Bone Spurs Got You Down?

A bone spur is a bony growth formed on normal bone. Most people think of something sharp when they think of a spur, but a bone spur is just extra bone. It's usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body.
A bone spur forms as the body tries to repair itself by building extra bone. It typically forms in response to pressure, rubbing, or stress that continues over a long period of time.
Some bone spurs form as part of the aging process. As we age, the slippery tissue called cartilage that covers the end of the bones within the joint breaks down and eventually wears away. Over time, this leads to pain and swelling, and in some cases, bone spurs forming along the edge of the joint. Bone spurs due to aging are especially common in the feet.

Bone spurs form in the feet in response to tight ligaments, to activities such as dancing and running that put stress on the feet, and to pressure from being overweight or from poorly fitting shoes. For example, the long ligament on the bottom of the foot, the plantar fascia, can become stressed or tight and pull on the heel, causing the ligament to become inflamed. As the bone tries to mend itself, a bone spur can form on the bottom of the heel, known as a heel spur. Pressure on the back of the heel from frequently wearing shoes that are too tight can cause a bone spur. This is sometimes called pump bump, or Haglund's Deformity, because it is seen in women who wear high heels.
Many people have a bone spur without ever knowing, because most bone spurs cause no symptoms. But if the bone spurs are pressing on the bones or tissues or are causing a muscle or tendon to rub, they can break that tissue down over time, causing pain, swelling, and tearing. Bone spurs in the foot can also cause corns and calluses when tissue builds up to provide added padding over the bone spur.
A bone spur is usually visible on an X-ray. But since most bone spurs do not cause problems, it would be

unusual to take an X-ray just to see if you have a bone spur. If you had an X-ray to evaluate one of the problems associated with bone spurs, such as arthritis, bone spurs would be visible on that X-ray.
Bone spurs do not require treatment unless they are causing pain or damaging other tissues. When needed, treatment may be directed at the causes, symptoms, or the bone spurs themselves.
Treatment directed at the cause of bone spurs may include weight loss to take some pressure off the joints (especially when osteoarthritis or plantar fasciitis is the cause) and stretching the affected area, such as the heel cord and bottom of the foot. Seeing a physical therapist for ultrasound or deep tissue massage may be helpful for plantar fasciitis.
Treatment directed at the symptoms could include rest, ice, stretching and non-steroidal anti-inflammatory drugs, such as ibuprofen. Education in how to protect your joints is helpful if you have osteoarthritis. When the spur is in the foot, changing footwear or adding an orthotic may help. If the spur is causing corns or calluses, padding the area or wearing different shoes can help. A podiatrist is the best trained in helping your bone spur and may also recommend a cortisone injection to reduce pain and inflammation of the tissues near the spur.
Bone spurs can be surgically removed or treated as part of a surgery to repair or replace a joint when osteoarthritis has caused considerable damage and deformity. Examples might include repair of a bunion or heel spur in the foot.
If you are suffering from bone spurs in the foot, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Related articles

• Can Bone Spurs Cause Heel Pain?

  ---

• Ray Allen Kept Out of Game By Bone Spurs

  ---

How Do I Use Crutches?

Sizing Crutches
Even if you've already been fitted for crutches, make sure your crutch pads and handgrips are set at the proper distances, as follows:

• Crutch pad distance from armpits: The crutch pads (tops of crutches) should be 1 1/2" to 2" (about two finger widths) below the armpits, with the shoulders relaxed.
• Handgrips: Place it so your elbow is slightly bent- enough so that you can fully extend your elbow when you take a step. 
• Crutch length (top to bottom): The total crutch length should equal the distance from your armpit to about 6" in front of a shoe. 

Begin the Tripod Position
The tripod position is the position in which you stand when using crutches. It is also the position in which you begin walking. To get into the tripod position, place the crutch tips about 4" to 6" to the side and in front of each foot. Stand on your "good" foot (the one that is weight-bearing).
Walking With Crutches
If your foot and ankle surgeon has told you to avoid ALL weight-bearing, you will need sufficient upper body strength to support all your weight with just your arms and shoulders.

1. Begin in the tripod position, remembering to keep all your weight on your "good" (weight-bearing) foot.
2. Advance both crutches and the affected foot/leg.
3. Move the "good" weight-bearing foot/leg forward (beyond the crutches).
4. Advance both crutches, and then the affected foot/leg.
5. Repeat steps #3 and #4.
Managing Chairs With Crutches
To get into and out of a chair safely:
1. Make sure the chair is stable and will not roll or slide. It must have arms and back support.
2. Stand with the backs of your legs touching the front of the seat.
3. Place both crutches in one hand, grasping them by the handgrips.
4. Hold on to the crutches (on one side) and the chair arm (on the other side) for balance and stability while lowering yourself to a seated position, or raising yourself from the chair to stand up.
Managing Stairs Without Crutches
The safest way to go up and down stairs is to use your seat, not your crutches.
To go up stairs:
1. Seat yourself on a low step.
2. Move your crutches upstairs by one of these methods:

• If distance and reach allow, place the crutches at the top of the staircase.
• If this isn't possible, place crutches as far up the stairs as you can, and then move them to the top as you progress up the stairs. 

