Morton’s Neuroma and High Heeled Shoes
Morton’s Neuroma and High Heeled Shoes
People who wear tight, narrow, high heeled shoes for fashion or for their main occupation are at a much higher risk of contracting a condition known as Morton’s Neuroma. This is a painful condition that affects the ball of your foot and can cause a sharp, burning pain. It results in the thickening or enlargement of the toe nerve and unfortunately, if not treated, in come cases it can develop into the tumor of the nerve.
Morton‘s Neuroma will also cause pain when walking. It usually affects the nerve between the base of the third and fourth toes (third web space). The size of the nerve in this area is bigger than other web spaces, making it easier for it to become irritated. Furthermore, people who wear tight, narrow, high heels or those with flat feet are more prone to having this nerve compressed.
This nerve function is a sensation response. When compressed or squeezed the patient will feel a darting pain, similar to having an electric shock. They will also be reluctant to have the area touched, particularly in the ball of their foot. Other symptoms include a tingling or numbness in their toes or a burning sensation in the ball of their foot that may radiate into their toes. During examination, when their toe is held and pressure is exerted on the tip, or when the area between the base of the third and fourth toes is tapped, the patient will feel a darting pain to both toes; consequently, they are keen for the doctor to take their hand away and not to touch the inflamed area. Patients have also reported that when walking for long periods of time the pain will escalate to the point that they will be in too much discomfort to continue.
Diagnosis
After administering an x ray to see the shape of the bones in the patients’ foot, there is also a need to perform an MRI (Magnetic Resonance Imaging) scan in order to observe the inflamed and swollen nerve. MRI is a type of scan that uses magnetic fields and radio waves to produce detailed images of the inflamed area and can also show the nerve as a 3D image. This can confirm whether the patient conclusively has the condition.
Treatment
Treatment depends on the severity of the symptoms. An initial measure can be for a patient to change their shoes to a pair that are more supportive, however, perhaps not as aesthetically pleasing. Another approach is to take medicine, usually through an injection of anti-inflammatory steroids into the the affected area. However, if the symptom persist for a long time, these conservative treatments can be less and less effective and therefore a doctor may recommend surgery as the best option. In this relatively minor surgical procedure the surgeon will remove the permanently ruined nerve that cannot be recovered as it could potentially develop into a tumor.
The Surgery
The surgery is often done on the top surface of the feet rather than on the sole side, making it easier to clean and dress the wound. During the operation, the patient’s sensation will be controlled by either a spinal anesthesia or general anesthesia. The procedure itself will usually take around 20 to 30 minutes. Following this, the patient will be required to take a day’s rest before they can resume walking on the heel of their foot again. The wound is stitched by a soluble thread, which should remain in place without being removed. Furthermore, the effected area also needs to be kept dry for 7 to10 days, therefore it is advisable for the patient to apply a waterproof plaster to the wound.
After a successful surgery, the patient should not feel any further pain in the affected area. As the nerve has been removed, they will also have no sensation of the skin on the third and fourth toes. As time passes, sensation will return to the the skin around this area from the nerve of the nearby toes.
In conclusion, it is an individual’s choice whether to risk looking pretty in high-heeled shoes at the expense of a potential need for surgery. Of course, a doctor can offer medical guidance but essentially it is an individual’s personal preference.
HEALTHY SHOES
Are you wearing proper shoes?
Here at Smiling Foot and Shoe Center, we believe that feet are one great part of the body we, often times, neglect. Many times we seem to be unaware of how important our feet are. They take us to places we need to go, and for every step, when our feet touch the ground the vibration force produced affects the body structure.
We take on average 5,000 to 8,000 steps a day. The force, thus, affects the joint’s health especially at the spine and knee. This is why we need to take good care of our feet. The way we choose the types of shoes we wear for 8 to 10 hours a day is a very important matter to always keep in mind.
Not only can a pair of shoes protect our feet from the outside risk factors, they are also a delight to look at, as we display as our very own stylish shoe designs
Heel Pain
Heel Pain
Symptoms
A common foot problem that many people suffer is heel pain. This is a condition in the foot that can effect any individual from any walk of life. The chance of a person developing these symptoms depends on how much they use their feet during the week. For example in a job that requires long hours standing up, the pain can be more severe as more strain is put on the feet. Another factor that can effect the severity of the pain is how well a person looks after their feet.
Heel pain usually occurs under the heel or just behind it. The most common symptom for a patient is that when they wake up in the morning and put their feet on the floor to make their first steps of the day, they will immediately feel a sharp pain in their heel. In order to not exert any more pressure on the area producing the pain, the patient will feel the need to tip-toe and avoid walking on their heels, as they move around the house. After a few minutes of walking, the heel pain will decrease as the process of walking stretches the fascia. However, after sitting down for a period of time, when walking is resumed the heel pain will return and will be as intense as previously felt.
This type of discomfort can be very frustrating and can leave a patient feeling as though they will never fully recover. In addition, as the symptoms develop, the pain will increase and will not subside as before. Furthermore, when taking a walk, or doing other exercises that exert pressure on their foot, the pain will continue to persist.
