Bunions: Overview – InformedHealth.org – NCBI Bookshelf

Introduction

Our feet often change as we get older. Sometimes the big toe starts leaning in towards the other toes, and a bump may start appearing on the joint at the base of the big toe.

Known as a bunion (medical term: hallux valgus), this is more likely to happen in women. It is one of the most common foot deformities. Many people have a bunion with only mild symptoms, or no symptoms at all. But bunions can also cause pain and pressure.

Wearing suitable shoes can relieve the symptoms. Surgery is the only treatment that can get rid of bunions.

Symptoms

In people who have a bunion, the first metatarsal bone gradually moves sideways towards the other foot. As a result, the front of the foot becomes wider and the joint at the base of the big toe bulges out. The big toe leans in towards the other toes, sometimes deforming them too. Bunions can be painful, but not all of them are – even if they are very big.

The pain is usually felt in the toes, on the bulging big toe joint or along the bottom of the foot. The big toe joint mainly hurts when you wear shoes that are too tight. If the bulge is very big, it might even hurt when wearing wide shoes. Bunions can sometimes damage nerves in the big toe, leading to numbness. The skin on the sole of the foot often becomes thick and hard. The big toe joint may be red and swollen, and sometimes inflamed too. It also becomes harder to move the big toe. Hammer toes or claw toes might develop as well. If that happens, the other toes are bent in the middle or push against each other. Corns often form on the affected toes.

Bunions can increase the likelihood of osteoarthritis in the big toe joint and lead to chronic pain. Last, but not least, the resulting deformity can make you unsteady on your feet, increasing the risk of falls.

Causes

Several factors influence the risk of developing a bunion. Some people are more likely to have bunions because of their genes. Contrary to popular belief, tight shoes aren’t the main cause. But they can contribute to the development of bunions and make the problem worse – especially shoes with high heels and pointed toes. Some people regularly wear tight shoes and never get bunions. And some people nearly always wear comfortable shoes that are wide enough, but develop a bunion anyway.

The risk of bunions is greater in people who have weak connective tissue, a short Achilles’ tendon, short calf muscles, or a joint disease such as rheumatoid arthritis. But they can also develop as a result of having a splayfoot or flatfoot.

Prevalence

Bunions are far more common in women than in men – probably because they tend to have weaker connective tissue in their feet and are more likely to wear tight, high-heeled shoes. It is estimated that about 1 out of 3 people over the age of 65 have a bunion to some degree.

Diagnosis

To determine whether foot problems are being caused by a bunion, the doctor will check whether the joint at the base of the big toe is bulging, look at the position of the toes in relation to each other, and see how well they can move. He or she will also look at the position of the legs. The examination is done while the patient is standing, walking and sitting. The doctor also looks at the state of the skin on the foot, checks for signs of osteoarthritis, and asks about the symptoms and how – if at all – they affect everyday life activities. To get a clearer diagnosis, the foot is x-rayed in a standing position.

Bunions can vary a lot in severity. The severity is determined based on the angle between the big toe and the foot bone leading up to it (the first metatarsal bone).

The difference between a “normal” big toe joint and a bunion isn’t always clear. Many people have mild bunions that never cause any problems.

Prevention

To prevent bunions, people are advised to wear comfortable, flat shoes. If there’s enough room for the front of the foot, there’s less pressure on the toes and the ball of the foot. Other advice includes walking barefoot in order to strengthen the foot muscles and allow the feet and toes to be in their natural position. Some doctors recommend using orthopedic shoe inserts (insoles). But there’s not a lot of research on how well this can prevent bunions.

Treatment

Bunions can get worse over time. Treatment is only needed if they cause problems. The most suitable treatment will depend on a number of factors, including the symptoms, the type of deformity, and whether the person has other medical conditions such as rheumatoid arthritis, diabetes or vascular (blood vessel) disease.

There are various conservative (non-surgical) treatments that aim to relieve the symptoms of bunions: Only a few good-quality studies have looked into how well they work, though.

• Splints: These toe-spacers or toe-supports are used to keep the big toe in a normal position. The aim is to relieve the symptoms and slow down the progression of the bunion – although it’s not clear whether this is possible. They can’t correct the misalignment. Splints are typically used at night.

• Well-fitting shoes: People are advised to wear flat shoes that give the toes enough room. If the toes or big toe joint hurt, bunion pads can be used. If the middle part of the foot hurts (metatarsalgia), the toes can be cushioned or supported using shoe inserts or wearing special “rocker bottom shoes.” Walking barefoot as much as possible is also recommended.

• Physiotherapy: Special exercises can be done to try to strengthen and stretch the foot muscles.

• Painkillers: These may include non-steroidal anti-inflammatory drugs (NSAIDs) in the form of tablets or an ointment. Due to potential side effects, tablets should only be used over a short period of time.

The few studies on conservative treatments suggest that measures such as wearing well-fitting shoes and using splints can only provide very little relief.

If the symptoms are severe and don’t get better, surgery can relieve them. Surgery is the only way to treat the cause of the symptoms, by correcting the misalignment. But there’s no guarantee that surgery will make the symptoms go away completely, and it can have side effects.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.

Sources

• Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC). Hallux valgus. AWMF-Registernr.: 033-018. April 2014.

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Bunions: Causes, Symptoms & Treatment

Overview

What is a bunion?

A bunion is a bump that forms on the outside of the big toe. This foot deformity occurs from years of pressure on the big toe joint (the metatarsophalangeal, or MTP, joint). Eventually, the toe joint gets out of alignment, and a bony bump forms. The medical term for bunions is hallux abducto valgus.

Who might get a bunion?

Up to one in three Americans have bunions. The foot problem is more common in older adults, especially women. Bunions can form on one or both feet.

What are the types of bunions?

Bunions on the big toe are the most common. Other types include:

• Congenital hallux valgus: Some babies are born with bunions.
• Juvenile or adolescent hallux valgus: Tweens and teens between the ages of 10 and 15 may develop bunions.
• Tailor’s bunion: Also called a bunionette, this bunion forms on the outside base of the little (pinky) toe.

What causes bunions?

Pressure from the way you walk (foot mechanics) or the shape of your foot (foot structure) causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem.

What are the risk factors for bunions?

You may be more likely to get a bunion if you have:

• Family history of bunions due to inherited foot structure problems, like flatfeet.
• Foot injuries.
• Inflammatory diseases, such as rheumatoid arthritis.

What are the signs of bunions?

A bunion resembles a turnip — red and swollen. In fact, some sources say the word bunion comes from the Greek word for turnip. Other symptoms include:

• Inability to bend the big toe, or pain and burning when you try to bend it.
• Difficulty wearing regular shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in the big toe.

Symptoms and Causes

What causes bunions?

Pressure from the way you walk (foot mechanics) or the shape of your foot (foot structure) causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem.

What are the risk factors for bunions?

You may be more likely to get a bunion if you have:

• Family history of bunions due to inherited foot structure problems, like flatfeet.
• Foot injuries.
• Inflammatory diseases, such as rheumatoid arthritis.

What are the signs of bunions?

A bunion resembles a turnip — red and swollen. In fact, some sources say the word bunion comes from the Greek word for turnip. Other symptoms include:

• Inability to bend the big toe, or pain and burning when you try to bend it.
• Difficulty wearing regular shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in the big toe.

Diagnosis and Tests

How are bunions diagnosed?

Your healthcare provider can diagnose a bunion by looking at it. You may also get X-rays to check for joint damage and bone alignment.

Management and Treatment

How are bunions managed or treated?

Bunions don’t go away. Treatment often focuses on relieving symptoms and may include:

• Bunion pads and taping: Over-the-counter bunion pads can cushion the area and ease pain. You can also use medical tape to keep the foot in the correct position.
• Footwear changes: Switching to shoes with wide, deep toe boxes can take pressure off of your toes. You may be able to use a stretching device to widen shoes you already own.
• Orthotic devices: Over-the-counter or custom-made shoe inserts (orthotics) can help to control alignment issues such as pronation that may be contributing to bunion formation. You can also place a spacer between the big toe and second digit. Some people find relief by wearing a splint at night to keep the big toe straight.
• Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) both oral and topical can be combined with ice packs help with pain and swelling.
• Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft-tissue adhesions to reduce pain and inflammation. There are actually exercises that can help improve muscle strength around the bunion and can modestly improve alignment.
• Injections: Steroid injections may reduce pain and swelling but may also be damaging if used too often or injected into the joint itself. This is often a late treatment of bunions when trying to avoid surgery.
• Surgery: If nonsurgical treatments don’t help, and walking becomes extremely painful, your provider may recommend surgery. This procedure is called a bunionectomy. Your provider removes the bunion and realigns bones to bring the big toe back into the correct position.

Prevention

How can I prevent a bunion?

Proper-fitting footwear is key to preventing bunions or keeping an existing bunion from getting worse. Your healthcare provider can offer tips on how to select appropriate shoes. In general, you should buy shoes with a wide toe box and soft soles. Avoid shoes that are narrow and pointed at the tip, and high heels that put pressure on the front of the foot. If you have flatfeet or another inherited structural foot problem, custom-fitted orthotics can help prevent, or slow the progression of, bunions.

Outlook / Prognosis

What are the complications of bunions?

Having a bunion may increase your risk of:

What is the prognosis (outlook) for people with bunions?

Without the right care, like changing your footwear or using orthotics, bunions can get worse over time. If you have severe pain when you walk or stand, you may become sedentary (inactive), which isn’t good for your health or quality of life. Most people get symptom relief with over-the-counter aids or through treatments at a medical office. If needed, surgery can help.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Difficulty walking.
• Lack of movement in the big toe.
• Severe inflammation or redness in toe joints.
• Signs of infection after surgery, such as fever.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Why did I get a bunion?
• What are the best treatments for bunions?
• What can I do to lower the risk of getting a bunion on my other foot?
• How can I lower the risk of other foot problems like calluses and corns?
• What complications can occur if I do not treat my bunion?

A note from Cleveland Clinic

Bunions are very common. While over-the-counter bunion pads and pain relievers ease symptoms, you should see a healthcare provider. Your provider can recommend other treatment options, such as shoe gear modifications, physical therapy, medications and orthotics. Treatments can reduce pain and stop bunion symptoms from getting worse. If the pain becomes severe, surgery to remove the bunion and realign the big toe can help you get moving again.

Bunions: Causes, Symptoms & Treatment

Overview

What is a bunion?

A bunion is a bump that forms on the outside of the big toe. This foot deformity occurs from years of pressure on the big toe joint (the metatarsophalangeal, or MTP, joint). Eventually, the toe joint gets out of alignment, and a bony bump forms. The medical term for bunions is hallux abducto valgus.

Who might get a bunion?

Up to one in three Americans have bunions. The foot problem is more common in older adults, especially women. Bunions can form on one or both feet.

What are the types of bunions?

Bunions on the big toe are the most common. Other types include:

• Congenital hallux valgus: Some babies are born with bunions.
• Juvenile or adolescent hallux valgus: Tweens and teens between the ages of 10 and 15 may develop bunions.
• Tailor’s bunion: Also called a bunionette, this bunion forms on the outside base of the little (pinky) toe.

What causes bunions?

