What causes foot pain? How can you treat it? Get all the answers you need with this in-depth guide on foot pain diagnosis and remedies.

Heel Pain: Plantar Fasciitis and Heel Spurs

If your foot pain is concentrated in the heel, it may be due to plantar fasciitis or heel spurs. Plantar fasciitis is an irritation or inflammation of the tough band of tissue (the plantar fascia) that connects the heel bone to the toes. This often causes the worst pain in the morning when getting out of bed. Heel spurs are abnormal bone growths on the bottom of the heel, which can also lead to pain while walking or standing.

To treat heel pain, you can try the following:

• Rest your foot
• Do heel and foot muscle stretches
• Take over-the-counter pain relievers
• Wear shoes with good arch support and a cushioned sole
• Use a cutout heel pad or custom-made orthotic insert
• Try physical therapy

If the pain persists, you may need to see a doctor about medical procedures.

What is the primary cause of heel pain? The main causes of heel pain are plantar fasciitis and heel spurs. Plantar fasciitis is an inflammation of the plantar fascia, while heel spurs are abnormal bony growths on the heel.

Toe and Ball of Foot Pain

Pain in the toes or ball of the foot can have several possible causes:

• Bunions – Bony bumps that form on the joint at the base of the big toe. Wearing tight, narrow shoes can aggravate bunions.
• Hammertoes – A toe that is bent at the middle joint, giving it a claw-like appearance. This is often caused by wearing shoes that are too tight.
• Neuromas – A thickening of the nerve, often between the toes, that can cause a burning or shooting pain.
• Metatarsalgia – Pain in the ball of the foot, often from overuse or wearing high heels.

To treat these conditions, you can try:

• Wearing wider, more supportive shoes
• Using cushioned inserts or pads
• Taking over-the-counter pain medication
• Trying physical therapy exercises

If home treatment doesn’t provide relief, you may need to see a podiatrist.

What are some common causes of toe and ball of foot pain? The main causes include bunions, hammertoes, neuromas, and metatarsalgia. These conditions are often exacerbated by wearing ill-fitting shoes.

Arch and Midfoot Pain

Pain in the arches or midfoot region can stem from a few different issues:

• Flatfeet – Also known as fallen arches, this condition can cause pain in the arches and heels.
• Tendinitis – Inflammation of the tendons that run along the arches and midfoot.
• Stress fractures – Small cracks in the bones of the feet, often from overuse.

To address arch and midfoot pain:

• Wear supportive shoes with good arch support
• Use custom orthotics or arch supports
• Avoid high-impact activities that aggravate the pain
• Take over-the-counter anti-inflammatory medication
• Try physical therapy exercises to strengthen the feet

Persistent or severe pain may require medical evaluation and treatment.

What are the most common causes of arch and midfoot pain? The primary culprits are flatfeet, tendinitis, and stress fractures in the midfoot region.

Ankle Pain

Ankle pain can stem from a variety of issues, including:

• Sprains – Stretching or tearing of the ligaments in the ankle, often from twisting or rolling the ankle.
• Arthritis – Inflammation and degeneration of the ankle joint, which can cause chronic pain.
• Instability – Weakening of the ankle joint and surrounding muscles, leading to instability and pain.

To treat ankle pain:

• Rest and ice the ankle
• Wear a brace or splint to provide support
• Take over-the-counter anti-inflammatory medication
• Undergo physical therapy to improve strength and stability
• In severe cases, surgery may be needed to repair damaged ligaments or joint issues

Seeking prompt medical attention is important, as untreated ankle injuries can lead to chronic instability and pain.

What are the main causes of ankle pain? Ankle sprains, arthritis, and instability are the primary culprits behind most ankle pain.

Foot Pain from Diabetes

For those with diabetes, foot pain can be an especially concerning issue. Diabetes can lead to several foot-related complications:

• Diabetic neuropathy – Nerve damage that causes numbness, tingling, and pain in the feet.
• Foot ulcers – Sores that develop on the feet, often due to poor circulation and nerve damage.
• Charcot foot – A condition where the bones in the foot weaken and eventually collapse, causing deformity.

To prevent and manage diabetic foot problems:

• Check your feet daily for any sores, blisters, or other issues
• Wear well-fitting, protective shoes at all times
• Keep your blood sugar levels under control
• See a podiatrist regularly for checkups and treatment
• Seek immediate medical attention for any foot wounds or infections

Proper foot care is essential for those with diabetes to avoid serious and potentially life-threatening complications.

How can diabetes lead to foot problems? Diabetes can cause nerve damage, poor circulation, and foot deformities that increase the risk of ulcers, infections, and other serious foot complications.

When to See a Doctor

In general, it’s a good idea to see a doctor if you have:

• Severe or persistent foot pain that doesn’t improve with home treatment
• An open wound or signs of infection (redness, warmth, swelling)
• Numbness, tingling, or burning in the feet (especially if you have diabetes)
• Difficulty walking or putting weight on your foot

Don’t wait to seek medical attention, as ignoring foot problems can lead to more serious complications. Your doctor can properly diagnose the cause of your foot pain and recommend the appropriate treatment plan.

When should you see a doctor for foot pain? You should seek medical attention if you have severe, persistent pain, open wounds, signs of infection, numbness or tingling, or difficulty walking. Ignoring foot problems can lead to more serious issues.

Foot pain When to see a doctor

Even relatively mild foot pain can be quite debilitating, at least at first. It is usually safe to try simple home remedies for a while.

Seek immediate medical attention if you:

• Have severe pain or swelling
• Have an open wound or a wound that is oozing pus
• Have signs of infection, such as redness, warmth and tenderness in the affected area or you have a fever over 100 F (37.8 C)
• Are unable to walk or put weight on your foot
• Have diabetes and have any wound that isn’t healing or is deep, red, swollen or warm to the touch

Schedule an office visit if you:

• Have persistent swelling that doesn’t improve at all after two to five days of home treatment
• Have persistent pain that doesn’t improve after several weeks
• Have burning pain, numbness or tingling, particularly involving most or all of the bottom of your foot

Self-care

If your foot pain is due to an injury or overuse, it will often respond well to rest and cold therapy. Avoid activities that can worsen your foot pain, and put ice on your foot for 15 to 20 minutes several times a day. Over-the-counter anti-inflammatory medications will also help with pain and may help with healing.

Even with the best of care, you may have some foot stiffness or pain, particularly first thing in the morning or after you’ve been active, for several weeks. If you are unsure of the cause of your foot pain, or if it is widespread or involving both feet, and particularly if you have diabetes, see your doctor before trying home remedies.

March 13, 2021

Show references

1. Fields KB. Evaluation and diagnosis of common causes of foot pain in adults. http://www.uptodate.com/home. Accessed Dec. 15, 2015.
2. Arthritis and diseases that affect the foot. Arthritis Foundation. http://www.arthritis.org/about-arthritis/where-it-hurts/foot-heel-and-toe-pain/. Accessed Dec. 15, 2015.
3. Chorley J. Forefoot or midfoot pain in the active child or skeletally immature adolescent: Overview of causes. http://www.uptodate.com/home. Accessed Dec. 15, 2015.
4. Foot complications. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/foot-complications/. Accessed Dec. 15, 2015.
5. Foot care. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html. Accessed Dec. 15, 2015.
6. Overview of foot and ankle disorders. Merck Manual Professional Version. http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/foot-and-ankle-disorders/overview-of-foot-and-ankle-disorders. Accessed Dec. 15, 2015.
7. Buchbinder R. Plantar fasciitis. http://www.uptodate.com/home. Accessed Dec. 14, 2015.
8. Arthritis and diseases that affect the ankle. Arthritis Foundation. http://www.arthritis.org/about-arthritis/where-it-hurts/ankle-pain/. Accessed Dec. 15, 2015.
9. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 18, 2015.

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Foot Pain in Arches, Ball, Heel, Toe and Ankle Problems

Feet. They carry you from here to there every day. But you may not think much about them until they hurt. And when they do, you want relief. To get the right treatment, you need to know the problem. The first thing to consider is where your pain is located.

Heel Pain

If your pain is in your heel, you may have plantar fasciitis. That’s an irritation or inflammation of the band of tough tissue connecting the heel bone to the toes. Usually, it hurts the worst in the morning when you’re getting out of bed. You can feel it in your heel or in your arch.

To treat it:

• Rest your foot.
• Do heel and foot muscle stretches.
• Take over-the-counter pain relievers.
• Wear shoes with good arch support and a cushioned sole.

Heel spursare another source of foot pain. These are abnormal growths of bone on the bottom of your heel. You can get them from wearing the wrong shoes or from an abnormal walk or posture, or even from activities like running. The spurs may hurt while you’re walking or standing. Lots of people have them, but most don’t have pain. People with flat feet or high arches are more likely to have painful heel spurs.

To treat them:

• Wear a cutout heel pad.
• Use a custom-made insert (called an orthotic) worn in the shoe.
• Wear shoes that fit well and have shock-absorbing soles.
• Take over-the-counter pain relievers.
• Rest your foot.
• Try physical therapy.
• If you still have pain, ask your doctor about medical procedures.

A stone bruise is a deep bruise of the fat pad of the heel or ball of the foot. It’s often from an impact injury, but it can also happen after stepping on a hard object. The pain feels like you’re walking on a pebble. It will gradually go away on its own.

In the meantime:

• Rest your foot.
• Ice the area.
• Take over-the-counter pain relievers.

A heel fracture is usually a high-impact injury such as from a fall or car accident. Your heel bone may not just break, it could also shatter. Heel pain, bruising, swelling, or trouble walking are the main symptoms.

To treat it:

• Don’t put pressure on the heel. You can use crutches.
• Protect the heel with pads.
• Wear a splint or cast to protect the heel bone.
• Ask your doctor about over-the-counter or prescription pain relievers.
• Try physical therapy.
• If you’re still in pain, ask your doctor about surgery.

 Psoriatic arthritis (PsA) is a mix of a skin disorder (psoriasis) and joint inflammation (arthritis). It’s a long-term condition that can run in families. PsA may cause stiffness and throbbing pain in the tendons over your fingers, toes, and other joints.