Causes
When the base of the foot (sole) muscle becomes so weak that the foot is unable to carry a person’s body weight during daily routines, this will result in heel pain. In this troublesome problem, muscle fiber tears off repeatedly at the same spot, producing a wound or fibrosis.
Heel pain appears to be more of an issue for people that work in the city, such as in office jobs. This is due to the fact that they usually wear smarter shoes with a harder sole. Furthermore, they will often walk on a harder, flatter floor for the majority of the day so the smaller muscles of the base of their feet will not be stretched as much; they will progressively become weaker day by day, until finally, during a period of heavy use, the muscles at the underside of the heel will tear off followed by inflammation. This incident will occur repeatedly in patients and, since the cause of these symptoms are the weak muscles under the feet, it can be very difficult for it to be cured unless the muscles on the underside of the feet are recovered beforehand. In contrast, people that work in other occupations or away from the city may not be exposing their feet to the same levels of intensity so their symptoms are usually much milder.
An x-ray picture of the heel bone with the calcite
An x-ray picture of the normal heel bone
Treatment
Taking painkillers does provide some relief, temporarily. However, after finishing a one or two week dose of pills, the pain will often return. Moreover, there is also potential for a stomach ulcer to develop as a side effect of taking painkillers for a prolonged period of time. Furthermore, some patients have also reported that they have felt the symptoms so often that painkillers are not having any effect. With this in mind, a viable option is to opt for treatment. If this is chosen, patients are injected with a medicine containing steroids into the most painful point of their heel. Some patients are reluctant to carry out this form of treatment and believe that steroid injections are dangerous. A common reason for this is because they have heard of the side effects of the steroids used in some painkiller pills and in the general medicinal balls. Needless to say, all medicines are dangerous if not used correctly or if not used with the guidance of experts. An injection differs from taking oral medicine for various reasons. Firstly, the oral medicine will be digested and absorbed into all parts of the body through the blood stream, however, an injection will only be effective in reducing the inflammation within the 2-3 centimeter area around the injected position; there is no effect on other parts of the body. Furthermore, as an injection is effective on a specific spot, it can be administered into the heel of a pregnant woman who may be suffering, without any complicated side effect, therefore the medicine itself is rather safe to use.
The effects of the injection will last for approximately three months. However, if the patient has weak muscles in the base of their foot, unfortunately the heel pain is likely to return. Also, if the problem is ignored and the issue is neglected for too long, there is a possibility that a calcite attached to the heel bone could develop. In this case, when taking a walk an individual will feel like there are thorns continually ‘pinching’ on their heel on each step that they exert pressure on the heel. The calcite will become so thick and long that the other treatments become inadequate and have little to no effect. In this situation, the only viable treatment option is to undergo surgery.
The surgeon takes out the calcite by using the special x-ray equipment, providing them with a crucial real-time picture.
If a patient does decide upon having surgery, this can be thought of as an effective method to cure heel pain. The surgeon will perform a small surgical procedure where a small incision is made into the heel area that harbours the wound. Next, the surgeon will trim out the fibrosis from the wound and take out the calcite, before also repairing the attached point at the underside of the foot muscle. This procedure is the cure of the root cause and prevents the heel muscle repeatedly tearing off. which is the main cause of the heel pain.
Who should take the surgery?
The following patient groups should seriously consider taking this surgery:
- Patients with chronic heel pain.
- Patients who have calcite in their heel.
- Those patients who have been continually injected with steroids, where symptoms persist.
- Patients who are unable to take anti inflammation medicine for a long duration.
- Patients who cannot walk for a long time.
- Those patients who walk in an unstable way or have back pain.
If patients are not comfortable with undergoing surgery to prevent heel pain as described above, they can make some small alterations to their day that will help ease their pain. One option is that they can take off hard sole shoes from time to time during the day. Another solution is to avoid walking on hard surfaces, by walking on grassy patches or smoother surfaces, where the option is available. This will give the muscles in the underside of the foot the exercise needed and will allow the inflamed muscle to rest, recover and get back to normal.
Bow legs (or bow knees) and knock-knee in children : Part 1
Recently there has been a new, revolutionary way of thinking towards the treatment of bowed-legs. Patients can wear specially designed shoes that are tailored to a patient’s particular needs and can therefore produce a change to the legs / knee structure. These custom made shoes, featuring patient specific insoles, can adjust the structure of the horizontal plane and the angle and the length of the legs. Fortunately, they can be fit as soon as the child is able to walk. Furthermore, they are also effective in elderly patients, where they can provide increased support in weaker areas.
Bow legs (or bow knees) and knock-knee in children : Part 2
It’s quite common for toddlers to appear mildly bow legged. In fact, toddlers can often have bowed legs that may even interfere with walking. Fortunately, bow legs usually begin to straighten once the child starts to walk and it can be thought of as a natural occurrence that the child will usually grow out of. Adolescents occasionally have bowed legs if the degree of deformation is rather severe which can cause a flaw in their appearance.