Pressure from the way you walk (foot mechanics) or the shape of your foot (foot structure) causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem.

What are the risk factors for bunions?

You may be more likely to get a bunion if you have:

• Family history of bunions due to inherited foot structure problems, like flatfeet.
• Foot injuries.
• Inflammatory diseases, such as rheumatoid arthritis.

What are the signs of bunions?

A bunion resembles a turnip — red and swollen. In fact, some sources say the word bunion comes from the Greek word for turnip. Other symptoms include:

• Inability to bend the big toe, or pain and burning when you try to bend it.
• Difficulty wearing regular shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in the big toe.

Symptoms and Causes

What causes bunions?

Pressure from the way you walk (foot mechanics) or the shape of your foot (foot structure) causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem.

What are the risk factors for bunions?

You may be more likely to get a bunion if you have:

• Family history of bunions due to inherited foot structure problems, like flatfeet.
• Foot injuries.
• Inflammatory diseases, such as rheumatoid arthritis.

What are the signs of bunions?

A bunion resembles a turnip — red and swollen. In fact, some sources say the word bunion comes from the Greek word for turnip. Other symptoms include:

• Inability to bend the big toe, or pain and burning when you try to bend it.
• Difficulty wearing regular shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in the big toe.

Diagnosis and Tests

How are bunions diagnosed?

Your healthcare provider can diagnose a bunion by looking at it. You may also get X-rays to check for joint damage and bone alignment.

Management and Treatment

How are bunions managed or treated?

Bunions don’t go away. Treatment often focuses on relieving symptoms and may include:

• Bunion pads and taping: Over-the-counter bunion pads can cushion the area and ease pain. You can also use medical tape to keep the foot in the correct position.
• Footwear changes: Switching to shoes with wide, deep toe boxes can take pressure off of your toes. You may be able to use a stretching device to widen shoes you already own.
• Orthotic devices: Over-the-counter or custom-made shoe inserts (orthotics) can help to control alignment issues such as pronation that may be contributing to bunion formation. You can also place a spacer between the big toe and second digit. Some people find relief by wearing a splint at night to keep the big toe straight.
• Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) both oral and topical can be combined with ice packs help with pain and swelling.
• Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft-tissue adhesions to reduce pain and inflammation. There are actually exercises that can help improve muscle strength around the bunion and can modestly improve alignment.
• Injections: Steroid injections may reduce pain and swelling but may also be damaging if used too often or injected into the joint itself. This is often a late treatment of bunions when trying to avoid surgery.
• Surgery: If nonsurgical treatments don’t help, and walking becomes extremely painful, your provider may recommend surgery. This procedure is called a bunionectomy. Your provider removes the bunion and realigns bones to bring the big toe back into the correct position.

Prevention

How can I prevent a bunion?

Proper-fitting footwear is key to preventing bunions or keeping an existing bunion from getting worse. Your healthcare provider can offer tips on how to select appropriate shoes. In general, you should buy shoes with a wide toe box and soft soles. Avoid shoes that are narrow and pointed at the tip, and high heels that put pressure on the front of the foot. If you have flatfeet or another inherited structural foot problem, custom-fitted orthotics can help prevent, or slow the progression of, bunions.

Outlook / Prognosis

What are the complications of bunions?

Having a bunion may increase your risk of:

What is the prognosis (outlook) for people with bunions?

Without the right care, like changing your footwear or using orthotics, bunions can get worse over time. If you have severe pain when you walk or stand, you may become sedentary (inactive), which isn’t good for your health or quality of life. Most people get symptom relief with over-the-counter aids or through treatments at a medical office. If needed, surgery can help.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Difficulty walking.
• Lack of movement in the big toe.
• Severe inflammation or redness in toe joints.
• Signs of infection after surgery, such as fever.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Why did I get a bunion?
• What are the best treatments for bunions?
• What can I do to lower the risk of getting a bunion on my other foot?
• How can I lower the risk of other foot problems like calluses and corns?
• What complications can occur if I do not treat my bunion?

A note from Cleveland Clinic

Bunions are very common. While over-the-counter bunion pads and pain relievers ease symptoms, you should see a healthcare provider. Your provider can recommend other treatment options, such as shoe gear modifications, physical therapy, medications and orthotics. Treatments can reduce pain and stop bunion symptoms from getting worse. If the pain becomes severe, surgery to remove the bunion and realign the big toe can help you get moving again.

Why Are My Toes Numb? 11 Causes of Numb Toes & Feet

Numbness in your toes is one of those nagging ailments that’s hard to pin down. It could be something serious — a byproduct of diabetes, for example — or it might just be that you’re wearing the wrong shoes.

Most numbness in your toes is harmless. But seek emergency help if:

• You’ve had a recent head injury that is followed by numb toes
• The numbness begins suddenly
• It spreads rapidly
• You have weakness
• It’s hard to think
• Talking is difficult
• You have a severe headache
• You’re dizzy

Here are a few of the things that may cause your toes to go numb:

Diabetes

High sugar and fats in your blood from diabetes can damage nerves, something doctors often call diabetic neuropathy. When it affects your feet and legs (or arms and hands), it’s called peripheral neuropathy. As many as half the people with diabetes have peripheral neuropathy.

If diabetes is causing your toes to go numb, you might see other signs of the disease, including:

Diabetes is serious, and if numbness in the toes and other foot problems related to the disease go unrecognized or untreated, it could lead to major complications, which could include an amputation. Have your doctor check your blood sugar level to see if diabetes might be the cause of the numbness in your toes.

Morton’s Neuroma

A Morton’s neuroma is a thickening of the tissue around a nerve that leads to the toes. The pressure on that nerve can cause pain in the ball of your foot and numbness in your toes. Activity or certain types of shoes can make it worse.

A doctor can diagnose a Morton’s neuroma. The treatments involve a change in footwear (high heels and tight shoes are problems), shoe inserts and, if needed, corticosteroid shots to ease the pain.

Metatarsalgia

Metatarsalgia (named for the metatarsals, the long bones in your foot between your arch and your toes) may begin with pain in the ball of your foot, but it can come with numbness or tingling in your toes.

We don’t know all the causes of metatarsalgia, but they may include the shape of your foot (high arches, bunions, or curled toes can cause it) and simple overwork. Distance runners are at risk of metatarsalgia. Being overweight may also help lead to it.

Metatarsalgia may not need medical attention. A change of shoes, shoe inserts, rest, and ice may help. But if those things don’t do the trick, and the pain and numbness in your toes last more than a few days, it may be time to call your doctor.

Raynaud’s Phenomenon

Cold weather or stress can slow the blood flow to the extremities in some people with Raynaud’s phenomenon. Toes can become numb and even change colors: red, white, or blue.

There are two types; primary and secondary. Primary happens by itself — the cause is unknown — and is generally harmless. But secondary Raynaud’s is linked to diseases that affect your autoimmune system, like rheumatoid arthritis or lupus.

If it’s secondary Raynaud’s, you may have symptoms of a rheumatic disease or arthritis that could include:

• Pain in a joint like the fingers, toes, ankles, or knees
• Redness in a joint
• Warmth in a joint

Your doctor can diagnose Raynaud’s and tell if other diseases could be associated with it. Most treatments for Raynaud’s itself (meaning, not any conditions linked to it) usually don’t include medications, but in severe cases, doctors may prescribe some.

Guillain-Barre Syndrome

An immune system disorder — in which the body’s immune system attacks the nerves — Guillain-Barre syndrome damages the covering around your nerves, which can cause numbness in your toes.

If Guillain-Barre is making your toes numb, you might also have:

• Weakness in your legs that spreads to your upper body
• A hard time making facial movements, or moving your eyes
• Rapid heart rate
• A hard time breathing
• Changes in blood pressure
• Pain that becomes worse at night

Guillain-Barre is a rare disease, but it’s serious. It can spread rapidly. You should get emergency help for:

• Any tingling or numbness in the toes that spreads up the body
• Weakness of any part of your body that’s spreading rapidly
• Trouble breathing while lying down

More Causes

Other medical issues that can cause your toes to go numb include:

Do Bunions Cause Nerve Pain?

If you looked down at your feet, would you be able to tell if you had a bunion? Many people mistakenly believe that a bunion is an abnormal growth at the base of the big toe that causes severe pain, but this isn’t correct.

A bunion (Hallux Valgus) is a deformity of the big toe joint where it connects to the foot. The big toe drifts in towards the other toes, and it’s the displaced joint that creates the visible bump and can damage the nerve.

Bunions can start as a minor issue and progress in severity over time. At first, you may not notice that you have a bunion because you don’t experience any pain, or at best, you occasionally put up with some foot discomfort.

Pain And Bunions

Bunions can range in size dramatically. Some will be small, while others can develop into large bumps that become irritated and painful when wearing shoes. Redness can be caused by rubbing of the shoe or inflammation of the nerve along the side of the big toe. When the nerve is inflamed it can cause that part of the foot to become numb.

When Should You Seek Bunion Treatment?

There isn’t a specific time to seek bunion treatment, regardless of the severity. A lot of people will seek treatment at the first signs of a bunion, while others will only book an appointment once the condition becomes quite painful or unsightly.

A few of the reasons you should seek treatment include:

You are unable to wear specific shoes – The size limits the types of shoes you can wear. Wearing certain types of shoes will rub the skin around the area of the bunion and cause pain and discomfort.

An unsightly bunion – unsightly bunion can be the source of social discomfort, like when you visit the beach or the pool.

The toes have overlapped – A big toe that is out of alignment can push the smaller ones out of alignment. As the condition worsens, a little toe may be pushed over the top of an adjacent toe. While pain and discomfort may be minimal, a deformed foot can make it painful or uncomfortable to wear shoes.

If you suspect you have a developing bunion or want to get back to a normal life without the unsightly lump, visit the Northwest Surgery Center, where trained foot professionals will help you return to a life free of bunions, painful or not.

Is the Side of your Big Toe Numb or Callused? – Foot & Ankle Center

The problem: a callus or numbness on the side of the big toe, leading to pain or a feeling of numbness or tingling.

The cause: a stubborn, inflexible big toe that forces the foot to roll to the inside during walking. This can result in calluses and pinched nerves, causing pain and numbness.

Want a home remedy? Try our 6-step home treatment plan.

Video: How to Treat Big Toe Numbness and Callus Formation

A common big toe problem is a callus and/or numbness on the side of the big toe. This can cause pain on the side of the big toe along with a feeling of numbness and tingling.

Try the 6-step home treatment plan below for three weeks.  If your pain, numbness and callus are not gone, call 206.344.3808 or use our Patient Portal to make an appointment.

What Causes Calluses and Numbness of the Big Toe?

A callus, pain or numbness of the big toe is caused by a jamming of the big toe joint during walking. This is called hallux limitus. When the big toe cannot move fully as you step forward, you are forced to roll off of the side of the toe. This pinches the skin and causes the callus. It can also irritate the nerve in the toe and cause numbness and pain. This condition is called “compressive peripheral neuritis”, which is an inflammation of the nerve in the toe due to excessive compression of the nerve.

Numb big toes and calluses on the big toe are also very common in patients with bunions. In fact, these problems are present in most patients with bunions. This is because patients with bunions are forced to roll over the side of the big toe – this pinches the skin causing the callus and numbness. But you don’t have to have a bunion for these problems to occur.

