Joint Pain Forum – News you can use!
When Walking Is a Problem
June 8, 2007
Do you have difficulty walking on uneven ground, or in high heels? Have
you sprained your ankle repeatedly? Do you sometimes feel your feet are
giving way or are unstable? Do you have painful bone spurs?
Foot and ankle pain are often difficult to diagnose since the
conditions may range from a common sprain to chronic lateral ankle pain
or even arthritis. A sprain can result from a fall, a sudden twist, or
a blow to the body that forces a joint out of its normal position and
stretches or tears the supporting ligament.
Chronic lateral ankle pain is usually caused by incomplete healing
after a sprain. Arthritis, however, is a little more serious.
Osteoarthritis is the most common type of arthritis and is often
exacerbated by the overuse of weight-bearing joints as people age or
indulge in high impact sports.
In osteoarthritis, the cartilage covering the bone ends gradually wears
away. In many cases, bone growths called "spurs" can develop in
osteoarthritic joints. The joint inflammation causes pain and swelling.
Some relief may be possible through rest or modified activity.
In finding solutions to foot and ankle pain, California Hospital
surgeon Dr. Jonathan Saluta recommends a conservative approach to
treatment, such as proper shoes, taping deformed toes, prescribing
special orthotic inserts and, in some cases, injections to relieve
"Good specialists will always consider the safest way to get their
patients back to their routines, without jeopardizing their patient's
wellbeing," says Saluta, who is based in Downtown Los Angeles.
Dr. Saluta, a Duke University fellow with an orthopedic specialty in
foot and ankle surgery, also cautions that it is unwise to ignore
untreated sports injuries, which may lead to joint arthritis, bony
dislocation and arch collapse. Surgery is considered a last resort.
"Great care must be taken to avoid damage to critical nerves and
vessels in the foot." As such, Dr. Saluta says, "surgery is recommended
only if all other conservative measures fail."
In the event surgery becomes necessary, more and more
doctors are turning to arthroscopy, a diagnostic and minimally invasive
procedure commonly used to evaluate knee disorders. This technology has
now been adapted for foot and ankle pain. Ankle arthroscopy can be used
for a variety of purposes; the most common is diagnosing injuries of
the cartilage surface.
Once injuries are diagnosed, treatment can be
implemented through the small arthroscopic portals. The outcome for
arthroscopic patients is excellent with less pain and bleeding, with
patients achieving an 84% success rate. These are results comparable to
open treatment. Usually ankle arthroscopy can be performed as an
Arthroscopy can also be used to remove bone spurs,
which may restrict the motion of the ankle. Large spurs may become very
painful and impair the ability to walk. Problems such as synovitis and
impingement from soft tissue scarring can also be treated by ankle
A more recent development is the technique for
arthroscopy of the posterior ankle. Through this approach, Achilles
tendonitis as well as painful posterior heel spurs can be treated. Heel
pain due to plantar fasciitis can be treated with an endoscopic
approach through the bottom of the foot. Results for this procedure are
usually as good as those performed with open techniques. Dr. Saluta
strongly advises that a surgeon with proper training and experience
with arthroscopic techniques should perform these procedures.
Dr. Saluta cautions that while the benefits of surgery
are numerous - not least of which are increased mobility, pain
reduction and overall improvement in the quality of life - it is
important for patients to consult their orthopedic specialist and
understand the options available and appropriate for their individual
situation. "Surgery may be an option for many patients. At the same
time, other therapies such as orthotic inserts, proper shoe fitting and
physical therapy, should not be overlooked."
Map | CONTACT