Nerve injuries are
common in the foot.
One type of injury is called a neuroma or a Morton’s
neuroma. A neuroma is the inflammation and swelling
of the covering of the nerve. The area most often
involved is the ball of the foot. This usually involves
the third and fourth toes.
It is believed that neuromas are caused by a variety of different
types of trauma. The injury which creates this condition
can come from mechanical imbalances such as pronation or improperly
fitting shoes.
A neuroma causes intermittent pain
in the ball of the foot. This pain can be
characterized by several different types of sensations, which
including cramping or tingling. Sometimes a neuroma
can feel like a hot needle between the toes or a lumpy wrinkle
on the bottom of the foot. Some numbness may be present.
This
condition is often aggravated by walking and wearing tight
fitting shoes. It can usually be relieved
by removing the shoe and rubbing the foot. Neuroma pain
is usually progressive.
There are several
alternatives when discussing the treatment of neuromas.
One is to live with the problem and avoid tight fitting shoes.
Another is the use of a series of two to three injections
of cortisone with local anesthetic around the inflamed, swollen
and irritated nerve tissue.
In addition to the injections, a third form of conservative
care is the use of functional orthotic devices. These
are used to control the biomechanical imbalances that are
present. These imbalances are a continued source of
irritation to the involved nerve. Orthotics are also
used in conjunction with surgery, as it is necessary to try
to control the mechanical imbalances even after surgical correction.
A surgical
approach is indicated when conservative measures fail to satisfactorily
relieve the pain and inconvenience this condition creates.
There is a relatively new procedure available using an endoscope.
It involves releasing the structure that creates pressure
on the nerve. This procedure is minimally invasive and
performed on an out-patient basis. It allows for earlier
return to activities sooner than traditional neuroma surgery.
This is a very exciting breakthrough for people who suffer
from neuroma pain. If pain, cramping or burning is interfering
with your walking program you should seek the help of a podiactric
footcare specialist.
Could
Your Feet Be Causing Back Pain?
by Dr. Kerry Zang
Back
pain affects millions of Americans and for many it starts
from the ground up. Ignoring how feet affect the lower
back can sometimes mean missing the source of back pain. When
walking, the body must adjust to many forces which affect
both the feet and the spine. When your foot hits the
ground, your whole body feels the effect. The greater
the impact of your step, the more impact it has on your body.
When you run, your lower extremities absorb two to five times
your body weight. This increased stress on your body
can result in lower back pain.
There
are new Viscoelastic shoe inserts that may help reduce some
of the shock placed on the feet everyday. These inserts are
made from a medical grade silicone that helps prevent
overloading of the natural shock absorbing mechanisms in the
foot. They provide therapeutic as well as preventative measures
in helping to alleviate pain.
Biomechanical
imbalances in your feet can also cause back pain. As
you walk, your heel swings from side to side.
When it is moving properly, the foot can flatten and regain
its arch during walking. If the heel is swinging too
much, the foot may flatten more than it should. If this
happens, some of the bones are forced to support too much
weight. The muscles then pull harder on these
areas, making it more difficult for the tendons and ligaments
to hold the bones and joints in place.
This can lead to many other problems.
Fortunately,
many of these problems can be improved by controlling foot
movement. Supportive shoes, over-the-counter inserts
and custom made inserts (orthotics) can help. Orthotics
help protect the tender areas of the foot from harsh, constant
use. A podiatrist can determine which is best for a
particular foot problem.
It is
important to consider the feet when determining the source
of back pain. The feet often play a major role in the
comfort of your whole body. The
old adage is often true, when your feet hurt, you hurt all
over.