To treat it:

• For mild cases of PsA, your doctor may recommend a nonsteroidal anti-inflammatory drug (NSAID) to block the chemicals that cause swelling in your joints. You can get this medication at the pharmacy (aspirin, ibuprofen, or naproxen) or with a prescription.
• Try hot and cold therapy. Heat helps blood circulation to lessen stiffness. Cold lowers swelling.
• Manage your stress, which can make your PsA flare.
• For severe cases, you may need more powerful medications. Options include disease-modifying antirheumatic drugs (DMARDs), including biologics, and corticosteroids.

Ball of Foot Pain

Metatarsalgia. You feel this pain and inflammation in the ball of your foot. Ill-fitting shoes are the usual cause. But you might get it from strenuous activity, such as running or jumping. It’s sometimes called a stone bruise as well.

To treat it:

• Take pain relievers.
• Ice and rest your foot.
• Wear comfortable footwear.
• Try shoe inserts to relieve pressure on the ball of your foot.

Morton’s neuroma causes a thickening of the tissue around the nerves between the bases of the toes (usually between the third and fourth toes). You typically feel pain, odd sensations or numbness over the ball of your foot. Women have it more often. It can be a result of wearing high heels or tight shoes.

To treat it:

• Wear shoe inserts to reduce pressure on the nerve.
• Get a steroid or other injection into the foot.
• Take pain relievers.
• Don’t wear high-heeled shoes or ones with a narrow toe box.
• Avoid activities that put pressure on the neuroma.
• Ask your doctor about surgery.

Sesamoiditis. Near your big toe are 2 bones that are connected only by tendons. They’re called sesamoids. You get sesamoiditis when the tendons surrounding them become injured and inflamed. It’s a form of tendinitis, common with runners and ballet dancers.

To treat it:

• Rest your feet.
• Ice where it hurts.
• Wear a foot pad under the toe in a comfortable shoe.
• Tape the big toe to immobilize the joint and allow for healing.
• Wear low-heeled shoes.
• Ask your doctor about steroid injections.

Arch Pain

Plantar fasciitis. This is the most common cause of arch pain. Plantar fasciitis can affect the heel, arch, or both. Treatment is the same regardless of the location. For persistent plantar fasciitis, an injection with a mixture of a steroid and local anesthetic can be helpful.

Fallen arches, or flat feet, happen when the arches of the feet flatten out (often when standing or walking), causing foot pain and other problems. Flat feet can be treated with shoe inserts, shoe adjustments, rest, ice, using a walking cane or brace, or physical therapy. Sometimes surgery is necessary.

Toe Pain

Gout, which is a form of arthritis, can causes pain in the toes. Crystals collect in toe joints, causing severe pain and swelling. The big toe is often affected.

To treat it:

A bunion is a bony bulge along the edge of the foot, next to the base of the big toe. It’s associated with misalignment of the first toe joint. Anyone can get them, especially if they wear ill-fitting or uncomfortable shoes. It often shows up as people age. People with bunions often also have hammertoes as well. Try changing to more comfortable shoes or wearing shoe inserts. If you’re still in pain, your doctor may suggest surgery.

A hammertoe is when your second, third, or fourth toe bends at the middle joint, creating a hammer-like appearance. It can come from a muscle imbalance, but it can also be brought on by wearing ill-fitting shoes.

Your doctor will likely recommend you wear shoes with a wide, deep toe bed. They may also give you exercises to stretch your toe muscles. If you still have problems, you can talk to your doctor about surgery.

Claw toe is when your toe points down or up and is unable to straighten. It’s often the result of nerve damage from diseases like diabetes or alcoholism, which weakens the muscles in your foot. Without special footwear to accommodate the claw toe, you may develop irritation and calluses.

To treat it:

• Change to better-fitting footwear. Avoid high heels and tight shoes.
• Do stretches for your toes and toe joints.
• Try shoe inserts.
• Ask your doctor about surgery.

An ingrown toenailis when skin on one or both sides of a toenail grow over the nail. It can be painful and may lead to infections.

To treat it:

• Soak the foot in warm water four times a day.
• Once daily, wedge a piece of gauze between the nail and wet skin.
• If these treatments don’t work, see a doctor.

Turf toeis when you feel pain at the base of the big toe. It’s an overuse injury usually caused by strain. Turf toe may also be a form of sesamoiditis or a sesamoid fracture.

A toe sprain may happen when you jam or stub your toe, damaging the tendon or soft tissues of the toe. If you don’t have a fracture, the pain and swelling should go away within days.

A toe fracture, or broken bone, can happen in any of the bones of the toes. Minor fractures may only require rest, ice, and pain relievers. Serious fractures may need surgery. Go to a doctor to be sure.

Hallux rigidus (stiff big toe) is a type of arthritis at the base of the big toe. Symptoms are pain and stiffness of the joint that worsens over time. Treatment can include pain relievers and stretching exercises. Surgery may be needed in some cases.

Corns and calluses. Corns are thick buildups of tough skin on a point of irritation or pressure on the foot or toe. They sometimes look like horns. Calluses are wider areas of tough skin buildup on the toes or feet. They happen as a result of irritation or pressure. Calluses and corns are generally caused by poor-fitting footwear.

To treat them:

• Wear better-fitting shoes.
• Soak the foot and use a pumice stone to wear down the extra skin.

A sesamoid fracture is a break in the small bones (sesamoids) that are embedded in tendons attached to the big toe. Pain in and around the big toe is the main symptom.

To treat it:

• Rest, ice, and elevate your foot.
• Wear stiff-soled shoes or foot pads to relieve pressure.
• Take pain relievers.
• If you’re still in pain, talk to your doctor.

Pain on the Foot’s Outer Edge

The outer edge of your foot, the fifth metatarsal bone, is a commonly broken bone in the foot. Pain, swelling, and bruising along the outer foot edge after an injury are symptoms. If you think you may have broken a bone, see a doctor and have an X-ray.

To treat it:

• Take pain relievers.
• Rest, ice, and elevate your foot.
• Don’t walk on it.
• Ask your doctor if surgery is necessary.
• A cast may be necessary in some circumstances.

Foot Pain That’s Anywhere or Everywhere

Neuropathy, or nerve damage in the feet, is most often caused by diabetes. The pain can be burning, stinging, or feel like electricity. It can happen anywhere in the feet. Ask your doctor about pain relief options and ways to prevent further worsening.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that can cause pain, stiffness, and swelling in the joints throughout your body. Almost everyone with RA gets symptoms in their feet and ankles. RA can affect the areas around your heels, the top of your feet, and the toes and the balls of your feet. Rest, ice, or nonsteroidal anti-inflammatory medication such as ibuprofen and naproxen may ease your symptoms. Shoe inserts can relieve pressure from the bone in your feet.

Osteoarthritis is when the cushioning cartilage in your joints wear out. Most often, the cause is aging. But osteoarthritis also can happen from injury or if you have flat feet or very high arches. You may have trouble walking, and your joints may feel stiff and painful.

To treat it, your doctor may recommend:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Custom shoe inserts
• Braces, a cast, or a boot to keep your foot immobile until the inflammation goes down
• Physical therapy to strengthen your muscles
• Steroid shots for more severe cases

Tendinitis is inflammation and irritation of tendons, the bands attaching muscles to bones. Tendons run along all the surfaces of the foot and can cause foot pain in many different locations.

To treat it:

• Rest your foot.
• Take pain relievers.
• Steroid injections can help.
• Surgery is rarely needed.

Metatarsalgia: Symptoms, Causes, Diagnosis, Treatment

What Is Metatarsalgia?

Metatarsalgia is a common overuse injury. The term describes pain and inflammation in the ball of your foot. It’s often thought of as a symptom of other conditions, rather than as a specific disease.

Metatarsalgia Symptoms

The main symptom of metatarsalgia is pain at the end of one or more of the metatarsal bones. Those are the bones in the ball of your foot, closest to your toes. 

• The pain can be sharp, a dull ache, or a burning feeling.

• You may feel like you’re stepping on a pebble.

• The pain is typically worse  when you walk or run.

• You may feel tingling or numbness in your toes. 

• Athletes who take part in high-impact activities and also have an inflammatory condition like bursitis often have more widespread pain in the ball and middle of the foot.  

Most often, the pain comes on over a period of several months, rather than suddenly.

Metatarsalgia Causes

The pain of metatarsalgia comes from too much pressure on one spot in your foot. It often results from the pounding your feet take during high-impact sports. Or you may have something unusual about your bones or muscles that affects the way pressure is distributed on your feet, such as: 

• A short first metatarsal bone or a long second metatarsal bone 

• Prominent metatarsal heads

• Tight toe extensors (muscles)

• Weak toe flexors (muscles)

• Hammertoe deformity

• Hypermobile first foot bone

• Tight Achilles tendon

Other things that can cause metatarsalgia include:

• Excessive pronation (side-to-side movement of the foot when walking or running)

• Shoes that don’t fit well  

• Being overweight

• Stress fractures in your toes or metatarsals

• Bunions 

• Torn ligaments in your feet

A condition known as Morton’s neuroma (interdigital neuroma) also causes metatarsalgia-like symptoms. Extra tissue builds up around a nerve, usually between your third and fourth toes. The irritated, inflamed nerve causes pain.  Morton’s neuroma can also cause toe numbness in addition to pain in your forefoot.

Metatarsalgia Risk Factors

In the U.S., forefoot injuries, including metatarsalgia, are common in athletes who participate in high-impact sports. Activities that involve running or jumping are most often to blame. While track and field runners are most at risk, other athletes, including tennis, football, baseball, and soccer players, often get forefoot injuries.

Other factors that raise your odds of metatarsal pain include:

• Having a high arch

• Wearing high heels

• Certain illnesses that cause joint inflammation, like osteoarthritis, rheumatoid arthritis and gout

• Age. The fat pad that cushions the ball of your foot gets thinner over time

Metatarsalgia Diagnosis

X-rays may help your doctor rule out other causes of forefoot pain. A bone scan can pinpoint places of inflammation.

Ultrasound can help identify conditions such as bursitis or Morton’s neuroma that cause pain in the metatarsal area.

The doctor may also ask for an MRI to look for causes of pain in your metatarsal and midfoot regions. These can include traumatic disorders, circulatory conditions, arthritis, neuroarthropathies, and conditions that cause biomechanical imbalance.

