Tag Archives: bursitis

Nerve entrapment / Neuroma

Summary

  • Thickening of the tissue that surrounds the nerve leading to the toes. Burning pain in the ball of the foot that may goes into the toes which generally intensifies with activity or wearing shoes. There may also be numbness or an unpleasant feeling in the toes.

How did I get this?

  • Anything that causes compression or irritation of the nerve can lead to the development of a neuroma (e.g. wearing high healed or tight shoes). Foot deformities are risk factors. Injury and trauma to the feet can also lead to this condition.

What can I do about it?

  • Placing an icepack on the affected area helps reduce swelling.
  • Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
  • Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
  • Padding techniques provide support lessening the pressure on the nerve and decreasing the compression when walking.

What help can I get for this?

    • Podiatry consultation for treatments that include footwear advice, padding, orthotics, and may advise guided injections for alleviating the pain.
    • Surgery may be considered if not responded adequately to non-surgical treatments.

When will it get better?

  • Appropriate treatment can provide swift relief, but you will still need to consider long-term measures to help keep your symptoms from returning.

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Intermetatarsal Bursitis – toe pain

Summary

  • A bursa is a fluid-filled cushioning sac. They are located near tendons, ligaments, skin, and muscles that would otherwise rub directly across the surface of a bone. They are very important to prevent friction, absorb shock, and decrease the wear and tear between moving structures. The intermetatarsal bursae are located on the bottom of the foot near the base of the toes. They can be irritated when one metatarsal bone takes more load than the others. When this happens, the soft tissue between the bone and the skin becomes compressed and inflammation in the bursa can begin. Walking barefoot on a hardwood or tiled floor without cushioning will increase pain noticeably due to the direct pressure on the metatarsal bursa.

How did I get this?

  • It is commonly due to strain or irritation of the bursa. Wearing narrow or excessively worn footwear throughout the day or while playing sports also increase your chance of bursitis developing in your feet and toes.

What can I do about it?

  • Anti-inflammatory tablets (e.g. Ibuprofen) can help although should not be taken for long periods without professional advice.
  • Hot or cold ice packs can help symptoms to improve.
  • Rest the foot.
  • Perform stretching exercises to improve joint motion.
  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a protective pad.
  • See a podiatrist.

What help can I get for this?

  • Podiatrists may advise appropriate shoes or add padding to your existing shoes, consider prescribing orthotics, advise taping / strapping.
  • Your Doctor may administer a cortisone injection to reduce inflammation if indicated, and possibly suggest surgical management.

When will it get better?

  • Conservative treatments may be sufficient to resolve symptoms and prevent recurrence. However, if the bursitis becomes chronic surgery may be necessary.

Stress Fracture

Summary

  • Stress Fracture occurs when excessive repetitive force is applied to a localized area of bone. Activities such as walking, running, and repeated jumping can subject the bones of the foot to large forces that often lead to microscopic cracks in the bone.

How did I get this?

  • Generally, it is repetitive stress (i.e. running, marching, sport etc.) although some bone diseases can pre-dispose to thin bones which therefore fracture more easily. In people with osteoporosis (thinning of the bone) there is an increased risk of stress fracture.

What can I do about it?

  • Rest the area and stop sporting activity.
  • Wear good fitting shoes with adequate support and cushioning.
  • Avoid high heels.
  • You can try a protective pad.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise appropriate shoes, consider prescribing orthotics, consider immobilisation, and advise on surgery.

When will it get better?

  • In the majority of cases, conservative care allows the bone to heal and normal activity can then be resumed. Surgery is sometimes necessary to stabilise the fracture site which allows longer time to resume activity.

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Posterior tibial tendon dysfunction

Summary

  • Posterior tibial tendon dysfunction (PTTD) is an injury involving overstretching or rupturing of the posterior tibial tendon, leading to tendon inflammation, weakness, foot deformity and arthritis. The posterior tibial tendon extends from the deep layer of muscle at the back of your leg. It runs along the inside of your ankle and down the inside of your foot to underneath your arch. This tendon, along with some strong stabilising ligaments, is one of the major supporting structures of the foot. In PTTD, the tendon’s ability to perform that job is impaired, often resulting in a collapsed arch or ‘flat foot’. PTTD is the most common type of flat foot developed during adulthood, and is also known as adult-acquired flat foot.
  • Symptoms include pain and swelling on the inside of your ankle which grows worse with increasing activity, tenderness over the midfoot especially during activity, weakness or an inability to stand on your toes, a collapsed arch and development of a flat foot, and gradually developing pain on the outer side of your ankle.

How did I get this?

  • Often occurs in women over 50 years of age and may be due to an inherent abnormality of the tendon. But there are several other risk factors which include obesity, diabetes, hypertension, previous surgery or trauma, inflammatory diseases, and arthritis. The tendon may also become inflamed if excessive force is placed on the foot, such as when running on a banked track or road.

What can I do about it?

 

  • Rest.
  • Short term nonsteroidal anti-inflammatory drugs such as ibuprofen.

What help can I get for this?

  • Podiatrist may advise immobilization of the foot for six to eight weeks with a removable boot to prevent overuse.
  • Podiatrist may prescribe shoe inserts such as a heel wedge or arch support.
  • Podiatrist may recommend that you use a custom-made orthotic or support.
  • Foot and ankle surgeon for surgical management such as tendon repair or ankle joint fusion if conservative treatments don’t work.
  • A program of exercises and therapy to help rehabilitate the tendon and muscle following immobilization.

When will it get better?

  • The success of nonoperative treatment first requires the assessment of the flexibility of the flatfoot deformity. It is common for a patient to take 4-6 months to achieve much of their recovery and 12-18 months before they reach their point of maximal improvement after surgery.

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Posterior Heel Spur

Summary

  • Posterior heel spur occurs where the achilles tendon inserts into the back of the heel bone. If there is excessive pull at the attachment, the area can become painful. In some instances a bone spur can form at the back of the heel. There is pain directly over the bone at the back of the heel.

How did I get this?

  • Overuse particularly in sport. However, bone spurs can take many years to form without being painful.

What can I do about it?

  • Rest.
  • Ice.
  • Heel raises can help.
  • An Achilles heel protector can be of benefit.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise appropriate shoes, stretching, heel raise , and possible guided injection for symptoms control.
  • Orthopaedic surgeon for surgical removal of bone spur.

When will it get better?

  • This can be a very difficult condition to treat and can take several months to settle. Whilst the treatment options can be of benefit, they will not reduce any bone spur. With surgery, it often involves a long recovery (6-12 months).

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Nerve entrapment – Neuroma

Summary

  • Nerve entrapment – Neuroma is caused by thickening of the tissue that surrounds the nerve leading to the toes. Burning pain in the ball of the foot that may goes into the toes which generally intensifies with activity or wearing shoes. There may also be numbness or an unpleasant feeling in the toes.

How did I get this?

  • Anything that causes compression or irritation of the nerve can lead to the development of a neuroma (e.g. wearing high heeled or tight shoes). Foot deformities are risk factors. Injury and trauma to the feet can also lead to this condition.

What can I do about it?

  • Placing an icepack on the affected area helps reduce swelling.
  • Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
  • Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
  • Padding techniques provide support lessening the pressure on the nerve and decreasing the compression when walking.

What help can I get for this?

    • Podiatry consultation for treatments that include footwear advice, padding, orthotics, and may advise guided injections for alleviating the pain.
    • Surgery may be considered if not responded adequately to non-surgical treatments.

When will it get better?

  • Appropriate treatment can provide swift relief, but you will still need to consider long-term measures to help keep your symptoms from returning.