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Sep272015

Working With Posterior Calcaneal Spur

Heel Spur


Overview


Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.


Causes


The plantar fascia is a big strong ligament on the bottom of the foot, starting at the bottom of the heel bone and running into the ball of the foot. As the arch of the foot becomes weak, it sags slightly with each step and this causes the plantar fascia to tug and pull at the heel bone with each step. Over a period of time, a spur forms where this big strong ligament tugs and pulls at the heel bone. Soon, inflammation (swelling) starts around this spur and the pain becomes almost unbearable. (Sometimes heel spurs may be present without being painful if no inflammation is present).


Heel Spur


Symptoms


Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.


Diagnosis


A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.


Non Surgical Treatment


Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve pain, reduce friction and transfer pressure from your sensitive foot areas. By eliminating the cause of the heel spur and plantar fasciitis (i.e. better shoes, orthotics to fix your gait, losing weight) will help reduce the pressure put on your fascia and heel and can reduce the inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery your only option.


Surgical Treatment


Though conservative treatments for heel spurs work most of the time, there are some cases where we need to take your treatment to the next level. Luckily, with today?s technologies, you can still often avoid surgery. Some of the advanced technologies to treat a Heel Spur are Platelet Rich Plasma Therapy. Platelet Rich Plasma Therapy (also known as PRP) is one of several regenerative medicine techniques that University Foot and Ankle Institute has helped bring to foot and ankle care. This amazing in-office procedure allows the growth factors in the blood to be used to actually begin the healing process again long after your body has given up on healing the area. Heel Pain Shockwave Therapy. Shockwave therapy is a non-invasive procedure done in the office that allows for new blood to get to the region of fascia damage and help with healing. Results have been excellent with more than 70 percent of patients getting relief with only one treatment. Topaz for Heal Spurs and pain. Another minimally invasive technology technique is called Coblation Surgery using a Topaz probe. This minimally invasive procedure involves controlled heating of multiple tiny needles that are inserted through the skin and into the plantar fascia. This process, like PRP and Shockwave therapy, irritates the fascia enough to turn a chronic problem back into an acute problem, greatly increasing the chances of healing. Heel Spur Surgery. Endoscopic Plantar Fasciotomy is one surgical procedure that we consider to release the tight fascia. University Foot and Ankle Institute has perfected an endoscopic (camera guided) approach for fascia release to allow rapid healing and limited downtime with minimal pain.


Prevention


In order to prevent heel spurs, it?s important that you pay attention to the physical activities you engage in. Running or jogging on hard surfaces, such as cement or blacktop, is typical for competitive runners, but doing this for too long without breaks can lead to heel spurs and foot pain. Likewise, the shoes you wear can make a big difference in whether or not you develop heel spurs. Have your shoes and feet checked regularly by our Dallas podiatrist to ensure that you are wearing the proper equipment for the activities. Regular checkups with a foot and ankle specialist can help avoid the development of heel spurs.

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Sep232015

What Are The Indicators Of Inferior Calcaneal Spur

Calcaneal Spur


Overview


Although a heel spur is often thought to be the source of heel pain, it rarely is. When a patient has plantar fasciitis, the plantar fascia pulls on the bottom of the heel bone. Over time this can cause a spur to form. Heels spurs are a very common x-ray finding, and because the heel spur is buried deep in soft tissue and not truly in a weight bearing area, there is often no history of pain. It is important to note that less than one percent of all heel pain is due to a spur. but frequently caused by the plantar fascia pulling on the heel. Once the plantar fasciitis is properly treated, the heel spur could be a distant memory.


Causes


Some causes of heel spurs include abnormal or lopsided walking, which places excessive stress on the heel bone, ligaments and nerves Running, jogging or jumping, especially on hard surfaces. Poorly fitted or badly worn shoes, especially those lacking appropriate arch support, excess weight and obesity.


Heel Spur


Symptoms


Major symptoms consist of pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may report heel pain to be more severe when waking up in the morning. Patients may not be able to bear weight on the afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.


Diagnosis


Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.


Non Surgical Treatment


There are various ways to treat heel spurs. The first is to rest and apply ice to the afflicted area. Shoe inserts and night splints can also treat plantar fasciitis, and in turn, heels spurs. Unless you have stomach sensitivities, you may want to consider taking over-the-counter anti-inflammatory medication such as naprosyn to lower the swelling. A physical therapist can recommend gentle exercises and stretches to relax the tissue around the heel bone to relieve the tension. Even with these treatments, a stubborn heel spur may not go away. A physical therapist may decide to inject cortisone into the area to decrease inflammation, but that can cause other problems such as plantar fascial rupture and fat pad atrophy. Extracorporeal shock wave therapy is also an option, which uses energy pulses to apply microtrauma around the heel spur. Surgery is also an option but is not suggested unless the heel spur lasts more than a year. To prevent heel spurs from returning, shoe inserts can relieve the pressure on the plantar fascia. Also continue the recommended stretches and exercises.


Surgical Treatment


Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.

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