Recognized as a bony bump, bunion formation occurs on the outer side of the big toe. It’s a foot deformity that comes about years of stress and compression over the big toe joint while foot injury and inflammatory diseases like that rheumatoid arthritis are other causes. Alignment disorders accompanied by pain, burning sensation on bending, limited range of motion, numbness, skin thickening over the area, and difficulty in wearing shoes are prominent symptoms encountered. Under critical circumstances nerves also get damaged. Consulting with a medical specialist in a respected field is advisable to grip the issue. The related practitioner easily diagnoses disease due to its prominence. As for physical examination, he checks the range of motion by moving a joint, asks questions regarding routine activities, and inquires about the family history of the bunion for further assessment. Reaching to depth is significant in uprooting issues so internal evaluation through X-ray for bones and MRI for diagnosing disorders of soft tissues is necessary.
Considering the test reports most effective treatment strategy is built. Both surgical and non-surgical options are jolt down and conceived to help the patient. Nonsurgical methods include wearing medicated shoes with plenty of foot space and sometimes with padding to cushion the affected foot. Painkillers are provided to help relieve pain and to get rid of soreness or inflammation cold compresses are suggested. The worse bunion can be corrected through surgery. Under the influence of localized anesthesia, the bony bump is removed, tendons are stretched and bones are adjusted to attain natural alignment. Few cases are treated through bone grafting fusing toe joints to restrict movement permanently. This helps to relieve pain and improve the contours of the foot. The patient could walk right after surgery.
Plantar fasciitis is one of the common kinds of heel pain associated with the plantar fascia, a band of tissues connecting the heel bone to the toes. It gets inflamed with constant stress and pressure due to standing, walking, or wearing unfit shoes. Growing age, obesity, or abnormal walking pattern are other reasons for this piercing pain. Consult a doctor if heel ache is experienced by taking the first step in the morning, after standing a couple of hours, or putting weight on feet after rest. Ignorance can prove brutal to the knee, hip, or back joints as pain interferes with the walking pattern.
An orthopedist inquires about medical history and carries out physical examinations to check for a tender area underlying the foot. Necessary assessments are made and the root cause of pain is located for treatment. In a few cases, medical specialists recommend imaging tests like MRI or X-Ray to infer other reasons that may be the cause like heel bone fracture. Conditions for plantar fasciitis vary from mild to severe and are treated accordingly. Mild pain can get better with rest, by applying ice to the painful area and using devices like splints at night to keep the plantar fascia stretched or orthotics to support the arch beneath the foot. Orthotics ease discomfort by distributing stress over the foot evenly. Painkilling medications are prescribed for relief and the patient is shown certain physical therapy exercises to strengthen muscles.
Severe pain drag towards other procedures counting in steroid injections for pain relief but repetition could weaken and may rupture plantar fascia. Platelet-rich plasma taken from the patient’s blood is injected into the concerned area as tissue repair startup. The issue that doesn’t improve with mentioned procedures, is extracorporeal shock wave therapy is installed wherein sound waves are focused on the heel area to restore the damage. The doctor might bring in a modern ultrasonic tissue repair technique through which a needle-like tool is vibrated with ultrasound energy and penetrated the injured plantar fascia, the motive is to break and remove spoiled tissue. Surgery is the ultimate cure when mentioned methods don’t prove worthwhile. Here the plantar fascia is separated from the heel bone. The surgical procedure is instigated using local anesthesia and through a small cut, the operation is managed.
Foot and ankle deformities
Foot and ankle deformities happen in response to the misalignment of bones and joints in the foot. It develops into a painful condition if not treated rightly. Foot structure is visibly altered and needs instant medical attention required. Some deformities exist by birth others may result because of continuous stress or strain over the foot. Ignoring little wear and tear could have crucial outcomes. An orthopedist diagnoses foot or ankle deformities through physical examination and in more depth through imaging tests to have a visual of damage to certain tissues or bones.
Deformities handled by orthopedists include:
- Bunions form a bony bump at the bottom of the big toe joint pointing outwards.
- Hammertoes, contraction of toes making them bend downward forming a hammer-like shape.
- Flat feet, it is a naturally inherited deformity or may also occur slowly causing wear and tear to tissues in the foot arch.
- Bone spurs are a hard bony deposit over natural bone.
- The high arch is either an inherited structure or occurs in response to neurological disorders.
- Joint dislocation, a displacement of a joint from the natural position due to repetitive strain or sudden hit.
- Charcot’s foot happens to diabetic patients having chronic nerve damage. Under this condition, foot bones degenerate and break up deforming natural contours.
