(Keywords: foot pain, chiropractic, plantar myofacitis, ankle sprain treatment, ankle fracture, chiropractic for Mortons neuroma)
There are amazingly 26 bones in the foot, each and every one capable of causing foot pain! In between are even more joints, likewise a rich source of pain. The cuboid alone abuts six different bones, all with a joint.
The foot is extremely richly endowed with nerves that send information to the brain, telling the brain exactly where the body is poised in space. We call it "proprioception" - you might think of it as position sense. It is so important that the body dedicates a specific tract in the spinal cord carrying this information to the brain. The "dorsal column" which does also carry other information.
Receptors in the joints and tissues of the feet send this position sense and light touch sense to the brain via the "dorsal column."
When one is kicking a ball, for example, even walking, it is extremely important that the brain has exact information about the position of each part of the body, in order to precisely coordinate movement.
Little wonder that the foot, with so many bones, joints, ligaments, nerves and muscles, all extremely pain sensitive, can cause so much discomfort.
Look for the metatarsal-phalangeal joints in the forefoot - the source of so-called Metatars-algia (algia = pain)in the ball of the foot.Notice
too the Cuboid bone. See how many other bones articulate with it? Six!
The cuboid is often the spoke in the wheel when it comes to foot pain.
"Do you appreciate your feet? Have you thanked your metatarsals for their hard work? How about your talus?"
Foot pain often starts after a inadequately managed ankle sprain. When you turn your ankle, it's not only ligaments that are sprained. Frequently several muscles are strained, either on the side of the leg and even under the foot, and the small bones in the midfoot are subluxated. Often the talus, or the cuboid, and the calcaneus (heel bone) too may become fixated and in fact any of the ankle and foot bones. It all starts with a thorough examination before any ankle sprain treatment. Prevention!
Metarsarsalgia, or ball of the foot pain, is a very common and sometimes extremely distressing problem. It can be acute, often recurs, and in many people becomes a chronic source of pain. A limp often develops with a negative knock-on effect at the knees, hips and spine.
It is usually, but not always associated
with a dropped transverse arch, in which case the toes often jut
upwards, and thick calluses form under the metatarsal heads (or "met
heads", for short) due to increased pressure on the second, third and/or
fourth met heads. The solution is not to scrape the callus away.
The arrow points clearly to the callus formation. Improper fitting and too-tight shoes may be the cause, especially women’s dress shoes with a high heel, which force more weight onto the forefoot.
Pointed shoes squeeze the ball-of-foot into a restricted space, forcing the met heads against each other, irritating the nerves that run between them. This may cause a Morton’s neuroma, a benign painful swelling of the nerve, leading to extreme discomfort in the forefoot and tingling and pain in some of the toes.
Associated with the meta-tarsalgia we often find a generalised plantar myofascitis
with pain running under the foot, down towards the heel.
Heel pain can be agonising, especially first thing in the morning.
The plantar fascia starts from a bump on the heel bone called the "tuberosity", running under the foot forwards to the toes. When there is chronic stress on this fascia, basic physiology tells us that it will produce a spur. This spur can grow very large, looking dramatic on X-ray, and is prominent and easily bruised. Medicine likes to cut it off.
But this is rarely necessary. A soft heel cushion, reducing
the bony fixations that are causing the fascial tension, and Active
Release of the plantar fascia, and usually it will come right in a few
weeks. The pain is usually worst first thing in the morning.
A Morton's neuroma is a not altogether rare condition in which the
nerve between the toes becomes swollen and inflammed. Flames of pain,
tingling and numbness in the toes is the result.
Read more about Mortons neuroma …
Lees meer over MORTONSE NEURALGIE …
FROM THE COAL FACE
Mrs Naude, a pharmacist, consulted me with a very acute attack of sacro-iliac pain in the lower back. Her back had been grumbling for some months since she started limping with pain under her foot, warning her of impending trouble, but despite various therapies her foot continued to hurt - for nearly two years. Finally, her back collapsed, and she spent three weeks in bed, had various scans. Neither pills nor physiotherapy helped, and an over-enthusiastic manipulation aggravated the problem.
Her back pain settled within a few weeks, but the foot was another matter. She had a very high arch with a fixation between two small bones in the midfoot. Owing to the chronic nature of the condition it presented with pain in the plantar fascia, pain in her heel, pain in the Met-heads, and pain in those two little bones. Fortunately she is not over weight.
Treatment is directed at the fixations of the cuneiform bones, stretching of the plantar fascia, adjusting the toes, a heelcup for the heel pain (actually both heels, otherwise she would have a leg length difference), and the 'alphabet' exercises. Rome won't be built in a day, nor Aachen and Cologne as they say in Holland, but she will get better in a month or two.There are few conditions that I like to treat more than metatarsalgia. Except in extremely deformed feet, this condition responds brilliantly to chiropractic treatment of the foot, without arch supports, bandages and the like.
The stretching and longitudinal frictioning of the muscles between the metatarsals may be very painful, but I can almost give a guarantee ... something no wise doctor ever does!
Update: Mrs Naude is fine. I treat at least five feet every day. I love 'em. A lot easier to fix than a difficult back.
