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Knee Pain Treatment
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Over the last few years, foot surgery has come to be recognized as a major orthopedic speciality. Modern orthopedic surgeries tend to use minimally invasive techniques in order to reduce complications posed by open surgery and thus, also reduce or improve post-surgery recovery. A minimally invasive foot surgery is a type of surgery that is performed with a very small incision.
By using such incisions, surgeons insert specially designed instruments to carry out the operation, without causing injury to the adjacent tissue. As a result, it makes the operation more manageable and easier to control. However, these minimally invasive foot surgeries are to be done by trained physicians and surgeons. The foot is first numbed and several 3mm incisions are inserted around the foot to enable access to special instruments. An X-ray machine is also used to monitor the instrument's direction to ensure precise cuts and corrections.
Typically painful bunions, plantar fasciitis, recurring corns, heel spurs, contracted toes and hammer toes are corrected by this type of surgery. With the constant and worthwhile contributions from several physicians, cost effective minimally invasive foot surgery was made possible.
Benefits of Minimally Invasive Foot Surgery
- No Trauma to the Soft Tissue: As opposed to traditional open surgery where deep incisions were made, the minimally invasive technique does not cause many injuries to the soft tissue. Since this technique involves relatively smaller incisions, it does not harm the soft tissues inside. As a result, the patient’s recovery time is quick.
- Shorter Surgery Time: When compared to open surgeries, the duration of the minimally invasive foot surgery tends to be shorter.
- Avoids Usage of Anesthesia: Only a local anesthesia is required and patients can be awake when the surgery is performed. Whereas in an open surgery a general anesthesia has to be administered and only certain patients will be qualified for that. For patients who are at risk due to medical history, performing a minimally invasive foot surgery should not be a problem, as only a local anesthesia to make the foot asleep has to be given.
- Minimal Pain: Patients require less use of pain relievers and studies have shown that patients who have undergone this type of surgery report lesser pain when compared with traditional techniques of foot surgery.
- No Scars: Due to the use of smaller incisions, the scars left behind by this procedure are less noticeable. They do not have jagged edges and are smaller than those left on by traditional open surgeries. Also, no stitches are needed.
- Day Surgery: You do not need to be hospitalized for a prolonged time as this surgery is typically a day care procedure. In case you have a concern or query you can always consult an expert & get answers to your questions!
A problem in the foot often results in rheumatoid forefoot deformity. The symptoms of this problem include pain and deformities in the foot and ankle. The forefoot gets symmetrically affected and the first rays give rise to hallux valgus, which drives the deformity of the toes.
Types of Deformities-
There are multiple foot deformities that can occur as a result of rheumatoid arthritis:
- Hallux Valgus
- Bunion deformity with problem at the MTP joint (Metatarsophalangeal joints)
- Clawing of toes
- Dislocation of the lesser MTP joint
- Increased plantar pressure
Deformities and pain are usually detected by a physical examination by the physician and at times an x-ray can be suggested for the same as well.
The primary goal of non-operative treatment is to make the deformed foot feel comfortable. The extent of the deformity is first diagnosed and then this treatment can be suggested based on it. It basically consists of pain control, shoe modification and medical management techniques:
- Wearing comfortable shoes to minimize the pain associated with the deformity
- Custom made or store bought inserts to offload prominent area
- Corn pads or paddings to protect bony prominence
- Specific devices can be used to eradicate clawing of toes
- Activity modification to manage pain better
- Physical therapy or stretching to improve joint mobility
Operative treatments are sought when the condition of the deformities is serious and the patient suffers from remarkable pain:
- Hallux Valgus is the most common form of foot deformity and can be managed with a surgery of arthroplasty, osteotomy or arthrodesis. Correction of the Hallux Valgus has good effects of controlling deformities and pain associated with rheumatoid arthritis.
- Procedure to correct clawed toes based on its intensity
- Bunion correction surgery for bunion deformities
Each procedure has its own recovery period and in most cases, it can be limited to a range of 6 weeks to get back to normalcy. After 6 weeks, physical therapy may be suggested to increase activity gradually. To gain full mobility it might take around 3-6 months, depending on the patient’s age and condition. Relief is generally noticed by the 6th week, but to get back to full recovery it might take months.
Common surgical complications can be applicable to operative procedures. There can be a compromise to the blood supply to the tip of the toes, blood clots, pulmonary embolism, recurrence of deformity. Such complications are to be addressed by the physician to reconsider the right therapy
Treatments for forefoot deformities are to be performed after thorough diagnosis and investigation. Corrective measures are to be taken to prevent deformities. In case you have a concern or query you can always consult an expert & get answers to your questions!
Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot.
Posterior Tibial Tendon Dysfunction: An Overlooked Cause of Flat Foot Pain
Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot.
Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking or climbing stairs.
This can be a painful condition. Let us look at the ways in which it may be cured.
- Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
- Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot’s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
- Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
- Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Oh my aching Heel!! The combination of foot and ankle consists of 26 bones, 33 joints and an excess of 100 tendons. The longest bone present in the foot is the heel. Over usage or injury to the heel would lead you to experience pain in the heels. The severity of the heel pain can range from mild to excruciating.
The cause behind heel pain is typically associated with excess usage of the heel bone. Straining of your heel occurs if you excessively pound your feet on surfaces that are hard, or you are overweight or even if you wear shoes that do not fit your feet properly. These strains cause irritation in the muscles, bones or tendons that are present in the heels. Some of the other common causes include:
- Heel Spurs: Development of heel spurs occurs due to the continuous stretching of the lining, which covers the heel. Upon continuous stretching, pieces of the lining tend to break off. Development of heel spurs is common in athletes who frequently jog or run. People who are obese also tend to experience pain due to heel spurs.
- Plantar Fasciitis: Development of Plantar Fasciitis occurs due to the inflammation of the tendinous tissue that connects the heel to the ball of the foot. Development of Plantar Fasciitis is common in athletes who frequently jog or run as well as people who wear shoes that don't fit the feet properly. It may occasionally be associated with Vitamin B12 deficiency and raised uric acid in blood
- Achilles Tendinitis: This is the inflammation of the Achilles tendon. Achilles Tendinitis occurs commonly in people who have active lifestyles, such as people who are joggers, runners or even dancers.
Physical therapy, medication or alternative treatments can be used to treat this form of pain. Medications for heel pain can only be in the form of anti-inflammatory drugs. Although these oral medications cannot significantly relieve heel pain, some injections containing substances such as corticosteroids, as well as Arthrocentesis (removal of fluid present in joints using hollow needles) might be able to provide relief. Recently PRP (Platelet Rich Plasma) injection have been found very useful in treating recalcitrant Plantar fasciitis and heel pains.
Common practices that can be used to relieve discomfort include:
- Application of ice to the heel for a duration of 15 minutes daily.
- Utilize over-the-counter pain medications.
- Have adequate amounts of rest.
- Wear shoes that fit properly.
- Walking on tip toes to stretch the plantar fascia helps to relieve heel pain.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Have you ever come across a person with usual toes, toes that are mysteriously curled or bend upwards, downwards or inwards? As strange and intriguing as it may appear, the condition can be quite painful and is known as toe deformity. In toe deformity, the foot bone is unusually and abnormally positioned, resulting in pain and discomfort.
Toe deformity in a person can be of different types. It can be:
- Hammer toe: This is one of the most commonly observed toe deformity. A hammer toe is characterized by the curling or bending down of the second toe at the proximal interphalangeal joint (the middle toe joint). The toe may further bend up at the distal interphalangeal joint (joint adjacent to the toe tip) or the metatarsophalangeal joint (meeting point of the foot and the toe) as well. In hammer toe, the awkward alignment results in a slight elevation in the joint of the middle toe. A hammer toe is often seen accompanied by a bunion (a bony bump or a deformity formed at the joint that links the foot with the big toe).
- Mallet toe: Mallet toe mostly affects the second toe (other toes may be affected). The deformity results in bending down of the toe at the distal interphalangeal joint (appears like a mallet).
- Claw toe: The deformity affects all the toes, with the big toe being an exception. Here, the toes bend up at the metatarsophalangeal joint and bend down at the distal interphalangeal joint. The deformity results in the toes curling down towards the floor (appears claw-like).
What causes Toe Deformity?
There can be many factors responsible for toe deformities.
- Toe deformity in a person may be congenital (present from birth).
- It can also be an outcome of medical conditions such as arthritis (osteoarthritis, rheumatoid arthritis), stroke, heart attack, diabetes, an injury, an accident, or wearing wrong footwear.
- Toe deformity can also be hereditary.
Signs and symptoms:
The symptoms for Toe Deformity (hammer toe, claw toe, and mallet toe) include
- There is redness, pain, and swelling in the affected part of the toe. In claw toe, however, there may or may not be pain associated with the condition.
- A person faces difficulties in straightening the toe.
- In hammer toe, corns, and calluses appear on the middle joint (top) of the affected toe.
- In mallet toe, ulcers may occur on the toe (in diabetic patients).
Initially, toe deformity appears flexible, where movement around the affected joint is possible. However, if left unattended, the condition can become severe and rigid, thereby restricting the movement (in the affected area). Treatment for toe deformity depends on how severe the condition is.
- In most cases, the treatment involves wearing custom-made shoes, fitted with supports (cushions or pads) and wider toe box.
- Using of tapes and splints may be helpful in correcting and repositioning the deformed toe.
- Patients with excruciating pain benefit immensely from cortisone injections.
- Corn pads can be used to deal with corns and calluses better.
- Toe stretching exercises are highly effective.
If severe cases or extreme rigidity, doctors may opt for surgical treatments like arthrodesis, tendon transfer, arthroplasty, to name a few. If you wish to discuss about any specific problem, you can consult an Orthopedist.