3. In the seated position, reach behind you with both arms.
4. Use your arms and weight-bearing foot/leg to lift yourself up one step.
5. Repeat this process one step at a time (Remember to move the crutches to the top of the staircase if you haven't already done so.).
To go down stairs:
1. Seat yourself on the top step.
2. Move your crutches downstairs by sliding them to the lowest possible point on the stairway. Then continue to move them down as you progress down the stairs.
3. In the seated position, reach behind you with both arms.
4. Use your arms and weight-bearing foot/leg to lift yourself down one step.
5. Repeat this process one step at a time (Remember to move the crutches to the bottom of the staircase if you haven't already done so.).
IMPORTANT! 
Follow These Rules for Safety and Comfort

• Don't look down. Look straight ahead as you normally do when you walk. 
• Don't use crutches if you feel dizzy or drowsy.
• Don't walk on slippery surfaces. Avoid snowy, icy, or rainy conditions.
• Don't put any weight on the affected foot if your doctor has so advised.
• Do make sure your crutches have rubber tips.
• Do wear well-fitting, low-heel shoes (or shoe).
• Do position the crutch hand grips correctly (See "Sizing Your Crutches).
• Do keep the crutch pads 1 1/2" to 2" below your armpits.
• Do call your foot and ankle surgeon if you have any questions or difficulties. 

If you are suffering from a painful foot deformity like bunions, hammertoes, Charcot foot, or flat feet , call our Glastonbury or Middletown office to make an appointment.

Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

Help! I Can't Walk On My Foot: Charcot Foot

Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation. Because of its seriousness, it is important that patients with diabetes- a disease often associated with neuropathy- take preventive measures and seek immediate care if signs or symptoms appear.

Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk- making the injury worse.
People with neuropathy (especially those who have had it for a long time) are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot.
The symptoms of Charcot foot may include:

• Warmth to the touch (the affected foot feels warmer than the other).
• Redness in the foot.
• Swelling in the area.
• Pain or soreness.

Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered.
Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition.
It is extremely important to follow the surgeon's treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg, or life.
Non-surgical treatment for Charcot foot consists of:

• Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can repair themselves. Complete non-weightbearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the surgeon determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot, or brace, and may be required to use crutches or a wheelchair. It may take the bones several months to heal, although it can take considerably longer in some patients.
• Custom shoes and bracing. Shoes with special inserts may be needed after the bones have healed to enable the patient to return to daily activities- as well as help prevent recurrence of Charcot foot, development of ulcers, and possibly amputation. In cases with significant deformity, bracing is also required.
• Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet.

If you are suffering from a painful foot deformity like Charcot foot , call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter. 

Related articles

• What Is Charcot Foot?

  ---

• Why Do My Feet Tingle? Diabetic Peripheral Neuropathy

  ---

High Heels and Foot Deformities

The big fashion news was the return of spike and stiletto heels, to which the doctors in our offices let out a groan. Another reason for sore, aching, painful feet.
High heels hurt and can cause significant health problems, like bunions, hammertoes, heel pain, and trapped nerves. Aren't you tired of wearing shoes that hurt your feet? A 1993 survey of 620 women found the majority were dissatisfied with their shoes, even though most spent between $50 to $200 on dress shoes.
"Shoes that are fashionable are expensive and come with hidden costs," says Ayman M. Latif, DPM of Connecticut Foot Care Centers. "You'll first spend the $150 on the shoes, then you pay for the taxi because you can't walk to work, and then you pay for the medical costs from the toll they put on your feet."

Women make up 90% of the 795,000 surgeries for bunions, hammertoes, neuromas, and bunionettes, the top four deformities linked to poorly designed and constructed shoes. Approximately 2/3 of these surgeries were because of the patient's shoe wear selections.
The total cost for this avoidable surgery is $2 billion annually. With an average time lost of work of 4 weeks per person, the cost of time lost is about $1.5 billion, making the total of medical costs and lost work time $3.5 billion, just for shoes.
You take on average 10,000 strides per day, and high heels shift the force of these strides to take pressure on the ball of the foot and metatarsal heads (bones at the base of the toes). A 3 inch heel creates 7 times more stress on the forefoot than a 1 inch heel, increasing the possibility of foot problems with every step you take.
Even a minor misstep in spike or stiletto heels can have a disastrous effect: women are twice as likely to sprain an ankle while walking in heels. Frequent wearers of high heels shorten the Achilles tendon over time, causing you to lose range of motion in the foot and suffer other foot problems.
Any heel over 2 inches is highly discouraged. If you are going to wear shoes higher than 2 inches do not wear them for longer than 2 to 3 hours. In other words, wear them to the restaurant and take them off when you get back in the car.
The American Orthopedic Foot and Ankle Society's 1993 study of 386 women showed that an astonishing 88% wore shoes that were too small for their feet. 80% have pain and discomfort and 72% already had foot deformities. The average women had not had her foot measured in over 5 years.
Forcing your foot into shoes that are too small and then subjecting it to the force and pounding of your every day walking creates deformities over time. Bunions, hammertoes, mallet toes, and claw toes are often the result of being a fashionable shoe lover.
Women should look for low, shock-absorbent heels with a rounded toe box that fits the shape of your foot.
For a dramatic representation of poorly fitting shoes, stand on a piece of paper and have a friend draw the outline of your weight-bearing bare foot. Now take the dress shoes you most commonly wear and place them over the tracing. If your forefoot is much larger and rounder than the toe box of your shoe, you may be setting yourself up for a painful bunion or hammertoe in the future.
If you are suffering from a painful foot deformity like a bunion, hammertoe, or neuroma, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter. 

Related articles

• Can I Have A Bunion On the Outside Of My Foot?

  ---

• What Are Hammertoes?

  ---

• Dr. Oz and High Heels

  ---

• What's That Bump on My Big Toe?

  ---