Most foot problems that people with diabetes face arise from nerve damage and poor circulation. One of the more critical foot problems these complications can cause is Charcot arthropathy, which can deform the shape of the foot and lead to disability. There are treatment options for the wide range of diabetic foot problems. The most effective treatment, however, is prevention. For people with diabetes, careful daily inspection of the feet is essential to overall health and the prevention of damaging foot problems. Surgery may be recommended if the foot deformity puts the patient at a high risk for ulcers or if protective shoewear is not effective. Unstable fractures and dislocations also require surgery to heal.
A variety of foot problems can lead to adult acquired flatfoot deformity (AAFD), a condition that results in a fallen arch with the foot pointed outward. Treatment ranges from nonsurgical methods such as orthotics and braces to surgery. Your doctor will create a treatment plan for you based on what is causing your AAFD.
If you sometimes feel that you are "walking on a marble", and you have persistent pain in the ball of your foot, you may have a condition called Morton's neuroma. It most frequently develops between the third and fourth toes usually in response to irritation, trauma, or excessive pressure. A combination of roomier, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses, and cortisone injections provide relief in over 80 percent of people with Morton's Neuroma. If conservative treatment does not relieve your symptoms, your orthopedic surgeon may discuss surgical treatment options with you.
Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes inflamed. More than 90% of patients with plantar fasciitis will improve within 10 months of starting simple at-home treatment methods. When more-conservative measures aren't working after several months, your doctor might recommend steroid injections, Tenex procedure, or surgery.
Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot resulting in flatfoot. Most patients can be treated without surgery using orthotics and braces. If orthotics and braces do not provide relief, surgery can be an effective way to help with the pain. Surgery might be as simple as removing the inflamed tissue or repairing a simple tear. However, more often than not, surgery is very involved, and many patients will notice some limitation in activity after surgery.
Most bones in the human body are connected to each other at joints, but there are a few bones that are not connected to any other bone. Instead, they are connected only to tendons or are embedded in muscle. These are the sesamoids. The kneecap (patella) is the largest sesamoid and there are two other sesamoids (about the size of a kernel of corn) in the underside of the forefoot near the great toe. Sesamoids provide a smooth surface over which the tendons slide and assist with weight bearing on the big toe. Like other bones, sesamoids can fracture causing the tendons to become inflamed. This is called sesamoiditis, and it is common among ballet dancers, runners, and baseball catchers. Treatment is generally nonoperative. However, if conservative measures fail, your physician may recommend surgery to remove the sesamoid bone.
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