Foot pain is one of the most common problems among musculoskeletal system disorders.
Our feet, which carry our body, play an important role in the integrity of the movement system.
Some scientists even believe that due to the important functions of the feet. They named them as the pain workers of our body. The feet, which undertake this great task, consist of a complex structure.
There are 26 bones in the foot. These interbone joints, ligaments and muscles provide foot stability and mobility. The foot is divided into 3 functional parts: front, middle and back.
Foot pain is an important health problem that increases with age. Almost one-third of people over the age of forty-five have foot pain. A significant portion of these foot pains make daily life difficult for the person
and significantly affect their quality of life and physical functions.
In addition, they also cause a significant increase in falls.
>Shoe examination should also be performed during the foot examination, and any unexpected wear on the shoes, if any, should be recorded.
When you look at the sole of a normal shoe, you can see wear on the outer side of the toe and heel due to load carrying
. In the shoes of a patient with flat feet, wear is observed on the inner side of the sole and the outer side of the heel. In severe cases, wear is also noticeable on the opposite corner of the heel. A shoe with excessive wear on the comb part and the back of the heel, wrinkling on the front face and lifting on the toe.
A shoe belongs to a foot with pes cavus (increase in the foot socket - the opposite of flat foot disease). As can be understood from these few
examples, it is possible to approach the diagnosis of some
diseases even with a good and careful evaluation of the shoe.
HEEL PAIN
Heel pain is one of the most common problems encountered in adulthood. It is encountered at a rate of up to 15%, especially in people aged 40-60
. Obesity, standing for long periods of time, walking and activities in some sports are predisposing factors. is shown. The heel is surrounded by a special fatty tissue. This fatty tissue is a shock-absorbing structure and absorbs 20-25% of the direct load on the heel.
The patient usually complains of severe heel pain with the first step in the morning. Later, there is pain that partially
relieves. To reduce the pain, patients try to walk by placing weight on the outer part of their feet, and sometimes even bend their toes to reduce foot pain.
Heel pain generally occurs in three ways. Pain arising from the heel and surrounding soft tissue
Pain arising from bones and joints in the heel area; Pain referred from other places
PLANTAR FASCIITIS
It is a disease of the tissue that extends from the heel to the toes and covers the sole of the foot widely
. It is a clinical picture that is usually seen in middle ages and is characterized by pain and tenderness that increases with walking under the heel and is not related to trauma. Morning pain is often severe, relieves with a few
steps, and then during the day, standing, especially climbing stairs and tiptoe walking, which causes the sole of the foot to stretch, increases the pain. The disease, which can be seen with foot deformities (flat feet, height of the foot arch), old age, athletes and marathon runners, and obesity, can sometimes be accompanied by inflammatory rheumatic diseases.
p>Plantar fasciitis, which causes foot pain, is often unilateral, but in 1/3 cases it is bilateral. In a high rate, the symptoms regress after one year. There is a significant
relationship between heel spurs and plantar fasciitis.
Treatment: Although the disease is self-limiting, it usually affects the daily life of the patient to a significant degree
. Many methods are used in treatment. The main methods used are;
rest, hot and cold applications, electrotherapy, taping, appropriate stretching exercises
base support, manual therapy, PRP, ESWT, non-steroidal painkillers, pain relief. Injection into the area where it is concentrated.
Muscle strength must be restored and adequate flexibility must be provided. Stretching the calf
muscles is also necessary. Unloaded before stretching , then it should be done by giving load. Appropriate
Use of shoes is also important.
OIL PILLOW SYNDROME
There is an oily texture with a honeycomb appearance between the heel and the heel skin. The most important cause of fat pad syndrome is atrophy of the fatty tissue in the heel of the foot. The heel pad normally consists of fatty tissue
and elastic tissue and has a shock absorbing feature. But this feature decreases with age and body weight, and the heel becomes uncushioned. Continuous stress on the cushion may also cause this insufficiency.
The localization of the pain is on the heel where the load is highest.
In the treatment, non-steroidal drugs, soft-heeled shoes and sports activities should be avoided for a certain period of time
.
TARSAL TUNNEL SYNDROME
It occurs as a result of compression of the nerve at the back of the leg as it passes through the nerve tunnel under the anklebone.
Pain in the back-inner part of the heel, sensitivity in the same area on the nerve. , numbness may occur. Complaints
especially increase after long walks. Foot pain does not decrease immediately and decreases gradually as weight loss decreases. Numbness may occur in the form of pain during the day and night. Suitable for treatment
non-steroidal painkillers along with insoles. Surgical treatment is an option for people whose symptoms do not go away.
STRESS FRACTURE OF THE HEEL BONE
It is a rare fracture that often occurs in military personnel. It is an insidious pain that occurs especially during reactive activities
. Pain occurs with pressure on the heel. In radiology, a line parallel to the posterior edge of the bone is seen. Scintigraphy or MRI gives good results for diagnosis. Its treatment is non-surgical. Appropriate shock reducing shoes should be preferred.
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