What is the Most Effective Treatment of Big Toe Calluses and Numbness?

Since a lack of motion of the big toe joint causes the big toe corn or callus, the best way to treat it is to use shoes and orthotics that enhance big toe motion. You want to use stable shoes (available on our shoe list). Custom orthotics can be prescribed specifically to give the big toe joint maximum motion in order to eliminate or reduce callus formation. For very best results and reduction of the callus, this requires a very specific orthotic called a “total contact orthotic”. Several studies have demonstrated that they can improve big toe motion. To be evaluated for orthotics to treat your big toe callus, make an appointment to see us in our Seattle foot and ankle clinic.

It is critical that any orthotic used to treat numbness or callus of the big toe works to enhance motion in the big toe joint. This is the only way to effectively reduce pressure on the medial side of the toe. The video below provides a full explanation of what either a custom or a prefabricated orthotic must do in order to treat this problem. (Note: This video was produced as an educational video for podiatrists and so it may be a bit technical).

What are Home Treatments for Big Toe Callus and Numb Big Toe?

Home treatments for calluses and neuritis of the big toe are focused on improving motion of the big toe joint and getting rid of the pressure on the side of the toe that leads to callus formation and numbness due to pressure on the nerve.

To improve motion of the big toe, you must support the arch and transfer pressure off of the big toe joint (see the video above for details on how this works).

The products below will help you prevent and treat the callus.  These are the products we recommend to our patients and they are also affiliate links so we may receive a small commission at no additional cost to you if your order from the link

Try the following 6-step treatment plan for three weeks.  If your pain, numbness and callus are not gone, call 206.344.3808 or use our Patient Portal to make an appointment or find a podiatrist in your community who specializes in biomechanics and orthotic therapy.

1. Use an Arch Support in Your Shoes

This will act to improve motion of the big toe joint so that you are less likely to roll of over the side of the toe.  OTC arch supports will not work as well as a custom orthotic because they don’t conform as close to your arch (see video), but will help.

For full size shoes the one we have found has the best ability to reduce pressure on the big toe is the FootChair Orthotic with adjustable arch height.  FootChair has excellent arch support so it is very effective at transferring pressure off of the big toe joint  region and improving big toe joint motion. Plus it comes with pads that can increase the arch height if necessary to further improve big toe joint motion.  This reduces the pressure and frictions that leads to numbness and callus formation.

For women’s dress shoes including flats and high heels  we recommend the FootChair Slim Orthotic with adjustable arch height.  de4It also has excellent adjustable arch support but is made to fit in women’s flats and heels.

For soccer cleats and men’s dress shoes we also recommend the FootChair Slim Orthotic.

2. Use Arch Support Flip Flops

Around the house, don’t go barefoot. Use a sandal with an arch support. This will act to decrease pressure on your big toe joint. We recommend the Vionic Flip-flops and Sandals for its superior arch support.

3. Wear a Stable Shoe

This will help prevent your foot from rolling into the big toe. This Vionic Walking Shoes for women and these for men are good examples. This brand is exceptional in the support they provide

4. Grind Away the Callus with an Electric Grinder

Grinding away the callus will decrease the pressure that leads to pain and numbness. The easiest way is to use a electric grinder like the Pedinova. Use it after a bath or shower when the skin is soft.

We have tried many of these grinders and find that many are under-powered and stop turning when a little force is applied. This one is salon grade and will give you the smooth feet you want. 

Instructions for Grinding Callus to Get Smooth Skin:

• First take a bath or shower or soak your feet
• Use the Large Sapphire Cone Bit (Figure 6) included with Beurer Electric Nail Grinder, to grind the thickened skin on the side of the toe or at the big toe joint.

  Figure 6

• Use gentle pressure and grind it thinner until it is normal thickness and smooth or starts to get warm.
• If it gets warm, stop and then do a little more later or the following day.
• Continue grinding a little each day until the callus is gone and the skin is smooth.

5. Buff away the callus

Another option to get rid of the callus on your big toe is a exfoliating tool such as the Ped Egg. This takes longer than the Pedinova grinder, but it is less expensive.

6. Use an Exfoliating Cream

An exfoliating cream will help get rid of the thickened skin that is causing pain and numbness of the big toe. Put this on each night after you use the grinder or Ped Egg on your callus. The cream we most often recommend to our patients is Urea 40% such as this Urea Cream 40.

7. Use a Callus and Blister Prevention Patch on the Insole of Your Shoe. 

These callus and blister prevention patches are made of a material called Polytetrafloroethelene or PTFE. PTFE has an extremely low coefficient of friction so it can dramatically decrease the friction forces that lead to callus formation. In fact, PTFE was developed originally as a suture material for fragile structures like blood vessels and nerves. Because it causes so little friction it doesn’t harm these very thin and fragile structures.

PTFE is also available in a self-stick patch under the brand name Engo. Engo patches can be applied to the insole of the shoe or on top of an orthotic right under the big toe. Applying these patches will help to decrease friction and by doing so will help prevent the formation of calluses and blisters. Engo PTFE patches can also be applied inside the shoe in areas at risk of blistering. Just cut out the shape you need and then peel and stick. The Engo patch should extend about 1/4 inch beyond the edge of the of the callus. You can get Engo PTFE patches here.

 Video: How to Treat Pain in the Big Toe Joint

Symptoms, Diagnosis & Treatment of Bunions

What is a (Hallux Abducto Valgus)

Bunions are a common foot disorder of the inherent bone structure at the front of the foot. Bunions are not a deformity passed on from previous generations, but certain types of feet are more prone to developing bunions. Bunions are described as a disorder in which the deviation of the normal alignment of the upper foot begins as the big toe, or Hallux, bends inward toward the smaller toes over a period of time, causing the bone of the big toe joint to protrude towards the inner foot. The misalignment of the big toe can also cause other toes to overlap. The result of this deformity can cause extreme pain and swelling at the protrusion or “bump” and make walking difficult. Bunions do not always become inflamed or painful and it is possible to have the disorder without ever having to seek treatment. However, because bunions transform the foot gradually, symptoms usually appear in adults during the later stages of the disorder.

Symptoms of a Bunion

Bunions can be exacerbated by wearing shoes that restrict or crowd the toes. The site of the bump can become exceptionally painful and inflamed. Other symptoms of developed bunions can appear as a burning sensation, numbness of the toes and in some cases, shooting pains in the foot.

Diagnosis of Bunions

Because bunions change the alignment of the Hallux (big toe), the bones in the upper foot eventually form a bump at the base of the big toe, or side of the foot, which can be seen with the naked eye. The podiatric foot and ankle surgeon may take x-rays to ascertain the severity of the bunion formation and to detect other causes for the pain, such as arthritis.

Treatment for Bunions

Treatment plans vary, depending on the size, type, and extent the bunion has impaired the patient’s foot. However, the pain caused by the condition is typically the focus of treatment for bunions. Bunion disorders do not always develop to a degree that requires anything more than professional observation on a regular basis. In less severe cases, the pain caused by bunions can be alleviated by changing the type of shoe worn by the patient. Your foot and ankle surgeon might prescribe limited activity, medications that reduce swelling and pain, and in some situations, the use of custom orthotic devices.

When is Surgery for Bunions Necessary?

Your podiatric surgeon will discuss surgical options with the patient if other recommended treatments have not alleviated the pain and continue to prevent routine activities prevented by bunions.

Recent advances in surgical techniques have led to a very high success rate in treating bunions.

Surgical procedures for bunions can involve removal of the protrusion of the bone on the foot, restructuring of the bones to correct the impairment of the foot, and include the reconstruction of soft tissue alterations which may have been caused by the bunion. Surgical corrections for bunions are aimed at eliminating the pain caused by the disorder.

The podiatric surgeon will recommend one or more surgical procedures on an individual basis. Considerations for surgery will be decided after evaluation of the patient’s previous treatment for the bunion, the age and over-all health of the patient and the regularity of physical activity, among other deciding factors. After surgery for bunions, the period of recovery will vary for each patient dependent upon the performed procedure(s).

90,000 Hand numbness: causes, diagnosis and treatment

Numbness of hands has been experienced by almost everyone. This often happens during sleep or when sitting for a long time in an uncomfortable position. In this case, a person may feel a tingling sensation, slight pain, a feeling of coldness. This numbness goes away quickly and does not pose any danger. But if the loss of sensitivity occurs often, for a long time and for no apparent reason, then this may indicate any disturbances in the body.In this case, it is necessary to consult a specialist who will help establish the cause and prescribe treatment.

Cause hand numbness

Swelling of the hands or numbness occurs as a result of compression of the nerve roots or blood vessels. Most often, this condition manifests itself in the forearm, elbow, hand or fingers. The reasons for the numbness of the hands can be divided into two types – these are physiological factors and factors associated with specific diseases.

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Physiological factors include:

• Prolonged uncomfortable posture while sleeping or sitting.
• wearing tight clothes or watches, bracelets, rings.
• hypothermia
• bad habits (smoking, alcohol)
• overweight

Diseases causing hand numbness:

• Diseases and pathologies of the spine (osteochondrosis, spondylosis, spinal hernia, bone growths)
• tunnel syndrome.It affects office workers, drivers, musicians, jewelers, builders, cashiers.
• vegetative vascular dystonia
• multiple sclerosis
• endocrine system diseases (diabetes mellitus)
• atherosclerosis
• Raynaud’s disease
• diseases of the cardiovascular system (stroke, hypertension, coronary heart disease)
• tumors

Diagnostics and treatment

In order for the numbness of the hands caused by physiological factors to go away, it is enough to change the position, take off uncomfortable clothes or jewelry, get rid of bad habits.If necessary, you can do a light hand massage or gymnastics. But in advanced cases (alcoholism, obesity), the help of a specialist may be needed.

If the numbness is caused by any disease, then only a doctor can determine the cause. And for this you need to undergo a medical examination. The patient may be assigned the following examinations: general and biochemical blood test, blood sugar test, general urine test, ECG, x-ray of the spine or brain, computed tomography, MRI, ultrasound.And based on the diagnosis, the attending physician will prescribe treatment.

Treatment methods

1 procedure for the course FREE OF CHARGE!

Incorporation of organic serum with hyaluronic acid into the joint capsule. As a result, the cartilage is reconstructed.More …

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Neuroprotective drugs of a new generation, which are able to restore the conduction of impulses in nerve tissues. Read more…

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Treatment and healing of cartilage with growth factors.Restoration of joint tissues with purified platelet blood. Read more …

Show other methods

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Introduction of titanium glyterosolvate into a diseased joint is a unique method of drug delivery without surgery and painful injections. Read more…

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This is an innovative way of administering drugs using ultrasound, which has the unique ability to loosen tissues.Read more…

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This is a promising method of physiotherapy with a great future. In life, waves of this range do not reach the earth, being sprayed into the atmosphere. The device generates these waves itself. Read more…

Combinations of drugs for drip administration through a vein. High digestibility and rapid achievement of a therapeutic effect set the infusion therapy Read more …

1 procedure for the course FREE OF CHARGE!

