What causes stabbing heel pain in the morning. How to diagnose plantar fasciitis. Which treatments provide relief for inflamed plantar fascia. When to see a podiatrist for persistent foot pain.

Understanding Plantar Fasciitis: The Source of Morning Heel Pain

Plantar fasciitis is a common condition that causes intense heel pain, especially when taking your first steps in the morning or after periods of inactivity. It occurs when the plantar fascia – a thick band of tissue that runs along the bottom of your foot from heel to toes – becomes inflamed or damaged.

The hallmark symptom of plantar fasciitis is a sharp, stabbing pain in the heel upon waking up and putting weight on your feet. This pain tends to slowly subside as you move around and the tissue warms up, but it can significantly impact your mobility and quality of life.

What exactly is the plantar fascia?

The plantar fascia is a crucial supportive structure in the foot. It acts as a shock absorber and helps maintain the arch of the foot. When this tissue is overstressed or injured, it can develop tiny tears that lead to inflammation and pain.

Common Causes and Risk Factors for Plantar Fasciitis

Several factors can increase your risk of developing plantar fasciitis:

• Foot structure abnormalities (high arches or flat feet)
• Prolonged standing or walking, especially on hard surfaces
• High-impact activities like running or dancing
• Obesity or sudden weight gain
• Aging (most common in adults 40-60 years old)
• Tight calf muscles or Achilles tendon
• Improper footwear with inadequate support

Understanding these risk factors can help you take preventive measures to protect your feet from developing plantar fasciitis.

Recognizing the Symptoms of Plantar Fasciitis

While morning heel pain is the most characteristic symptom, plantar fasciitis can manifest in other ways:

• Pain that worsens after (not during) exercise or activity
• Increased pain when climbing stairs or standing on tiptoes
• A dull ache or burning sensation along the bottom of the foot
• Swelling or tenderness in the heel area
• Pain that is more severe after long periods of rest or inactivity

Can plantar fasciitis affect both feet?

While plantar fasciitis often affects just one foot, it’s not uncommon for both feet to be impacted. About 30% of people with plantar fasciitis experience symptoms in both feet simultaneously.

Diagnosing Plantar Fasciitis: When to See a Podiatrist

If you’re experiencing persistent heel pain, especially in the morning, it’s important to consult a podiatrist for a proper diagnosis. A medical professional can rule out other potential causes of heel pain, such as stress fractures or nerve issues.

During your appointment, the podiatrist will likely:

1. Examine your foot and assess your range of motion
2. Ask about your symptoms and medical history
3. Perform imaging tests like X-rays or MRI if necessary
4. Evaluate your gait and foot structure

Are there any self-tests for plantar fasciitis?

While a professional diagnosis is crucial, there are some at-home tests you can perform to help identify plantar fasciitis:

• The Windlass Test: Dorsiflexing your big toe while standing should reproduce pain if you have plantar fasciitis.
• Palpation Test: Pressing on the medial calcaneal tubercle (a bony prominence on the inside of your heel) should elicit pain in plantar fasciitis cases.

Remember, these tests are not definitive and should not replace a professional evaluation.

Effective Treatment Options for Plantar Fasciitis

Fortunately, there are numerous treatment options available for managing plantar fasciitis. Most cases can be resolved with conservative measures, but more severe or persistent cases may require advanced interventions.

Conservative Treatments

• Rest and ice therapy
• Stretching exercises for the plantar fascia and calf muscles
• Over-the-counter pain medications (NSAIDs)
• Supportive footwear with good arch support
• Custom orthotics or insoles
• Night splints to keep the plantar fascia stretched overnight
• Physical therapy

Advanced Treatments

If conservative measures don’t provide sufficient relief, your podiatrist may recommend:

• Corticosteroid injections to reduce inflammation
• Extracorporeal shock wave therapy (ESWT)
• Platelet-rich plasma (PRP) injections
• Tenex procedure (minimally invasive removal of scar tissue)
• Surgical intervention (rarely necessary)

How long does it take for plantar fasciitis to heal?