- Clubfoot, a hereditary deformity where the foot of a newborn are twisted badly. This condition needs to be fixed before the baby starts walking.
- Other ailments include ankle deformities such as varus ankle, valgus ankle, and talolisthesis
Not all deformities are subject to non-surgical patterns for treatment. Only those that can get better through physical or stretching therapies, wearing a device like orthotics, using comfortable footwear with padding, or some extra support to ease pain are liable to such conservative care solutions. In other deformities where the pain is intolerable, repairing and alignment through surgery are suitable to conduct. The procedure begins with anesthesia to the patient, the targeted bone is cut, aligned, and join back with necessary repairs to tendons and associated soft tissues. In some cases, ends of the bone are reshaped or in worse conditions fused to restrict joint movement permanently. Surgical hardware including pins, plates, and screws are brought in to grip the joint in place until healing ends.
Fractures could be crucial especially foot or ankle fractures because of the intricate anatomy this part has. Numerous small bones are linked together to build feet structure and ensure high-end mobility. A little trauma to any bone could hinder walking patterns thus immobilizing a person. On-time consultation with an orthopedist is important otherwise it could turn into a humongous issue. An orthopedist diagnoses on basis of physical examination and assesses the reason by a thorough discussion with the patient. He may look for bruises, visible deformity, redness, inflammation, and press to check tenderness. Also, he tries to move the patient’s foot in certain directions cautiously to judge the range of motion. The final evaluation is made over imaging tests like MRI, X-ray, CT scan, and weight-bearing CT scan as these tests are much supportive in picturing internal destruction.
Slight and non-displaced fractures could be handled through rest, icing, compression with an elastic bandage, and elevation. A Plaster cast, splint, or brace may be applied externally to sort out issues whereas severe damages need to be operated on for correction. Through surgery debris of damaged bone fragments and torn tissues are removed. Repair is made to tendons, ligaments, and muscles. Displaced bone is put in place and fixed to an aligned position with screws, pins, and plates. Under the influence of anesthesia and depending on the extent of the fracture surgery is performed. In cases where it is hard to restore movement of joint and pain is dreadful, joint fusion is made through the grafting method. Although it immobilizes joints, the pain is managed successfully. After the surgical procedure foot is immobilized through external support for healing in accurate alignment.
The imbalance of activity of tendons, muscles, or ligaments that hold the toes while lying flat leads to a hammertoe deformity. It’s a painful ailment curling the toes downwards and middle joints in the toes to bend upwards creating a hammer-like shape. Usually, the second, third, and fourth toe is affected by this disorder. Hammertoe hinders the functionality of the foot making it tough to wear shoes. Avoiding its progression could worsen the symptoms and as the joint is bent upwards it rubs with the shoe forming corns and calluses. Stress over soft tissues in toes, wearing tight shoes, an injury or trauma to the foot, growing age, diseases like arthritis and diabetes, and using the foot in a consistent imbalance position can bring about hammertoe condition.
An orthopedist can diagnose hammertoe condition by looking at the deformity, he tries to straighten the toe to see whether it’s flexible or stiff. Scanning tests are prompted for internal appraisal. Evaluating test results and assessments made through physical checkup doctors develop a best-fitted treatment plan. Flexible hammertoe could be treated through physical therapy and muscle strengthening exercises as tissue weakness is a major reason for hammertoe’s condition. Wearing comfortable yet spacious shoes from toes with extra padding for relieving pressure could bring in betterment. Stiff hammertoe needs surgery to be fixed as the joint is contracted to its extreme point. Here tendons and ligaments are lengthened, stiffness is released and bones at the end of stiff joints are removed to get straight stature. Surgical pins are used to keep the toe in a straight position whereas in cases pins are of no advantage bone fusion is conducted to straighten the toe permanently. A bone graft is placed between the treated bone ends to initiate a fusion process where the bone doesn’t heal on its own.
Plantar fasciitis is the most common face of heel pain we recognize. However, many other reasons could be associated with it, like infection, bursitis, fracture, or an injury due to hard impact. Wearing unfit shoes, growing age, or damage to the foot especially nerves can induce heel pain. Some are managed through home care by applying ice, taking rest, compression, and wearing comfortable shoes while in some cases pain doesn’t end instead enhanced day by day. Their attention is needed and a quick consultation with an orthopedist is required.
An orthopedist at first physically diagnoses the foot, looking for visible symptoms. He will ask about the walking pattern of the patient and inquire about daily activities. Imaging and laboratory tests are recommended for further evaluation. Treatment through medicines, physical therapy, and easing the foot with comfortable wear is an immediate attempt. Still, if the pain doesn’t vanish surgery is the last resort for a cure.
