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Diabetes Heel Pain

Heel Pain: Symptoms & Signs

Heel Pain: Symptoms & Signs

Pain in the heel can result from a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Because of walking and daily movement, we are always at risk for injury or trauma to the heel area. Common causes of pain in the heel include blisters and corns. Plantar fasciitis, inflammation of the "bowstring-like" tissue in the sole of the foot stretching from the heel to the front of the foot, is one condition commonly associated with heel pain. Sometimes diseases that affect other areas of the body, like peripheral vascular disease or arthritis, can also result in pain in the foot or heel. Sever's disease is a cause of heel pain in children that results from injury to the growth plate of the heel bone. Treatments for heel pain depend on the particular cause. REFERENCE: Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015. Medically Reviewed by a Doctor on 4/7/2017 Continue reading >>

Diabetic Foot Problems

Diabetic Foot Problems

What foot problems can be caused by diabetes? Diabetes mellitus can cause serious foot problems. These conditions include diabetic neuropathy (loss of normal nerve function) and peripheral vascular disease (loss of normal circulation). These two conditions can lead to: Diabetic foot ulcers: wounds that do not heal or become infected Infections: skin infections (cellulitis), bone infections (osteomyelitis) and pus collections (abscesses) Gangrene: dead tissue resulting from complete loss of circulation Charcot arthropathy: fractures and dislocations that may result in severe deformities Amputation: partial foot, whole foot or below-knee amputation What are the symptoms of a diabetic foot problem? ​Symptoms of neuropathy may include the loss of protective sensation or pain and tingling sensations. Patients may develop a blister, abrasion or wound but may not feel any pain. Decreased circulation may cause skin discoloration, skin temperature changes or pain. Depending on the specific problem that develops, patients may notice swelling, discoloration (red, blue, gray or white skin), red streaks, increased warmth or coolness, injury with no or minimal pain, a wound with or without drainage, staining on socks, tingling pain or deformity. Patients with infection may have fever, chills, shakes, redness, drainage, loss of blood sugar control or shock (unstable blood pressure, confusion and delirium). How do some of these complications develop? ​Neuropathy is associated with the metabolic abnormalities of diabetes. Vascular disease is present in many patients at the time of diagnosis of diabetes. Ulcers may be caused by external pressure or rubbing from a poorly fitting shoe, an injury from walking barefoot, or a foreign object in the shoe (rough seam, stone or tack). Infecti Continue reading >>

6 Reasons You Shouldn’t Assume Foot Pain Is A Heel Spur

6 Reasons You Shouldn’t Assume Foot Pain Is A Heel Spur

If you feel pain in your heel, you might think you have a heel spur. It’s a common assumption — and a heel spur can cause foot discomfort. However, only 50 percent of people who have heel spurs actually feel any pain because of it. “A heel spur can be an incidental finding on an X-ray. You can have one even if you don’t have heel pain,” Dr. Davis says. “When we’re treating people, we don’t focus on the spur because often the spur doesn’t have to go away for the pain to resolve,” says orthopaedic foot and ankle surgeon, Alan Davis, MD. A heel spur won’t trouble you unless it is prominent beneath your foot, and you can feel it under the skin. If you concentrate too much on a heel spur, you could miss the true underlying problem, he says. Where does the pain start? The foot is a complex structure of ligaments, tendons and bones, so heel and foot pain can come from a variety of sources, Dr. Davis says. “Oftentimes, it’s not related to having a heel spur. Plantar fasciitis or any other entity that causes inflammation around the heel can cause heel pain,” Dr. Davis says. Dr. Davis says the first step is to understand where in the foot you feel the most pain: Is it in the heel, arch or toes? It is important for the diagnoses and treatment to understand where a person feels the most tenderness. What’s causing your foot pain? Repetitive overuse. This is a leading cause of heel pain. People at risk are those who walk heavily on their feet, run long distances, or carry extra weight. You are also susceptible to heel bone inflammation and discomfort if you have a tight Achilles tendon, which connects the calf muscle to the heel bone. Impact injuries. These can cause deep bruises on either the fat pad or the ball of the foot that make it feel like you’ Continue reading >>