The recovery time for plantar fasciitis can vary significantly depending on the severity of the condition and the individual’s response to treatment. Most people experience improvement within a few months with consistent conservative treatment. However, some cases may take up to a year to fully resolve.

Preventing Plantar Fasciitis: Proactive Measures for Foot Health

While not all cases of plantar fasciitis can be prevented, there are several steps you can take to reduce your risk:

• Maintain a healthy weight to reduce stress on your feet
• Wear supportive shoes with good arch support and cushioning
• Replace athletic shoes regularly, especially if you’re a runner
• Stretch your calves and plantar fascia regularly
• Avoid sudden increases in exercise intensity or duration
• Use proper technique during physical activities
• Consider using custom orthotics if you have foot structure abnormalities

Are certain types of exercises better for preventing plantar fasciitis?

Low-impact exercises like swimming, cycling, and yoga can help maintain fitness while reducing stress on your feet. If you enjoy high-impact activities, consider cross-training to give your feet a break and strengthen supporting muscles.

The Impact of Plantar Fasciitis on Daily Life and Work

Plantar fasciitis can significantly affect a person’s quality of life and ability to perform daily activities. A study mentioned in the original text highlighted that over half of the participants with plantar fasciitis reported moderate interference with their normal work activities, while one-third experienced severe or extreme interference.

This condition can impact various aspects of life, including:

• Mobility and ability to exercise
• Work performance, especially in jobs requiring prolonged standing
• Sleep quality due to nighttime pain
• Mental health and overall well-being

How can you manage plantar fasciitis at work?

If your job requires long periods of standing or walking, consider these strategies:

• Use anti-fatigue mats if possible
• Take regular breaks to sit and stretch
• Wear supportive, cushioned shoes
• Use custom orthotics designed for your work shoes
• Apply ice to your feet during breaks
• Perform gentle foot exercises throughout the day

Complementary Therapies and Lifestyle Changes for Plantar Fasciitis

In addition to conventional treatments, some people find relief from plantar fasciitis through complementary therapies and lifestyle modifications:

• Acupuncture
• Massage therapy
• Yoga or Pilates to improve flexibility and strengthen supporting muscles
• Dietary changes to reduce inflammation
• Stress reduction techniques

Can dietary changes help with plantar fasciitis?

While there’s no specific diet for plantar fasciitis, an anti-inflammatory diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may help reduce overall inflammation in the body. Some people also find that reducing their intake of processed foods and sugar helps manage symptoms.

Remember, it’s essential to consult with your healthcare provider before making significant changes to your diet or exercise routine, especially if you have other health conditions.

When to Seek Immediate Medical Attention for Foot Pain

While plantar fasciitis is often a chronic condition that develops over time, there are situations where foot pain may indicate a more serious problem requiring immediate medical attention:

• Sudden, severe pain following an injury
• Inability to bear weight on the affected foot
• Visible deformity or swelling
• Signs of infection (redness, warmth, fever)
• Numbness or tingling in the foot
• Pain that doesn’t improve with rest or home treatments

Could heel pain be a sign of something more serious than plantar fasciitis?

While plantar fasciitis is a common cause of heel pain, other conditions can present similar symptoms. These may include:

• Heel spurs
• Achilles tendinitis
• Stress fractures
• Tarsal tunnel syndrome
• Bursitis

A proper diagnosis from a healthcare professional is crucial to ensure appropriate treatment and rule out more serious conditions.

In conclusion, while plantar fasciitis can be a painful and disruptive condition, understanding its causes, recognizing its symptoms, and knowing the available treatment options can help you manage the condition effectively. Remember, early intervention and consistent care are key to preventing chronic pain and long-term foot problems. If you’re experiencing persistent heel pain, don’t hesitate to consult with a podiatrist or foot specialist for personalized advice and treatment.