A joint or spine block is a quick way to help a joint or back.In case of acute pain, the blockade helps to quickly relieve pain syndrome and help locally More …

“HONDRO” in Latin means “cartilage” and that says it all. Introduction of cartilage cells into damaged segments of the spine More …

Treatment with the patient’s autologous blood cells. The introduction of blood is carried out intramuscularly, which provokes the body to intensify the fight against chronic infection, suppuration and trophic ulcers, the immunity is enhanced and effectively resists new infections.Read more…

Infrared treatment with a wavelength of 0.8-0.9 microns affects the internal focus of the problem. This relieves inflammation, swelling and pain in the joint. Degenerative processes in the joint attenuate as metabolic processes inside the joint are accelerated many times. Read more …

Nutrition and growth of cartilage cells by applying peloid dressings. The base comes from Lake Sivash, where mud is mined with a high concentration of Dunaliela Salina microalgae, which is rich in beta-carotene.

Types of hand numbness

• Left hand goes numb. This can often be associated with heart disease. Especially if the little finger or ring finger becomes numb.
• The right hand goes numb. This can occur against the background of narrowing of blood vessels, osteochondrosis of the cervical or thoracic region, disorders of the nervous system.
• Hands go numb. Leakage can occur due to endocrine disruption, tunnel syndrome, median nerve entrapment, inflammation and joint injury.Numbness can be accompanied by burning and pain in the fingers.
• Numbness in fingers. Numbness can occur due to an uncomfortable posture or monotonous work, against the background of osteochondrosis, tunnel syndrome, poor posture, blood circulation, arthrosis.

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Age 64 years Diagnosis Arthrosis of the 2nd stage. Treatment result The patient is satisfied

Sergey Igorevich “I was treated in a polyclinic … did not give much effect! After the first procedure of plasmacythophoresis, I feel filling in the joint, mobility has improved! ”

Age 70 years Diagnosis Osteoarthritis Treatment result The patient is satisfied

Galina Fedorovna “During the procedure of plasmacytophoresis, I felt a slight bursting, and then everything became fine! The clinic helped me! ”

Age 70 years Diagnosis Osteochondrosis Treatment result The patient is satisfied

Lyudmila Emelyanovna “At our age, the main thing is to maintain clarity of mind and the ability to move.I have already advised the clinic to my friends! ”

Age 72 years Diagnosis Osteochondrosis, arthrosis Treatment result The patient is satisfied

Boris Khazievich “I had pain in the lower back and in the hip joint. After the treatment, I began to fall asleep without pain, I sleep normally! ”

Age 77 years Diagnosis Osteoarthritis Treatment result Pains gone

Tamara Grigorievna “My kneecap was very painful, I could not walk.Now my joint is being restored and I can walk without pain! Already after the 2nd procedure, there was an improvement. ”

Age 60 years Diagnosis Osteoporosis, arthrosis Treatment result Pain passed

Hans Harvig “I am from Holland, I could not walk and stand without crutches, neither in Germany nor in Holland they could help me. They helped here. Now there is no pain, I am satisfied. ”

Age 66 years Diagnosis Osteoarthritis Treatment result The patient is satisfied

Vladimir Mikhailovich “There was a high pain sensitivity in the knee joints when standing up and squatting.The clinic did not help me properly. And here everything is on time, calmly and without nerves! ”

Age 65 years Diagnosis Arthritis Treatment outcome Completely satisfied

Elena Antonovna “There was very severe pain in my knee, I could not even walk. And after the first procedure, it helped me a lot. I wanted to run right away, but the doctor did not allow me to run. ”

Age 71 years Diagnosis Trophic ulcer Treatment result Autodermoplasty performed

Lyudmila Viktorovna Lyudmila Viktorovna got rid of an ulcer in a month! And after autodermoplasty there was no trace of an ulcer! Now she has a healthy leg, the ulcer has healed!

Age 64 years Diagnosis Arthrosis grade 3 Treatment result Pain has passed

Valentina Alekseevna After the first injection of a liquid prosthesis into the joint capsule, the knee began to unbend, the amplitude of joint movement increased, and the patient’s quality of life improved.

If you have frequent and prolonged numbness of your hands, you can undergo an examination at our medical center MEDICUS, which operates in three main areas of medicine – neurology, orthopedics and treatment of vascular diseases. Experienced MEDICUS doctors will help you pinpoint the cause of numbness and prescribe an effective treatment. You can make an appointment with a doctor via the Internet by filling out an online form or by calling 986-66-36.

We know how to make our patients’ lives better

• We have ALL Your DISCOUNT CARDS *.
• Refund of personal income tax for medical services – minus 13% of the cost of the procedure.
• FREE OF INTEREST installments for treatment.
• THOUSAND PATIENTS got rid of disabilities and crutches thanks to our help.
• Discounts for pensioners (55+, everything is fair!), Disabled people, blockade soldiers, participants of the Great Patriotic War.
• The latest TECHNOLOGIES , which are not available in polyclinics. DISCOUNTS up to 30%!

* You can use discount cards of all medical centers in St. Petersburg for treatment at the Medicus Medical Center.

Why arms and legs go numb. Reasons and what to do about it?

Are your hands going numb? Most people periodically encounter this phenomenon. Often, the discomfort is temporary and does not cause negative consequences. However, discomfort in the limbs can also be a signal of serious illness. We figure out in which cases you can not worry, and in which you should seek medical help.

The hand goes numb: when is it normal and goes away on its own?

The main cause of numbness in different parts of the body is associated with impaired blood circulation and transmission of nerve impulses.Sometimes this happens due to various diseases (which – read below), but much more often a person accidentally squeezes soft tissues himself, and then wonders why his hands become numb. And here’s why: he slept in an uncomfortable position, put on too tight clothes, forgot to take off his bracelets before going to bed, sat with his legs tucked in. In all these cases, a gentle warm-up is sufficient to normalize blood flow and relieve numbness.

Slight tingling and partial loss of sensation can also be associated with overexertion as a result of lifting weights to a level above the heart or prolonged monotonous work with the hands (typing, knitting, etc.).). After a short rest, the symptom, again, goes away on its own. The same applies if the hand becomes numb due to temperature changes or nervous strain.

Do your arms and legs go numb regularly? It’s time to see a doctor!

Occasional, transient cases of numbness should not be a cause for concern. But if the limbs become numb on a regular basis, pain appears, and there are no obvious external stimuli, it is worth planning a visit to the Daily Medical medical center, where experienced specialists will quickly figure out whether your problem is dangerous or not.

Why do fingers go numb during pregnancy? Many doctors consider numbness of the limbs in pregnant women to be normal or evidence of minor disorders. Often the symptom is associated with a lack of vitamins and minerals. So a doctor’s consultation is necessary, but you should not worry about this, because often it is enough to drink the prescribed course of vitamins to solve the problem.

What diseases can be suspected if the hand becomes numb

Timely diagnosis of numbness-related diseases is very important.The fact is that the upper and lower extremities are the “terminal stations” of the nervous and circulatory system. If fingers and legs go numb, face goes numb, it means that somewhere “the signal is interrupted”, there may be malfunctions in the nervous or circulatory system. There are a number of conditions that can be indicated by numbness in the extremities.

• Compression neuropathies – compression of a nerve with subsequent muscle weakness, spasms and loss of sensation. The most common tunnel syndrome is compression of the median nerve in the wrist.At first, there is a slight discomfort, but later the hands become very numb at night, pain appears that cannot be relieved with painkillers. A characteristic feature is the first, second and third fingers go numb. For cubital nerve syndrome (in the elbow area) and scalene anterior syndrome (on the neck), numbness of the fourth and fifth fingers is characteristic, mainly during the day. And radiculopathy (compression of the spinal roots) can be recognized by the numbness of the thumb and index fingers, which increases with neck movement.

• Peripheral neuropathy is a violation of the transmission of nerve signals throughout the body. Develops against the background of type 2 diabetes, lack of vitamin B12, alcoholism.
• Osteochondrosis of the cervical and thoracic spine is another common ailment associated with numbness of the limbs. It is extremely important not to confuse the symptoms of osteochondrosis, which is characterized by chest pain, with critical conditions. If your heart hurts, feels sick, cold sweat comes out, your left hand hurts and grows numb, call an ambulance immediately!
• Multiple sclerosis is a pathology in which signal transmission from the brain to the body is impaired.Numbness is one of the early signs of illness. In addition, you can suspect multiple sclerosis if you feel dizzy, impaired short-term memory, worried about nausea, spasms, color blindness.

Numbness can also appear as a result of various infections in the body, thrombosis of the extremities, deficiency of vitamins E, P and group B.

Who to contact if the limbs become numb

Only a doctor can determine exactly what makes fingers numb, identify hidden diseases and prescribe effective treatment.First, you will need a consultation with a therapist, and then, depending on the accompanying symptoms, a neurologist, cardiologist or endocrinologist. From examinations can be prescribed ultrasound of the vessels of the hands and / or peripheral nerves, MRI, cardiography, general urine and blood tests, hormone tests, etc.

Based on the history, the doctor decides what to do when the hands go numb and selects therapy, which may include taking vitamin complexes and medications, physiotherapy, massage, therapeutic exercises, injections of anti-inflammatory drugs.In severe cases, surgical intervention will be required.

Prevention of diseases

In order to encounter numbness of the extremities and related diseases as rarely as possible, you need to monitor the state of the nervous and circulatory system and lead a healthy lifestyle. Smoking and alcohol are especially bad for blood supply. But obesity, decreased physical activity, unbalanced diet with a high content of salt and carbohydrates can have no less negative consequences.But a diet rich in vegetables, fruits, herbs and legumes, on the contrary, will be an excellent preventive measure. Also, do not forget to drink enough fluids and try not to be in the same position for a long time.
90,000 Are your toes burning? Treatment at the Stoparthrosis clinic in Moscow

Contents

The main causes of burning in the toes

The problem is more often caused by endocrine and vascular abnormalities. No less dangerous is the violation of innervation when squeezing the sciatic and femoral nerves, damage to the connective and epidermal tissues.A burning sensation at the base of the foot, on the outer lateral sides, in the area of ​​the big toe, causes a clamping of the plantar nerve in the ankle.

The problem is directly related to osteochondrosis in the sacral region with radicular syndrome. Disturbances in the nervous network of the vascular walls reduce the nutrition of soft tissues, cause trophic lesions with a characteristic symptom. Prolonged compression leads to the death of nerve fibers. Burns toes:

• With circulatory disorders.This is due to problems with the arteries, a lack of oxygen in the veins that carry oxygen to the heart. In the first case, burning occurs due to the pathology of peripheral vessels, in the second – due to thrombosis.

• Systemic vasculitis – lesions of muscular arteries, medium and large aortas, as in Wegener’s granulomatosis, thromboangiitis obliterans.

• Morton’s neuroma. The symptom occurs due to the proliferation of fibrous tissue, induration and compression of the plantar digital nerve between the heads of the metatarsal bones.

• Fungal infection. The reproduction of pathogenic microorganisms on the skin is manifested by dryness, flaking, itching and burning.

• Joint pathologies. Arthrosis, synovitis, gout, bursitis, arthritis in addition cause numbness, pain, swelling.

• Plantar fasciitis. In women, it occurs with a curvature of the thumb joint, in men with obvious flat feet and clubfoot.

