Author Archives: Shalini

Patient -L5 S1 Radiculopathy

Summary

  • Bulging discs in your lower spine can press on the nerves that supply your feet, causing you to feel pain in your heels.

 

How did I get this?

  • A previous back injury or wear and tear arthritis or bone spurs in the lower back.
  • It is more common in the 40-60 age group, golfers and dancers.

 

What can I do about it?

  • Avoid activities or movements which cause the pain.

 

What help can I get for this?

  • Your doctor may arrange scans of your lower spine, and pain relief medication
  • Exercises for postural correction
  • A Pain clinic may help with epidural injections.
  • Surgery may be required to attend to the spinal problem.

 

When will it get better?

  • Pain relief medication should give fast relief.
  • Exercises and postural correction may take some weeks to improve.

Patient -Reactive Arthritis

Summary

  • Inflammation, heel pain and bone spurs are found in patients with Reactive Arthritis.

 

How did I get this?

  • Reactive Arthritis is caused by an infection which may also affect the eyes and urinary tract.

 

What can I do about it?

  • Anti – inflammatory pain medication will give some relief, but you will require medical attention

 

What help can I get for this?

  • Your doctor may order blood tests and prescribe antibiotics, anti-inflammatories and immunosuppressants.
  • Your podiatrist will help with footwear advice and modification, insoles and orthotics to reduce load on the painful areas.

 

When will it get better?

  • Managing the symptoms may provide fast relief, but treatment may take weeks to eradicate the infection and settle inflammation.

Patient – Inflammatory Bowel Disease

Summary

  • Heel pain is often associated with Chron’s Disease and Ulcerative Colitis.

 

How did I get this?

  • There is a higher incidence of inflammation in the heel where the achilles tendon and the plantar fascia attach.

 

What can I do about it?

  • Rest
  • Use immunosuppressant and pain relief if prescrib

 

What help can I get for this?

  • Scans may identify inflammatory hot spots.
  • A Podiatrist will provide splinting or immobilisation, orthotics, footwear advice and strengthening exercises.
  • Your doctor may advise blood tests and medication, and possibly referral to a rheumatologist.

 

When will it get better?

  • Managing the symptoms may provide fast relief, but treatment will be long term and involve appropriate footwear and support to reduce load on the painful areas.

Patient – Osteomalacia

Summary

  • Heel pain caused by a weakness in the bone structure, leading to fractures.

 

How did I get this?

  • Deficiencies in Vitamin D, Phosphate, and Calcium.
  • Osteomalacia may be associated with Coeliac Disease, Liver and Kidney problems.

 

What can I do about it?

  • Rest
  • Dietary advice and supplements

 

What help can I get for this?

  • Xrays or scans may identify fractures.
  • A Podiatrist will provide splinting or immobilisation, footwear advice and strengthening exercises.
  • Your doctor may advise blood tests and medication, along with referral for dietary advice.

 

When will it get better?

  • Appropriate dietary supplements will help strengthen bones.
  • Fractures may take 3 months to stabilise.

Patient – Lateral Plantar (Baxter) Nerve entrapment

Summary

  • Heel pain that often shoots under the outside of the heel and travels up the leg

 

How did I get this?

  • The nerve under your heel becomes pinched by a muscle connecting your big toe and your heel bone.
  • You may have a low arch foot type, or the area could be irritated by footwear.

 

What can I do about it?

  • Wear supportive cushioning footwear.
  • Avoid going barefoot.
  • Modify your activity to stop doing the things that cause pain.
  • Short term use of pain killers can give relief.

 

What help can I get for this?

  • A Podiatrist will provide padding, cushioning or orthotics to reduce load in the painful area.
  • Xrays or scans may identify bony lumps or soft tissue abnormalities.
  • If other treatment is not successful surgery may be required to release tissue around the nerve.

 

When will it get better?

  • Activity modification plus appropriate footwear and orthotics should see an improvement in 6-8 weeks.

Patient – Heel Fat Pad Atrophy

Summary

  • Damage or wasting of the fat pad under your heel makes it painful to stand or walk.
  • Loss of fat pad can put more pressure on nerves and bloodvessels.

 

How did I get this?

  • Often associated with ageing, but may also be associated with diabetes, rheumatoid arthritis, peripheral vascular disease, trauma and long term corticosteroid use

 

What can I do about it?

  • Wear supportive cushioning footwear.
  • Avoid going barefoot.
  • Short term use of pain killers can relieve the pain.

 

What help can I get for this?

  • A Podiatrist will provide padding, cushioning or offloading pads, and advise appropriate footwear.
  • Xrays or scans may identify bony lumps or soft tissue abnormalities.

 

When will it get better?

  • A bruised fat pad should recover in 4-6 weeks with appropriate cushioning and footwear.
  • Wasting (atrophy) of the fat pad will require constant protection from footwear and padding

Patient – Neoplasm Bone Tumour

Summary

  • Bone tumours in the foot account for less than 2% of all bone tumours, and approximately 80% are benign. They can become painful if they cause enlargement of the bone or fractures.

 

How did I get this?

  • Previous breast, bladder, lung, kidney or colorectal cancer most frequently metastasize to the foot.
  • Most heel bone tumours are discovered on xray for other unrelated conditions.

 

What can I do about it?

  • Rest or non-weightbearing activity may help in preventing fractures.

 

What help can I get for this?

  • Your doctor will arrange scans and specialist treatment.
  • Your podiatrist may be able to assist with cam walker immobilisation.

 

When will it get better?

  • Benign tumours may require surgical excision and a period of recovery for bone strengthening.
  • Malignant tumours will need advice from an oncologist and orthopaedic specialist