Do You Wake Up to Heel Pain? It Could be Plantar Fasciitis

In a perfect world, you jump out of bed to take on the day well-rested and full of energy, but your feet may have other plans, hobbling you with pain. As you gingerly make your way to the bathroom, the pain slowly subsides, but your day certainly didn’t get off to the start you had hoped for.

This routine is the hallmark of plantar fasciitis, which can cause moderate to severe pain in your heels and along the bottoms of your feet after long periods of inactivity.

At Mountain View Foot & Ankle, Dr. David B. Glover and our team specialize in heel and foot pain, with the goal of helping our patients in South Ogden, Utah, find much-needed relief. If you wake to heel pain, the odds are good that you may be dealing with plantar fasciitis.

Here’s a look at plantar fasciitis and, more importantly, how we can get you hopping out of bed with a spring in your step.

Behind plantar fasciitis

Plantar fasciitis is a condition that causes pain and inflammation in your plantar fascia, a band of tissue that stretches along the bottom of your feet from your heels to your toes. This thick band of connective tissue provides critical support in your feet and endures a fair amount of stress during the course of a normal day.

Should this tissue become overstressed, however, it can develop tiny tears that lead to inflammation and the pain you feel in the morning. The reason why the pain flares with your first steps after a long period of inactivity is because the inflammation causes your plantar fascia to tighten.

So when you first step down on your foot in the morning, this tight tissue pulls painfully until it warms up and stretches out.

On top of the compromised tissue, plantar fasciitis can also lead to heel spurs, which are extra growths of bone that can compound the problem and add to the pain in your heels.

The stress on your plantar fascia, and the resulting plantar fasciitis, can develop because of:

• Poor foot structure (overly high or low arches)
• Spending long hours on your feet
• Engaging in high-impact sports like road running
• Carrying extra weight
• Aging

No matter the underlying cause of your plantar fasciitis, our goal is to help you find relief.

Treating plantar fasciitis

If you’re exhibiting the symptoms we described above, you should come see us so we can properly diagnose the problem. If we find that plantar fasciitis is the culprit, we set to work to find you relief.

Typically, we like to start out conservatively with:

• Rest
• Anti-inflammatory medications
• Gentle stretching exercises
• A change in footwear
• Custom orthotics
• Night splints

If your pain persists, we may recommend a corticosteroid injection to address both the pain and the inflammation.

And should these measures prove unsuccessful, we may recommend a surgical solution, but this is extremely rare.

The bottom line is that we work with you until you find relief from this type of heel pain. To get started on treating your plantar fasciitis, please call us at 801-614-2996, send us a message here on our website, or use our easy online scheduling tool to request an appointment.

Optima Foot and Ankle: Podiatrists

Do You Wake Up to Heel Pain? It Could Be Plantar Fasciitis: Optima Foot and Ankle: Podiatrists

When you get up in the morning, and your feet hit the floor, having a stabbing pain in one or both heels can really ruin the mood and set your day up for an unhappy experience. If this happens frequently, and you also notice the same pain when you stand up after being seated, you could have plantar fasciitis.

At Optima Foot and Ankle in Bend, Oregon, Drs. Laura Schweger and Evan Ross can correctly diagnose plantar fasciitis as the source of your heel pain and help you combat this unpleasant condition.

Plantar fasciitis can disrupt your life

Plantar fasciitis is caused by inflammation that develops in the band of tissue that stretches across the bottom of your feet from your toes to your heel, known as the plantar fascia. Stress can cause small tears to develop in your plantar fascia, leading to the inflammation called plantar fasciitis.

Almost anyone can develop plantar fasciitis, but you are more at risk as you age and:

• Are overweight or obese
• Have very high or low arches
• Run or do another activity that involves high impact on your feet
• Work on your feet all day
• Wear the wrong footwear, like high heels all day every day  

In one study, more than half of the participants with plantar fasciitis said the pain at least moderately interfered with their normal work activities, and one in three participants said they suffered from severe or extreme interference. 