The doctor may also do other tests and procedures to help make a diagnosis and figure out the proper treatment.

Metatarsalgia Treatment

There are several options when it comes to treating metatarsalgia.

Medical Treatment

To relieve metatarsalgia pain, the doctor may have you:

• Stay off your feet. Avoid high impact activities for a while and prop up your injured foot when you can.

• Ice the injured foot. Try rolling it over a frozen water bottle.

• Use a pressure bandage.

• Wear cushioned pads, arch supports or other orthotics in your shoes.

• Do gentle stretching and strengthening exercises.

If you have a callus on the bottom of your foot where you feel pain, the doctor may scrape it down to take off some pressure.

You may need surgery to fix problems with your bones or release a pinched nerve. 

Medication 

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, Nuprin) or naproxen (Aleve, Naprosyn), can relieve pain in the short term.

If a pinched nerve is the cause of your pain, the doctor may try a nerve block in combination with long-acting steroids.  

Recovery 

Once the pain is gone, you can increase stretching and strengthening exercises and gradually get back to normal activity.  Try a low-impact type of exercise at first, like swimming.

Metatarsalgia Complications

Metatarsalgia can lead to other problems if you don’t treat it. You’re likely to change the way you walk to take pressure off the painful spot on your foot. That can cause pain elsewhere in your foot or in your other foot, and all the way to your lower back or hips. You can even develop a hammertoe.

Metatarsalgia Outlook

Most people recover from metatarsalgia with treatment. But you need to understand what caused it in your case and take steps to keep it from coming back.

Metatarsalgia Re-injury Prevention

Taking good care of your feet can help you avoid another bout with metatarsalgia.

• Get shoes that fit correctly. If you run a lot, get new shoes often. 

• Don’t wear high heels.

• Use pads, arch supports or other orthotics your doctor recommends.

• Keep calluses from building up. You can soak your feet and gently rub the area with a pumice stone.

• Get to a healthy weight.

• Increase the amount and intensity of athletic activity gradually.

• Always stretch and warm up before you exercise.

Mind-Body Therapy, Accupunture, and More

The term ”alternative therapy” generally is used to describe any medical treatment or intervention that is used in place of conventional medicine. When alternative therapies are used in conjunction with conventional medicine, it is called complementary medicine. Alternative therapy encompasses a variety of disciplines, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others.

In the past decade, strong evidence has been gathered for the benefits of mind-body therapies, acupuncture, and some nutritional supplements for treating pain. Other alternative therapies such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate pain in some cases. More research is needed to see how these therapies compare to conventional treatments.

Mind-Body Therapies

Mind-body therapies are treatments that are meant to help the mind’s ability to affect the functions and symptoms of the body. Mind-body therapies use various approaches, including relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis. Relaxation techniques can help alleviate discomfort related to chronic pain.

Acupuncture

Although the World Health Organization currently recognizes more than 30 diseases or conditions that can be helped by acupuncture treatment, one of the main uses of acupuncture is for pain relief.

Sixteenth Century Chinese doctors believed that illness was due to an imbalance of energy in the body. In acupuncture, disposable, stainless steel needles are used to stimulate the body’s 14 major meridians, or energy-carrying channels, to resist or overcome illnesses and conditions by correcting these imbalances.

Acupuncture is also thought to decrease pain by increasing the release of chemicals that block pain, called endorphins. Many acu-points are near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins (morphine-like chemicals produced in our own bodies during times of pain or stress). Endorphins, along with other neurotransmitters (body chemicals that modify nerve impulses), block the message of pain from being delivered up to the brain.

Acupuncture may be useful as an accompanying treatment for many pain-related conditions, including: headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis and myofascial pain. Acupuncture also may be an acceptable alternative to or may be included as part of a comprehensive pain management program.

Chiropractic Treatment and Massage

Chiropractic treatment is the most common non-surgical treatment for back pain. Improvements in people undergoing chiropractic manipulations were noted in some trials. Research also suggests that chiropractic treatments may be helpful for headaches, neck pain, certain arm and leg conditions, and whiplash. Serious complications such as stroke, pinched nerves and worsening of herniated discs have been rarely reported.

Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that may generate and sustain pain. Available data suggest that massage therapy, like chiropractic manipulations, holds considerable promise for managing back pain.

Therapeutic Touch and Reiki Healing

Therapeutic touch and reiki healing are thought to help activate the self-healing processes of an individual and therefore reduce pain. Although these so called “energy-based” techniques do not require actual physical contact, they do involve close physical proximity between practitioner and patient.

In the past few years, several reviews evaluated published studies on the efficacy of these healing approaches to ease pain and anxiety and improve health. Although a few small studies showed these techniques are beneficial and have no significant adverse side effects, the limitations of some of these studies make it difficult to draw definitive conclusions. Further studies are needed before the evidence-based recommendation for using these approaches for pain treatment can be made.

Dietary Approaches to Treating Pain

Some people believe that changing dietary fat intake and/or consuming plant foods that contain anti-inflammatory agents can help ease pain by limiting inflammation.

A mostly raw vegetarian diet was found helpful for some people with fibromyalgia, but this study was not randomized and was without a control group. One study of women with premenstrual symptoms suggested that a low-fat vegetarian diet was associated with decreased pain intensity and duration. Weight loss achieved by a combination of dietary changes and increased physical activity has been shown to be helpful for people suffering from osteoarthritis.

Still, further research is needed to determine the effectiveness of dietary modifications as a pain treatment.

Nutritional Supplements

There is some evidence indicating that glucosamine sulfate and chondroitin sulfate may be marginally effective for knee osteoarthritis, but other studies have found no benefit at all. These natural compounds were found to be well-tolerated and safe.

Other dietary supplements, such as fish oils, also showed some early evidence of benefit, although more research is needed.

Herbal Remedies

It has been difficult to draw conclusions about the effectiveness of herbs. If you decide to use herbal preparations to better manage your pain, it is of critical importance to share this information with your doctor. Some herbs may interact with drugs you are receiving for pain or other conditions and may harm your health.

Things to Consider

Alternative therapies are not always benign. As mentioned, some herbal therapies can interact with other medications you may be taking. Always talk to your doctor before trying an alternative approach and be sure to tell all your doctors what alternative treatments you are using.

Causes, Symptoms, Diagnosis & Treatment

Overview

What is heel pain?

Heel pain is a common foot and ankle problem. Pain may occur underneath the heel or behind it. Many conditions can cause pain in the heels, including:

• Plantar fasciitis.
• Achilles or flexor tendonitis/tendonosis.
• Bone spurs.
• Sever’s disease (mostly in children 8-14 years old).
• Bursitis.
• Stress fractures.
• Inflamed tendons.

It’s important to have a medical evaluation to help you determine the exact cause of your heel pain so that the proper treatment regimen can begin.

Heel pain can make it difficult to walk and participate in daily activities. Most painful heel conditions improve with nonsurgical treatments, but your body needs time to recover.

How common is heel pain?

More than 2 million Americans experience heel pain every year. The problem affects people of all ages and genders.

Where does heel pain develop?

You might experience pain, soreness or tenderness anywhere in the heel. You typically feel heel pain:

• Behind the heel.
• Beneath the heel.
• Within the heel bone itself.

What causes pain behind the heel?

Several problems can cause pain to develop in the back of the heel:

• Achilles tendinitis: The Achilles tendon is a fibrous tissue that connects the calf muscle to the heel bone. It’s the body’s longest and strongest tendon. Runners and basketball players are more prone to Achilles tendinitis. This overuse injury inflames the tendon. Tendonitis causes pain, swelling and stiffness in the back of the heel.
• Bursitis: Bursitis occurs when fluid-filled sacs called bursae (plural of bursa) swell. These sacs cushion joints, allowing for fluid movement. You may have a tender, bruise-like feeling in the back of the heel. Bursitis typically occurs after you spend a lot of time on your feet.
• Haglund’s deformity: Chronic inflammation and irritation can cause an enlarged bony bump (called a pump bump) to form in the back of the heel. Shoes with higher heels, such as pumps, can make the bump and pain worse.
• Sever’s disease (calcaneal apophysitis): Sever’s disease is a frequent cause of heel pain in active children between 8 and 14. Kids who participate in activities that require a lot of running and jumping are more prone to this problem. The increased athletic activity irritates the growth plate in the back of the heel.

What causes pain beneath the heel?

Problems that cause pain underneath the heel include:

• Bone bruise (contusion): Stepping on a hard, sharp object can bruise the fat padding underneath the heel. You might not see discoloration, but your heel will feel tender when you walk. A stress fracture, as well as Sever’s disease, may cause pain all along the back of the heel on the bottom, side and back of the heel.
• Plantar fasciitis: Plantar fasciitis is by far the leading cause of heel pain. It occurs when the fascia, connective tissue that runs along the bottom (plantar surface) of the foot, tears or stretches. People who run and jump a lot are more likely to develop this painful condition. Treadmills and hard surfaces (such as concrete) for exercise or work are common irritants.
• Heel spurs: Chronic plantar fasciitis can cause a bony growth (heel spur) to form on the heel bone. Heel spurs aren’t usually painful, although some people have pain.

What are the risk factors for heel pain?

Anything that puts a lot of pressure and strain on your foot can cause heel pain. The way you walk (foot mechanics) and your foot’s shape (foot structure) are also factors.

You may be more likely to develop heel pain if you:

• Are overweight (have obesity).
• Have foot and ankle arthritis, flat feet or high foot arches.
• Run or jump a lot in sports or for exercise.
• Spend a lot of time standing, especially on concrete floors.
• Wear improperly fitted shoes without arch support and/or cushion.

What are the symptoms of heel pain?

Heel pain symptoms vary depending on the cause. In addition to pain, you may experience:

• Bony growth on the heel.
• Discoloration (bruising or redness).
• Stiffness.
• Swelling.
• Tenderness.
• Pain after standing from a resting/sitting position.

How is heel pain diagnosed?

Your healthcare provider will assess your symptoms and perform a physical exam. You may also get X-rays to check for arthritis, bone fractures, bone alignment and joint damage.

Rarely, you may need an MRI or ultrasound. These can show soft tissue problems which X-rays don’t reveal.

What are the complications of heel pain?

