Wednesday, July 29, 2015

What Is a Bunion?

What Is a Bunion?
Buions are a common problem that most people experience as an unnatural, bony hump that forms at the base of the big toe where it attaches to the foot. Often, the big toe deviates toward the other toes. When this occurs, the base of the big toe pushes outward on the first metatarsal bone -- which is the bone directly behind the big toe -- forming a bunion. If this happens on the little toe and fifth metatarsal, it's called a bunionette.

Because a bunion occurs at a joint, where the toe bends in normal walking, your entire body weight rests on the bunion at each step. Bunions can be extremely painful. They're also vulnerable to excess pressure and friction from shoes and can lead to the development of calluses.

What Causes Bunions?

Foot problems typically develop in early adulthood and get worse as the foot spreads with aging. For many people, bunions run in the family. They may be just one of several problems due to weak or poor foot structure. Bunions sometimes develop with arthritis. In people with leg length discrepancies, bunions usually form in the longer leg.

Women are especially prone to developing bunions. Years of wearing tight, poorly fitting shoes -- especially high-heeled, pointed shoes -- can bring on bunions. Such shoes gradually push the foot bones into an unnatural shape.

How are bunions treated? 

Bunion treatment should always start with changing footwear to relieve symptoms and to prevent the bunion from progressing. Shoes with a wide toe-box, minimal slope, and good arch support can help relieve the bunion pain. Some people find that ice application and anti-inflammatory medications can help relieve the inflammation around the bunion.

To reduce tension on the inner part of the joint of a bunion, stretching exercises are sometimes prescribed. Depending on the structure of the foot and severity of the bunion, custom insole orthotics can slow the progression of the bunion and address underlying biomechanical causes.

Inflammation of the joint at the base of the big toe can often be relieved by a local injection of cortisone.

Bunion Treatment: When to Consider Bunion Surgery

Bunions can cause pain and difficulty wearing certain shoes. When simple treatments don't relieve your symptoms, surgery may be considered for treatment of the bunion. What are the signs that surgery may be the right treatment for your bunion?

In general, surgery is recommended only when pain from the bunion prevents a patient from wearing normal shoes.

There is a common misconception that surgical treatments for a bunion are better and quicker than non-surgical treatments. Unfortunately, patients who rush into surgery may have unrealistic expectations, and may be unsatisfied with surgery.

Patients considering bunion surgery should understand the following about surgical treatments of bunions:

Bunion Surgery Is Not Cosmetic Surgery:
Bunions may not be pretty, but cosmetic deformity is not a good reason to perform surgery. There are too many potential complications to perform a bunion surgery simply for cosmetic reasons.

Patients Must Have Realistic Expectations:
Bunion surgery can be helpful at relieving pain, but patients should not expect to have "normal" feet after surgery. In one study, a leading researcher on foot problems such as bunions, found that 1/3 of his patients could not wear the type of shoe they desired prior to surgery.

Surgery can be an excellent treatment option for patients with problems from their bunions. That said, patients must understand this is a procedure that has potential complications and a lengthy rehabilitation.

The patients who tend to be unsatisfied with bunion surgery are those patients who are having surgery done to allow them to have normal looking feet or allow them to wear slim shoes. If that sounds like your motivation, think long and hard about surgery.



Thursday, July 23, 2015

TOCA Tip: How to Use Your Crutches!

TOCA Tip: How to Use Your Crutches!

If you break a bone in your leg or foot, have a procedure on your knee or lower leg, or suffer a stroke, your doctor may recommend that you use a walking aid while you are healing or recovering. Using crutches, a cane, or a walker can help keep your weight off your injured or weak leg, assist with balance, and enable you to perform your daily activities more safely.

When you are first learning to use your walking aid, you may wish to have a friend or family member nearby to help steady you and give you support. In the beginning, everything you do may seem more difficult. With just a few tips and a little practice, though, most people are able to quickly gain confidence and learn how to use a walking aid safely.