Slideshow: What Your Feet Say About Your Health

Slideshow: What Your Feet Say About Your Health

Cold Feet, Many Culprits If your toes are always cold, one reason could be poor blood flow -- a circulatory problem sometimes linked to smoking, high blood pressure, or heart disease. The nerve damage of uncontrolled diabetes can also make your feet feel cold. Other possible causes include hypothyroidism and anemia. A doctor can look for any underlying problems -- or let you know that you simply have cold feet. When feet ache after a long day, you might just curse your shoes. After all, eight out of 10 women say their shoes hurt. But pain that’s not due to sky-high heels may come from a stress fracture, a small crack in a bone. One possible cause: Exercise that was too intense, particularly high-impact sports like basketball and distance running. Also, weakened bones due to osteoporosis increases the risk. Raynaud’s disease can cause toes to turn white, then bluish, and then redden again and return to their natural tone. The cause is a sudden narrowing of the arteries, called vasospasms. Stress or changes in temperature can trigger vasospasms, which usually don’t lead to other health concerns. Raynaud’s may also be related to rheumatoid arthritis, Sjögren’s disease, or thyroid problems. The most common cause of heel pain is plantar fasciitis, inflammation where this long ligament attaches to the heel bone. The pain may be sharpest when you first wake up and put pressure on the foot. Arthritis, excessive exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis. Less common causes include a bone spur on the bottom of the heel, a bone infection, tumor, or fracture. Sometimes the first sign of a problem is a change in the way you walk -- a wider gait or slight foot dragging. The cause may be the slow loss of normal sensation in your feet, br Continue reading >>

Diabetes And Heel Pain

Diabetes And Heel Pain

The fact that diabetes causes and contributes to serious foot issues has been well-established within the medical field. When people talk about diabetes in conjunction with foot health, the two big issues frequently discussed are Charcot foot and diabetic foot ulcers. Given the serious nature of these conditions, the attention is certainly warranted. That said, it can be a mistake to look past heel pain and how it relates to diabetes! Understanding the connection between diabetes and heel pain—and other foot conditions related to the disease—can be beneficial in helping you to mitigate and prevent damage to your lower limbs. In turn, this can be useful in allowing you to stay active – while at the same time minimizing pain and lowering your risk for complications. The complete picture of the link between diabetes and heel pain is still being researched within the medical community, but we are at point where numerous studies have established a connection between the two medical issues. One of the common agreements amongst experts in the field is the role weight plays in how heel pain and diabetes are linked. An overwhelming majority of diabetic individuals—almost 90% by some counts—are overweight for their respective body structures. Excess weight is a well-known risk for heel pain, and especially plantar fasciitis (which is already the most common source of heel pain for adults). The plantar fascia is an important connective tissue bridging the bottom of the heel to the bottom of the forefoot. The purpose of this flexible tissue is to assist in supporting the foot arch. Under ideal circumstances, the fascia allows your foot to absorb and distribute the force loads that come naturally during activities like walking, running, and jumping. Excessive weight create Continue reading >>

Is There A Relationship Between Plantar Fasciitis And Diabetes?

Is There A Relationship Between Plantar Fasciitis And Diabetes?

Question: Hi! Every morning when I wake up I have terrible foot pain. I've done some research and am pretty sure that I have plantar fasciitis. During my research I came across a source that stated that women with diabetes are at a higher risk for plantar fasciitis. Is there any truth to that? Answer: Dear Reader, The research I performed on this topic indicates that no known relationship between plantar fasciitis and diabetes has ever been established. In fact, plantar fasciitis occurs when a long fibrous plantar fascia ligament along the bottom of the foot develops tears in tissue resulting in pain and inflammation. Some of the signs and symptoms of plantar fasciitis are burning, stabbing, or aching pain in the heel of the foot. The most common cause for plantar fasciitis is an overload of physical activity or exercise. This is commonly seen in athletes who change or increase the difficulty of their exercise. Another cause of plantar fasciitis is arthritis, which makes the elderly women more prone to this condition. Also, wearing incorrect shoe sizes can cause tears in the tissue. Contributing factors include people with high arches, flat feet, and obesity. Diabetes could be a contributing factor with further heel pain and damage, but mostly among the elderly. The current treatment options for plantar fasciitis are changing physical activities, resting the foot, and applying ice. Orthotics can be helpful to promote healing and may be able to reverse it in some cases. I hope that helps! Continue reading >>