Heel pain can interfere with your ability to get around, work, exercise and complete daily tasks. When it hurts to move, you can become sedentary. An inactive lifestyle can lead to weight gain. You may also become depressed because you can’t do the things you love.

Untreated Achilles tendonitis can cause the tendon to break down (tendinosis). In time, the Achilles tendon can tear or rupture. This problem may require surgery.

How is heel pain managed or treated?

Most problems that cause heel pain get better over time with nonsurgical treatments. Therapies focus on easing pain and inflammation, improving foot flexibility and minimizing stress and strain on the heel. These treatments include:

• Injections: Steroid injections can ease pain and swelling. Steroid injections should rarely, if ever, be given for a tendon problem but may certainly help for plantar fasciitis and bursitis.
• Orthotic devices: Over-the-counter or custom-made shoe inserts (orthotics) can take pressure off the heel. Some people find relief by wearing a splint at night, especially if they get morning pain. A walking boot may be necessary for more severe symptoms. You may also need to switch to more supportive shoes for everyday wear and exercise.
• Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) combined with ice packs ease pain and swelling.
• Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft tissue adhesions. These treatments may reduce pain and inflammation.
• Stretching exercises: Your healthcare provider can show you how to do heel stretching exercises for tight tendons and muscles.
• Taping: You can use athletic or medical tape to support the foot arch or heel.

It’s rare to need surgery to treat most causes of heel pain.

How can I prevent heel pain?

To prevent heel pain or keep pain from returning, it’s important to keep your foot and heel tendons flexible. You should stretch regularly and wear properly fitted, supportive shoes. Runners are especially prone to heel pain. You can prevent running injuries by covering fewer miles and running on softer surfaces.

What is the prognosis (outlook) for people who have heel pain?

Heel pain typically goes away with nonsurgical treatments, but recovery takes time. You need to be patient and give your body time to mend. If you return to your usual activities too quickly, it can set back your recovery. In rare situations, you may need surgery.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Pain that doesn’t improve in a few weeks with rest or pain relievers.
• Pain that makes walking or movement difficult.
• Severe foot or heel swelling, inflammation or stiffness.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What is causing my heel pain?
• What is the best treatment for me?
• What can I do to lower the risk of getting heel pain again?
• What types of symptoms need more urgent evaluation?

A note from Cleveland Clinic

Heel pain often improves over time with nonsurgical treatments. Your healthcare provider can determine what’s causing the pain. Your provider can also show you stretching exercises and recommend orthotics and other methods if needed. Many people try to ignore heel pain and continue with activities that make the problem worse. But it’s essential to give your body time to recover. Otherwise, you may develop chronic heel pain that sidelines you for an extended time. The longer you have heel pain the harder it is to effectively treat, so it’s important to get evaluated.

Charcot Foot; Symptoms, Causes, Diagnosis, Treatment & Management

Overview

Charcot foot is a rare but serious complication that can affect persons with peripheral neuropathy, especially those with diabetes mellitus. Charcot affects the bones, joints, and soft tissues of the foot or ankle. The bones become weak and can break and the joints in the foot or ankle can dislocate. If not caught in its earliest stage, the joints in the foot collapse and the foot eventually becomes deformed. A deformed foot can cause pressure sores to develop in the foot or ankle. An open wound with foot deformity can lead to an infection and even amputation.

Charcot foot develops in persons who have peripheral neuropathy. This is a condition in which the nerves in the lower legs and feet have been damaged. The damage causes a loss of sensation in the feet.

Symptoms and Causes

In the early stages, the foot is red, feels warm to the touch, and there is significant swelling of the extremity.

Researchers have not found one, single cause for Charcot foot. But there are certain known events that create the right conditions for it to develop. One common known event is an unrecognized sprain or injury. Because the individual has peripheral neuropathy, they cannot feel pain or other sensations and the injury can go unnoticed. If a broken bone in the foot or ankle is not correctly treated, the deformity can worsen, lead to foot sores and infection. Charcot foot has also been seen as a complication following organ transplantation in patients with diabetes. (This is due to the use of drugs to prevent organ rejection, which also have the side effect of causing bone loss and fractures.)

When the midfoot is involved in Charcot foot, the arch collapses, which rounds the bottom of the foot. This is called a rocker-bottom foot deformity. Depending on the location of the bone break, the toes can start to curve under like claws or the ankle can become deformed and unstable.

Diagnosis and Tests

In its early stages, Charcot foot is difficult to diagnose. X-rays are often normal. If X-rays and laboratory tests are normal, Charcot foot is diagnosed by knowing the signs of the condition. Charcot foot is suspected in persons who have diabetes and peripheral neuropathy and the following signs: a red, hot, swollen foot (without a foot ulcer) and an increased skin temperature in the affected foot (compared with the other foot).

Management and Treatment

Early diagnosis and treatment can prevent more damage and avoid deformity and other complications. Treatment has three goals: take the weight off the foot, treat bone disease (usually with cast; bisphosphonates and other supplements are sometimes used), and prevent new foot fractures.

Non-surgical treatment

The first and most important treatment is rest or to take the weight off of the affected foot (also called “offloading”). In the early stage of Charcot foot, offloading helps prevent inflammation and stops the condition from getting worse and prevents deformity. Protected weight-bearing (walking in a walking boot) in later stages can prevent complications from the existing deformity and avoid new deformities.

Offloading may involve putting the foot into a cast, which protects it and keeps it from moving. The patient usually wears a series of casts or a removable cast walker over a total of 8 to 12 weeks. Crutches, knee walker, or a wheelchair are used to avoid putting any weight on the affected foot. The cast is changed several times as the swelling in the foot goes down. A cast stays on the foot until the redness, swelling, and heat are resolved.

After the cast is removed, the patient is given a prescription for footwear. Prescription orthopaedic footwear properly fits the foot and relieves pressure points to prevent a repeat injury and ulcers. A common device used is a Charcot Restraint Orthotic Walker (CROW). The doctor may also recommend changes in the patient’s activity to avoid further trauma to the feet.

Surgical treatment

Surgery is recommended for those patients who have severe ankle and foot deformities that are unstable and at high risk of developing a foot ulcer. In addition, if the deformity makes braces and orthotics difficult to use, surgery may be indicated. After surgery, the patient will have to avoid putting full weight on the Charcot foot for an extended period of time.

All people with Charcot foot must be dedicated to wearing protective footwear and taking extra care of their feet for the rest of their lives. Education of the patient and family members about preventive foot care and signs to watch for is an important part of preventing future problems.

Deformity in any part of the foot or ankle can cause skin ulcers from the bone pressing against the shoe or the ground. When Charcot foot affects the ankle, the joint may become unstable or “floppy” because tissue has replaced the bone in the joint. This so-called “floppy foot” also can cause ulcers.

Ulcers are often difficult to heal due to complications of diabetes, poor circulation in the feet, being on your feet for long periods of time, and the development of infections. An infected ulcer that does not heal can be limb-threatening and even result in amputation of the foot or even the leg.

Outlook / Prognosis

All persons with diabetes who have been treated for Charcot foot should have regular foot care with a foot and ankle specialist or a specialist in diabetic foot problems. These specialists will watch for new changes related to Charcot and other diabetic foot complications. Patients who have Charcot foot from other causes also should have regular follow up as recommended by the doctor.

What Is Athlete’s Foot? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Athlete’s foot is highly treatable with nonprescription, over-the-counter (OTC) medications. Your chosen treatment should be used for 2 to 4 weeks, according to the Centers for Disease Control and Prevention (CDC).

Medication Options

OTC antifungal creams, gels, lotions, sprays, and powders for athlete’s foot should contain one of the following active ingredients:

Your doctor may also recommend prescription oral antifungal medicines — examples include terbinafine or itraconazole — or oral antibiotics for any bacterial infections that may develop.

There are also prescription topical creams designed to kill the fungus that causes athlete’s foot.

Alternative and Complementary Therapies

For athlete’s foot, some people swear by home remedies such as tea tree oil or footbaths that contain certain herbal products. However, there have been very few studies evaluating the effectiveness of these remedies for athlete’s foot, and what few exist have yielded conflicting results.

A study published in the Australasian Journal of Dermatology found that a 50 percent tea tree oil solution cured athlete’s foot in about two-thirds of people. The only side effect was minor skin irritation, and that affected nearly 4 percent of study participants.

In addition to tea tree oil, a compound in garlic called ajoene has been shown to have antifungal properties, and some research suggests that it’s effective against tinea pedis.

However, in the United States, this compound can be found only as an ingredient in garlic supplements, and it’s unclear whether these products can help with athlete’s foot.

Prevention of Athlete’s Foot

Steps you can take to prevent athlete’s foot include:

• Keeping feet clean and dry
• Washing your feet with soap after exercising
• Avoiding wearing heavy, closed shoes or thick socks
• Changing socks often
• Making sure socks are washed between uses
• Using antifungal foot powder on feet and in shoes
• Wearing flip-flops in gym showers or locker rooms to avoid contact with fungi
• Airing your feet out by taking your shoes off, or wearing sandals, as often as possible
• Avoiding public swimming pools and public showers
• Not sharing with others items used during exercise (equipment, towels, etc.)

Try wearing only cotton socks, which are more effective at absorbing sweat. If possible, choose footwear made with breathable materials, such as leather. Shoes made of vinyl and similar materials can retain sweat and create an environment for fungi to grow. When you’re doing laundry, consider using hot water and bleach, which can kill fungi in ways detergent can’t.

Related: Is That Rash Psoriasis or Something Else?

Diabetic foot, symptoms, diagnosis, treatment

Description of the disease

Diabetic foot is a severe complication of diabetes, manifested by damage to blood vessels, nerves, muscles and bones of the foot. It is expressed in the appearance on the skin of the foot of deep non-healing ulcers, areas of tissue necrosis. In severe cases, even the bones and ligaments of the foot can be affected. By the way, it is the diabetic foot and the gangrene that develops in connection with it are the most common cause of limb amputation in diabetes mellitus.

How does the diabetic foot arise?

Everyone knows that the main symptom and the main pathological factor of diabetes mellitus is an increased blood glucose level. Normally, the concentration of sugar in the body keeps the hormone insulin at a constant level, which is actively produced by the pancreas when the concentration of glucose increases – for example, after eating. Through chemical reactions, insulin utilizes the glucose that has entered the body and maintains its concentration in the blood at a relatively constant level.

