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28 Aug 2015 
Overview


Heel bursitis is a common foot pain in athletes, and is often mistaken for Achilles tendinitis, although it can also occur together with Achilles tendinitis. Heel bursitis occurs when small cushions in the heel called bursas become inflamed and swell with fluid irritating surrounding tissue and pressing on nerves. Other names given to heel bursitis are Achilles bursitis and Retrocalcaneal bursitis.


Causes


Systemic diseases such as rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, psoriatic arthritis, scleroderma, systemic lupus erythematosus, pancreatitis, Whipple disease, oxalosis, uremia, hypertrophic pulmonary osteoarthropathy, and idiopathic hypereosinophilic syndrome have also been associated with bursitis.


Symptoms


Nagging ache and swelling in or around a joint. Painful and restricted movement in the affected joint. Pain radiating into the neck or arms when bursitis strikes the shoulder (the most common site). Fever, when associated with an infection.


Diagnosis


A thorough subjective and objective examination from a physiotherapist may be all that is necessary to diagnose a retrocalcaneal bursitis. Diagnosis may be confirmed with an ultrasound investigation, MRI or CT scan.


Non Surgical Treatment


If you follow these steps, most attacks of bursitis should subside in four or five days and all symptoms should be gone within two weeks. Rest the body part that hurts. If you suspect that one activity has caused the pain, stop it until the pain is entirely gone. A sling, splint, or padding may be needed to protect the area from possible bumps or irritation. Try over-the-counter pain relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling, though they won?t accelerate healing. Acetaminophen will help with pain but it doesn?t reduce inflammation. Ice it, then heat it. Apply ice packs during the first two days to bring down swelling. Then use heat-warm baths or a heating pad (on a medium or low setting)-to ease pain and stimulate blood flow. Don?t push it. Resume exercising only after you feel better. Start with gentle activity. Skip the liniments. Liniments and balms are no help for bursitis. Liniments don?t penetrate deeply enough to treat bursitis, they mainly warm the skin and make it tingle, thus distracting attention from the pain beneath. Massage is likely to make matters worse. Undergo physical therapy. Physical therapy strengthens joint muscles that have been affected by bursitis and may help prevent the bursitis from getting worse.


Surgical Treatment


Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and removed surgically.
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20 Aug 2015 
HammertoeOverview


A Hammer toe is a term that is commonly used to describe any type of toe deformity. It is a common problem that may or may not be a problem. What does a hammer toe look like? In a hammertoe the deformity usually exists in one toe (at the proximal inter phalangeal joint) - the base of the toe points upward and the end of the toe points down.


Causes


The incorrect position of the person's toes inside of their shoes also causes the formation of calluses or corns on the surfaces of their toes which are constantly bent as they are wearing inappropriate shoes because the surfaces are consistently rubbing against the hard materials of the interior of the shoes causing regular friction.


Hammer ToeSymptoms


A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.


Diagnosis


Some questions your doctor may ask of hammertoes you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.


Non Surgical Treatment


Apply a commercial, non-medicated hammer toe pad around the bony prominence of the hammer toe to decrease pressure on the area. Wear a shoe with a deep toe box. If the hammer toe becomes inflamed and painful, apply ice packs several times a day to reduce swelling. Avoid heels more than two inches tall. A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. While this treatment will make the hammer toe feel better, it is important to remember that it does not cure the condition. A trip to the podiatrist's office will be necessary to repair the toe to allow for normal foot function. Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly.


Surgical Treatment


Surgically correcting a hammertoe is very technical and difficult, and requires a surgeon with superior capabilities and experience. The operation can be done at our office or the hospital with local anesthetic. After making a small incision, the deformity is reduced and the tendons are realigned at the joint. You will be able to go home the same day with a special shoe! If you are sick and tired of not fitting your shoes, you can no longer get relief from pads, orthopedic shoes or pedicures, and have corns that are ugly, sensitive and painful, then you certainly may be a good surgical candidate. In order to have this surgery, you can not have poor circulation and and must have a clean bill of health.
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