Treating plantar fasciitis 

Once you have a confirmed diagnosis of plantar fasciitis, our team can lay out a course of treatment to help you repair damage to your plantar fascia and relieve your pain. You’ll need to lay off the exercise and rest your feet, since more impact can cause tears to worsen. Over-the-counter pain medication is typically sufficient to manage discomfort.

Your podiatrist may recommend orthotics, which are custom-made shoe inserts that can help relieve plantar fascia strain. We’ll also decide if specialized stretching exercises can help lengthen and strengthen your plantar fascia. If necessary, we can administer platelet-rich plasma injections to speed healing and mitigate pain. 

In most cases, you won’t need to have surgery to deal with your plantar fasciitis. The above treatments will allow your plantar fascia to heal naturally, and you can continue conditioning exercises to keep the band of tissue supple and flexible, preventing future problems.

Learn much more about plantar fasciitis and whether you may be a good candidate for particular treatments by calling 541-383-3668 or scheduling an appointment online.

Why You Might Not See a Plantar Wart

Summer is the time to adventure outdoors, whether you’re a hiker, runner, or pickleball enthusiast. However, the season can also mean you’re more prone to get a plantar’s wart. Read on to learn more.

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Foot problems become more likely when your feet are subjected to repetitive stress, as they are each time you hit the road or trail for your daily run. Learn simple strategies for minimizing your risk of common running-related foot issues.

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Surrounded by endless outdoor beauty, it’s no surprise hiking is so popular in Oregon. Choosing the right hiking boots is essential to enjoying your trial time. To that end, here are a few tips for choosing the right hiking boot.

Treating Plantar Fasciitis Without Surgery: 3 Effective Options

Discover how you can treat your plantar fasciitis without going under the knife. From stretching exercises to orthotics, we explore three effective nonsurgical options that can bring you relief.

Managing Psoriatic Arthritis Foot Pain

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symptoms, possible causes and tips for solving the problem

Many people are familiar with the unpleasant situation when in the morning after sleeping in the legs there is pain. At the same time, a person will feel well-rested and full of energy.

When pains of this kind appear after a tiring day at work, long walks, it is natural. And what are the causes of pain in the legs after sleep and whether something needs to be done about it, only the doctor knows.

Causes of the phenomenon

Not everyone knows why legs hurt after sleep. Unpleasant sensations after waking up are associated with external or internal causes. The former include injuries, uncomfortable posture during sleep, excessive physical strain, uncomfortable shoes or standing for a long time.

Internal causes include circulatory problems, overweight, pinched nerves, infectious diseases, and tissue inflammation.

The appearance of unpleasant pain may also be associated with diseases of internal organs or systems. In such a situation, it is necessary to seek medical help as soon as possible.

Pain in the calves, feet may be precursors of:

• rheumatism;
• arthrosis;
• arthritis;
• osteoporosis;
• varicose veins;
• fasciitis.

Such diseases may not show any signs during the waking period. But after a long rest, when the body relaxes as much as possible, the pain worsens. Other signs of disease, such as swelling, may also be present.

If pain is felt in the calf muscles, this may indicate pathologies of the cardiovascular system, blood stasis. Since the blood flow becomes more active in the morning, the pain intensifies, signaling the presence of a problem.

Blood stasis is most often associated with physical inactivity. If a person spends a long time in a sitting position, the body does not have enough oxygen. Because of this, a lot of harmful substances are concentrated in the blood, which leads not only to the appearance of pain, but also to other unpleasant symptoms.

Everyone needs to know why legs hurt after sleep. Unpleasant sensations in the calf area may indicate the presence of such diseases:

• hernia;
• scoliosis;
• displacement of the vertebral discs.

Burning sensation in the area of ​​the toes may signal vascular problems. In women, pain in this area often occurs due to wearing uncomfortable shoes.