Heel spurs are a bony projections, protruding underneath the heel bone. Calcium deposition leads to this condition but it gives off no symptoms thus tough to diagnose. Patients usually feel no pain but it may become a reason for damage to plantar fascia in some cases. Unusual walking patterns putting strain on ligaments and muscles of the foot, repetitive damage to the membrane covering heel bone, overweight, old age, and diabetes are some of the whys and wherefores to heel spurs. It is much common among people doing lots of running and jumping.
Diagnosing this condition is impossible unless a complaint about heel pain arises. Your health care provider orders an x-ray of the foot to inquire about the reason, which discloses the presence of heel spur if exists. Treatment includes surgical or non-surgical ways and means. Most immediate is rest, icing, and oral administration of anti-inflammatory drugs and painkillers. Further, it could be improved by foot stretching exercises as guided by a physiotherapist. An orthopedist may inject cortisone injections to relieve inflammation and pain but couldn’t repeat as its frequent use can rupture plantar fascia. Wearing comfortable shoes, orthotics, and night splints are other suggestions your doctor makes.
A point where all other conservative methods don’t prove workable surgery becomes a need. Surgery aims to release stress over muscles causing pain. Two missions are accomplished through surgical procedures first, gastrocnemius recession where one of the calf muscles is lengthened to increase the range of motion. Second, the plantar fascia is partially cut to decline stress. It’s an endoscopic procedure made through a small incision. A heel spur is removed surgically if it’s bigger. Patients recover soon after surgery with improved conditions.
Joint pain and arthritis
Arthritis is a degenerative disease that brings about deterioration of joints leading to painful motion and in worse conditions inability to move. Arthritis has many faces, it may occur due to wear and tear, attack by an immune system, injury to joints, or deposition of uric acid. Growing age increases the probability of having an arthritic foot or ankle joint. Major symptoms comprise swelling, stiffness of joints, warmth over the affected area, pain while moving especially after a long period of rest, and inability to put weight over the foot.
Foot and ankle arthritis need on-time treatment for painless treading. Notify an orthopedist who will then give a physical examination of the foot once the issue is presented. He will check the range of motion, and find tender areas and swelling over a diseased joint. The internal view is taken through imaging tests that elaborate damage to joints in detail. X-rays, MRIs, or CT-scan all help quote inner matter. The initial treatment plan includes medications, injections, and topical pain or inflammation relievers. Comfortable shoes, foot-supporting elements like orthotics, and regular physical therapy are also recommended to reduce symptoms.
Failure to preliminary conduct drives towards a surgical solution. Looking upon the severity of the issue an orthopedist opts either for fusion or joint replacement surgery. Through the fusion method end of the bones are fused using a bone graft aiming to permanently immobilize the diseased joint. Bone graft is kept in place using screws, pins, or plates and the whole procedure is commenced under influence of local anesthesia. In severe conditions, joint replacement surgery is conducted and the damaged joint is replaced with a prosthetic one that replicates the motion of a natural joint. The artificial joint is made up of metal, ceramics, or plastic components.
When ligaments are stretched beyond their natural range of motion sprain occurs. It’s a partial or complete tear to ligaments that help stabilize joints. Sudden twisting or turning of the foot, an injury through hard contact, landing on an uneven surface, weak foot muscles, or wearing unsuitable shoes could be a reason for foot and ankle sprains. This condition commonly happens to sportsmen. Symptoms vary depending on the severity of the injury. Pain, tenderness around the injured area, swelling, bruising, inability to put weight on the foot, and limited range of motion all are symptoms that develop after damage.
While a physical examination of a foot an orthopedist touches the affected part to look for tender areas and assess the extent of injury by moving the foot to check the range of motion and position which cause pain and uneasiness. In severe conditions to see an internal picture doctor may ask for an x-ray, ultrasound, MIR or CT scan. This gives an in-depth evaluation of damage to bone and soft tissues around. The motive is to relieve pain, reduce swelling, restore movement and initiate healing of torn ligaments. The Foremost attempt of a doctor is to lessen pain, swelling, and inflammation for which rest is advised. The Joint is compressed with an elastic bandage and elevated to reduce swelling. Ice is applied to soothe inflammation. Doctors also prescribe necessary medicines to relieve pain and inflammation along with devices to support or immobilize the foot until it heals. With a reduction in swelling and pain, the patient is guided by a physiotherapist to undertake necessary exercises to strengthen the foot joint to regain lost range of motion.