Make Your Home Safer
Making some simple safety modifications to your home can help prevent slips and falls when using your walking aid:

*Remove throw rugs, electrical cords, food spills, and anything else that may cause you to fall.

*Arrange furniture so that you have a clear pathway between rooms.

*Keep stairs clear of packages, boxes, or clutter.

*Walk only in well-lit rooms and install a nightlight along the route between your bedroom and the bathroom.

*In the bathroom, use nonslip bath mats, grab bars, a raised toilet seat, and a shower tub seat.

*Simplify your household to keep the items you need within easy reach and everything else out of the way.

*Carry things hands-free by using a backpack, fanny pack, or an apron with pockets.


If you are unable to bear any weight on your leg or foot, you may have to use crutches.

If your injury or surgery requires you to get around without putting any weight on your leg or foot, you may have to use crutches.

Proper Positioning:
*When standing up straight, the top of your crutches should be about 1-2 inches below your armpits.

*The hand-grips of the crutches should be even with the top of your hip line.

*Your elbows should be slightly bent when you hold the hand-grips.

*To avoid damage to the nerves and blood vessels in your armpit, your weight should rest on your hands, not on the underarm supports.

*Lean forward slightly and put your crutches about one foot in front of you. Begin your step as if you were going to use the injured foot or leg but, instead, shift your weight to the crutches. Bring your body forward slowly between the crutches. Finish the step normally with your good leg. When your good leg is on the ground, move your crutches ahead in preparation for your next step. Always look forward, not down at your feet.

*To sit, back up to a sturdy chair. Put your injured foot in front of you and hold both crutches in one hand. Use the other hand to feel behind you for the seat of your chair. Slowly lower yourself into the chair. When you are seated, lean your crutches in a nearby spot. Be sure to lean them upside down—crutches tend to fall over when they are leaned on their tips.

*To stand up, inch yourself to the front of the chair. Hold both crutches in the hand on your uninjured side. Push yourself up and stand on your good leg.

*To walk up and down stairs with crutches, you need to be both strong and flexible. Facing the stairway, hold the handrail with one hand and tuck both crutches under your armpit on the other side. When you are going up, lead with your good foot, keeping your injured foot raised behind you. When you are going down, hold your injured foot up in front, and hop down each step on your good foot. Take it one step at a time. You may want someone to help you, at least at first. If you encounter a stairway with no handrails, use the crutches under both arms and hop up or down each step on your good leg, using more strength.

*If you feel unsteady, it may be easier to sit on each step and move up or down on your bottom. Start by sitting on the lowest step with your injured leg out in front. Hold both crutches flat against the stairs in your opposite hand. Scoot your bottom up to the next step, using your free hand and good leg for support. Face the same direction when you go down the steps in this manner.

Monday, July 20, 2015

Joint Pain During Monsoons?!

Joint Pain During Monsoons?!

Yes, your joints pain is can probably a better indicator than your local weather station, but that doesn’t mean you shouldn’t turn off the news or the radio just yet.

Weather-related joint pain is usually seen in patients with osteoarthritis and rheumatoid arthritis and most commonly affects hips, knees, elbows, shoulders and hands. The joints contain sensory nerves called baroreceptors that can detect barometric changes.  The receptors especially react when there is low barometric pressure, such as before a rain storm may occur. People with arthritic joints seem to be more sensitive to the barometric changes.

Symptoms of certain persons are influenced by weather changes but it is not predictable what type of weather changes will bother people.  It is important to realize that only symptoms such as pain and stiffness are influenced by weather. Weather cannot not cause joint damage or arthritis.  In summary, lowering barometric pressure as seen with an approaching storm or elevation of attitude, and increase in humidity can influence the development of joint pain and stiffness.

The best advice I can give to you is to be as proactive as possible –all year round, regardless of the weather. Drink plenty of water, and keep your joints active by doing non-weight bearing exercises and stretches. Omega-3 fatty acids, glucosamine and chondroitin sulfate may also be very beneficial.


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