However, if a person is sick with diabetes, this slender system fails, and excess glucose begins to accumulate first in the blood, and then gradually penetrate into the tissues of the body. And, since absolutely everything in our body is interconnected, the violation of carbohydrate metabolism inexorably entails a violation of the metabolism of proteins and fats. In sum, this becomes the reason for the gradual destruction of small capillaries and nerve endings and, as a result, poor blood circulation in the tissues.

The feet are under almost constant stress, and the skin on them is often injured, especially if a person has diabetes mellitus, which is always accompanied by dry skin.Invisible abrasions, cracks and wounds on the skin, combined with a deterioration in blood circulation and tissue nutrition, turn into deep, long-term non-healing wounds, and then, if an infection joins, into ulcers.

Diabetic foot is a fairly frequent complication of diabetes mellitus and can occur in any patient, however, doctors note that patients with bad habits (smoking and drinking alcohol), as well as with concomitant hypertension and high blood cholesterol levels, have a risk of developing diabetic the feet are much higher.

Varieties and symptoms of diabetic foot

According to the main cause leading to the development of diabetic foot, doctors distinguish three clinical forms of this complication: ischemic, neuropathic and mixed.

Ischemic is called the diabetic foot, which has arisen as a result of the predominant damage to the blood vessels and capillaries of the lower extremity. At the same time, manifestations of circulatory disorders are in the first place among the symptoms.
The tissues of the foot suffer from oxygen deficiency, edema and pain appear when walking. But sensitivity remains, there are no calluses and deformities of the foot. Blisters form on the skin, which, without healing, eventually turn into painful sores with uneven edges.

The cause of the neuropathic diabetic foot is a predominant lesion of the nerves of the lower extremity. The most striking symptom of the disease is a decrease in the sensitivity of the foot to temperature changes and touch.At the same time, the skin of the foot and lower leg is dry, flaky, rough calluses appear on the foot, non-healing chronic cracks between the toes and painless ulcers with smooth edges. As the disease progresses, the foot may become deformed.

The mixed form of diabetic foot is characterized by a combination of both vascular and neuropathic causative factors and, accordingly, their manifestations.

Diagnostics and treatment of diabetic foot

Stages of development

Doctors distinguish five stages of development of diabetic foot:

• First stage – ulcers are located only on the skin, without affecting underlying tissues
• Second stage – ulcerative lesions affect the subcutaneous tissue severe cases – muscles and ligaments
• Third stage – joints and bones are involved in the pathological process
• Fourth, fifth stage – gangrenous changes in the lower limb of varying prevalence.

Diagnostic methods

As a rule, diagnostics of diabetic foot is not difficult: the combination of characteristic symptoms and diabetes mellitus speaks for itself. However, for effective treatment of this disease, it is imperative to determine its stage and form. For this, special studies are carried out aimed at studying the intensity of blood circulation in the foot (dopplerometry, angiography), an X-ray of the foot is taken. If there are ulcers or cracks, then it is necessary to take their contents for bacteriological examination.

How to treat?

1. The main principle of diabetic foot treatment is to lower blood sugar levels, that is, to compensate for the underlying disease – diabetes mellitus.
2. Shoes must be comfortable and healthy, because if the diabetic foot has already begun to develop, each crack or abrasion can become fatal and end in gangrene. Bad habits, especially smoking, which provokes vasospasm and aggravates the course of the disease, should be abandoned once and for all.
3. Ulcers are cleaned and treated with antiseptic preparations, areas of dead tissue are removed – this is necessary to prevent the development of foot gangrene.
4. If a patient suffers from an ischemic form of a diabetic foot, he needs medicinal and, in some cases, surgical restoration of blood flow.
5. The neuropathic form requires taking medications that improve the metabolism in the nervous tissue and stimulate the restoration of nerve endings in the lower extremities.

How to avoid?

Preventive measures for diabetic foot can be reduced to three main points:

• control over the underlying disease and maintaining diabetes mellitus in the stage of compensation by following a diet and taking antihyperglycemic drugs;
• complete rejection of bad habits , especially smoking
• wearing comfortable shoes and taking care of your feet – a neat, non-traumatic pedicure and moisturizing creams that will help fight dry skin.If rubbing or cracks do appear, consult your doctor, because these may be the first symptoms of a severe complication of diabetes mellitus.

The main thing is to remember that diabetes is not a death sentence. It is only important to take care of yourself, control blood sugar levels and not aggravate the course of the disease with bad habits. And if even the slightest problems with your legs appear, even if at first glance these are only harmless corns or cracks, do not hesitate to consult a doctor.Our experienced endocrinologist will take all possible measures to improve your condition.

See also : Blood tests, diseases of the pancreas.

Foot cancer symptoms, diagnosis, treatment

Foot cancer: diagnosis, possible causes

What is

Foot cancer is a malignant neoplasm in the form of a sarcoma.

Sarcoma is a cancer that develops in human bone tissues.

Classification

Sarcoma has the following forms.

Osteosarcoma

Cancer that develops in bone structures. The areas it affects are areas of the bone, as well as the soft tissue near the bone.

This is the most common form of cancer. It most often occurs in adults, unlike other forms of cancer that can occur in children. It is very easy to diagnose this form.The zone of distribution of osteosarcoma is the calcaneus.

Ewing’s Sarcoma

Ewing’s sarcoma is a cancer of the bone skeleton that affects the lower part of the tubular bones, often affecting the foot.

This form is aggressive and asymptomatic. It causes painful sensations already at such stages of its development, when metastases may appear. Typically occurs in children, adolescents and adults under twenty.

Chondrosarcoma

A type of cancer that affects the cartilaginous parts of the foot.Often it is a tumor of a dense nature, which is located very close to the cortical bone layer. It can grow into the bone to a depth of various nature.

This form of cancer is difficult to diagnose because it looks like a benign tumor. It is usually detected in people of middle and older age.

Reasons

It is believed that foot cancer can develop due to the following factors:

• Heavy loads on the foot;
• Injuries, damage to the tissues of the foot;
• Hereditary tendency towards cancer;
• Chemotherapy that was given to treat another disease;
• Chronic osteomyelitis;
• Long-term exposure to ultraviolet rays;
• Skeletal anomalies, bone deformities (acquired or congenital).

The more factors there are in the history, the greater the risk of pathology.

Symptoms

There is a chance that the symptoms of foot cancer will not appear for some time. The picture of the disease can be similar to myositis, myalgia, rheumatoid arthritis.

But there are, nevertheless, several characteristic symptoms of the disease:

• The emergence of hard growths on the bone, bulges, changes in the shape of the fingers;
• Swelling, edema;
• Soft tissues increase in size;
• Unpleasant sensations localized in the sole of the foot, the lifting zone, fingers, lower leg;
• Headache, fatigue, fever, skin redness, lack of appetite.

Diagnostics

It is necessary to contact an oncologist who will prescribe an examination.

Its main types:

Biopsy

A procedure in which a small piece of tissue is taken for analysis. Based on the results of this study, a diagnosis is made, which will determine the type of tumor.

Radiography

This procedure can determine where the tumor is and what its nature, type, reveals ossification in soft tissues.

MRI (magnetic resonance imaging)

This procedure uses magnetism to render the organs in layers.

Computed tomography

In some cases, foot cancer can metastasize to the lungs, so this diagnostic procedure is necessary to identify possible complications. The scan provides a three-dimensional image of human organs.

Positron emission tomography

This type of study, using low doses of radioactive sugar, allows you to measure the nature of the activity of cells in the human body.

Treatment

It is necessary to treat cancer of this type in a comprehensive manner.

There are the following methods:

Surgical intervention

There are two methods for treating sarcoma in surgery.

Prosthetic-sparing

With this method, partial removal of damaged tissues occurs.

Complete amputation of a limb

This method is used if the cancer has spread to the nerve tissue and blood vessels through the bone.

Chemotherapy

In order to make abnormal cells harmless, the patient takes cytotoxic drugs, which can subsequently improve the results of surgical treatment. Most often, chemotherapy is given before surgery and resumed after surgery in order to kill any remaining cancer cells.

Radiation therapy

The method involves the use of high-energy beams while preserving as many healthy cells of the body as possible.Usually this method is used after surgery. It is also recommended for the treatment of tumors when surgery is impossible.

Forecast

Despite all the risks associated with cancer treatment, today the survival rate for patients with foot cancer is eighty percent. The chances of recovery are directly related to the timely visit of the patient to the oncologist.

Prevention

To reduce the risks of foot oncology, you need to adhere to a healthy lifestyle, wear comfortable shoes, prevent injuries to the limbs and not give your feet excessive physical exertion.

For foot cancer, contact the Onco.Rehab clinic for help.

90 025 90 000 treatment and diagnosis of causes, symptoms in Moscow

What is it

The diabetic foot is one of the serious complications of diabetes mellitus. These are negative (pathological) changes in the feet in the form of ulcers, damage to bones and joints, loss of skin sensitivity. The disease is not only significantly common among patients with diabetes mellitus, but in advanced cases, without a timely visit to a doctor, it can lead to amputation.

Causes and prevention of diabetic foot

The causes of the diabetic foot lie in the general changes in blood circulation against the background of diabetes mellitus. When an excessive amount of glucose is contained in the blood for a long time, disturbances in carbohydrate and lipid metabolism inevitably occur. The nature of these disorders is still being actively studied, since the topic of diabetes mellitus is extremely relevant for many thousands of patients. Changes in metabolic processes become either the cause or the catalyst of atherosclerosis, i.e.e. narrowing of the arteries and deterioration of the blood supply to the tissues of the body. First of all, due to physiological characteristics, the tissues of the lower extremities begin to suffer, especially the nerve endings: the cells do not receive the required amount of nutrients and gradually either die off or undergo irreversible changes. After that, the small wounds appearing on the feet heal more slowly, the pain syndrome is weakened due to the incorrect work of the nerve endings, the wounds can grow, bacteria and viruses can enter them, causing suppuration, which without treatment will quickly turn into trophic ulcers.

