Jeffrey Conforti, D.P.M.
2 Sears Dr., Suite 201
Paramus, NJ 07652

201-986-1900

 

Arthritic Foot Care

In our lifetimes we walk 75,000 miles, putting a great deal of stress on the 26 bones and 30 joints in our feet. As we age, our feet lose flexibility and elasticity. Our shock absorbers weaken, and if you add arthritis to that combination, joints become inflamed and distorted. Arthritic foot care becomes imperative at this point.

Start taking better care of your feet by buying better fitting shoes. Hammertoes, neuroma, and bunions form when our shoes fit poorly. Buy shoes with a lower heel and with more room in the shoe. Rheumatoid arthritis will cause you to lose your arch. Buying shoes with arch support will help, as will buying shoes that contour to your foot.

Leave a fingers width between your foot and the shoe. If your finger cannot fit inside your shoe when it is on your foot, it is too tight. Buy rubber soled shoes. The cushioning of the rubber absorbs shock and the flexibility of the rubber helps the ball of the foot, where you push off from as you walk. Look for square or rounded toed shoes giving your toes lots of room to move.

Exercise will also help. Stretching the Achilles tendon, the cord at the back of the heel, will prevent further pain and injury. This will also increase your foots mobility. Lack of mobility will cause significant stress and pain. Massages will also alleviate some pain. Knead the ball of your foot and your toes from top to bottom.

To stretch your Achilles tendon, lean against a wall, with palms flat on the wall. Place one foot forward and one foot back with the heel flat on the floor, then lean forward. Feel the pull in the Achilles tendon and calf. Hold for five seconds and repeat three times. The big toe stretch is another exercise that may alleviate stiffness. Place one thick rubber band around your big toes. Pull the toes toward the other toes on the foot. Hold for five seconds and repeat ten times. Another exercise to try is the toe pull. Place a thick rubber band around the toes of each foot. Spread your toes for five seconds and repeat ten times.

Pain can be alleviated with non-steroid, anti-inflammatory drugs, heat, and ultrasounds. Topical medications with Capsaicin may also help. Thus far, there is no remedy for pain that is one hundred percent effective. Buying shoes that give your feet plenty room with low rubber heels and soles will help. If needed, use heat and anti-inflammatory drugs, and exercise your tendons and toes. Lastly, arthritic foot care should incorporate massages to help your feet with circulation and to relieve the stress locked up in your feet.

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age.

Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever's disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid sports activity which only worsens the problem. Over the counter pain medications targeted at relieving inflammation can be helpful for reducing the amount of heel pain. Combined with rest and pain medication, a child with Sever's disease should wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect just one heel of either foot as well as the heels of both feet. It is important to have a child experiencing heel pain get an examination by a foot doctor who can apply the squeeze test, which compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

Treatment methods should usually continue for at least 2 weeks and as long as 2 months before the heel pain goes completely away and the child can resume normal physical and athletic activities again. A child can continue doing daily stretching exercises for the legs and feet to prevent the heel pain of Sever's disease from returning.

Plantar Fasciitis Treatment

A study conducted by Luca M. Sconfienza, M.D., of the University of Genoa in Italy focused on a relatively new treatment option combines steroid injections and ultrasound waves. This form of treatment was found to be 95% effective in plantar fasciitis patients in the study.

The plantar fascia is a connective tissue that stretches the bottom length of your foot from the heel. The condition of plantar fasciitis is an inflammation of this connective band, known for causing discomfort and pain while standing or walking. Although the condition can be treated, conservative methods may take up to a year before they become effective.

Conventional treatments include certain exercises, night splints, arch support, staying off your feet and overall rest. Previously the cure for plantar fasciitis was shockwave therapy, which directs sound waves to the area where pain is being experienced. Despite the treatment’s success it is considered painful and requires several sessions before any notable results occur. It is also fairly expensive and does not cure the pain for every plantar fasciitis patient.

Dr. Sconfienza examined the effects of a new technique that combined ultrasound-based methods similar to shockwave therapy, applying a steroid injection directly to the plantar fascia. This form of treatment is a one-time outpatient procedure that involves a small dose of local anesthesia. A needle punctures the affected area and causes a nominal amount of bleeding that assists the fascia in healing. This technique is known as dry-needling.

Dr. Sconfienza found that 42 of the 44 patients that were involved in the new procedure had their symptoms disappear completely within a three week timespan, including pain. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza said. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”

Morton's Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.  Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.

If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

Foot & Ankle Medical & Surgical Care
                                                 
Paramus, NJ Location
2 Sears Drive
Paramus, NJ 07652
201-986-1900
 
 
Affiliated With
Hackensack University Medical Center
The Valley Hospital
Board Certified, American Board of Foot & Ankle Surgery
Board Certified, American Board of Podiatric Orthopedics
 

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