• Neuropathy. Nerve irritation leads to loss of sensation and a burning sensation in the foot.

Toes burn due to diabetic neuropathy. Metabolic disorders end with tissue edema, incorrect passage of electrical impulses, damage to peripheral nerves, and numbness. A commonplace reason is strong friction when wearing tight shoes. An uncomfortable last puts pressure on the fingers, injures the skin and causes an unpleasant symptom.

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How to treat a burning sensation in the toes

Isolated therapy does not exist, since it is not a pathology, in a clinical manifestation. A strategy is drawn up to eliminate the underlying disease. The patient is examined by specialized specialists and a preliminary diagnosis is made.Then sent for angiography, X-ray, Doppler vascular, electroencephalography. According to the indications, treatment is prescribed.

• The classical scheme includes taking antihistamines that relieve puffiness, itching – allergies, altiv, zilol, rupafin.

• For joint diseases, NSAIDs are prescribed – Nise, Ibuprofen, chondroprotectors – shark cartilage, terafles, chondroxide.

• In case of problems of a vascular nature, statins, venotonics are prescribed, it is recommended to wear compression underwear.

Patients undergo courses of laser therapy, sessions of osteopathy, manul therapy, reflexology. One of the most effective methods of treating the musculoskeletal system is spinal traction. Comprehensive measures allow you to correct the condition in 7-14 days.

Make an appointment with us for treatment by phone +7 495 134 03 41 or leave a request on the website.

90,000 Numbness of fingers, pain in ribs and changes in odors – is it from the nerves or is it more serious? We speak as a neurologist | 161.ru

Root cause of changes

The cause of tremors in the hands can be diseases of the nervous system, such as essential tremor, Parkinson’s disease, multiple sclerosis, cerebellar damage (part of the brain responsible for balance. – Approx. Auth. ) , acquired dementia (dementia), alcoholism, the consequences of tick-borne encephalitis, trauma of the peripheral nerve and some others. Also, this condition can be observed with pathology of the endocrine system (thyrotoxicosis, diabetes mellitus), poisoning with toxic substances, excessive consumption of coffee, lack of vitamin B12, stress, excessive physical exertion.

The degree of manifestation is within the normal range

The norm can be considered if the tremor occurs with excitement (if it does not interfere with a person in his professional and personal life) or after excessive physical exertion.

Propensity to the problem

We must not forget that tremor can manifest itself in people who abuse alcohol. The tendency to essential tremor is inherited.

Decision

Find out the reason, if possible eliminate the provoking factor, take medications prescribed by your doctor.

Where to go?

If you are concerned about this problem, see a neurologist. Sometimes the therapist can cope with the problem, if the reason is not in the pathology of the nervous system.

The root cause of changes

It can be glaucoma and other eye diseases, increased or decreased blood pressure, atherosclerosis of the vessels that feed the retina and neck vessels, cerebrovascular accident (stroke), poisoning with certain medicinal substances, lack of trace elements (for example, iron, vitamin B12 and folic acid in the development of anemia).And also a sharp rise from a lying or sitting position.

The degree of manifestation is within the normal range

If this condition occurs with a sudden change in position and there are no other symptoms that bother the person, it does not require treatment. In other cases, it is necessary to look for and eliminate the cause.

Propensity to the problem

This condition is possible when eye fatigue due to prolonged stay at the computer.

Solution

The most important thing is to organize the workplace correctly, to relax your eyes – during breaks, look out the window, and not at the phone. If it doesn’t help, we run to the doctor.

Where to go?

Oculist, neurologist.

The root cause of changes

This occurs with orthostatic hypotension – redistribution of blood from the head to the lower extremities.

The degree of manifestation is within the normal range

This can be normal and pathological.Norm – if a person sat and jumped up, tall and thin people are especially prone to this state. In diseases of the endocrine system, as well as in the elderly, this is an additional factor in falls and requires treatment. This condition can be caused by drugs.

Propensity to the problem

This problem often occurs in the elderly, as well as tall and thin people (due to the fact that the blood does not have time to quickly redistribute through the vessels).

Decision

The doctor recommends controlling your actions and trying not to get up abruptly. If you still feel dizzy, then take a comfortable position – sit back or lie down and lift your legs at an angle of 45 degrees.

Where to go?

If the problem occurs frequently, then your specialist is a cardiologist, if necessary and if cardiological pathology is excluded, he will refer you to a neurologist.

The root cause of changes

There are two types of headaches – primary and secondary.Primary ones arise in the absence of diseases that can cause headaches – hypertension, tumors in the brain, infectious diseases, heart disease, diabetes mellitus, lung diseases, pathology of the temporomandibular joint and others. Primary headaches include migraine (throbbing one-sided headache), tension headache (muscle spasm when a hoop seems to squeeze the head), cluster headache (shooting pain in the eye area, lacrimation), and some others.

Propensity to the problem

Women suffer from migraines more often, cluster headaches – mainly men, tension headaches occur with physical and mental strain, problems in the cervical spine, after traumatic brain injuries. Certain foods, alcohol, lack of sleep, or, conversely, an excess of sleep, stress, changes in the weather can provoke headaches.

Solution

Consequences of wearing high-heeled shoes: harm to high heels

Millions of women around the world wear high-heeled shoes and simply adore them, they are ready to spend a fortune on a pair of new shoes and with a smile endure the pain that arises when wearing them.But, as in many other fashion frenzy of bygone days, the researchers found many disadvantages in this – they proved that wearing high-heeled shoes, even for a relatively short period of time, can have a serious effect on the body. Scientists argue that the gait of young women who wear heels for more than 40 hours a week (even when they wear low-heeled shoes) is very different from the gait of women who do not wear high-heeled shoes.In the future, this leads to injuries and deformities of the foot.

Effect of footwear with high heels on the feet

High-heeled shoes undoubtedly have a huge impact on the feet. Wearing such shoes has a harmful effect on the feet, which in the future may result in constant pain or even the need for surgical treatment. Over time, high-heeled shoes or shoes with narrow or pointed toes can cause: Bursitis of the thumb

Bursitis of the big toe – bony growths that appear around the base of the big toe, and provoke it to bend towards the other fingers, which can cause pain; Calluses are thickening of an area of ​​skin that usually appears after prolonged rubbing.Calluses can cause pain over time, often with bunion; Hammer toe – This condition occurs when the end of the toe, often the second, bends downward due to tight and uncomfortable shoes, which leads to deformation. This condition can only be corrected with medical devices or surgery; Morton’s neuroma is damage to the nerves in the metatarsal area, which leads to thickening of the tissues, and further to pain and numbness.Often, to relieve symptoms, you have to resort to surgery and remove part of the tissue; Lump: The technical name for this condition is Haglund deformation. It is a bony build-up in the heel that results from constant friction and pressure from the hard heel counter and straps of high-heeled shoes. The only way to cure this condition is through surgery, which removes excess bone tissue; Metatarsalgia is painful inflammation of the head of the metatarsal bones of the foot as a result of constant pressure on the metatarsal bones, which are located between the toes and the instep of the stupa.

Wearing high-heeled shoes increases the risk of ankle injury as it affects balance: the higher the platform or heel, the higher the risk. Small women with short legs and small feet find it much more difficult to walk. When walking in high-heeled shoes, their gait changes greatly, unlike when they wear flat-heeled shoes, because, thanks to the heels, their height increases significantly, and therefore they have to balance, which often leads to the risk of falls , and therefore to deformation, sprains and fractures of the ankle.

Effect of high heel shoes on legs and knees

Wearing high-heeled shoes affects the legs and knees. Of course, high-heeled shoes visually lengthen the legs and improve their shape, but they can also provoke the appearance of some serious problems that cause difficulty when walking, even if you wear flat-heeled shoes. Achilles tendon: wearing high-heeled shoes causes a significant contraction of the Achilles tendon, which after a relatively short period of time can cause serious problems with walking, since this tendon is responsible for cushioning the foot; this function is taken over by the muscles of the lower leg, which can lead to injuries; Calf muscles: As with the Achilles tendon, wearing high-heeled shoes causes the soleus and calf muscles to contract.Over time, this can lead to stiffness in the calf muscles, which will cause pain when wearing high-heeled shoes; Knees: High heels significantly increase the pressure on the knees, especially on the inside of the knees, which is where osteoarthritis most often develops in women. One study found that the pressure on the knee joint increased by 26%, which is significant considering the forces that the knee joint is already exposed to.

Effect of high-heeled shoes on the hips and spine

Wearing high-heeled shoes alters the mechanics of the whole body, as a result of which most of the body must be somehow balanced in order to avoid falling.While you may look good, this state of altered body mechanics can cause deformities in your hips and spine. High heels force the pelvis to protrude forward, increasing the lumbar curve and forcing the buttocks to bulge. This can create significant pressure on the lumbar region, which can lead to future spinal problems. The thighs also suffer, because the calf muscles do not work as efficiently when wearing high-heeled shoes as without them, and therefore some of the load is taken over by the thigh muscles.Over time, this can cause damage to the small muscles around the hip joints, which are responsible for normal gait.

Our recommendations

Below we provide some tips for those who still do not want to give up high-heeled shoes.

How to minimize the potential harm of high heels: Limit wearing high heels to 2-3 times a week. If this is not possible, try to take them off as often as possible, for example, while sitting at a table;

When you are sitting, try to bend and unbend your legs more often, so you will help the calf muscles to stay in good shape;

Give preference to wedges over stiletto heels, because wedges provide the best support for your foot;

It is better to buy shoes at the end of the day, because the feet swell a little during the day, so they increase slightly in size, which will provide you with a more comfortable fit.Naturally, high-heeled shoes make your legs look slim and attractive. However, if worn frequently, it can cause serious problems.

Therefore, we advise you to wear stiletto heels only on holidays; opt for more comfortable shoes that will provide better support for your feet, which will benefit your entire body. When using the material, an active link to www.webmedinfo.ru is required. Share: 4421

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The Customs Union proposes to ban sneakers and high heels

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Following the lace panties of Russian women, they want to deprive ballet flats and stiletto heels.

Popular sneakers, ballet flats and stiletto heels may be outlawed due to the health risks they pose to Russians.Deputy of the lower house of parliament Oleg Mikheev (“Fair Russia”) sent an appeal (available to Izvestia) addressed to the head of the Eurasian Economic Commission, Viktor Khristenko. In his proposal, the parliamentarian proposes to include new medical orthopedic requirements for shoes in the technical regulations of the Customs Union. Among other things, flat-soled shoes – sneakers and ballet flats, as well as high-heeled shoes were the first to fall into disgrace. All these modifications of shoes, although they are in great demand among the population, lead to violations of the structure of the foot.

Oleg Mikheev noted that, according to statistics, about 40% of the adult population suffers from flat feet. In many respects, and because of this, in 2014, the first call-up of young men in the Russian Armed Forces with flat feet took place, since without this disease it is almost impossible to find a conscript, according to the deputy.

– Previously, it was mainly women who suffered from uncomfortable shoes, since the lion’s share of complications are caused by high stiletto heels, the wearing of which leads to the development of transverse flat feet, bursitis, neuromas, deformities and other complications, – said Mikheev.“But now men are also at risk. Fashionable sneakers, loafers, loafers without heels are also dangerous to health. In such shoes, the longitudinal arch of the foot is not supported, the result is flat feet, deformation of the leg muscles, varicose veins of the lower extremities, chronic venous insufficiency.