If the discomfort occurs only in the foot, it may be a sign of circulatory problems, nerve damage or gout. Heel pain often occurs with flat feet. In addition, it will signal the presence of an inflammatory process in the muscles – plantar fasciitis. Pain in the feet may be associated with osteoporosis. In this way, the body can signal that the host is overweight.

Such symptoms manifest themselves in a variety of ways and it is difficult to determine the disease that caused them only by sensations. This is the doctor’s prerogative.

Signs of various diseases

Since discomfort in the legs after waking up can be a harbinger of many diseases, it is necessary to consider the main ones.

If your legs hurt after sleeping, the reasons may be as follows.

Varicose veins

Women are most susceptible to this disease and the pathology is manifested by severe pain in the legs after sleep. Seizures are possible at night.

Veins will be visible on the skin, turning into painful bands of a purple hue. The greatest danger is varicose veins of deep veins, since in the initial stages it is difficult to diagnose. In addition to the fact that the muscles of the legs hurt after sleep, there may be a burning sensation in the limbs and other unpleasant sensations.

If the disease is detected at the beginning of development, then, as a rule, conservative treatment will be sufficient. In later stages, surgery is likely to be required.

Arthritis

Arthritis may be the reason why feet hurt after sleeping. With this disease, both large joints (thigh, ankle, knee) and small feet and fingers can be affected. Pain most often appears in the morning or after a heavy load. Even after rest, these unpleasant symptoms do not go away.

The temperature may also rise because the joints are inflamed. Possible redness of the skin. In a severe or advanced case, deformation of the joints will begin. If after sleep your legs hurt, but you need to disperse in order for the unpleasant symptoms to go away, then this just speaks of incipient arthritis.

Treatment should be carried out in a timely manner at the onset of the disease. So it will be possible to get rid of the disease using conservative methods: painkillers, anti-inflammatory drugs. In an advanced stage, it may be necessary to replace the joint with a prosthesis.

Rheumatism

This disease is also the reason why the legs may feel uncomfortable in the form of pain in the legs. It is considered quite dangerous, as it affects not only the joints, but also the internal organs.

The greatest burden falls on the heart. The disease develops against the background of a streptococcal infection – a sore throat.

In rheumatism, severe inflammation of the joints occurs. In addition to pain, there is swelling, pain on palpation. The change occurs on the ECG, which indicates that there are malfunctions in the work of the heart muscle.

The danger of rheumatism is associated with its complications. He is difficult to treat. Treatment should be started as early as possible in the hospital.

Osteoporosis

This condition is also the cause of pain in the heels after sleep. Pathology most often develops in women during menopause. Since the body lacks hormones, changes occur in the structure of bone tissue, its density decreases.

The danger of the disease is frequent fractures that heal with difficulty. X-rays can help diagnose the disease. And to determine how much tissue density has decreased, it is recommended to conduct densitometry.

Tendinitis

In this disease, the calves of the legs hurt after sleep. Tendinitis is an inflammation of the tendons. It develops with injuries, infections, disorders of the immune system, local inflammatory processes.

The symptoms will be:

• redness;
• puffiness;
• pain;
• degenerative tissue damage;
• crunching, crackling when trying to move the leg.

If the disease is detected in a timely manner and its treatment is started on time, then using only conservative methods, a complete restoration of the tendons is possible. When the form is running, surgery will be required.

Heel spur

It can also cause discomfort in the legs after sleep. The problem most often occurs in older people. The main causes of occurrence: flat feet, excessive load on the feet, traumatic injury. Symptoms: unbearable pain in the heel. They can appear at any time of the day.

X-ray is used to diagnose the disease. In the treatment, surgical methods are used, since with the help of conservative therapy it is impossible to get rid of the build-up.

Fasciitis

Pain in the heel area. The causes of discomfort, as a rule, are two: overweight and uncomfortable shoes.

