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Anatomy

Walk around the block. Stand on your toes to reach something on the top shelf. Jump to spike the volleyball. You've used your feet. Your feet put on about 1,000 miles each year.

Each foot is made up of 26 bones; 7 of them are ankle bones known as the tarsals; 5 are in the instep and are called metatarsals; and the last fourteen make up your toes and are known as phalanges. The foot has 30 joints. Ligaments hold the bones and joints in place.

Symptoms

Common Foot Problems and Treatment Options

Achilles Tendinitis

Symptoms:
Symptoms of Achilles tendinitis include a mild amount of pain after use that continues to feel worse, pain that is sometimes severe that runs along the tendon, stiffness, and swelling.

Cause:
The Achilles tendon is the largest tendon in the body. Overuse of the tendon, an abrupt increase in exercise or use can cause the tendon to become inflamed.

Treatment:
Treatment varies depending upon the severity of the injury.

Rest:
Do not perform the exercise which caused the irritation for at least one week. When returning to the activity, do so gradually.

Medication:
Your physician may recommend anti-inflammatory medication.

Orthoses:
Special inserts can be created for your shoe to relieve stress on the tendon.

Stretching, massage, ultrasound and exercises:
Any combination of these may be used to restore function.

Surgery:
Surgery is the last option for treatment. If needed, your Powder River Orthopedics & Spine - A Campbell County Clinic physician can recommend surgery to remove tissue and repair tears that are impeding your recovery.

For More Information go to www.aaos.org and www.webmd.org.

Adult (Acquired) Flatfoot

Cause:
Adult flatfoot is caused by aging tendons in the foot stretching or rupturing, causing the arch to flatten. Illness or injury can contribute to this effect.

Symptoms:
Symptoms of adult flatfoot include feet that tire after standing for a long period of time, difficulty standing on toes, difficulty moving heel or midfoot, aching feet in the arches, swelling along the inside of your arch, and pain that interferes with activity. People with rheumatoid arthritis may develop the deformity.

Treatment:
Initial treatment includes rest, application of ice and anti-inflammatory medications.

Physical therapy::
Physical therapy may be prescribed.

If this is not effective, your Orthopedist may recommend stretching, PT, or splinting.

Shoe modifications:
Careful shoe selection, and possibly inserts called orthotics can relieve pain.

Medication:
Your physician may recommend medication to relieve pain.

Rest and ice:
Relieve pressure from the feet. Ice will decrease swelling.

Injection:
Injecting a corticosteroid into the joint may be helpful if other methods aren't working.

Surgery:
Your Powder River Orthopedics & Spine - A Campbell County Clinic physician will discuss surgery options with you if less conservative methods do not help you. The goal of surgery to repair tendons. More sever deformities may require surgical reconstruction of the foot and fusing one or more of the joints.

For More Information go to www.aaos.org and www.webmd.org.

Arthritis of the Foot and Ankle

Cause:
Two forms of arthritis - osteoarthritis and rheumatoid arthritis - are the primary forms of arthritis that affect the foot and ankle. Osteoarthritis is known as the 'wear and tear' arthritis that is caused by cartilage that covers the ends of the bones thinning as we age. Rheumatoid arthritis attacks joints throughout the body, and the cause has not been determined.

Symptoms:
Symptoms of arthritis include pain, swelling, stiffness, corns, bunions, reduced flexibility and tenderness.

Treatment:
Many ankle fractures can be treated in a cast or brace. Surgery may be recommended if the ankle joint is not properly aligned or is unstable. Plates, screws or pins may be applied to realign and repair the broken bones

Recovery can take 6 weeks -3 months or longer, depending on the severity of the fracture. Many ankle fractures cause arthritis to develop in the join. This can lead to chronic pain, and limited mobility. Weight loss can reduce stress on painful arthritic joints.

Injections: Steroid injections may be prescribed by your PROS Orthopedics Surgeon based upon location of affected area.

Medication:
Your physician may recommend pain relievers and anti-inflammatory medication to decrease swelling.

Shoe modifications:
Careful shoe selection, and possibly inserts called orthotics can relieve pain.

Exercise:
A physical therapist can recommend an exercise program for you. Water therapy and swimming are excellent ways to remain active if you have arthritis.

Weight control:
If you are overweight, lose weight to decrease pressure on joints.

Injection:
Injecting a corticosteroid into the joint may be helpful if other methods aren't working.