Copyright © 2011 Dr. Spence D. Harper, P.c.. All Rights Reserved

Copyright © 2011 Dr. Spence D. Harper, P.c.. All Rights Reserved

Nails whose corners or sides dig painfully into the skin, often causing infection are referred to as "ingrown". They are frequently caused by improper nail trimming but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. If the ingrown portion of the nail is painful or infected, Dr. Harper can remove the affected portion; if the condition reoccurs frequently, Dr. Harper can permanently remove the nail and eliminate the condition. This common problem can generally be traced to faulty biomechanics which place too much stress on the heel bone, ligaments, or nerves in the area. Stress could result while walking or jumping on hard surfaces, or from poorly made footwear. Being overweight is also a major contributing factor. Some general health conditions - arthritis, gout, and circulatory problems, for example - also cause heel pain. Growths of bone on the underside of the heel bone are referred to as Heel Spurs. They can occur without pain; pain may result when inflammation develops at the point where the spur forms. Both heel pain and heel spurs are often associated with plantar fasciitis, an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Treatments may range from exercise and custom-made orthotics to anti-inflammatory medication or cortisone injections. Discuss your treatment options with Dr. Harper by contacting his office today for an appointment. Diabetes mellitus is a chronic disease that affects the lives millions of people and millions more are unaware that they even have the disease. The disease is marked by the inability to manufacture or properly use insulin, and impairs the b Continue reading >>

7 Foot Problems That Can Be Serious

7 Foot Problems That Can Be Serious

If you want to know the state of your health, try looking down. “There’s no question it’s extremely important that people pay attention to their feet,” says Terry Philbin, D.O., spokesperson for the American Academy of Orthopedic Surgeons (AAOS) and a foot and ankle specialist at the Orthopedic Foot and Ankle Center in Westerville, Ohio. The condition of your feet can give you clues to a host of medical issues, such as diabetes, arthritis, and even heart disease. Read on to find out what to look for and what it may mean. 1. Pain “There’s no pain that should be ignored,” says Jane Andersen, D.P.M., a podiatrist in Chapel Hill, North Carolina and a member of the American Podiatric Medical Association. Any type of pain—new or prolonged—warrants a visit to your primary care doctor or podiatrist. Pain in the feet can signal a host of conditions, from fractures to plantar fasciitis (inflammation in the tissue that connects your heel bone to toes), to arthritis. Noting the time of day when the pain occurs can give you a hint as to the cause. Pain in the morning, when you first get up, can point to arthritis or plantar fasciitis. With both conditions, pain will recede as the foot loosens up throughout the day. A common cause of heel pain, plantar fasciitis often affects runners, and people who are overweight. Wearing high heels, or shoes that don’t have enough arch support also raises the risk. Dr. Andersen often sees people in her practice whose plantar fasciitis is caused by exercising in worn out shoes. “Athletic shoes don’t last very long,” she says. If you can estimate the mileage you put on shoes, then a good rule of thumb is replacing shoes every 350-500 miles, or anything over a year old, she says. Pain that gets worse throughout the day may in Continue reading >>

Heel Pain

Heel Pain

What is heel pain? Heel pain is pain felt in one or both heels that may become worse at certain times of the day, or develop after exercise or strenuous activity. The foot is made up of more than 20 bones, 30 joints and 100 tendons. Of these bones, the heel bone, or calcaneus, is the largest in the foot. The heel supports the body weight during walking, running and generally moving around. In particular, the heel acts as a cushion that protects the other structures of the foot, such as the muscles, ligaments and tendons. Heel pain can be localised in the underside or the back of the heel. Heel pain is a very common complaint and although many people will only experience mild and short-lived pain, for some people this pain can become debilitating. Causes Heel pain is commonly the result of an abnormal gait, which can lead to excessive stress on the heel bone and soft tissues attached to it. Other factors that can cause heel pain are: Plantar fasciitis The most common cause of heel pain is plantar fasciitis. It occurs when the connective tissue that supports the arch of the foot (plantar fascia) becomes inflamed and irritated. Plantar fasciitis is often associated with heel pain experienced first thing in the morning, or after sitting for a period of time. The pain tends to reduce after some walking, as the fascia is stretched. Plantar fasciitis can occur rapidly and cause intense pain. Overweight or obese Many people who experience heel pain are commonly overweight or obese. Carrying extra weight puts an incredible amount of stress on the plantar fascia and the bursa of the feet, which normally act as shock absorbers. The excessive stress on the bursa and plantar fascia over time can cause inflammation and injury, resulting in heel pain. Diabetes High blood glucose level Continue reading >>

What Is Plantar Fasciitis?

