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Ask Our Doctor About: General Foot Pain

The questions on this Website have been answered by Board Certified Foot and Ankle Specialists associated with OurHealthNetwork.com. The foot and ankle physicians and surgeons in this group have a combined 100 years of practice experience. The information and opinions expressed below should not be viewed as diagnoses and treatments, but rather as information to help you understand your foot or ankle related problem. All medical problems should be diagnosed and treated by a foot and ankle specialist in your state, or your family doctor. 

Subject: Calcaneal Apophysitis (or Sever's Disease)

"What can you tell me about Calcaneal Apophysitis? A local podiatrist has told me that this may be the cause of my 9-year-old son's heel pain that started about 1 month ago."
Dr. Kasdan's response: "Calcaneal Apophysitis (or Sever's Disease) is an inflammation of the growth plate (epiphysis) on the back of the heel. It causes a separation of tissue on either side of the growth plate. It is due to the excessive pull of the Achilles Tendon on its attachment to the heel, which occurs with too much sports activities and jumping. Certain foot types such as flat feet and pronation can help to bring this problem on. One of the most common ways to treat this problem is with rest. In extreme cases, patients may be placed in a non-weight-bearing cast for a time. This is sometimes followed by physical therapy and custom-made orthotics. Even when properly treated, and the pain subsides, this problem can continue to recur until the growth plate closes, which is usually between 16 and 20 years. In my experience, one of the best ways to prevent this problem from returning is with the use of custom-made orthtoics. These will reduce the pull of the Achilles tendon on the heel, reducing the stress on the growth center; and, they help to correct the abnormalities in the feet which predispose the foot to Sever's Disease."

Subject: Foot trauma

"My son was using a power jack. While it was in reverse he pulled the lever to make it stop, but the machine malfunctioned and crushed his foot. He had x-rays and was told nothing is broken. Yet today, four days later, he has bruises on the backs of all his toes, and he can't feel any of his toes or the top part of his foot. He has pain in his foot and shooting, burning pain up his calf. To me it sounds like he may have a stress fracture or nerve damage? I am most worried about him still having nymbness..."
Dr. Kasdan's response: "You are right. The two most common results of this type of trauma are stress fractures and injured nerves. I suggest that your son visit his family doctor as soon as possible for an evaluation. Another possible result of an injury is a condition called Compartment Syndrome. This is a swelling in one of the compartments of the foot or leg, which is so great that it cuts off the normal blood supply to the foot. This can lead to permanent nerve, blood vessel, muscle, and tendon damage."

Subject: Hallux Limitus

"You have helped me in the past and I hope you can help me now. Can you please tell me what this diagnosis means? Hallux Rigidus (limitus) and effusion of joint."
Dr. Kasdan's response: "When bunions (or bumps) form on the top of the joint where the big toe joins the foot, it is due to bone which forms at the joint and gradually becomes larger. This bone bump will usually interfere with movement at the joint, causing pain when the toe is flexed upward, as it does when walking. This produces a painful problem called Hallux Limitus, which causes pain with each step. Sometimes these bumps become so large that the top of the shoe will put pressure on the bump, causing even more pain.
    This problem is usually due to one of the following causes: A long 1st metatarsal (the bone which connects to the big toe); a rigid forefoot, usually associated with supination (a turning in of the foot); or an injury to the joint.
      In the early to middle stages of the development of this problem (when pain is present only when walking in a shoe), custom-made orthotics will help to keep pressure off of the joint, and they will accommodate for the long 1st metatarsal, a rigid forefoot, and supination. Custom-made orthotics can not only relieve your pain, but in most cases they can stop the problem from becoming worse. In 30 years of practice, I have found custom-made orthotics have provided the relief patients needed without undergoing surgery.
      In the later stages of this problem, where the bump (bunion) is very large and always painful (both in and out of shoes), surgery may be the only way to acheive relief. After surgery, inorder to help prevent the problem from returning, you may need custom-made orthotics. Please click here for more information about custom-made orthotics."

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