Surgery:
Your Powder River Orthopedics & Spine - A Campbell County Clinic physician will discuss surgery options with you if less conservative methods do not help you. The goal of surgery is to realign the bones and decrease your pain. The type of surgery performed depends on the specific reason for the flatfoot

For More Information go to www.aaos.org and www.webmd.org.

Broken Ankle

Cause:
The cause of a broken ankle is a trauma whether a motor vehicle accident, sports injury, or fall as possible examples.

Symptoms:
Symptoms of a broken ankle include immediate and severe pain, swelling, bruising and tenderness, being unable to place weight on the foot, and deformity.

Treatment:
Treatment consists of using a cast or brace to realign the bones so they may heal properly. It takes at least six weeks for a broken ankle to heal.

Surgery:
Your Powder River Orthopedics & Spine - A Campbell County Clinic physician will assess if surgery is necessary to realign the bones properly using a plate, metal or screws.

For More Information go to www.aaos.org and www.webmd.org.

Bunions

Symptoms:
Symptoms of a bunion include a bump at the base of your big toe. If the bunion is swollen and sore so that it interrupts your daily activities, surgery may be recommended.

Cause:
Bunions may be cause by many things, including poor shoe selection. There may also be a pre-disposition to this condition

Treatment:
Shoewear modification or inserts may be prescribed to ease pain.

Surgery: if the bunion pain interferes with your daily activities or deformity is so severe that it interferes with shoe wear, surgery may be recommended.

Treatment is conservative unless the pain becomes too great and affects your daily activities.

Shoes:
Make sure you have proper fitting shoes. Protective pads may relieve pain.

Surgery:
Surgery may be recommended by your Powder River Orthopedics & Spine - A Campbell County Clinic physician if the bunion pain interferes with activities you enjoy. It will realign bone, ligaments, tendons, and nerves to your big toe can return to its regular position.

For More Information go to www.aaos.org and www.webmd.org.

Claw Toe

Cause:
The cause of claw toe is uneven pull of the tendons or tendon rupture.

Symptoms:
Symptoms of claw toe include the toe bending upward at the ball of the foot and downward at the middle toe joints.

Treatment:
mild deformities may be treated by stretching and splinting or taping the toes together. Modification of shoes may be necessary.

Splinting or taping toes into position:
This will hold the toes in the proper position.

Stretching:
Gently massage your toes and stretch them to normal position.

Exercise:
Pick up small objects such as marbles with your toes to strengthen them.

Shoe modifications:
Select shoes carefully: Shoes should be soft and roomy in the toe area. High heels should not be worn. In the later stages, pads can be inserted into your shoes that make walking and standing more comfortable. Shoes can be stretched to accommodate the deformed toe.

Surgery:
Your PROS Orthopedics Surgeon may recommend surgery to straighten the toe. This involves cutting tendons and or ligaments to allow the toe to return to its normal positions. A pin is usually utilized until the toe heals and then is removed 2 weeks after surgery.

For More Information go to www.aaos.org and www.webmd.org.

Corns

Symptoms:
A corn is a spot on the foot that is tender in the middle with yellowish dead skin around the outside.

Cause:
Corns are caused when calluses form on toes from pushing against the shoe. The skin thickens in this pressure area and irritates the tissue underneath. Occasionally, there is a deformity of the toe.

Treatment:
Treatment varies depending on the size and the amount of pain you are experiencing.

Soak your feet:
Place your feet in warm water daily and gently massage with a pumice stone or callus file.

Corn pads:
Non-medicated corn pads can be purchased in many stores. Medicated pads are not recommended because they may actually cause more irritation leading to infection.

Cushion:
Lamb's wool between your toes can help cushion soft corns.

Shoe modifications:
Make sure you have shoes that fit properly with plenty of room in the toe area.

Surgery: If deformity of the toe is present, surgery may be recommended.

For More Information go to www.aaos.org and www.webmd.org.

Flexible Flatfoot in children

Cause:
Flexible flatfoot in children may be caused by a tight heel cord or a rigid flatfoot. Most often, a child is born with it and it corrects itself in the first five years of life.

Symptoms:
Most children with flexible flatfoot do not have any symptoms other than the arch in the foot being absent. It usually corrects itself over time without any medical intervention.

Treatment:
There is no treatment recommended for flexible flatfoot unless your child complains of pain.

