Foot Pain & Joint Problems

Hammer/Clawed Toes

This condition describes a contracture of the toes as a result of muscle imbalance within the foot. This contracture can result in rigidity of toes and corns can develop on the tops of toes.

Callus on the ball of the foot can also result as the joint becomes more exposed.

Treatment

Podiatry treatment is directed towards the cause of the deformity.

A functional orthotic can be prescribed to correct abnormal functioning of your foot.

Padding or silicone gels can be used to create a splint and control excessive extension and flexion within your toes.

Plantar pads can also be used to deflect pressure away from the ball of your foot if they are being exposed by pressure or early heel lift.

The podiatrist can also use soft tissue release techniques and prescribe stretches to further correct the contractures within your foot.

 

Neuroma

A neuroma is the swelling of a nerve that is a result of a compression or trauma usually in the ball of the foot.

The most common cause of neuroma in ball of the foot is the abnormal movement of the long bones behind the toes, most commonly between the third and fourth toes.

A small nerve passes between the spaces of these bones splitting at the base of the toe. It is in this area the nerve gets pinched and swells, forming the neuroma.

Symptoms include burning pain, tingling, and numbness in one or two of the toes. A popping sensation can often be felt when walking. Pain is intermittent and is aggravated by anything that results in further pinching of the nerve.

A puncture wound or laceration that injures a nerve can also cause a neuroma. These are called traumatic Neuromas.

Treatment

Any abnormal movement in your metatarsal bones will be addressed and a functional foot orthotic can be used to achieve this (custom-made inserts that correct abnormal function of your foot).

A combined podiatry treatment of cortisone injections and orthotics can be a very successful form of treatment.

 

 

 Arthritis

Arthritis is a disease characterized by the inflammation of the cartilage and lining of the body’s joints. Inflammation causes redness, warmth, pain and swelling. The primary targets for arthritis are people over the age of 50. Arthritis is a major cause of foot pain because each foot has 33 joints that can become affected by the disease.

Osteoarthritis

There are many different types of arthritis. The most common type is called osteoarthritis. Osteoarthritis causes excessive strain and the wearing away of cartilage in the joints of the foot. Movement becomes very difficult and painful. The pain and swelling worsens while standing or walking, and stiffness usually occurs after periods of rest.

Rheumatoid Arthritis

Another type of arthritis is rheumatoid arthritis. It can develop at any age and there is no single cause for this condition. It is a most crippling form of disease that can affect people of all ages. It can cause severe deformities of the joints with associated fatigue of the entire body. People who suffer from rheumatoid arthritis often develop severe forefoot problems such as bunions, hammer toes, claw toes, and others.

Causes

There are many causes of arthritis. Heredity plays a major role. However, arthritic symptoms can develop due to many other factors. Some of these include bacterial and viral infections, prescription and illegal drugs, traumatic injuries, and bowel disorders such as ileitis and colitis.

Forefoot problems such as hammer toes, claw toes, mallet toes, and bunions often develop as a result of arthritis, particularly Rheumatoid arthritis. Problems can also develop in the heel and ankle area due to the erosion of the involved joints.

Treatment and Prevention of  Arthritis

Conservative treatment (non-surgical treatment) of the arthritic foot includes proper footwear, orthotics, and/or forefoot supports. Arthritic footwear should provide the following benefits:

  • High, wide toe box (high and wide space in the toe area)
  • Removable insoles for fitting flexibility and the option to insert orthotics if necessary.
  • Rocker Soles designed to facilitate ambulating (walking) and to reduce stress and pain at the ball-of-the-foot.
  • Arthritic footwear should also accommodate swelling of the foot. Orthotics designed to provide comfort, support and extra cushioning are also recommended.
  • Orthotics made with a material called Plastazote are often recommended because they mold to your feet to provide customized comfort.
  • The proper footwear and orthotics will reduce pressure to provide a comfortable and healthy environment for the foot.
  • Forefoot supports such as gel toe caps, gel toe shields, gel toe straighteners and others can often provide relief.

 

High Arched Feet (pes cavus)

Pes cavus describes a foot that has an abnormally high arch profile. This foot type tends to be quite rigid with associated retracted toes and inward pointing rear-foot.

A more mobile type of cavus is often seen with its own distinct associated dysfunctions.

Often there is no clear cause of this foot type although neuromuscular dysfunction and familial predisposition are often factors.

Treatment

  • Podiatry treatment of pes cavus depends on the degree of mobility in your foot. This will dictate presenting symptoms and degree of gait dysfunction.
  • A rigid presentation will require orthoses that cushion your feet, increasing shock absorption.
  • A more mobile presentation will require a more dynamic orthoses that maximises foot function and minimises joint stress and deformity

 

Flat Feet – Adult

Adult acquired flat feet describes a progressive, often painful deformity that results from the gradual stretch of ligaments that support the arch of the foot.

Pain, inflammation and swelling can occur around the inside of the ankle and this can further weaken the soft tissue flattening the foot further.

Pain occurs because tendons and ligaments have been damaged. Once this damage has occurred the condition can only worsen and podiatric interventions are necessary.

This type of condition affects women more commonly, especially in middle to old age. Other contributing factors include diabetic neuropathy, obesity and hypertension.

Treatment

  • This condition is best treated early.
  • Rest, anti-inflammatory therapy and cast fittings to control your ankle movement is essential.
  • After initial symptoms have receded custom made orthotics and proper footwear are prescribed by the podiatrist in order to maintain stability of your foot and ankle.

 

Gout

Gout is caused by abnormal metabolism of substances called purines that result in accumulation of uric acid in the blood stream and formation of crystalline deposits in joints or soft tissues. Gout occurs most frequently in men.

When this happens, there is a sudden onset of extreme pain with associated swelling, redness, and increased warmth to the skin or joint resembling an infection.

Gout classically occurs in the big toe joint. It also commonly occurs in the knee joint. It is rarely seen in more than one joint at a time.

Factors that contribute to the onset of gout are alcohol, red meats, aspirin and certain medications for high blood pressure.

Treatment

 

Podiatry treatment often consists of both medications for gout (Allopurinol) and for infection (antibiotics).

Once the proper medication is prescribed the symptoms of your gout will start to subside quite rapidly. Left untreated the clinical course may take several days for the attack to subside.