Injuries

They also cause discomfort in the limbs, the feet also hurt after sleep. This is true not only for adults, but also for children. Injuries can be different: bruises, sprains, tears. If you suspect injury to the joints or tendons, you should consult a doctor.

First aid for trauma: apply ice to the affected area and take an anesthetic. Treatment is usually carried out at home using conservative methods. Only in exceptional cases is surgery necessary.

Why does a child’s legs hurt after sleep

The main cause of pain is associated with the so-called growth syndrome, which occurs at the age of 4-7 years. During this period, the bones and ligaments of children grow unevenly, not keeping up with each other.

They press on the joint capsules and cause discomfort. If the pain is associated with this symptom, then they most often appear in the lower leg, calf and ankle joints. There will be no fever or lethargy.

If the disturbing joint turns red, it hurts the baby to move his leg, a rash occurs and symptoms of intoxication of the body are noticeable, it is urgent to show the baby to the doctor. If there are no noticeable signs of the disease, the baby feels good, then it is worth calming down not only the parents, but also the baby. You can stroke the sore leg, make a light massage. Give your child a warm bath by adding sea salt or relaxing scented foam to it, if there is no allergy.

If the pain is severe and the child cannot calm down, it is recommended to use ibuprofen-based ointments.

A child in a period of intensive growth can be helped using the following recommendations:

1. Review the daily routine. Good rest is important.
2. Get out in the fresh air more often.
3. Moderate physical activity.
4. Increase the amount of fresh fruits, vegetables and dairy products in the diet.
5. Maintaining a friendly atmosphere in the family.

Also, the situation when a child has a leg pain in the morning after sleep can also occur for other reasons:

1. Orthopedic pathologies. Violation of posture, scoliosis, flat feet, congenital pathologies of the hip joints. Since there is a shift in the center of gravity, the maximum pressure falls on the legs.
2. Chronic foci of infection: caries, adenoiditis, tonsillitis.
3. Rheumatoid arthritis.
4. Endocrine pathologies: diabetes mellitus, adrenal diseases.
5. Blood diseases:.
6. Tuberculosis.
7. Neurocirculatory dystonia. In this case, there will also be headaches, discomfort in the region of the heart, a feeling of lack of air.
8. Congenital pathology of the cardiovascular system.
9. Anomaly of connective tissue. Children with such anomalies can suffer from varicose veins, scoliosis, flat feet, and posture curvature.
10. Injuries, bruises.
11. Leukemia.
12. Still’s disease.

When a baby’s legs hurt in the morning, the child should be seen by a pediatrician, hematologist, neurologist and orthopedic traumatologist.

Which doctor to contact

First of all, it must be determined what caused the appearance of unpleasant pain in the legs after sleep. Based on this, it will be clear which specialist can help in this situation and direct you to the necessary examination.

If there is a problem, and there is no answer to the question why the legs hurt in the morning after sleep, then the situation may be related to rheumatism. You should contact a rheumatologist, family doctor, vertibrologist, cardiologist.

Arthritis, arthrosis, osteoporosis are treated by orthopedic traumatologists and rheumatologists. The first specialists also carry out the therapy of fasciitis.

Problems associated with varicose veins are helped by phlebologists or surgeons.

Folk methods of treatment

If pain in the legs occurs repeatedly after that, you can use the recipes of traditional medicine:

1. Rubbing the feet with chestnut tincture. The course of treatment is 2 weeks. It’s easy to prepare. You need to take 50 g of chopped chestnut and pour 500 ml of vodka into it. Infuse for 2-3 weeks in a dark place and then start using it for its intended purpose.
2. Linden and mint decoction. Can be added to foot bath. For a liter of hot water, you will need 15-20 g of linden and a few mint leaves. This procedure is also effective for varicose veins. It can be done daily.
3. Ice compress relieves puffiness. Pieces of ice must be wrapped in a towel and apply a compress for a few minutes to the affected area.
4. Homemade balm. To prepare it, you will need 30 ml of vegetable oil, 10 drops of mint, eucalyptus, lemon or tea tree oil. All components should be thoroughly mixed. Apply the product to the affected area 2 times a day with light massaging movements.
5. Honey compress. For him, you need to melt the honey in a water bath. The resulting liquid is smeared on the legs and wrapped tightly. It is advisable not to remove such a compress all day.