Exercise:
Stretching exercises will lengthen the heel cord.

Shoe modifications:
Shoe inserts may be recommended to relieve pain.

Casting:
A short term cast may help stretch tight heel cords.

Surgery:
Surgery may be recommended in adolescence if there is persistent pain.

For More Information go to www.aaos.org and www.webmd.org.

Heel Fracture

Cause:
A heel fracture is caused by a great deal of force such as a motor vehicle accident or a fall. It is important to seek medical care immediately.

Symptoms:
Symptoms of a heel fracture are pain on the outside of the ankle, just below the lower leg bone, or on the heel pad. You will likely be unable to bear weight on the heel; the foot may become swollen and stiff.

Treatment:
Treatment of a heel fracture depends on the severity of the break. Fractures which are not displaced, or in the elderly may be treated with a cast. If the bones remain intact, surgery may not be necessary. Please see your PROS Orthopedics surgeon for an evaluation.

Splint:
A splint may be placed on the heel after the swelling decreases.

Surgery:
Surgery is needed if the bones have shifted out of place, and frequently involve the joints in the foot.

surgery is required to put the fragments back in position and realign the joint position. Plates, pins or screws may be used to hold the bones in position. Recovery from this type of injury can be prolonged, taking many months or a year to recover.

Frequently arthritis develops in the foot in this type of injury, causing pain and limited mobility. This may be severe enough that one or more joints in the foot may require fusion to control the pain.

For More Information go to www.aaos.org and www.webmd.org.

Hammer Toe

Cause:
Hammer toes are caused by shoes that don't fit well, causing the toe to bend in a fixed position for a period of time. This leads to the muscles tightening so they can no longer stretch out.

Symptoms:
Symptoms of hammer toe are bending at the middle of the second, third, or fourth toes.

Treatment:
In their early stages, hammer toes can be treated conservatively.

Shoe modifications: Shoes should be roomy in the toe area and narrow, high-heeled shoes should not be worn. Your physician may also recommend cushioning or straps inside your shoes.

Exercises and stretching:
You can gently massage your toes to stretch them.

Strengthen toes by picking objects off the floor with them.

Surgery:
Similar to the treatment for mallet toe, surgery can straighten toes if other methods are not successful.

For More Information go to www.aaos.org and www.webmd.org.

Ingrown Toenail

Inflamed ingrown toenails can lead to an infection after conservative and before surgery

Cause:
Inflamed ingrown toenails can lead to infection after conservative treatment and before surgery.

Infections may require treatment with antibiotics and sometimes surgery to clean out the infection.

surgery: if surgery is required, involves removing part of the toe nail in such a way that it will not grow back.

Symptoms:
If you are experiencing an ingrown toenail, you will experience symptoms of pain, swelling, and tenderness at the point where the toenail grows into the skin.

Treatment:
Treatment is generally conservative.

Soak the foot in warm water 3-4 times each day. Keep the foot dry the rest of the day.

Shoe modifications:
Make sure you have roomy shoes in the toe area. Sandals may be more comfortable.

Medication:
Over the counter pain relief medications may help you.

Insert cotton or waxed dental floss between the nail and skin to gently lift the edge away from the toe. This should be changed every day.

Surgery:
Surgery may be recommended if there is inflammation, swelling, pain and discharge. This would indicate the toe is probably infected.

For More Information go to www.aaos.org and www.webmd.org.

Midfoot (Lisfranc) Fracture

Cause:
A midfoot fracture is caused by a twisting fall that breaks or shifts the bones in the midfoot. It can also occur if you drop something heavy on the top of your foot.

Symptoms:
Symptoms of a midfoot fracture include swelling and pain on the top of the foot and bruising. It is often misdiagnosed as a sprain because they are difficult to see on an x-ray. A person diagnosed with a foot "sprain" who does not rapidly improve should be evaluated by a PROS Orthopedics Surgeon.

Treatment:
This condition almost always requires surgery, utilizing pins or screws to repair the dislocated joint or broken bones. Rarely, the injury may be treated with a cast. It is important that these injuries are diagnosed early so that proper treatment may be applied immediately this injury. Even when treated properly, this type of injury frequently leads to pain and stiffness in the foot.

Casting:
If the bones have not been forced out of position, a cast may be applied.

Surgery:
Surgery may be needed to stabilize the bones. You will need a cast after surgery.

