Feet Pain Concerns

Leg Length Discrepancy Shoe Lifts


Overview
For discrepancies over five centimeters, more aggressive surgical procedures-specifically leg lengthening procedures-are typically required. The specifics of this operative procedure are beyond the scope of this informational page, but your child's physician will be able to discuss the details in reference to your child's specific problems when considered appropriate.Leg Length Discrepancy

Causes
Common causes include bone infection, bone diseases, previous injuries, or broken bones. Other causes may include birth defects, arthritis where there is a loss of articular surface, or neurological conditions.

Symptoms
Patients with significant lower limb length discrepancies may walk with a limp, have the appearance of a curved spine (non-structural scoliosis), and experience back foot pain from sciatica (http://dinorahbela.wordpress.com/2015/06/24/surgical-treatment-for-hammer-toes) or fatigue. In addition, clothes may not fit right.

Diagnosis
A systematic and well organized approach should be used in the diagnosis of LLD to ensure all relevant factors are considered and no clues are overlooked which could explain the difference. To determine the asymmetry a patient should be evaluated whilst standing and walking. During the process special care should be used to note the extent of pelvic shift from side to side and deviation along the plane of the front or leading leg as well as the traverse deviation of the back leg and abnormal curvature of the spine. Dynamic gait analysis should be conducted during waling where observation of movement on the غير مجاز مي باشدittal, frontal and transverse planes should be noted. Also observe head, neck and shoulder movements for any tilting.

Non Surgical Treatment
Treatment for an LLD depends on the amount of difference and the cause, if known. The doctor will discuss treatment options carefully with you and your child before any decisions are made. It is important to note that treatment is planned with the child?s final height and leg lengths in mind, not the current leg lengths. Treatment is generally not needed if the child?s final LLD is predicted to be 2 centimeters or less at full height. However, the child should return to an orthopaedic doctor by age 10 for re-evaluation. Treatment is often recommended for LLDs predicted to be more than 2 centimeters at full height. If treatment is done, it usually doesn?t begin until the child starts walking. Possible treatment options include, A ?lift? in one shoe to level the child?s hips. This is often the only treatment needed for small discrepancies.
Leg Length Discrepancy
Surgical Treatment
Surgical options in leg length discrepancy treatment include procedures to lengthen the shorter leg, or shorten the longer leg. Your child's physician will choose the safest and most effective method based on the aforementioned factors. No matter the surgical procedure performed, physical therapy will be required after surgery in order to stretch muscles and help support the flexibility of the surrounding joints. Surgical shortening is safer than surgical lengthening and has fewer complications. Surgical procedures to shorten one leg include removing part of a bone, called a bone resection. They can also include epiphysiodesis or epiphyseal stapling, where the growth plate in a bone is tethered or stapled. This slows the rate of growth in the surgical leg.
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Addressing Mortons Neuroma


Overview
MortonMorton's neuroma is a painful foot condition that occurs when a nerve, usually between the third and fourth toes, expands and becomes compressed. Shoes, particularly high heels or shoes with tight toe boxes, and walking often make the pain worse. In some cases, patients with Morton's neuroma find short-term pain relief when they do not put weight on the affected foot pain from heels (audreyleuenthal.jimdo.com).

Causes
A Morton?s Neuroma are a result of complex biomechanical changes that occur in your feet. There are a number of theories as to the exact cause of the scarring and thickening, but it basically boils down to overload of the tissue structure. The body lays down scar tissue to try to protect the overloaded structure. Tight-fitting shoes may exacerbate a Morton?s Neuroma. Shoes such as high heels and shoes with tight toe boxes (eg womens fashion shoes and cowboy boots) are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. The slope causes the front of the foot to bear your weight. The angle of the toe box then squeezes your toes together. Footwear is not the only cause of a Morton?s Neuroma. Injuries to the foot can also be a factor in developing the condition by changing your foot biomechanics. Poor foot arch control leading to flat feet or foot overpronation does make you biomechanically susceptible to a neuroma.

Symptoms
The symptoms of Morton?s Neuroma tend to come and go over time. They are typically exacerbated by physical activity or by wearing certain shoes. Morton?s Neuroma symptoms include sharp pain in the ball of the foot, pain radiating to the tips of the toes, burning pain in the second, third, or fourth toes, numbness in the toes, sensation of a lump between the toes.

Diagnosis
There is a special orthopedic test called the Morton's test that is often used to evaluate the likelihood of plantar nerve compression. For this test, the client is supine on the treatment table. The practitioner grasps the client's forefoot from both sides and applies moderate pressure, squeezing the metatarsal heads together. If this action reproduces the client's symptoms (primarily sharp, shooting pain into the toes, especially the third and fourth), Morton's neuroma may exist.

Non Surgical Treatment
Treatments may include rehabilitation measures to reduce nerve Irritation. Switching to low-heeled, wide-toed shoes with good arch support. Wearing padding in the shoes and/or between the toes. Wearing shoe inserts to correct a mechanical abnormality of the foot. Having ultrasound, electrical stimulation, whirlpool, and masغير مجاز مي باشدe done on the foot. The foot may be injected with cortiغير مجاز مي باشدteroids mixed with a local anesthetic in order to reduce pain. Relief may be only temporary, however, if the mechanical irritation is not also corrected. Injections with other types of medications such as alcohol, phenol, or vitamin B12 are sometimes used.Morton neuroma

Surgical Treatment
Surgery for neuroma most often involves removing affected nerve in the ball of the foot. An incision is made on the top of the foot and the nerve is carefully removed. Surgeon must remove the nerve far enough back so that the nerve doesn?t continue to become impinged at the ball of the foot. Alternatitvely, another type of surgery involves releasing a tight ligament that encases the nerve. Recovery after Morton?s neuroma (neurectomy) surgery is generally quick. Typically patients are walking on the operated foot in a post-surgical shoe for 2 - 4 weeks, depending on healing. Return to shoes is 2-6 weeks after the surgery. Factors that may prolong healing are age, smoking, poor nutritional status, and some medical problems.

Prevention
Always warm-up thoroughly before vigorous athletics. Avoid activities that cause pain. Stretch and strengthen the feet through gradual exercise.
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