The current regulation of the Customs Union for footwear determines the parameters of the strength of fasteners of parts, water resistance, chemical composition, but there are no biomechanical and orthopedic requirements in it.

The press service of the Eurasian Economic Commission (EEC) told Izvestia that they are considering any proposal to change the technical regulation and, depending on the validity of the proposals, make their own adjustments.

– There is a certain procedure according to which this will happen. Upon admission to us, the initiative is transferred to an expert council, which consists of specialized specialists. However, the very introduction of amendments to the regulations is not legally enshrined in our legislation, and in the appeal of Deputy Mikheev, we are talking about an amendment to the regulations already adopted, – noted in the EEC.- Therefore, it is impossible to say for sure how long his initiative will be considered, but the fact that due attention will be paid to it, we can say absolutely for sure.

Medical specialists also believe that the lack of clear parameters and restrictions on the production and sale of footwear creates health problems for citizens.

– There is indeed a health hazard from wearing high heels and flat shoes. And this applies not only to women, but also to men and even children. A heel higher than 4.5 cm destroys not only the foot, but also the knee joints, pelvic bones, affecting the female organs, leading to the prolapse of the vaginal walls, prolapse of the uterus, and also affects the joints of the spine and even the brain, – said the orthopedic surgeon Vladimir Khoroshev.- Ultimately, this leads to distraction, loss of attention, later – loss of memory, early disability.

The doctor also noticed that in European countries there is a completely different attitude to the production and wearing of shoes.

– It should be noted that in the USSR they did not particularly follow this either. But in European countries, the popularity of orthopedic insoles and the correct choice of footwear give pensioners the opportunity to walk normally at 80 and sometimes even at 90, while our pensioners, due to inattention to this issue, sometimes barely move their legs at the age of 55-60. – said Khoroshev.

However, Alevtina Project author and shoe designer Alevtina Kamenetskaya believes that nothing depends on the height of the heel.

– When choosing shoes for yourself, it is important to pay attention to the brand of the manufacturer, the quality of the last, to measure it against your own parameters. If the last is made in accordance with the anatomical features of the foot, which is more common among manufacturers of branded shoes and handmade shoes and is almost never the rule in the production of cheap Chinese shoes, then it is safe for health, she said.- I have the largest collection of shoes, including a model one, with heels. However, in my bag I try to wear removable shoes without a heel, which saves me in those cases when I need to rest my feet during the day or save a model on an uneven section of the road.

Some time ago, on the territory of the Customs Union, a ban was introduced on the production, import and sale of lace panties due to the fact that these products did not comply with the technical regulations of the CU. The defender of the lace panties was then the deputy head of the Ministry of Industry and Trade Viktor Yevtukhov, who promised to achieve the abolition of this ban in Russia.

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  Millions of women around the world wear high-heeled shoes and simply adore them, they are ready to spend a fortune on a pair of new shoes and with a smile endure the pain that arises when wearing them. But, as in many other fashionable madness of bygone days, the researchers found many flaws in this – they proved that wearing […]

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Arm pain: main causes, treatment and diagnosis

Everyone has encountered this unpleasant phenomenon. The pain in the hands is sharp and aching, aggravated by exertion or by the action of cold. It can cover the entire limb, or be localized in a limited area.Such a variety of symptoms is explained by many reasons that can cause pain in the arm – the portal medaboutme.ru tells about them.

Pain can be muscle, neurological, or associated with bones, joints and periarticular tissues. The real cause of pain may be hidden in a completely different part of the body. That is why it is unacceptable to self-medicate, simply eliminating the pain syndrome. So you can miss the signs of a serious illness that requires timely treatment.

Any arm pain lasting more than 3 days requires medical attention.

Main causes of arm pain

• Injuries. This can be a bruise, sprain, dislocation or fracture. The pain from a bruise disappears in a few days, with sprains, dislocations and fractures, you should consult a traumatologist. Serious injury is evidenced by constant severe pain, severe swelling, inability to make movements, as well as a change in the shape of the hand and its parts.
• Overvoltage. It can be caused by short-term severe overstrain, or constant stress on the same muscle groups and ligaments. This type includes tunnel syndrome – a disease that affects people who constantly work with a computer mouse when the workplace is not properly organized. Overvoltage can also cause other occupational hand injuries.
• Diseases of the spine. In osteochondrosis, protrusions and hernias of intervertebral discs, compression of the nerves connecting the spinal cord and limbs often occurs.A pinched nerve can cause severe hand pain, muscle numbness, and motor impairment.
• Diseases of the joints: arthrosis or arthritis, bursitis, tendonitis, etc. Arthritis can be caused by psoriasis, infectious diseases or age-related changes in the joints. Sometimes these diseases begin when metabolic processes change during pregnancy. Bursitis is an inflammation of the joint capsule and the accumulation of fluid in it.
• Gout. Although gout usually affects the joints of the lower extremities, sometimes it also affects the joints of the hands.With gout, the affected joint swells, becomes red and hot. The pain is very strong, literally unbearable. The attack usually begins at night.
• Neuritis. This disease causes numbness of the hand or part of it, aching pain along the nerve, dysfunction of the limb.
• Heart disease. Dull, pulling, or burning pain in the left arm may be a symptom of a heart attack or worsening heart disease. It is especially dangerous if at the same time the patient is nauseous, his face becomes pale, a strong inexplicable fear may appear.These symptoms may indicate myocardial infarction.

Hand Pain Treatment

Foto: Shutterstock

It is impossible to determine the causes of the pain syndrome without a thorough examination. Trying to numb the pain with home remedies or medication can be wasting time and triggering a serious illness – the true cause of the pain.

It is better not to wait for the weather by the sea, but to go to the doctor. You may need to do a number of tests, undergo computed or magnetic resonance imaging, x-rays or myelography.After determining the cause of the unpleasant symptoms, the doctor will prescribe treatment. As a rule, therapy is complex, including drug treatment, physiotherapy procedures, and special exercises. Many diseases require adherence to a special therapeutic diet.

Paraarticular tissues: variants of lesion and their treatment (continued) | Khitrov N.A.

The article is devoted to variants of lesion and treatment of para-articular tissues

The main problem for people in modern society is the ability to lead an “independent life.”Diseases of the musculoskeletal system cause mechanical, physical, psychological and aesthetic suffering. The preservation of the organs of movement is a medical and social task. A large proportion of diseases of the locomotor apparatus are periarthritis – lesions of the para-articular tissues (PPAT) of the joints.
Paraarticular tissues represent a set of periarticular structures and tissues distant from the joints. Periarticular tissues include: tendons of muscles and their sheaths, bursae, ligaments, fascia, aponeuroses.Structures distant from the joints are: muscles, neurovascular formations, subcutaneous fat [1].
Among PPAT are distinguished:
• tenosynovitis – inflammation of the tendon sheath;
• tendinitis – inflammation of the tendon;
• bursitis – inflammation of the bursa;
• enthesopathy (enthesitis) – inflammation of enthesis – the place of attachment of a tendon or ligament to a bone or joint capsule;
• capsulitis – damage to the joint capsule;
• fasciitis, aponeurositis – damage to the fascia and aponeuroses;
• myofascial pain syndrome – changes in the skeletal muscle and adjacent fascia.
Neipel in 1966 first used the term “enthesopathy”, J. Ball in 1971 reported a high frequency of enthesopathies in ankylosing spondylitis. In 1991, it was recognized that enthesopathies are a distinctive pathogenetically significant characteristic of spondyloarthropathies. This is especially true of enthesopathies of the heel regions (enthesitis of the Achilles tendon, plantar aponeurosis, achillotendinitis, bursitis, etc.), which are usually combined with peripheral articular syndrome, but in some cases are the only or dominant in severity of the musculoskeletal system in spondyloarthritis.
In enthesis, the fibers of the tendon or ligament, before passing into the bone structure, become more compact, then cartilaginous, and finally calcified. Nutrition of enthesis occurs through anastomoses through the tendon sheaths – peritenon, perichondrium or periosteum. Enteses are metabolically active and well-innervated.
It is the area of ​​enthesis that becomes the “weak link” in the apparatus of the periarticular tissues, where, under excessive load, micro- and macroscopic injuries occur, which subsequently lead to local inflammation [2, 3].
Inflammation takes on an important role both in enthesopathies and in other PPATs, underlies the exacerbation of PPATs, and enhances tissue degeneration. Inflammation in enthesis is not limited to connective tissue (eg, tendinitis or fibrositis). The involvement of cartilage and bone in the pathological process is also noted, which leads initially to the onset of periostitis, and later to the appearance of bone erosion.
Abroad, rheumatic lesions of soft tissues are united by the term “extra-articular rheumatism” (non-articular rheumatism) or “soft tissue rheumatism” (soft tissue rheumatism).
Earlier, an article was published in breast cancer, in which the PPAT of the upper extremities and back was considered in detail [4]. In this publication, we will dwell in detail on the lesions of the paraarticular tissues of the lower extremities.