For More Information go to www.aaos.org and www.webmd.org.

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Morton's Neuroma

Cause:
A neuroma is a painful swelling of the nerve caused by pressure or irritation on the nerves.

Symptoms:
The symptoms a Morton's Neuroma include the feeling that you are walking on a small ball, burning pain in the ball of the foot that may radiate into the toes, and numbness or unpleasant feelings in the toes. You will usually feel more pain during activity or while wearing shoes.

Treatment:
Treatment is conservative in its early stages.

Shoe modifications:
Shoes should be roomy and soft-soled; narrow, high-heeled shoes should not be worn. Inserts may be recommended to lift and separate the bones so the nerve doesn't have as much pressure.

Injection:
Injecting a corticosteroid medication into the area may decrease swelling and inflammation.

Medication:
Your physician may recommend over-the-counter or prescription medications to reduce inflammation.

Surgery:
If the above treatments are not helpful, your Powder River Orthopedics & Spine - A Campbell County Clinic physician may recommend surgery to resect a portion of the nerve or stretch tissue around the nerve.

For More Information go to www.aaos.org and www.webmd.org.

Plantar Fasciitis

Cause:
Plantar fasciitis is caused by an inflammation of the tough tissue that connects the heel bone to the base of your toes.

Symptoms:
The main symptom of plantar fasciitis is severe heel pain when you get out of bed in the morning, but improves with walking.

Treatment:
Soft shoe inserts (orthodics), stretching of plantar facsia may be prescribed. If this is not effective, your Orthopedist may prescribe splints to be worn while sleeping. Treatment of plantar fasciitis is conservative.

Rest:
Try to avoid placing weight on your foot as much as possible.

Medication:
Over the counter pain relief medications may be recommended.

Home exercises:
You may be referred to a physical therapist to begin a home exercise program.

For More Information go to www.aaos.org and www.webmd.org.

Posterior Tibial Tendon Dysfunction

Symptoms:
Symptoms of posterior tibial tendon dysfunction include pain and swelling inside the ankle, developing a flatfoot, pain on the outer side of the ankle or foot, weakness and inability to stand on toes, and tenderness over the midfoot, especially during activity.

Treatment:
treatment: may include anti-inflammatory medications, splinting, or use of crutches or walker to avoid bearing weight.

Once symptoms have subsided, shoe modifications or inserts may be prescribed. Treatment depends on the stage of the disorder when you seek treatment.

Rest is necessary for 6-8 weeks. You may have a cast or boot to prevent overuse.

Medication:
Your physician may recommend medication of decrease inflammation.

Shoe modifications:
After the cast is removed, heel wedges and arch supports may be helpful. You may also require custom-made inserts for better support.

Surgery:
Surgery may be recommended by your Powder River Orthopedics & Spine - A Campbell County Clinic physician if these treatment methods are not effective. Persistent pain or deformity may require surgery to release pressure in the tendon to repair the tendon or to correct a deformity in the foot.

For More Information go to www.aaos.org and www.webmd.org.

Sesamoiditis

Cause:
Sesamoiditis is caused by inflamed and irritated sesamoids in the foot. The sesamoids are bones in the foot which are not connected to any other bones, but to the tendons instead.

Symptoms:
Symptoms of sesamoiditis are gradual development of pain under the great toe on the ball of the foot, possible swelling and bruising, and possible difficulty in bending and straightening the big toe.

Treatment:
Treatment is usually very conservative.

Rest and stop activity that causes pain. Using a cushioning pad may relieve pain.

Ice the sole of your foot.

Shoe modifications:
Make sure shoes are comfortable with low heels. When you return to activity, it may be helpful to have cushioning underneath the balls of your feet.

Tape the large toe so it is bent slightly downward.

Medication:
Your physician may recommend medication to relieve the pain.

Corticosteroid injection:
An injection may reduce swelling.

Brace:
If symptoms do not improve, a removable brace may be worn for a period of time.

For More Information go to www.aaos.org and www.webmd.org.

Sprained Ankle

Cause:
A sprained ankle is caused by the stretching and tearing of ligaments when they are forced to go beyond their normal limits.

Symptoms:
Symptoms of a sprained ankle pain, tenderness, swelling and instability.

Treatment:
The RICE method can be used to treat initial sprains. The RICE method stands for Rest, Ice, Compression and Elevation of the affected area. Treatment of a sprained ankle varies depending on the grade of sprain. Any concerns should be evaluated by your PROS Orthopedics Surgeon.