For more interesting cases from the chiropractic clinic,
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Ever think of sending a card to your doctor, chiropractor, dentist? Tell him/her how much you appreciate their efforts, how much you are improving. When you know he or she has really gone the extra mile, a bottle of wine at Christmas wouldn't go amiss! We in the healing professions can also do with a little encouragement from time to time.
I got this letter from an English lady who crossed the North Sea to consult me in Holland for pain in the foot. It turned out to be Metatarsalgia of two years duration. Only three treatments: "I can walk without pain, yes!"
Better still, think about sending your Chiropractor (or your doctor for that matter!) an inspirational Chiropractic book.
Chiropractic Care of Foot Pain
As in all conditions the first step in treating metatarsalgia is to determine the cause of the pain. Proper fitting footwear is obviously the start.
Mobilising the metatarsals, adjusting the toes, and deep stretching and soft tissue therapy of the muscles between and under the metatarsals is extremely effective.
Checking for fixations in other parts of the foot are important. They can be adjusted with the help of a
Thulitables drop board.
Shoe inners may be very helpful, particularly if pronation of the foot exists. A common chiropractic brand is made by Foot Levelers. FootLevelers is one of the foremost manufacturers of shoe inserts
SPRAINED ANKLE TREATMENT
The foot and ankle obviously functionally go together. Ankle joint injuries are certainly worthy of a page of their own. Whilst I don't have the research to back it up, my opinion is that many foot pain problems begin after an improperly managed sprained ankle , in which the subluxated bone(s) were never corrected.
Spare a thought for this giraffe. Think the poor devil's got foot pain?
We've heard it all before, we know about the high blood pressure, the knee arthritis etc Etc ETc ETC .... and we've tried so many diets and, and, and ...
Our free WEIGHT LOSS PROGRAMS really do work. Start by simply eating rather less CARBS. One less potato, only a small helping of pasta and pizza, and more salads and veg. IT DOES WORK. And it WILL spare your feet.
Finally, exercises for the foot are are important in the treatment of foot pain. However, they are specialised and difficult to teach over the internet.
One simple option is the so-called alphabet exercises: sitting on a chair, well back, with the shoes off, move each foot tracing out say about 5 letters of the alphabet. Flex your toes and foot as high as you can (called dorsi-flexion), then drop them down, tracing out an A. Try and move all parts of the foot including the toes. The knee shouldn't move.
More exercises for the foot and ankle can be found here.
ANKLE EXERCISES ...
Podiatrists us a variety of orthotics to aid in the treatment of foot pain to unload the pressure on the ball of the foot. Various pads, cushions and bandages each have a place in the care of foot pain.Choosing the right shoes, of course, is also vital. The first and most basic rule: if the shoe doesn't immediately feel comfortable, move on... don't buy into "you'll wear it in", "it'll stretch". BUYING RUNNING SHOES ...
When bones in the foot or ankle are fractured there are invariably other tissues involved. Sprained ligaments, pulled muscles, injured hyaline cartilage and subluxated for fixated joints.
Unmanaged, once the cast has been removed, these other conditions frequently lead to chronic foot and ankle pain and, if you changes your gait, knee, hip and back pain. ANKLE FRACTURE ...
When massaging away your foot pain you may want to consider a few different massage oils. Here are a few choices...
MASSAGE OILS ...
Shin splints is a painful condition of the inner side of the
shinbone. Since some of the muscles involved are inserted into the foot,
the pain may radiate into the foot.
Read more about SHIN SPLINTS
Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.
Interesting challenges of the day
1. Mr B has the trophy for the most acute neck in February. He has quite advanced lower neck arthritis for a forty year old, thanks to a severe fall on the head from a trampoline. But this is upper cervical pain. Right rotation is simply impossible. Luckily he is improving rapidly, eighty percent better he says after three treatments. See cervical facet syndrome.
2. Mrs C is a new patient with a long history of lower back pain, hip pain and pain in both feet. We'll see how we get on, Rome wasn't built in a day.
3. Miss U sprained her ankle two months ago, wearing high heels. She still has severe mid foot pain. Xrays and perhaps a CT scan.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of foot. It started after a long drive in the car. Update, she's forty percent less painful after four treatments, but the leg is still numb. Update two; she 60% better, but it's slow and is going to take the full 6 weeks to heal. Further update; a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. Mrs Y, a 70 year old woman is on maintenance care fo a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection in the shoulder. After 4 operations he is incapacitated and going rapidly down hill.
8. Mrs Z, an 78 year old woman is doing remarkably well with a bad sciatica. But at over 200 lbs she is not losing weight, in fact gaining despite my suggestions. She's high risk for a stroke. Referral to a dietician to crack the whip.
9. Mr A, a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. Reassured him it's not hip arthritis.
10. Mrs B, a 64 year old woman has had Scheuermanns disease; it's left with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment, provides she come every six weeks or so for treatment.
11. Mr C, a young engineer fell off his mountain bike injuring his cervical spine and pelvis. Luckily both responded very quickly to a few chiropractic adjustments. Update: his neck is sore again. It all goes back to a whiplash injury ten years ago when he was rammed by a fully laden truck carrying a load of stone. Time for Xrays.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes. Chiropractors shouldn't be treating the elderly? Bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional
response which turned out to be exactly correct. I now consult a local chiropractor.
You write a superb newsletter, too.
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