Thigh

PPATs in the femoral region are of a varied nature and are mainly represented by tenomyositis of the thigh muscles, which often proceed in a painless form and are characterized by clicks during movement, which are heard from a distance. Pain syndrome is present in enthesopathies of the greater trochanter of the femur, inflammation in the synovial bags of the girdle of the lower extremities.
Patients of different ages complain of clicks in the hip joint (pain is usually absent). The patient himself shows the movements in which clicks occur. This clinic is caused by: friction of the ilio-tibial tract against the greater trochanter, friction of the tendon of the iliopsoas muscle against the ilio-pubic elevation, friction of the gluteus maximus muscle against the greater trochanter, as well as instability of the hip joint. This symptom occurs with developmental anomalies, dysplasia of the connective tissue of the structures of the thigh, degenerative-dystrophic processes, injuries, etc.
Imaging research methods (X-ray, ultrasound, MRI), in addition to detecting dysplasias and other changes in the hip joint, rarely contribute to the diagnosis. A well-collected history, assessment of the volume and nature of movements in the hip joint and in the lumbar region, and careful palpation contribute to the clarification of this type of PPAT. The main treatment is to calm the patient down, explain the essence of the disease, prescribe exercises for the development of soft tissue structures interested in the formation of clicks, under the supervision of an exercise therapy methodologist.Physiotherapy is possible, the use of soft orthoses on the lumbar-femoral region.
In the hip region, there are pain syndromes caused by damage to the tendon-ligamentous and muscle structures.
Iliopsoas tendinitis – characterized by pain in the upper thigh that makes it difficult to walk. In this case, there is a limitation of extension due to pain in the groin and back. There is pain when flexing the hip, painful clicks during full extension of the hip joint.Possible abdominal pain. Often the pain is localized below the groin, which corresponds to the place of attachment of the muscle to the lesser trochanter of the thigh. Palpation through the anterior abdominal wall can reveal painfully compacted muscles. With this PPAT, it is possible that the cutaneous femoral nerve is pinched – Bernhardt-Roth neuralgia, associated with numbness and paresthesia along the outer surface of the thigh.
Syndrome of the muscle stretching the fascia lata of the thigh – characterized by the appearance of pain and discomfort when the affected leg is thrown onto a healthy leg.Spontaneous pain is rare (there may be a feeling of a “driven nail” in the iliac wing).
When the patient is on his side, with the leg on top slightly bent in the hip and knee joints, the region of the greater trochanter of the femur protruding from above is well palpated. The resulting pain syndrome is regarded as trochanteritis. Trochanteritis variants usually include trochanteric enthesitis and the more rare trochanteric bursitis.The causes of trochanteritis are congenital or acquired disorders of the structure of the pelvis or legs, heavy mechanical stress, trauma, hypothermia, excess body weight, especially arising in a short time. Often it is not possible to establish the cause.
Enthesitis of the greater trochanter is a common cause of pain in the hip region. This disease complicates the course of osteoarthritis in women 40-60 years old, but it can proceed without coxarthrosis. It is manifested by pain radiating along the outer surface of the thigh.A typical complaint of the patient is the inability to lie, especially to sleep on the side of the lesion. There is a distinct local soreness of the greater trochanter region, preservation of the volume of passive rotation in the hip joint, and pain with resistance to active abduction of the hip. If the pain increases with movement, walking, then we are dealing with enthesopathy of the abductor muscles. Persistent pain indicates trochanteric bursitis.
Unlike coxarthrosis, trochanteritis has characteristic pain points on palpation.With trochanteritis, there is no restriction of movements in the hip joint, both passive and active. X-ray data make it possible to differentiate signs of coxarthrosis with manifestations of enthesitis in the region of the greater trochanter of the femur.
Bursitis of the femoral region is less common in the pathology of entheses, tendons and ligaments in this area. Most often, the following bags of the pelvic region are inflamed: the trochanteric bursa (bursa trochanterica), the iliac-comb bursa (bursa iliopectinea) and the ischial bursa (bursa ischiadica) [5].
Trochanteric bursitis – develops more often than other types of bursitis of the hip. The trochanter bag is located near the greater trochanter of the femur. Trochanteric bursitis develops more often in professional athletes. Women are more likely to get sick. The predisposition of women to the disease of trochanteric bursitis is explained by the structural features of the female pelvis. The female pelvis is wider, and the greater trochanter is further from the midline of the body, which contributes to stronger friction of the muscles against it [6].
The main symptom is pain in the region of the greater trochanter (along the lateral surface of the thigh).Walking, various movements, and lying on the side of the lesion increase the pain. The onset of trochanteric bursitis may be sudden, but is more often slowly progressive. Disturbed by pain when flexing the hip, when getting up from a chair and when climbing stairs. Night pains are especially troubling – when patients roll over or lie on the sick side, these pains wake them up.
If asked to show the area of ​​greatest pain, the patient accurately points to the area of ​​the greater trochanter. If there really was pain in the joint, the patient would point to the groin area.
The best way to diagnose trochanteric bursitis is to palpate the greater trochanter region to detect local tenderness. The examination is carried out in the position of the patient lying on a healthy side, with the leg slightly bent at the hip joint and knee. Pressure on the greater trochanter causes severe pain, often radiating along the outer side of the thigh to the lower back.
Iliaccal bursitis is the second most common disease among inflammations of the bursae of the thigh.The ileal-comb bursa is located in front of the lumbar-iliac muscle. With the accumulation of a significant amount of exudate in it, it can be determined in the groin in the form of a tumor-like formation. Due to the fact that the ileal-comb bursa is very close to the joint, the picture of its inflammation is very similar to the inflammation of the hip joint itself. The main symptom of this type of bursitis is soreness and swelling of the anterointernal part of the thigh below the level of the inguinal ligament, the pain intensifies with hip extension.Compression by a stretched bursa of the femoral nerve can lead to pain and paresthesias in the thigh.
Sciatic bursitis (seated tailor syndrome) – develops when sitting on a hard surface, especially in thin people. The ischial bursa is located in close proximity to the ischial tuberosity. Possible enthesopathy of this area, which occurs both within the framework of some kind of spondyloarthritis (reactive arthritis, ankylosing spondylitis), and independently. The sciatic tubercle is stressed when a person is sitting, especially on a hard base.The patient’s complaint is typical of pain in this position, to a lesser extent when walking. Pain with sciatic bursitis, in contrast to ilio-scallop, increases with hip flexion.

Elbow

In the area of ​​the knee joint, PPAT are most often represented by bursitis, enthesopathies and tenosynovitis.
Prepatellar bursitis – bursitis of the pre-patellar bursa (“parquet knee”). The inflamed pre-patellar bursa is located on top of the patella and is not connected to the knee joint cavity.Its inflammation is infrequent, it is caused by repeated injury or stress with prolonged kneeling. It is characterized by fluctuating swelling, edema, unexpressed pain syndrome, possible local fever, skin hyperemia. Can become infected, especially if the skin is damaged.
Relapses of bursitis can be avoided by eliminating the etiological factor (protection of the knee joint in chronic trauma with an orthosis). When the prepatellar bursa is infected, which is a consequence of acute trauma and a violation of the integrity of the skin in the front of the knee joint, there is swelling, sharp, twitching pain in the pre-patellar region, aggravated by palpation.Visually, there is also noted hyperemia, hyperthermia of the skin. In this case, the contents of the bursa include pus and the patient should be treated as a patient with a purulent process.
Baker’s cyst (KB) is a fluid-stretched synovial bag of the popliteal fossa located in its medial section between the inner head of the gastrocnemius and semimembranosus muscles and communicating with the knee joint through an anastomosis.
The most recognized is the valve mechanism for the penetration of articular fluid through the fistula from the knee joint cavity into the BC, when the return flow of fluid from the BC into the articular cavity is difficult [7].In 1877 W.M. Baker noted a close relationship between the presence of intra-articular injuries and diseases of the knee joint with the development of popliteal cysts.
KB in most cases occurs as a secondary disease. The causes of its occurrence are joint synovitis (osteoarthritis, rheumatoid arthritis, etc.), post-traumatic conditions of the knee joint. KB at small sizes is usually painless, it is not visible to the naked eye, its palpation is difficult. There is no clinical clinic on the background of symptoms of knee joint lesion.
At large sizes, the BC is visible visually and is easily palpable as a dense-elastic tumor-like formation of an oblong-ovoid shape, localized in the soft tissues of the popliteal region, mainly in the medial parts of the popliteal fossa (Fig. 1). At significant sizes, the KB can partially prevent flexion in the knee joint. Patients with large KB feel heaviness along the posterior surface of the joint during physical exertion, a feeling of discomfort, the presence of a tumor-like formation in the popliteal fossa.The symptom complex may include pain in the calf muscles or sensory disturbance along the back of the lower leg, especially after a long walk or while climbing and descending stairs. All these symptoms can be isolated, but more often they are combined with the clinic of intra-articular pathology of the knee joint, which is present in this case [8–10].

Resorption of fluid from the CB is possible with its reverse development until it completely disappears. Such a benign outcome is characteristic of cysts that have formed recently, usually after excessive mechanical overload of the knee joints during construction work, sports, intensive labor in summer cottages, etc.e. In the case of persistent synovitis of the knee joint, KB becomes chronic. In the chronic course of CB, the fluid undergoes partial resorption, which leads to its thickening and complicates its aspiration from the cyst cavity. With prolonged flow, fibrin accumulates in the CB, bridges, septa, daughter cysts are formed (Fig. 2).

Usually, CB is benign, only psychologically frightening patients. However, with a rapid accumulation of effusion in the popliteal bursa, a rupture of the BC with the spread of articular fluid along the posterior interfascial spaces of the leg is possible.The clinical picture of an acute rupture of the CB resembles a picture of leg vein thrombosis (leg edema, bursting pains). After a breakthrough, the effusion from the knee joint and the CB itself disappears.
Possible suppuration of KB, which clinically resembles thrombophlebitis of the superficial veins of the leg and is characterized by the occurrence of effusion and pain in the popliteal fossa against the background of an articular anamnesis, hyperemia, hyperthermia in this area, as well as chills, fever, and a change in the blood count.
The use of ultrasound and MRI allows you to establish the presence of CB, its topographic location in the popliteal fossa, visualize the contours and contents of the cyst, trace its boundaries and length, determine the connection of the cyst with the joint cavity, identify signs of wall rupture and inflammation, damage to intra-articular structures, osteoarthritis, knee arthritis joint.Popliteal ultrasound is necessary not only for the diagnosis of CB, but also for the detection of common pathological conditions: deep vein thrombosis (thrombophlebitis), aneurysm of the femoral and popliteal artery, abscess, tumor, muscle rupture, etc.
Often, the patellar ligament suffers, which carries a large functional load, being a link between the quadriceps and the lower leg, taking part in the extension of the knee joint. In this case, the patella is considered as the sesamoid bone.Patellar ligament injury occurs during mechanical stress and trauma, usually at the junction of the ligament (in the form of enthesopathy) with the lower edge of the patella (“jumper’s knee”) and the tibia (“football player’s knee”).
“Jumper’s knee” – “upper” ligamentitis of the patellar ligament. The cause of the disease is mechanical overload of the knee joint, which can be both sudden and chronic. Most often, patellar ligamentitis develops as a result of inadequate quadriceps tension.The “jumper’s knee” is most often observed in tennis players, athletes, football players, basketball players, volleyball players. Long jumps on hard surfaces are usually a contributing factor.
The clinical picture consists of pain, swelling and painful restriction of mobility. Pain localized below the patella is aggravated by palpation and sitting. Visually, a slight swelling is determined in this place. There is a limitation of mobility in the knee joint and a feeling of loss of its strength.
Osgood-Schlatter’s disease (Osgood-Schlatter’s disease) – can be considered in a narrow sense as “lower” ligamentitis of the patellar ligament, which is enthesopathy. Usually and traditionally Osgood-Schlatter disease is considered as chondropathy – periostitis and inflammation of the tibial tuberosity. The causes of the “footballer’s knee” can be periodic minor injuries to this area, often occurring in boys during adolescence during physical activity.
The clinical picture of Osgood-Schlatter disease is typical: most often it begins with mild pain in the tibial tuberosity, which appears only with significant physical exertion. With the progression of the disease, pain occurs even with less stress. In rare cases, pain occurs at rest. A hallmark of pain in Osgood-Schlatter disease is their intensification in the tibial tuberosity with tension of the quadriceps femoris muscle and when the patient is on his knees.A pathognomonic symptom is local soreness, from insignificant to severe, on palpation and / or percussion of the tibial tuberosity. Palpation of other adjacent areas is usually painless. The range of motion in the knee joint does not change. Radiographically, in the chronic course of Osgood-Schlatter disease, bone remodeling with cystic remodeling and fragmentation of the tibial tuberosity is noted. With a short (acute) course of the process in the form of enthesopathy, the pathology may not be detected radiologically [11].
Crow’s foot enthesopathy and tenomyositis is a common variant of PPAT in the knee joint area. “Goose foot” (pes anserinus) is the place of attachment to the tibia of the tendons of the tailor (m. Sartorius) , thin (m. Gracilis) and semitendinos (m. Semitendinosus) muscles. Anatomically located 3-4 cm below the projection of the knee joint gap along its medial surface. This PPAP often complicates the course of gonarthrosis, in other cases it is observed with a healthy knee joint.The disease often develops in people who spend a lot of time on their feet, such as athletic runners.
The patient’s complaints of pain when walking are typical. The patient points a painful point with his finger. There is an increase in pain during flexion and extension of the knee joint. On examination, a sharp palpation soreness with an area of ​​3-4 square meters is determined. see. Often the symptoms of enthesopathy bother the patient much more than the manifestations of the actual gonarthrosis.
Anserine bursitis – less common than crow’s feet tenomyositis, observed in women over 55-60 years old, suffering from gonarthrosis.Most of them are overweight, deformity of the knee joints. As a rule, in these patients, in addition to complaints characteristic of gonarthrosis (joint pain, aggravated by exertion and by the end of the day), there are also complaints of pain that occurs at night with the pressure of one knee on the other and forcing to change the position of the legs. All these patients have severe local pain in the anserine area on palpation. A visually noticeable deformation is possible – swelling of this area.With ultrasound, crow’s foot bursitis is easily diagnosed as an anechoic accumulation of fluid.