What Is Plantar Fasciitis?

Plantar fasciitis is a foot condition characterized by sharp, stabbing heel pain. This pain often occurs when you get out of bed in the morning or stand up after sitting for a long period of time. "The majority of heel pain is caused by plantar fasciitis, or an inflammation of the tissue on the bottom of the foot," says Alan K. Mauser, DPM, a podiatrist in Louisville, Kentucky. Located on the bottom of the foot, the plantar fascia is a dense band of tissue that covers the bones. This band of tissue, says Dr. Mauser, acts like a bowstring on the bow. "When you're off your foot it's not tight, but when you step down it becomes tight," he says. "Over time a person can develop a strain or inflammation of the fascia into the heel bone, and it becomes a chronic and repetitive condition. One never really rests their foot enough to heal and get better." Plantar fasciitis is usually described as shooting pain in the heel. The condition can also cause some swelling in the heel. While pain from plantar fasciitis can be extremely intense after rest, it usually eases during the day — although it may reappear after exercise or long periods on your feet. Causes and Risk Factors Plantar fasciitis occurs when the plantar fascia becomes tight from too much pressure on the tissue, which leads to inflammation. As tension in the plantar fascia increases, tiny tears form in the tissue. The more tension and tearing that occur in the plantar fascia, the more inflammation and irritation there will be. This buildup of tension and tearing causes plantar fasciitis and results in heel pain. Men between ages 40 and 70 are most likely to experience the condition. There are a number of risk factors that can lead to plantar fasciitis, including: Obesity or sudden weight gain: Excess weight can damage Continue reading >>

Diabetes And Heel Pain – A Link To Plantar Fasciitis?

Diabetes And Heel Pain – A Link To Plantar Fasciitis?

It is well-established that diabetes can lead to problems with one’s feet. That being the case, can diabetes and heel pain induce plantar fasciitis? Is there a known link between plantar fasciitis and diabetic heel pain symptoms? The purpose of this article is to reveal current thinking about diabetes as a potential cause of plantar fasciitis and also to investigate reasons behind that thinking. Plantar Fasciitis and Diabetes In Diabetic Feet¹, Podantics Podiatry of Adelaide, Australia observed that approximately one out of every four individuals with diabetes will contract foot problems of some type. Similarly, an article entitled Diabetes and Heel Pain² noted that, of those diabetics who developed foot problems, the problems were “almost always associated with heel pain.” The article added that these problems are typically linked to circulation issues or neuropathy (nerve damage). Based on information from these two sites, let’s take a deeper look into these two types of symptoms. Diabetes Foot Pain Symptoms – Circulation Circulation issues are related to a reduced blood flow in parts of the body. With diabetes, this commonly occurs in veins and arteries providing blood to organs, legs, and arms below the stomach level. Such symptoms are labeled as peripheral vascular disease (PVD). Limited blood flow can lead to painful foot issues including swelling and dryness. This also hinders the body’s normal process of healing. Similar to what is discussed in a previous article entitled What is Plantar Fasciosis, reduced blood flow in the feet can also increase the risk of additional injury. Due to the lessened flow, important nutrients and critical oxygen do not get to the feet. This subjects the feet to further difficulties including, in particular, stabbing he Continue reading >>