Surgery opts as a last resort when non-surgical treatments fail to heal. Through surgery torn ligament is sewn back and secured in position using surgical hardware like pins, screws, plates or staples. But in cases where the ligament is too short to stitch back reconstruction is made by putting in a tendon graft for ligaments to grow. The graft is fixed in place with pins, screws or plates and the joint is immobilized until healing completes.
Tarsal tunnel syndrome
Such syndrome grows due to repeated pressure over the tibial nerve fleeting through the tarsal tunnel within the ankle. Flat feet, growth of bony structure in the tarsal tunnel, varicose veins, inflammation due to arthritis, a tumor near a tibial nerve, injury to the ankle, sprains, swelling, and diabetes can be counted in as reasons for nerve compression.
Certain credentials help to diagnose tarsal tunnel syndrome these include numbness, pain, or pricking pain in or around the tibial nerve passing through the ankle. The foot sole also experiences sharp pains and sensations like pins and needles, burning, or a sudden electric shock kind of feeling beneath the foot. Symptoms vary among patients, in some cases symptoms arise gradually while in others appear all of sudden. Physical activity involving feet and rest after long-standing aggravates the symptoms.
Consultation with an orthopedist becomes compulsory if any of mentioned symptoms are experienced. The doctor will proceed with questioning about the routine activities and inquiring medical history of the patient. Physical examination is made to see visible signs and tinel’s test is performed by tapping the tibial nerve gently to see if pain arises due to pressure. The core issue is analyzed through electromyography, a test to spot nerve malfunction and MRI is conducted to detect the presence of any mass or bony growth.
RICE is the immediate treatment considered I.e rest, ice, compression, and elevation viable to ease inflammation and swelling. Painkillers and anti-inflammatory drugs are prescribed for oral administration. The movement of the ankle is limited or maybe be completely immobilized with a brace, cast, or splint to prevent a nerve from compressing. Customized shoes to support foot arch are recommended for patients with flat feet. If the condition doesn’t improve with all given remedies minimal invasive surgery to release ligament is conceived. It helps to release the pressure over the tibial nerve hence reducing pain. The procedure commenced with localized anesthesia.
Sesamoiditis is an inflammation of tendons and sesamoid bones joined to the big toe. Usually, a bone is connected to another bone but sesamoid bones are unique they are joined to foot structure through tendons only. Individuals putting weight on the ball of the foot most frequently are within the circle to get this ailment. Runners and dancers are more prone to develop sesamoiditis.
The gradual development of disease symptoms under a big toe like swelling, pain, difficulty to bend, putting weight, bruising and redness can be noticed. Visiting an orthopedist is needed as the condition may get worse to handle. On a visit, the doctor asks questions concerning routine activities and the time when signs of disease begin to progress. Further assessment is made through physical examination by checking tenderness over the affected area and moving joints in various directions to check the range of motion. A stress fracture to sesamoid bones and damage to soft tissues will be detected through imaging tests like x-ray, MIR or CT-scan. Understanding the nature of the disease most worthy treatment plan is adopted. Immediate relief lies within rest from activities that put stress on sesamoid bones whereas icing and foot elevation assist in reducing inflammation further. An orthopedist may temporarily immobilize the big toe with a brace or splint if a condition is severe. Therapies like soft tissue therapy and physical therapy are other attempts doctors make to improve the matter. For faster pain relief steroid injections are directly injected into the affected area. In some cases surgery becomes essential and one of the sesamoid bones is removed to ease the pain.
Tendon or ligament injury
Tendons and ligaments are a strong band of tissues and are connecting bodies between muscles to bones and bone to bone. A hard impact or sudden change in direction while walking, running or jumping damages ligaments or tendons in the foot. Athletes are more susceptible to getting this injury. A pop sound is heard or felt at the instance of injury followed by pain and bruising. The patient will feel difficulty in putting weight on foot while walking and strength of joint decrease as ligaments and tendons provide stability in healthy condition.
Physical diagnosis is made on the first visit to an orthopedist who checks for tender areas, bruises, cuts and range of motion. MRI is ordered to evaluate internal circumstances. In mild cases, the joint is immobilized and injury is repaired on its own but severe injuries need to be operated on. Anaesthesia is given to the patient and a cut is made over the affected part. Ligaments are either sewn back or reconstructed. In reconstruction, tendon graft is extracted from healthy joint and fixed at injury site using pins, staples, screws or plates. It provides a base for ligaments to grow again. After keeping under observation for a few hours patient is discharged the same day.