Punitha Chennai Pain Clinic

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks.

Today ‘working’ usually implies sitting at a desk from morning to evening. While this may seem more comfortable than working in the fields, sitting at a desk can trigger a host of back problems. This is because sitting in the same position all day makes the spine bend forward and lowers the efficiency of the back muscles. Working at a desk not only strains your back, but also restricts your movements to typing on a keyboard and moving a mouse.

Once a back problem begins, it usually lasts a lifetime hence; here are a few tips to save your back.

1. Get yourself a good chair: Your chair is crucial to your back’s health. Avoid the hard backed plastic chairs and pick a more flexible mesh backed office chair if you sit at the table for a long span of time. Ergonomic chairs may seem expensive, but are worth the expense in the long run.
2. Stretch your muscles: Sitting in the same position all day, puts the muscles under stress and with time can constrict the muscles. Make it appoint to stand up every 30 minutes and stretch your back and sides. Also try rotating your hips and shoulders form time to time.
3. Take a break: No matter how much work you have in front of you, take a break at the end of each hour. Taking even 2 minutes off out of 60 every hour can have a huge impact on your health. If you still feel guilty skip using the phone to connect with your colleague and walk over to their desks instead.
4. Get a pedometer: Keeping a pedometer will help you track the number of steps taken in a day. Ideally, a person should take 10,000 steps a day to stay healthy. If you sit at a desk for majority of the day, take every opportunity you can to up the count on your pedometer. Go for a walk around your office after lunch or park your car a little way off from the office to create opportunities to walk.
5. Take the stairs: As far as possible avoid escalators and elevators. Instead climb stairs for a quick workout. If your office is on the 20th floor, walking up may not be feasible, but you could get off the elevator on the 18th floor and walk up the remaining two floors.
6. Eat healthy: Lastly, pay attention to what you eat. Avoid eating at the office canteen or picking up a bite at the coffee shop and carry lunch from home. This ensures that you eat a balanced meal.

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

1. Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

2. Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

3. Swimming: Swimming again is a good aerobic exercise and is good for back and over all fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight bearing exercises.

4. Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically.

Torn or damage cartilage is not just a problem for the sportsmen. It can occur to anyone. It is generally caused due to a direct hit on the body parts. Its treatment is far more complicated than a simple bone injury. The best sign to know whether or not you have injured your cartilage is to check out your activities. If you have hurt your joint and don’t notice major symptoms, like if you are still capable of putting weight on and move the joint, you might have had a cartilage injury. It doesn’t hurt you a lot in the beginning, but might get worse later. 

Here are the initial care and self-treatment procedure: 

1. Protection: It is the first thing that has to be kept in mind. You must protect the affected area from any further injury. Thus, providing an external support, for example, use a knee brace. 
2. Rest: Provide complete rest to the affected joint. The rest is must during the first two or three days. Crutches may help the situation if you’ve got an injury around your knee or ankle. It is then advisable to return back to light activity over the next few days or weeks, as prescribed by the doctor. 
3. Ice: It is best to apply an ice pack to the injured area for about 15 to 20 minutes in every two to three hours. This must be repeated in the first two to three days. 
4. Compression: Use a bandage to provide the needed compression to the injured area to avoid any swelling and movement. This will not let things go beyond control. 
5. Elevation: You must keep the injured area raised. Keep it supported on a pillow to reduce swelling. 

If there is an unbearable pain, take painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). If your condition doesn’t improve after the initial therapy, you must consult a doctor immediately. 

1. Physiotherapy: It can be helpful in treating the affected joint. If there is any difficulty in moving the affected joint, you must opt for physiotherapy. A professional will be able to teach you exercises that will strengthen your muscles and provide support to the joint. This will help you in getting rid of the pain. It can be also beneficial at a time when you are recovering from any surgical procedure. 
2. Surgery: If physiotherapy doesn’t work, it means you have severe cartilage damage. In that case, you might be advised to take up surgical procedures to set things in proper shape. Surgery is done either by opening the joint or by Arthroscopy. There are various types of surgery which can be done. 1st the old and successful surgery wherein damaged part of the cartilage is debrided and filled with normal cartilage from the non-weight bearing part of the joint. 2nd is ACI (Autologous Chondrocyte Implantation) is a 2 stage procedure wherein chondrocyte is grown using stem cell and implanted in defect part in 2nd stage. 3rd is multiple drilling of the area usually done in children.