Thus, the cause of the development of diabetic foot is initially a violation of blood supply against the background of hyperglycemia. And further development is negatively influenced by injuries, injuries to the feet, fungal lesions, tight shoes, hypertension.

Unfortunately, many patients with diabetes mellitus also experience SDS. Therefore, a responsible and attentive attitude to one’s health is so important, because there are effective methods for the prevention of diabetic foot.Firstly, it is monitoring and control over the course of diabetes mellitus – an experienced specialist of our Center will help with this. Secondly, you need to develop the habit of regularly examining your feet and noting any minor changes, up to and including a long-lasting callus. The disease is too serious to neglect even the smallest details. Thirdly, it is useful to learn simple manipulations for care, maintaining foot hygiene: daily examinations, regular washing, changing socks, wearing comfortable shoes, cutting nails. It is better to go barefoot and in shoes with open toes less often to avoid injury.

Symptoms of a diabetic foot

Diabetic foot syndrome is very insidious: dying nerve endings do not allow a person to track pain syndrome, as a signal of changes that have begun in the tissues. Therefore, the problem remains unnoticed for a long time.

There are three types of diabetic feet with their specific symptoms:

• Neuropathic – associated with the destruction of nerve endings. It is expressed in increased dryness of the skin of the feet, numbness, decrease or loss of skin sensitivity, painful sensations when walking, which pass at rest.
• Ischemic – associated with impaired blood supply. It manifests itself in edema, redness, severe pain in the feet at night, changes in skin color, ingrown nails, pigmentation.
• Mixed or neuroischemic – occurs often, because usually violations occur in the circulatory and nervous systems in an interconnected manner. Therefore, the symptoms listed above may be present at the same time.

Additional general symptoms that should raise suspicion include:

• Calf cramps;

90,040 itching in the feet, tingling sensations;

• fast fatigue of the feet;
• long non-healing scratches, calluses;
• small bubbles with clear liquid;

Foot ulcers are the most severe and neglected symptom.

Diagnostics

Diagnosis of a diabetic foot consists in studying the history of the course of diabetes mellitus, interviewing, examining the patient. In addition, to find out the mechanism of the complication, it is necessary to examine the condition of the joints, blood vessels, nerve endings of the foot – this can be X-ray, MRI, angiography, ultrasound Doppler ultrasound.

Diabetic foot treatment

Treatment options for a diabetic foot depend on the capabilities of the medical center you visit.At the FNCC, the treatment of diabetes mellitus and complications is one of the main areas of activity, therefore our specialists have all the necessary knowledge, skills and are provided with a modern medical and diagnostic base for the successful treatment of patients.

Treatment is usually divided into conservative and surgical. Conservative measures primarily include measures to stabilize blood sugar levels and reduce stress on the legs. In some cases, drug therapy with vasodilators may be helpful.When contacting a doctor at the stage of ulceration, it is important to prevent their spread, if the condition of the ulcers is neglected, then it is necessary to remove them surgically.

In addition to removing ulcers, surgical treatment of a diabetic foot consists of minimally invasive (i.e., minimal intervention) surgery. During the operation, a balloon is inserted into the large vessels of the foot through a small opening, moving along the vessel, it expands the gap. After that, a stent is inserted into the narrowing site of the vessel, which will support the walls to prevent re-narrowing.

Our specialists consider the diabetic foot in a complex manner, together with the underlying disease (diabetes mellitus) and possible concomitant ones (atherosclerosis, neuropathy, hypertension). Therefore, the treatment is carried out in a comprehensive manner in order to achieve the maximum effect: several specialists can be involved in the treatment of one patient, often even from different departments (gastroenterological, surgical, cardiological). With this approach, patients receive all the necessary medical care in one place under the supervision of their attending physician.

You can sign up for a consultation through a special form on the website or by phone.

Diabetic foot: symptoms and treatment

The danger of insufficient attention to the diagnosis and treatment of diabetes mellitus lies in the development of many extremely serious complications. In 8-10% of cases, its manifestation at a late stage is the diabetic foot – the result of tissue death and dysfunction of blood vessels and nerves in the lower extremities.Ulcers form on the feet of patients, which in some cases can lead to gangrene and even amputation of part of the limb. Given that the risk group includes up to 50% of patients with diabetes mellitus, it is necessary to take timely care of prevention and diagnosis. Our medical center in Moscow will help you with this: at the CBCP clinic you will undergo examinations using the latest equipment and receive professional advice to avoid the development of a diabetic foot.

What is a diabetic foot?

Medical practice shows that many people with diabetes mellitus symptoms ignore the problem of metabolic disorders in the body and seek medical attention only when serious complications appear.Only in 50% of cases calls are recorded at an early stage.

A number of patients really pay attention and begin treatment for this disease when they show signs and symptoms of developing diabetic foot syndrome:

• the tissues become “overgrown” with ulcers;
• under the influence of infections, necrosis develops;
• the leather on the sole is cracked;
• in part of the vessels, blood flow is disturbed or completely stopped;
• the limb itself loses its function.

A person cannot step on their feet due to pain, and then completely loses the ability to move independently. The tissues of the foot gradually die off – this concerns the nerves, joints, bones and blood vessels. The patient inevitably becomes disabled.

Meanwhile, the symptoms of a diabetic foot are a severe and advanced stage of diabetes mellitus (in 90% we are talking about type II diabetes), which requires immediate and qualified treatment.Ulcers will not “overgrow” by themselves, and a gradual decrease in physical activity will lead to an aggravation of the disease. Most often, signs and symptoms appear 10-15 years after the first manifestations of diabetes. At the same time, in most cases, this concerns patients who do not pay due attention to diabetic treatment and prevention.

Of course, not all diabetic patients develop diabetic foot syndrome. However, about half of them are at risk, and statistics show the occurrence of this complication in 10% of diabetics.

Why does a diabetic leg ulcer occur?

Causes of

Often, diabetic foot syndrome is a consequence of diabetes mellitus, which is accompanied by atherosclerosis, coronary heart disease, arterial hypertension, smoking, and alcohol abuse.

However, a diabetic leg ulcer can also be caused by a seemingly harmless cause. People with diabetes may not pay attention to calluses, calluses, a crack in the heel, an ingrown toenail due to tight shoes.Meanwhile, these minor injuries provoke the disease.

Diabetes mellitus negatively affects the work of the whole organism, but the lower extremities suffer the most (especially since they have a serious daily load). Saturation of blood with excess sugar and glucose destroys blood vessels – large and small (distinguish between macro- and microangiopathy in diabetes), bones and muscles. Due to the anatomical features, blood circulates in the legs of any person worse than in the rest of the body, so it is the feet that are the first to suffer from total circulatory problems in diabetes.

The mechanism of occurrence of diabetic foot

Nerves are affected, the sensitivity of tissues is dulled, so a person may feel weak pain from cracks in the soles, small ulcers on the skin of the foot. This phenomenon is called diabetic neuropathy, and it is extremely insidious.

Small injuries take a long time to heal, but the patient does not take them seriously, as the level of pain is reduced. By the way, this prevents many diabetics from feeling that they are wearing the wrong shoes, which injure their feet.Only over time, growing ulcers and cracks begin to interfere with walking.

Due to the deterioration of tissue nutrition:

• the skin of the foot becomes darker;
• ulcers form on it;
• the shape of the nails changes;
• bones are deformed;
• joints work poorly.

As a result, any injury threatens the formation of a wound, into which infection and bacteria easily penetrate.In turn, they soften the tissues – the wounds grow into trophic ulcers, the cells begin to die off, forming necrotic areas of black color. The process affects the subcutaneous fat, muscles, and then penetrates the ligaments and bones. In the end, on the basis of ulcers, gangrene, abscesses, phlegmon develop.

Classification of forms of diabetic foot

Diabetic foot syndrome is distinguished by the severity of the disease. There are 6 stages, starting from zero (the foot is deformed, hyperkeratosis occurs, calluses are formed) and ending with the fifth (extensive spread of gangrene).

The traditional classification includes 3 forms of the disease.

1. The most common neuropathic form (about 70% of all cases). Diabetes mellitus affects, first of all, the nervous apparatus of the legs, due to which the sensitivity of tissues to heat, pain, and touch is significantly reduced. The skin becomes dry, hyperkeratosis occurs (the skin is excessively flaky), anhidrosis (sweating is disturbed), flat feet develop. The bones of the foot can become deformed (a common symptom is the formation of a Charcot joint) and become overly fragile, which increases the risk of unexpected fractures.

2. ischemic form accounts for up to 10% of cases. It is characterized by atherosclerotic disturbance of the blood supply to the foot due to the destruction of large and small vessels under the influence of excess sugar and glucose. As a result, the leg swells noticeably, and the swelling practically does not subside. Walking causes discomfort or pain in the patient, he is limp, gets tired quickly and is unable to travel long distances. Visually, you can see how the skin pigmentation changes.

3.Approximately 20% of cases of diabetic foot syndrome occur in mixed form , which is also called neuroischemic. This is the most complex disease, since the symptoms and signs of the previous forms are clearly expressed in it.

Most often, individual forms (neuropathic or ischemic) are diagnosed in the early stages. Their occurrence depends on what problems the patient is facing – whether he is worried about neuropathy or ischemia. Over time, the manifestations of the disease become more complicated, and both forms flow into one another.

The most severe form is diabetic gangrene . In this case, the blood supply is disturbed over a wide area of ​​the leg – up to the top of the lower leg. This provokes the development of anaerobic infection, since the cells on the affected limb do not resist its penetration. This is the most advanced form of the disease, when only amputation can help. That is why treatment for diabetic foot symptoms should be started as early as possible.

Symptoms and signs of diabetic foot

What are the signs to recognize the appearance of this disease? All people diagnosed with diabetes mellitus need to closely monitor them.At the first visual signs and symptoms, see a doctor and undergo a qualified examination.

