Sunday, November 22, 2015

HEEL AND FOOT PAIN

HEEL & FOOT PAIN

Heel pain is an extremely common complaint, and there are several common causes.
Plantar Fasciitis:  It is the most common condition that causes heel pain. Plantar fasciitis is due to irritation and inflammation of the tight tissue that forms the arch of the foot. The most common symptom is pain under the heel after a period of rest, i.e. severe pain and inability to walk in the morning after getting up from sleep. The same might happen after sitting for a long time and then trying to walk. Interestingly the pain gets better after a few steps though it may not go away completely.  Again, the pain may get worse with prolonged walking and standing. X ray may show a bony spur which may develop in long standing cases of heel pain due to plantar fasciitis, but it may not cause the symptoms.

Posterior Heel Pain:  Posterior heel pain causes symptoms behind the foot, rather than underneath. Posterior heel pain causes include Achilles tendinitis and retrocalcaneal bursitis. These patients may also develop bony growth behind the heel bone and when they are large may lead to rupture of Achilles tendon. Patients may have difficulty to walk comfortably on the affected side and pain that occurs at night or while resting.
Treatment Options:
Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.
1.Rest - Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking.  Rest can reduce the severity of pain and will allow the inflammation to begin to cool down.
2.Ice Packs - Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.
3.Exercises and Stretches - Are designed to relax the tissues that surround the heel bone. Some simple exercises performed in the morning and evening, often help patients feel better quickly.
4.Anti-Inflammatory Medications - Help to both control heel pain and decrease inflammation.
5.Shoe Inserts - Are often the key to successful treatment of heel pain. The shoe inserts often permit patients to continue their routine activities without heel pain.
6.Injection therapy - In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.
7.Removable walking cast - May be used to keep your foot immobile for a few weeks to allow it to rest and heal and is used only for severe cases.
8.Night splint - Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
9.Weight reduction – It helps to reduce stress on foot and heel and thus help to reduce the severity of pain.

If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered.
Healthy Joint Club says:
Not being able to take first step out of bed in the morning can be frightening. More over severe pain from the heel may force you to restrict several day time activities. Except for a handful of cases and some uncommon conditions, most cases improve with treatment and time. Even though the time taken for the recovery may vary from person to person there is a natural tendency for these conditions to get better spontaneously.
STRETCHING EXERCISES
     
1.PLANTAR FASCIA STRETCH:
Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold for 10 seconds and repeat 5 to 10 times.
2.ACHILLES STRETCH:
Stand on forefoot at the edge of stair, reach the step below with your heel, until you feel the stretch in the arch of the foot. Hold this position for 10 seconds and repeat 5 to 10 times.          
3.HEEL RAISE:
Stand behind the chair or any support and raise your body up onto your toes and hold for 5 seconds. Then slowly lower down yourself. Repeat 5 to 10 times.
4.TOWEL PICK:
Drop a towel on the ground and pick up the towel with your toes. Release and repeat 5 to 10 times.
5.FROZEN CAN ROLL:
Take a frozen juice can or tin, roll your feet on the can from front to back. Do it for 3 to 5 minutes.
6.TOWEL STRETCH:
Loop a towel around your toes and pull the foot towards your body keeping your leg straight. Hold this for 10 seconds and relax. Repeat 5 to 10 times.

Dr.A.Mohan Krishna
M.S.Ortho.,MCh orth (U.K)
Consultant Orthopedic surgeon,
Apollo Hospital
Appointments
Cell: 9247258989
         9441184590
email: bonesandjointsclinic@gmail.com
online appointments: 
www.drmohankrishna.com
www.bonesandjointsclinic.com




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