis are sudden weight gain or obesity, long distance running, and poor arch support in shoes. I have extremely flat and pronated feet, had gained weight rapidly during each of my pregnancies and also didn’t get orthotic inserts regularly, choosing rather to try and extend the life of old supports.

When the plantar fascia, or the thick tissue in the bottom of the foot that connects the heel to the toes, becomes overstretched, it becomes inflamed. This condition is known as plantar fasciitis. This inflammation makes it difficult to walk and perform certain movements of the foot. It may be caused by shoes with poor support; sudden weight gain; long distance running, especially downhill or on uneven surfaces; or a tight Achilles tendon. People whose feet have a high arch or are flat footed are also prone to plantar fasciitis. You Might Also Like Symptoms.

Why is this stretch valuable? Tight hamstring muscles (which cross both the knee and hip joints on the back of the leg) can lead to limited extension and exaggerated flexion of the knee during the running stride (they tend to pull the lower part of the leg backward). This over-flexion at the knee actually increases the amount of dorsiflexion at the ankle during the landing phase of the running stride (remember that the entire leg functions as a kinetic chain; change one thing, in this case hamstring flexibility, and that change will 'ripple' right down the leg to the ankle joint).

Above were some of the plantar fasciitis treatment options. Whether the soreness is light or perhaps severe, it will always be recommended to look for consultation from your foot as well as ankle physician. He can look at things properly as well as recommend an individual the finest therapy for plantar fasciitis depending on your foot framework and the seriousness of pain. This may prevent further problems and also can help you come out of the discomfort swiftly. Bear in mind, like all the other areas of the body, feet are also important. In the end, they may be the ones which support you almost everywhere. About the Author

For more severe cases, surgery and other advanced treatments are often necessary. One example is the shock wave therapy. Here, the doctor needs to make use of sound waves to stimulate the affected area and treat it. This is often used for cases that have not received good results from conventional treatments mentioned earlier. The problem is that shock wave therapy often causes bruises and temporary pain. Surgery is the last resort. During surgery, doctors will have to remove or detach the never connecting the foot to the toes. This is necessary when the pain is almost unbearable already. plantar fasciitis stretches
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