Signs of a diabetic foot

• Ingrown toenail is formed if the corners are not properly trimmed. They can grow into tissues, and in these places inflammation occurs and pus is formed, which is fraught with more serious consequences.
• A darkened nail indicates hemorrhage underneath. The most common cause is uncomfortable shoes.The consequences are the same – inflammation, pus, ulcer.
• Thickened nail can be caused by fungal infection. Due to the irregular shape of the nail, the tissues under it are injured, it can press on the adjacent fingers. In general, diabetics need to closely monitor the prevention of fungal diseases.
• Calluses and corns – a common sign of the onset of diabetic foot. It is in them that imperceptible hemorrhages occur, pus is formed. Most patients “treat” these formations with patches and ointments, only exacerbating the problem.
• Cuts are caused by various factors, but in any case, they should be carefully treated, as the wounds can be attacked by infection.
• Cracked heels are directly related to dry skin in the neuropathic form of diabetic foot. Cracking leads to ulceration and bleeding.
• Deformation of the joints and bones on the foot provokes the formation of calluses and wounds on the skin.

Symptoms of a diabetic foot

A common symptom for all forms of diabetic foot is discomfort or pain when walking, associated with a violation of the integrity of tissues, wounds, suppurations, ulcers.

• With ischemic form, the patient quickly feels tired in the legs when walking, limps. After light exertion, the limbs swell, the skin is cold to the touch, has a pale shade, against which pigmented spots stand out. When probing the veins of the foot, a noticeably weakened pulsation is observed. Calluses, cracks, wounds form on the skin, which do not heal for a long time. They are replaced by festering or scabby ulcers. The skin itself becomes dry, sweating is extremely scarce.
• In the neuropathic form of the diabetic foot, the areas of the foot that are most affected by the pressure when walking are usually affected: thumbs, interphalangeal space.Signs such as cracks, abrasions, and edematous ulcers are also characteristic. Very often, joints and bones change shape (protruding bones, hook-, hammer-like fingers), they are affected by osteoporosis, the joints swell, and the bones undergo fractures. The accumulation of fluid in the tissues is often observed, the pulse in the arteries is preserved, and the sensitivity of the tissues decreases.

Which doctor treats diabetic feet?

In order to undergo high-quality diagnostics and receive qualified treatment, you must contact one of the following doctors:

• Diabetologist – most often he is an endocrinologist who deals with metabolic disorders and, in particular, diabetes mellitus;
• General and vascular surgeons treat dysfunctions of the vessels of the lower extremities, the consequences of atherosclerosis;
• The neuropathologist will determine the degree of disorders of the nervous system in the leg area;
• the orthopedist will select the correct shoes to relieve the foot;
• Podiatrist specializes in foot care and treats patients with diabetic foot syndrome.

Diagnosis of diabetic foot syndrome

When heading to the office of a diabetic foot of an endocrinologist-diabetologist, be prepared for the fact that there may be a need to visit an orthopedist, vascular surgeon, etc. Accordingly, the range of diagnostic procedures in each individual case may vary.

An important role in the diagnosis, detection of signs of the disease is assigned to … the patient himself. If you are at risk, periodically self-examine your feet for any of the above signs of illness.At the slightest suspicion, visit a diabetic foot clinic.

• The doctor determines the degree of sensitivity of the foot tissues, reflexes and other indicators.
• Laboratory tests that show characteristic changes in the composition of the blood are extremely important.
• Most often, the presence of ulcers requires bacterial sowing of their content on the microflora.
• In ischemic form, ultrasound examinations of the vessels are prescribed. The method of duplex scanning of the veins of the lower extremities is extremely informative.
• Depending on the specific case, angiography, CT arteriography can be used.
• X-rays are taken to diagnose changes in bones and joints.

The CBCP Clinic offers the latest research on vascular dysfunction in diabetic foot. Ultrasound of the vessels of the lower extremities, carried out on modern equipment of an expert class, allows the doctor to obtain maximum information about the pathology.

How is a diabetic foot treated?

• If the patient’s condition does not require hospitalization and the disease is not started, the doctor will correct the diet in order to achieve the correct balance of carbohydrates and the release of the required amount of hormones in the body.
• If during the diagnosis problems with blood pressure are identified, systemic drug therapy with beta-blockers, inhibitors, diuretics, etc. is prescribed.
• Treatment of diabetic foot is inextricably linked with therapy for diabetes mellitus.Therefore, the patient takes insulin and medications in strictly adjusted doses to stabilize the level of sugar and glucose in the blood.
• To combat the expansion of ulcers due to the multiplication of microbes, antibiotic therapy is carried out. The patient is taking antispasmodics, actovegin, a-lipoic acid preparations.
• If there are suppurations, ulcers on the foot, treatment by an orthopedist is necessary. Special orthopedic devices, bandages, insoles, movement restraints, etc. are used.
• Wounds and ulcers are treated with antiseptics and antibacterial agents. If necessary, the surgeon excises necrotic tissue, removes potentially dangerous calluses, corns.
• Severe vascular lesions are treated by a vascular surgeon. Modern medicine offers a wide range of low-traumatic methods: stenting, bypass grafting, angioplasty, thromboembolectomy, etc.
• If the foot is covered with gangrene and does not respond to treatment, amputation is performed.

Prognosis for diabetic foot syndrome

Is it possible to stop the disease and get rid of its symptoms? Modern medicine answers the question positively – with one caveat: if treatment is started in a timely manner and at an early stage. That is why it is so important to seek professional help at the first symptoms and signs of a diabetic foot. For diabetics, regular visits to the doctor are a must!

Prevention of diabetic foot symptoms

• Particular attention should be paid to prevention for people with a solid diabetes “experience”.In addition to preventive measures for diabetes mellitus (control of nutrition, blood glucose levels, etc.), there are specific recommendations:
• Wearing special shoes without seams, with orthopedic insoles;
• performing gymnastics for the foot, self-massage;
• Thorough foot hygiene, accurate pedicure;
• Skin treatment with creams recommended by a doctor.

Why is it important to see a doctor and start treatment on time, when the first symptoms appear?

The consequences of diabetes mellitus at an early stage seem insignificant to many patients, so some of them delay the visit to the doctor.However, the changes in your body caused by the disease will not go away on their own, and in the absence of medical care, your condition will only get worse every year. It should be remembered that in 10-25% this disease leads to disability, therefore, the timeliness of the measures taken is extremely important.

Diagnostics and treatment at the Center for Circulatory Pathology

The Center for Circulatory Pathology (CBCP Clinic) offers modern methods of examining vascular disorders in diabetes mellitus and diabetic foot syndrome.At your service – experienced doctors of functional and ultrasound diagnostics, innovative diagnostic methods, equipment used in leading clinics in Europe. At CBCP, highly qualified specialists are admitted. You will receive detailed recommendations from an endocrinologist, vascular surgeon.

Epidermophytosis of the feet: causes, symptoms, diagnosis

For the development of the disease, it is necessary not only to get the pathogen, but also the presence of factors that contribute to the further reproduction of the fungus:

• deep skin folds of the feet;
• change in the chemical composition of sweat;
• endocrine disruptions;
• hyperhidrosis;

90,040 injuries to the skin of the legs;

• vegetative vascular dystonia.

After contact of fungi on the skin, they can be in saprophytic form for a long time without causing clinical symptoms. For epidermophytosis, several variants of the course are characteristic, and some suggest the spread of the process to the nail plate.

Symptoms of epidermophytosis

The first symptoms of the disease appear as itching in the interdigital folds, especially between the 4th and 5th fingers. At first, itching is slight, accompanied by peeling and cracks, from which serous fluid is released.If nothing is done at this stage, then the rest of the interdigital spaces and part of the foot are gradually affected. In conditions of constant wetting, fungi multiply even more abundantly, which contributes to the progression of the disease.

Through the ulcers, the pathogen easily penetrates deep into the tissues, which provokes the development of an eczematous reaction. This complication is manifested by profuse, itchy blisters filled with serous contents.

A similar course can last for years. In this case, periodic purulent complications are possible, when the vesicles are filled with a thick liquid, and the inflammation passes to the dorsum of the foot, accompanied by sharp pain and restriction of movements.

In one of the variants of the course, conglomerates of deep dense vesicles with serous fluid may appear on healthy skin. The vesicles open up on their own: first, the tire falls off, and then the bottom of the vesicle is exposed, from which the serous fluid is regularly separated. The resulting ulcers can merge and move to large areas of the skin of the soles, causing significant discomfort when walking.

In the process of reproduction, fungi produce toxins that have a sensitizing effect.Immunity responds with the development of an allergic reaction in the form of a rash, localized mainly on the palms. The rash consists of small vesicles with a serous component, which, bursting, expose the delicate, oozing surface of the epidermis. Microscopy of scrapings from these ulcers cannot reveal fungi, since the process is caused not by the pathogen itself, but by their toxins.

The peak incidence of dermatomycosis is observed in the summer, since during this period all the predisposing factors are realized.

When the nail plate is damaged, excessive subungual hyperkeratosis develops. The nail turns yellow and the edge is jagged. Most often, such changes appear on the 1st and 5th toes of the foot, since they account for the maximum contact with the infected surface.

Treatment of epidermophytosis

For a better forecast, it is important to pay sufficient attention to the correct treatment of the infected areas. Doctors strongly recommend daily foot baths with potassium permanganate.All crusts must be carefully removed, vesicles can be opened and the tire removed for better healing. After the baths, wet dressings are applied moistened with 0.1% copper sulfate and 0.4% zinc, or 1% resorcinol solution.

As soon as it is possible to achieve the cessation of wetting, the use of Dermozolone or Mycozolone is indicated. For drying and epithelialization of ulcers, you can use alcohol dyes, Castellani paint. If necessary, it is possible to use fungicidal pastes or ointments.

The result is determined not only by the selected drugs, but also by their correct use, taking into account the phase of the disease and the doctor’s advice. After visual normalization and disappearance of painful symptoms, experts recommend conducting a microscopic control study. In case of negative results, you can stop using antifungal ointments.

Having achieved a positive response from treatment, do not forget about possible relapses. After the main process subsides, it is necessary to wipe the feet with 1% thymol or 2% salicylic alcohol for another month, after which they must be powdered with boric powder.

It is important to take proper care of your shoes. To this end, it is recommended to wipe the shoe insoles with a formaldehyde solution, after which the shoes must be stored in an airtight bag for 2 days, and then dried. It is advisable to boil the rest of the clothes for 10 minutes. If this is not possible, then you need to get rid of clothes and shoes, because the reuse of these wardrobe items contributes to a new infection.