Stop

The complex structure of the foot and ankle joint maintains the human body in an upright position. Having a vaulted structure, the foot performs supporting and spring functions. The arch of the foot is fixed with longitudinal and transverse ties, as well as a plantar aponeurosis. The many muscles in the foot are active ties that attach at different levels of the foot. Tendons serve as “bridges” between the bones and muscles of the foot, which are tightly attached to them.In cases where the musculoskeletal system of the legs is subjected to significant stress, the ligaments of the foot are injured.
Among the reasons that can cause the development of tendinitis of the foot, there are: excessive physical exertion on the foot, mechanical damage and trauma, pathology of the skeleton, flat feet, improper posture, systematic wearing of high-heeled shoes, habitual subluxation of the foot, age-related deviations, degenerative-dystrophic disorders in the tissues of the foot, joint diseases (rheumatoid arthritis, gout, etc.)), metabolic disease. Due to the high frequency of tendinitis and enthesitis, the foot is called an “enthesitic organ”.
Achillodynia, or tendonitis of the Achilles tendon is a condition often found in spondyloarthritis. Severe damage to the Achilles tendon can be seen in patients with joint hypermobility syndrome with severe flat feet, usually over the age of 30. With Achillodynia, there is swelling and pain during exertion in the distal tendon and / or where the tendon attaches to the heel bone.In the latter case, the pain may be associated with bursitis of the bursal bag, which is located here. The pain is most pronounced when walking and standing for a long time.
Flexion and extension of the foot increases pain. The area of ​​greatest pain is at the junction of the tendon with the calcaneus and 2–3 cm proximally. The tendon in the indicated area is swollen and thickened. Spontaneous tendon rupture can occur, characterized by the sudden onset of severe pain along the back of the foot, especially during dorsal flexion.
Tendonitis of the posterior tibial muscle – inflammation of the tendon of the posterior tibial muscle and its vagina. The place of greatest pain is located on the medial surface of the ankle joint. Pain and swelling are noted along the tendon. The pain intensifies when the foot is tucked inward, with palpation and percussion of the medial ankle region. This PPAT is often combined with tibial tunnel syndrome, regarded as tarsal canal syndrome .Under the medial ankle, along with the tendons of the posterior tibial muscle and the flexor muscles of the fingers, the tibial nerve passes. Tenosynovitis of these muscles with concomitant expansion of the tendons leads to mechanical symptoms of compression and ischemia of the tibial nerve, which is manifested by pain, paresthesias and numbness, spreading along the medial part of the foot. Tinel’s symptom and cuff test are used for diagnostics [12].
Tendonitis of the peroneal muscles – under the lateral ankle there is (both isolated and with concomitant inflammatory arthropathies) a sausage-like thickening along the tendon sheath of the peroneal muscles.When walking and palpating this area, pain occurs.
Plantar fasciitis (PLF) is a disease caused by inflammatory-degenerative changes in the plantar fascia. The clinical sign of PF is pain in the sole, and especially in the heel. Heel pain usually occurs and / or worsens with exertion. Pain is more pronounced in the morning. With a pronounced process, pain spreads over the entire plantar surface of the foot, aggravated by pressure on the bottom of the foot (when walking, running, palpation).The pain is felt more strongly at the first steps, after getting out of bed. Permanent microtraumatization of the fascia can cause chronic aseptic inflammation with pain. Analysis of patient complaints, physical examination, radiography, ultrasound, MRI contribute to the diagnosis of PLF.
Against the background of PLF, as a compensatory reaction, the formation of marginal bone growths (osteophytes), called “heel spurs” (PS), is possible. PS are deposits of calcium on the lower part of the calcaneus.PSs are often associated with PLF. The PS on the back of the calcaneal tuberosity is often associated with Achilles tendon inflammation (tendinitis) and can cause soreness and pain in the back of the heel that worsens when the foot is bent.
The PS are anatomically located at the site of enthesis – along the attachment of the plantar fascia or Achilles tendon to the heel bone.
It is important to note that PS may not cause any symptoms at all and are accidentally discovered during an x-ray.PS mainly affects people over 40 years old, and women are more predisposed to this disease. PS is often observed in the elderly, since involutional changes in the tissues lead to a decrease in the elasticity of the plantar fascia. Other factors in the development of PS: overweight, obesity, prolonged standing, flat feet or, conversely, a high arch of the foot, poorly fitted or worn shoes, metabolic disorders.
In most cases, patients complain of intense, very sharp pain in the heel while walking.A characteristic symptom of PS is the so-called “starting” pain – arising in the morning or after prolonged sitting. The cause of pain is trauma to the soft tissues with a spur.
X-ray reveals the presence of bony outgrowth along the plantar or posterior surface of the calcaneus. This outgrowth looks like a thorn and may be accompanied by periostitis, erosion of the calcaneus. In the early stages, an x-ray absence of a bone spike is possible. In this case, the cause of pain is inflammatory changes (plantar fasciitis or heel bursitis).X-ray detection and size of PS do not always correlate with the severity of pain. Large PNs can exist painlessly due to adaptation of perifocal tissues to painful stimuli.
The absence of a heel spur in combination with heel pain requires a differential diagnosis, primarily with systemic inflammatory diseases (rheumatoid arthritis, Reiter’s syndrome, etc.), which can also debut with heel pain.
Plantar fascial fibromatosis, or Ledderhose syndrome (SL) – non-inflammatory fibromatosis.SL is similar and is often combined with Dupuytren’s contracture. This PPAP is manifested by local thickening of the plantar fascia. Initially, the disease does not cause suffering, but in the final stages, the plantar fascia thickens, contracts, leading to flexion contracture of the fingers. This makes walking painful. In some patients, symptoms occur on both feet.
Palpation-dense, painless, rounded, and cord-like nodules in SL are most often present near the highest point of the transverse arch of the foot.The nodules are usually painless and only painful when rubbing against shoes or the floor. Ultrasound and MRI reveals an infiltrating mass in the aponeurosis next to the plantar muscles, which makes it possible to identify the degree of damage.
Regarding risk factors for SL, it should be noted that the disease is often familial, more common in men, combined with palmar fibromatosis, Peyronie’s disease, epilepsy, and diabetes mellitus. The connection with alcoholism, smoking, liver diseases, thyroid gland, strenuous work with a load on the legs is discussed.
In the early stages of treatment, it is recommended to avoid direct pressure on the nodules, use soft insoles, instep supports in shoes. In the later stages of SL, surgical methods of treatment are used with a difficult prognosis, since tendons, nerves and muscles are located very close. As with Dupuytren’s contracture, relapses of the disease often develop. The foot is under stress of the whole body, which leads to frequent postoperative complications.

Treatment

In the treatment of PPAT, the main condition is the exclusion of provoking factors, primarily mechanical overload.It is necessary to limit the mechanical stress on the structures that are involved in a particular lesion. With pronounced inflammation, complete rest is shown with the use of orthoses, a splint in the acute period of the disease. The motor regime, physiotherapy exercises, massage, manual therapy should be mechanically gentle and carried out in a painless area.
Local injection therapy, primarily with glucocorticoids (GCs), taking into account the anatomical and morphological features of PPAT, indications, contraindications, correctly selected dose of GC, the number and frequency of administration, allows to achieve good clinical results in the treatment of PPAT.
Also used are analgesics, weak opioids, muscle relaxants, sedatives. When the acute process subsides, physical methods are used: heat and cryotherapy, magnetic, laser therapy, electro- and phonophoresis, mud applications, balneotherapy. Shock wave therapy and mental relaxation techniques are used. In case of PPAT on the background of rheumatic diseases, treatment of the underlying disease is necessary.
PPAT as a particular type of musculoskeletal diseases, regardless of etiology, is largely due to common pathogenetic patterns that determine the appearance and transition of the disease into a chronic state.Effective relief of pain syndrome is the primary task of PPAT pharmacotherapy, since pain is the most painful sensation that determines the severity of suffering and a decrease in the patient’s quality of life [13].
Anti-inflammatory drugs are an indispensable condition for PPAT therapy, including primarily non-steroidal anti-inflammatory drugs (NSAIDs) for local (cutaneous) and systemic (oral, rectal and intramuscular) use. The therapeutic efficacy and tolerability of various NSAIDs are individual for each patient, and when prescribing NSAIDs, a strictly personal approach is required with an assessment of the effectiveness and side effects of the drug used [14, 15].
For anti-inflammatory and analgesic effects, it is advisable to use Amelotex (international non-proprietary name – meloxicam) – NSAIDs belonging to the class of oxicams, derivatives of enolic acid, which has analgesic, anti-inflammatory and antipyretic effects. Meloxicam predominantly inhibits the enzymatic activity of COX-2, inhibits the synthesis of prostaglandins in the area of ​​inflammation to a greater extent than in the mucous membrane of the stomach or kidneys, and rarely causes erosive and ulcerative lesions of the gastrointestinal tract compared to other NSAIDs.Meloxicam has a number of other pharmacological properties that make it possible to predict its high efficiency in the treatment of pain and inflammation: influence on the synthesis of the most important pro-inflammatory cytokines (interleukin-6, tumor necrosis factor α), blockade of metalloproteinase synthesis, antihistamine effect, decrease in the activity of aggressive cells (macrophages and neutrophils ) in the foci of inflammation, etc. [16-18].
Amelotex is available in the form of a solution for intramuscular injection, suppositories, tablets and gel.One ampoule (1.5 ml) contains 15 mg of meloxicam as an active substance.
To relieve pain and inflammatory syndrome in PPAT, it is advisable to use the intramuscular route of drug administration due to the rapid therapeutic effect and minimal side effects on the gastrointestinal tract. If intramuscular injections are impossible, in order to avoid a negative effect on the gastrointestinal tract, an alternative prescription of NSAIDs in the form of rectal suppositories is possible (this reduces the risk of developing gastropathies).
At the beginning of treatment, in the acute period, it is desirable to conduct a course of intramuscular injections of Amelotex, 1.5 ml 1 r. / Day for 10-15 days, or rectal use of Amelotex, 1 suppository, 1 r. / Day for 1-2 weeks. Further, while maintaining the clinic, it is possible to switch to oral administration – 15 mg / day.