Rest the ankle. You may need crutches so you do not walk on it.

Ice immediately. Continue this for 20-30 minutes daily until the swelling subsides.

Compress the sprain with dressings, bandages, or ace-wraps.

Elevate the ankle above the heart as much as possible for 48 hours.

Splinting:
A splint may be applied to prevent movement of the ankle.

Cast or brace:
For the most serious sprains, a cast or brace may be applied.

Rehabilitation:
It is important to follow a sprain with an exercise program to strengthen the ankle. This will help prevent sprains from recurring.

For More Information go to www.aaos.org and www.webmd.org.

Stiff Big Toe (Hallux Rigidus)

Cause:
Stiff big toe is caused by arthritis in the first joint of the big toe, causing a bone spur to develop which blocks the upward motions of the big toe.

Symptoms:
Symptoms of stiff big toe are pain in the joint when you are active, swelling around the joint, a bump on the top of the foot, and stiffness in the big toe that makes it difficult to bend the toe upward.

Treatment:

Medication:
Your physician may recommend pain relief and anti-inflammatory medications to bring down the swelling and relieve pain.

Ice packs and alternating cold and hot water baths will bring down the inflammation. You'll need two buckets - one with ice and the other with hot water. Immerse your foot in the cold water bucket for 30 seconds; after that, immediately immerse your foot in the hot water bucket. Continue to do this for five minutes. You can do this up to five minutes each day.

Surgery:
If conservative treatment is not effective, your PROS Orthopedics Surgeon may advise a small outpatient procedure to remove the bone spur blocking the upward motions of the big toe.

For More Information go to www.aaos.org and www.webmd.org.

Stress Fractures of the Foot and Ankle

Cause:
Stress fractures are caused by overuse. They are tiny cracks that form in the bone which develop with repeated impact. The muscle transfers stress to the bone, and a fracture occurs. Poorly fitting shoes and a change of surface such as grass tennis courts to clay can contribute to fractures.

Symptoms:
Symptoms of stress fractures include pain that develops gradually that is worse when bearing weight and decreases at rest, swelling on the top or side of the foot or ankle, tenderness, and possible bruising.

Treatment:
Treatment varies depending on the location of the stress fracture, but may initially consist of bracing and restricting weight bearing on the foot or ankle. Occasionally, long periods of casting may be indicated.

Reduce activity level.

Shoe modifications:
Protective footwear may be recommended for 2-4 weeks.

Casting:
A cast may be necessary if the fracture is on the outside of the foot, in the navicular or talux bone.

Surgery:
Certain stress fractures which do not heal with casting may require surgery. A screw or pin may be used to hold the bone fragments in place. Sometimes a bone graft can be made to place in the stress fracture to speed healing.

For More Information go to www.aaos.org and www.webmd.org.

Talus Fracture

Cause:
A talus fracture is caused by a trauma such as a motor vehicle accident, fall from heights, and snowboarding. This type of injury should be immediately evaluated by a medical Orthopedic Surgeon.

Symptoms:
Symptoms of a talus fracture are acute pain just above the heel, inability to bear weight, and swelling and tenderness. The talus is a small bone between the heel bone and the two bones of the lower leg.

Treatment:
Your PROS Orthopedics Surgeon will determine the correct course of treatment. These are frequently serious injuries. While a cast may be used to treat, many talus fractures require surgery to re-align the bones. Screws, and or plates may be used to hold the ones in correct alignment for healing.

A more serious type of talus fracture sometimes causes a portion of the talus to die, due to lack of blood supply. This can lead to serious pain and dysfunction in the foot and ankle, requiring further surgeries and in severe cases, amputation.

Orthopedics surgeons are medical Orthopedic Surgeon who specialize in treating disorders and injuries of the bones, joints and spine. Treatment is important to prevent development of arthritis and chronic pain.

Splint:
A splint is applied immediately to the talar area.

Elevate the foot above the level of the heart.

Ice the area for 20 minutes of every hour.

Avoid placing weight on the foot.

Surgery:
Surgery is often needed to realign bones. Casting for 6-8 weeks is necessary for proper healing.

Rehabilitation:
After surgery, exercises to restore strength and flexibility are important.

For More Information go to www.aaos.org and www.webmd.org.

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