Complicated epidermophytosis should be treated with antibiotics.Most often, Methicillin, Cephaloridin, Erythromycin are prescribed. During the period of treatment, you should follow the correct daily routine and bed rest.

Prevention of epidermophytosis

In prevention, disinfection of surfaces in all public places involving skin contact is important. Employees of these places and their regular visitors are advised to periodically see a dermatologist.

Potential carriers of the fungus need to strictly follow the rules for caring for feet and shoes: at the end of the day, wash your feet with soap, then wipe them dry with a towel, change socks daily and never wear someone else’s shoes.When going to public baths or the pool, individual slippers should be used, which should be disinfected regularly.

90,000 causes of occurrence, symptoms of the disease, diagnosis and treatment methods

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct prescription of treatment, you should contact your doctor.

Flat feet: causes, symptoms, diagnosis and treatment.

Definition

The human foot consists of 26 bones that are connected by muscles and tendons. It is an excellent shock absorber that protects against excessive shock loads while walking, running and jumping.

Flat feet is an orthopedic disease characterized by a change in the shape of the arches of the foot, accompanied by the loss of its shock-absorbing function.Such a foot is not able to fully spring, smoothing out the shock load, it comes into contact with the surface with the entire plane, which causes pain and micro-shocks of the ankle.

Causes of flat feet

All babies are born with flat feet. In the process of growth, due to the work of muscles and ligaments, arches (concavities) are formed. However, for their full development, it is important that the child be able to walk barefoot on various surfaces – only a smooth floor does not give the necessary load on the feet.Orthopedic doctors note an increase in the number of children with acquired flat feet, especially in large cities.

The next reason is hereditary weakness of the muscles and ligaments of the foot and lower leg, in which the risk of developing flat feet increases with an increase in body weight, wearing high-heeled shoes, a sedentary lifestyle (insufficient physical activity). The risk group includes people whose profession requires a long stay in a standing position – hairdressers, salespeople, etc.

Flat feet can result from trauma to the ankle, tarsal or heel bones, and muscles and ligaments that strengthen the arch of the foot.

Flat feet occurs as a complication of poliomyelitis, when the muscles of the sole and lower leg are paralyzed.

Disease classification

Children are distinguished:

1. Physiological forms of flat feet – calcaneal-valgus deformities in newborns and mobile flat feet in children. No treatment required.
2. Pathological forms of flat feet – congenital vertical position of the talus, tarsal coalitions, valgus-adducted foot, neurogenic deformities of the foot and hypermobile flat feet with shortening of the Achilles tendon.For these pathologies, surgical treatment is recommended.

In adults , according to the nature of the decrease in the height of the arches , there are:

1. Transverse flat feet, characterized by a decrease or complete loss of the transverse arch of the foot.
2. Longitudinal flat feet, which is characterized by a decrease or complete loss of the longitudinal arch of the foot.
3. Combined flat feet, when combined flattening of both arches of the foot is revealed.

There is an X-ray classification of flat feet, which determines 3 degrees of the disease.X-ray is used to analyze the angles of the arch of the foot and to assess additional bone changes against the background of flat feet.

Doctors subdivide flat feet into fixed and non-fixed:

• with fixed flat feet, the flatness of the arches of the foot remains even without load;
• with non-fixed flat feet, the arches of the foot are restored as soon as the load on the foot stops.

Symptoms of flat feet

It is possible to speak with confidence about the presence of a flat foot in a child only closer to the age of 6-7 years, when the main stage of the intensive formation of the support of the lower extremities is completed.By and large, up to this age, all children ‘s feet, to a greater or lesser extent, look flat.

Only cases of congenital flat feet can be distinguished – in such children, the sole is usually convex, and the upper (back) part of the foot is unnaturally concave. Once in an upright position, such a baby rests on the heel.

At the age of 7-8 years, a child with flat feet may begin to complain of pain in the legs, which gets worse in the evening; after a long walk, the legs sometimes swell.In children with flat feet, shoes wear out on the inside, which can also lead parents to think about the disease.

In adults, flat feet can be asymptomatic for a long time, so a person does not seek medical help for a long time. With a detailed survey, the patient complains of discomfort in the feet area, rapid fatigue when walking. Over time, with prolonged walking or long standing, the pain spreads to the lower legs, but disappears after rest. Subsequently, soreness appears with less stress and can partially persist even after rest.In some cases, there is a violation of gait, limping.

In addition, difficulties arise when choosing shoes – you have to take shoes half a size or a size larger than before.

With long-term uncorrected flat feet, deformation of the toes develops – they creep on top of each other, as a result, corns, calluses, ingrown nails are formed.

Diagnostics of flat feet

The basic principle of diagnostics and assessment of flat feet in children is the differentiation of pathological forms of flat feet and physiological ones.Most children are seen by a pediatric orthopedic traumatologist with a so-called mobile flat foot, a condition that does not require treatment. Mobile flat feet is considered a normal variant, does not lead to pathological changes and tends to improve spontaneously as the child grows. Pathological variants of a flat foot in children are characterized by varying degrees of limitation of mobility in the joints of the foot, secondary changes and, as a rule, require surgical treatment.

In adults, the diagnosis of flat feet is established on the basis of complaints and the results of a medical examination, which is performed under load, without load, while walking. To objectify the picture, the doctor assesses the degree of reduction of the arches of the foot in centimeters, specifies the nature of the installation of the feet with a goniometer, draws attention to painful keratoses (corns, calluses) and metatarsalgia (soreness) in the forefoot.

For screening examination of patients who do not have complaints, plantoscopy is used – the study of a footprint in a standing position.Normally, a foot with well-defined arches is not completely in contact with the supporting surface – the front part of the foot, its outer edge and heel area are imprinted. The more pronounced the flat feet, the more completely the contour of the foot is painted over. Plantoscopy makes it possible to quickly, accurately and without harm to health identify deviations and send the patient for an in-depth examination.

Instrumental diagnostics involves radiography of the feet in three projections. Based on the analysis of the X-ray, the doctor determines the degree of flat feet, evaluates possible complications in the form of osteoarthritis (wear of the articular cartilage) and various deformities.

Diabetic foot, treatment and symptoms – (Clinic Di Center)

Diabetic foot is a lesion of the tissues of the foot in a patient with diabetes mellitus. Untimely treatment of a diabetic foot entails formidable complications that entail serious consequences: from high amputation of the lower limb to the death of the patient.

Diabetes mellitus is currently one of the most important problems of modern medicine.Everywhere there is a tendency to an increase in the number of patients with diabetic foot syndrome, whose share in Russia is 4-10% and in the USA 3-8% of all patients with diabetes mellitus.

The combination of purulent-necrotic lesions with critical ischemia of the lower extremity leaves little chance of maintaining the latter. The number of patients with neuroischemic lesions is constantly growing and has already reached 40% in the structure of diabetic foot syndrome. As a rule, these patients are burdened with a heavy load of concomitant diseases, which sharply increase the risk of surgical treatment and call into question the possibility of anesthesia.

Symptoms and mechanisms of development.

The following signs of diabetic foot syndrome may be observed:

• numbness, decreased sensitivity;
• changing the shape and color of the foot;
• Thickening and deformation of the shape of the nails;
• deformity of the joints of the foot;

90,040 difficulty and pain in walking;

90,040 edema;

90,040 itching, dryness and flaking;

• temperature rise in combination with a wound.

The mechanism of development of the diabetic foot always has the same clinical scheme:

• Nerve damage. The sensitivity in the limbs decreases, and the person detects wounds and injuries late, and starts therapy late.
• Circulatory disorders. Due to poor blood flow, tissues are slowly regenerated, even small wounds and ulcers are difficult to heal.
• Inclusion of joints in the picture. It is a problem in itself and deforms the contour of the legs and interferes with normal movement, increasing the risk of injury and calluses.
• Fungal and bacterial infections. A weakened person is generally less protected from them. Pathogenic microorganisms easily penetrate into the violation of the integrity of the skin, significantly complicating healing and increasing the susceptibility to general infection.

Non-healing wound sites lead to diffuse purulent inflammation, destruction and death of deeper tissue structures. If the situation goes this far, there is a risk of amputation.

Amputation? No!

The above factors for a long period of time determined the dominance of lower limb amputations in this category of patients.The prevailing fear of surgeons about organ-preserving operations on the foot in critical ischemia, and even against the background of diabetes mellitus, is quite natural, since the proportion of unsatisfactory results was very high.

The lack of modern possibilities at the previous stages of the development of surgery and the reserved attitude of surgeons to the use of the available methods of vascular surgery in patients were also essential. It was believed that in diabetes mellitus, reconstructive vascular operations are not indicated, since in this disease, damage to small vessels or microvasculature predominates.However, according to a number of studies, patients with diabetes mellitus can successfully perform operations to restore patency of the arteries of the lower extremities, and their effectiveness is much higher and long-term results are better than with drug treatment.
In addition, surgical reconstruction of the arteries in a patient with ischemic foot ulcers significantly increases the likelihood of healing. Successful performance of intravascular coronary operations has opened up opportunities for surgical correction of another life-threatening manifestation of atherosclerosis of critical lower limb ischemia.In recent years, there have been reports of a good therapeutic effect of percutaneous balloon plastic surgery in critical ischemia of the lower limb in patients with diabetes mellitus.

Treatment of diabetic feet with balloon plastic

An innovative method of treating diabetic feet with balloon plastics in Saratov and Engels can be performed at the Medical Di Center. This operation takes place under local anesthesia and removes the blockage of the vessels of the foot. The puncture site of the artery is treated with an antiseptic and a local anesthetic is injected under the skin.The doctor then inserts a balloon catheter into the vessel.
As soon as the balloon reaches the site of the stenosis, it is inflated under pressure, as a result of which the sclerotic plaques are straightened and pressed into the walls of the vessel. The balloon is then removed. Thus, vascular patency is restored and blood flow is normalized. A pressure bandage is applied to the puncture site to prevent bleeding.

Benefits of this technique:

• performed under local anesthesia and no general anesthesia,
• low-trauma (gentle) procedure that does not require an incision,
• Possibility to return to the usual rhythm of life in a few days.

Balloon repair is indicated in cases where there is no clinical improvement despite ongoing therapy and lifestyle changes.