Prevention

Sports that include leg exercises will help prevent these unpleasant symptoms. Such varieties include swimming, skating, skiing, cycling, long walks. Such physical activity will help keep the muscles of the legs in good shape and, accordingly, will prevent the appearance of pain in the legs after sleep.

To prepare your joints and muscles for an active day, it is enough to do 15 minutes of leg exercises after waking up.

Massage is an excellent preventive method. It is convenient to do it in the evening, which will relieve fatigue in the legs and relax. Baths with the addition of essential oils will also be useful and effective.

Sea salt baths are effective for relaxing the legs. At the bottom of the container, you can lay a layer of river pebbles and with massaging movements, as it were, roll the pebbles with your feet. This simple method will normalize blood circulation.

Conclusion

If you experience pain in the legs after sleep, you should consult a doctor, as such sensations may indicate serious illness, especially if the pain syndrome manifests itself repeatedly. You should not expect the pain to go away on its own, however, like self-medication is also unacceptable.

Only a qualified specialist will be able to determine the true cause of the ailment, make the necessary appointments. If a child appears in the legs after sleep, it is important to monitor the condition of the baby and consult a doctor with the slightest doubt. Under no circumstances should such a situation be ignored.

Metastases in the spine in cancer: symptoms and back pain, prognosis and treatment

Metastases in the spine are foci of malignant lesions in the bone tissue formed by cancer cells that have separated from the primary tumor and spread in the body with the blood or lymph flow. According to statistics, metastases account for 90% of all malignant neoplasms in the spine. They disrupt the supporting function of the spinal column, can lead to compression of the spinal cord, nerve roots, and severe neurological disorders.

Many types of cancer metastasize to the bones, most commonly to the vertebrae. In most cases, tumor cells spread hematogenously through the bloodstream. Metastases on the spine weaken the bone tissue, this threatens pathological fractures of vertebrae, which lead to severe pain, a significant decrease in the quality of life, compression of the spinal cord and nerve roots.

In 95% of cases, spinal metastases are extradural , that is, they are outside the dura mater. In more than half of the cases, the foci are localized at different levels of the spinal column.

Some facts and figures:

• The spine is in third place in the list of organs in which various malignant tumors most often metastasize. The first two places belong to the lungs and liver.
• 70% of all bone metastases are spinal metastases.
• 5-30% of patients with stage 4 cancer have spinal metastases.
• Secondary lesions in the spine are more common in men than in women. Most cases occur at the age of 40-65 years.
• Only 10% of patients experience symptoms.
• Approximately 70% of symptomatic lesions are found in the thoracic region, 20% in the lumbar region, and 10% in the cervical region.
• In 60% of cases, lesions are located in the anterior part of the vertebral body.

What malignant tumors most often metastasize to the spine?

Primary foci are located in the following organs:

• light – 31%;
• mammary gland – 24%;
• gastrointestinal tract – 9%;
• prostate – 8%;
• lymphomas – 6%;
• melanoma – 4%;
• kidneys – 1%.

About 13% are malignant tumors of other localizations. In 2% of cases, the location of the primary tumor is unknown.

What are the symptoms of spinal metastases in stage 4 cancer?

Some patients with spinal metastases have no symptoms at all. Usually there are no complaints, as long as the tumor foci are small, do not compress the spinal cord and its roots, do not weaken the vertebra.

The main symptom of spinal metastases is pain in the neck, back, or lower back. Pain in the spine can be caused by a host of other pathologies. It is difficult to find a person over 40-50 who has never experienced them. Back pain in oncology is usually constant, painful, does not go away after rest, worse at night, in the morning upon awakening. Gradually, the tumor grows, more and more squeezing the spinal cord and nerve roots. After a few weeks or months, symptoms such as muscle weakness, numbness, tingling join the pain.