The Link Between Diabetes And Heel Pain

The Link Between Diabetes And Heel Pain

Doctors estimate that 30 million people in the United States live with diabetes, a condition in which individuals struggle to regulate blood sugar levels. Of those 30 million, one in four will experience foot problems ranging from neuropathy to reduced circulation. Many will also develop heel pain from heel spurs or plantar fasciitis. Understanding the link between diabetes, heel pain, and other food conditions related to diabetes can help individuals mitigate and prevent damage to the feet, stay active, and minimize pain and complications. Could Diabetes Be the Cause of Your Heel Pain? While the link between diabetes and heel pain isn’t fully understood, numerous studies have established a connection between the two conditions. Foot experts at the Foot and Ankle Specialty Center in Philadelphia state, “Studies have repeatedly shown that diabetics are more prone to developing plantar fasciitis.” Many experts speculate that the link between heel pain and diabetes is correlated with weight. Almost 90% of individuals with diabetes are also overweight, a known risk factor for heel pain and plantar fasciitis. Under ideal circumstances, the plantar fascia, a flexible ligament also known as the foot’s arch, allows the foot to absorb and distribute the impact from walking, jumping, and running. However, excess weight adds additional strain to the fascia, which can result in strain, tears, inflammation, and the development of painful calcium deposits known as heel spurs. Treating Plantar Fasciitis with Type 2 Diabetes While most cases of plantar fasciitis and heel pain can be successfully resolved at home using proven conservative treatment methods, there are a few special considerations you should keep in mind while treating heel pain alongside diabetes. Many foot probl Continue reading >>

Diabetes And Foot Problems Treatment And Complications

Diabetes And Foot Problems Treatment And Complications

Diabetes and foot problems facts Two main conditions, peripheral artery disease (PAD) and peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes. Symptoms and signs of diabetic foot problems arise due to the decreased sensation from nerve damage as well as the lack of oxygen delivery to the feet caused by vascular disease. Diabetic foot problems also include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails. These problems are not specific to diabetes, but may occur more commonly due to the nerve and vascular damage caused by diabetes. Treatment depends on the exact type of foot problem. Surgery or even amputation may be required for some cases. Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life threatening if bacterial infection develops (wet gangrene). Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet. How can diabetes cause foot problems? Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes. Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. This is sometimes referred to as "hardening" of the arteries. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (medically known as intermitte Continue reading >>

Severe Chronic Heel Pain In A Diabetic Patient With Plantar Fasciitis Successfully Treated Through Transcranial Direct Current Stimulation.

Severe Chronic Heel Pain In A Diabetic Patient With Plantar Fasciitis Successfully Treated Through Transcranial Direct Current Stimulation.

Abstract BACKGROUND: Recently, transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, was proposed as a suitable method for the treatment of several chronic pain syndromes. We describe a case of severe heel pain in a diabetic patient with plantar fasciitis successfully treated with tDCS. METHODS: The present study investigated whether tDCS treatment could reduce pain and pain-related anxiety in a 65-year-old diabetic man affected by treatment-resistant right heel pain due to plantar fasciitis. The patient underwent five tDCS treatment sessions on 5 consecutive days. Each session consisted of 20-min anodal tDCS over the left primary motor cortex leg area. RESULTS: The neurostimulation protocol induced a decrease in pain intensity and pain-related anxiety that outlasted the stimulation (1 week). Furthermore, the patient stopped the intake of opioid medication. CONCLUSIONS: Therapeutic neuromodulation with tDCS may represent an alternative option for treating severe lower-extremity pain. Continue reading >>

Diagnosing Heel Pain In Adults

Diagnosing Heel Pain In Adults

Heel pain is a common condition in adults that may cause significant discomfort and disability. A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Narrowing the differential diagnosis begins with a history and physical examination of the lower extremity to pinpoint the anatomic origin of the heel pain. The most common cause of heel pain in adults is plantar fasciitis. Patients with plantar fasciitis report increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. Tenderness at the calcaneal tuberosity usually is apparent on examination and is increased with passive dorsiflexion of the toes. Tendonitis also may cause heel pain. Achilles tendonitis is associated with posterior heel pain. Bursae adjacent to the Achilles tendon insertion may become inflamed and cause pain. Calcaneal stress fractures are more likely to occur in athletes who participate in sports that require running and jumping. Patients with plantar heel pain accompanied by tingling, burning, or numbness may have tarsal tunnel syndrome. Heel pad atrophy may present with diffuse plantar heel pain, especially in patients who are older and obese. Less common causes of heel pain, which should be considered when symptoms are prolonged or unexplained, include osteomyelitis, bony abnormalities (such as calcaneal stress fracture), or tumor. Heel pain rarely is a presenting symptom in patients with systemic illnesses, but the latter may be a factor in persons with bilateral heel pain, pain in other joints, or known inflammatory arthritis conditions. Key clinical recommendation Labels References Radionuclide bone scanning and magnetic resonance imaging are more sensitive and specific than plain-film radiographs in diagnosing osteomyelitis. B 2 Continue reading >>

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