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All You Will Need To Understand About

All You Will Need To Understand About

Overview
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Heel pain is a problem for many people. It What makes you grow taller during puberty? standing and even walking around for long periods of time very uncomfortable. Several different conditions can lead to uncomfortable heels, but the most common culprit is plantar fasciitis. This is the inflammation and swelling of the plantar fascia, a tendon that runs along the sole of your foot and attaches to the bottom of the calcaneus, or heel bone. Repeated hard impacts or strain from overuse causes micro-tears to develop in the tendon, irritating it. The minor damage compounds over time and causes the tissue to swell and tighten, painfully pulling on the heel bone.

Causes
While heel pain has many causes, it is usually the result of poor biomechanics (abnormalities in the way we walk). This can place too much stress on the heel bone and the soft tissues attached to it. The stress may result from injury, or a bruise incurred while walking, running or jumping on hard surfaces: wearing poorly constructed footwear : or being significantly over weight. Systemic diseases such as arthritis can also contribute to heel pain.

Symptoms
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience ?First step? pain (stone bruise sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.

Diagnosis
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.

Non Surgical Treatment
Orthotics, by treating the cause of the problem, lead to the cure bette than 90% of the time. A small number of patients have waited so long that the plantar fascia has become thickened and filled with scar tissue and are not helped by ?conventional? means. Those are the patients that have, traditionally, required surgical treatment in which the plantar fascia is cut off the heel bone. Luckily, most surgery has been replaced by a relatively new mode of treatment, ESWT or Extracorporeal Shockwave Therapy. ESWT involves the application of multiple shockwaves to the diseased tendon or ligament and has an approximately 85 to 90% success rate. Keep in mind we are talking about this success rate in patients who are ?tough cases,? that is, already had the conventional treatment. The ESWT machines look like miniature renal lithtripsors (kidney stone crushers). There are virtually no side effects to ESWT other than the price as only about 30% of insurance companies are paying for it. They realize that it is less costly and safer than surgery but also know that many more people who would avoid surgery would have no problem getting ESWT so the volume of services would go up. You don?t have to live with painful heels.

Surgical Treatment
When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most beneficial for your condition.

Prevention
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The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. The primary treatment is rest. Cold packs application to the area for 20 minutes several times a day or after activities give some relief. Over-the-counter pain medications can help manage the pain, consult your healthcare professional. Shoes should be well cushioned, especially in the midsole area, and should have the appropriate arch support. Some will benefit from an orthotic shoe insert, such as a rubber heel pad for cushioning. Orthotics should be used in both shoes, even if only one foot hurts. Going barefoot or wearing slipper puts stress on your feet. Put on supportive shoes as soon as you get out of bed. Calf stretches and stretches using a towel (place the towel under the ball of your feet and pull gently the towel toward you and hold a few seconds) several times a day, especially when first getting up in the morning. Stretching the Achilles tendon at the back of the heel is especially important before sports, but it is helpful for nonathletes as well. Increasing your exercise levels gradually. Staying at a healthy weight. Surgery is very rarely required.