The mechanism of pain in metastases in the spine is different, depending on this, it may have some characteristic features:

• As the tumor grows, inflammation develops, tissue tension in the region of the spinal column. This causes pain, which patients describe as “pain in the depths.” It intensifies at night and decreases after waking up, when a person begins to move.
• When nerve roots are compressed, radicular pain . They are burning, shooting, spread down the course of the nerve, “go down” along the arm or leg, often accompanied by weakness in the muscles, numbness, tingling.
• Sudden severe pain may indicate that the tumor has led to the destruction of the vertebra and its pathological fracture. Usually, such pains arise and intensify during movements, in a sitting position.

One of the severe complications caused by compression of the nerves descending in the lower part of the spinal canal – cauda equina syndrome . In this case, the function of the intestines, the bladder is disturbed, there is weakness in the legs, loss of sensation in the buttocks, saddle anesthesia (loss of sensation in the perineum, inner surface of the upper thighs). Often, with the development of cauda equina syndrome, emergency surgical intervention is required.

If metastases in the spine strongly compress the spinal cord, then movements and sensitivity are disturbed below the place of compression, urinary and stool incontinence occurs, and erectile dysfunction in men.

Metastases in the sacrum do not involve the spinal cord, but can lead to compression or tumor infiltration of the nerve roots. There is pain that spreads to the buttocks, perineum, back of the leg. Sensitivity disorders, urinary and fecal incontinence, cauda equina syndrome, and erectile dysfunction in men may also occur.

Diagnosis of metastases in the spine

The main diagnostic methods are CT and MRI. They help to visualize in detail the structures of the spinal column, tumor tissue. Radiography is less informative, since X-ray does not show metastases in the spine very well, only bone structures are visible. Usually this study is used when a pathological fracture is suspected.

Diagnosis is confirmed by biopsy. The doctor receives a fragment of the tumor tissue and sends it to the laboratory for cytological, histological examination, molecular genetic analysis. Biopsy material can be obtained in different ways:

• The most common percutaneous biopsy is performed using a needle inserted under X-ray control.
• Less commonly, part or all of the tumor is removed surgically. Such a biopsy is called respectively incision and excision .

Appointment for a consultation around the clock

+7 (495) 668-82-28

Treatment of metastases in the spine

With stage 4 cancer, the chances of remission are very low. But the patient can still be helped. Treatment may have the following goals:

• Increase life expectancy.
• Reduce pain and other symptoms.
• Improve movement, ability to walk, perform daily activities.
• Eliminate vertebral instability, prevent pathological fractures.

Surgery

Minimally invasive surgery can be performed to stabilize the vertebrae and reduce pain. A needle is inserted into the vertebra and the volume of bone tissue is replenished with special cement.

Patients with spinal column metastases do not tolerate open surgery well and often develop complications. Therefore, the indications for such operations are limited:

• If the patient’s life expectancy is 6 months.
• If there is only one hearth.
• If there are severe neurological disorders, impaired movement and sensitivity.

At the moment, there is no clear evidence that active surgical treatment helps to significantly increase life expectancy in these patients.

Chemotherapy

Systemic chemotherapy is used for metastases in the spinal column. This helps to reduce the size of the tumor, save the patient from pain. Various types of chemotherapy drugs are used. For some tumors, hormonal therapy, targeted therapy, and immunotherapy are effective. Sometimes they resort to chemoembolization : a catheter is inserted into the vessel supplying the tumor and a chemotherapy drug is injected through it in combination with embolizing drug , which clogs the lumen of the vessels, depriving the tumor tissue of nutrients and oxygen.

Radiation therapy

Studies have shown that radiation therapy for spinal metastases helps to cope with pain caused by tumor lesions in 70% of cases.