Question: My foot doctor has advised surgery for painful bone spurs on the top of my feet. But I can’t afford to stay off my feet for eight weeks. Would medication, laser treatment, or anything else relieve the pain?
Answer: Bone spurs, an overgrowth of bone at or near joints (usually those of the big toe), don’t cause pain; shoe pressure on the spurs does. Try wearing roomier shoes, stretch shoes, or extra-depth orthopedic shoes. Putting pads inside your regular shoes may help, so long as the pads don’t put more pressure on the spurs. Aspirin or ibuprofen may relieve the pain temporarily, but that’s not a long-term solution. Sometimes an injection of a long-acting corticosteroid (Depo-Medrol, Hydrocortone) can provide relief for months.
If those simple measures aren’t sufficient, surgery to file down the protuberances may indeed be your best bet. Recovery from surgery rarely takes eight weeks, however. Most people can resume sedentary activities, such as desk work, within a few days and light walking without crutches or a cane in three or four weeks. So far, laser treatment for bone spurs seems to off no advantage over traditional surgery.
FEET ON FIRE
Question: I have a severe burning feeling on the soles of both feet My circulation is normal, and soaking and applying powders haven’t helped. Could this be a symptom of a serious ailment?
Answer: A burning sensation on the soles of your feet can arise from any number of causes, from ill-fitting shoes to diabetes. The most serious cause is peripheral neuropathy-damage to the leg nerves—often from diabetes or alcoholism and less commonly from vitamin deficiencies or lead poisoning. A rare disorder called erythromelalgia increases blood flow to the hands and feet and can also produce a searing sensation.
Some people experience fiery feet because they’re sensitive to a chemical in the inner lining of their shoes (particularly some types of athletic shoes). Try changing your footgear to see if the problem subsides. If not, see your physician to rule out medical causes.
Question: What can you tell me about Morton’s neuroma?
Answer: Morton’s neuroma, a fairly common abnormality, is a benign tumor of a nerve in the web between two toes. The tumor causes pain when you walk or otherwise put pressure on the area. It may even feel as if a marble or pebble were inside the ball of the foot.
Treatment of the neuroma typically begins with injections of anesthetics or corticosteroids. Orthotics, special shoe inserts, can also help. If these measures don’t work, surgical removal of the neuroma usually brings complete relief.
SPARE THE SCALPEL
Question: I’m 72 years old and have a hammertoe and bunions on feet. I’m in no pain whatever; but my podiatrist insists that I need surgery to correct the problems. What do you advise?
Answer: You should change podiatrists. If the hammertoes and bunions don’t bother you and don’t hinder your mobility, then surgery is unnecessary.
Question: For some time, I’ve had painful tingling in my legs, especially when I walk. My doctor says that’s due to stenosis in my lower spine. What is that> and what can be done about it?
Answer: As people get older, spinal stenosis—narrowing of the spinal canal—may begin to develop. Usually the canal becomes crowded due to the growth of bony spurs, a form of osteoarthritis. Less often, displaced joints and ligaments encroach on the spinal canal.
As the canal narrows, it can compress the spinal cord or the nerves that branch from it. That causes symptoms such as yours, as well as weakness and pain. For mild symptoms, non-surgical treatments may provide adequate relief. Those treat-ments include aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs; a spinal brace; and modified posture-leaning forward slightly whenever possible to decrease the pressure on the nerves.
Although those measures don’t always work, they’re worth trying before resorting to surgery. If necessary, a surgeon can remove parts of the vertebrae and anything else encroaching on the canal. Rehabilitation after the operation can take a while, but most patients eventually report good results.
TREATING SWOLLEN LEGS
Question: I’ve had lymphedema in both legs for 12 years, and my ability to walk has steadily worsened. My doctor’s only recommendation is an extremity pump to pressurize a sleeve that covers each leg. Are there any other treatments?
Answer: Lymphedema is swelling of an arm or leg due to obstruction of the flow of lymph, a milky-looking body fluid. Leg swelling from lymphedema can be treated in several ways, but all treatments lose effectiveness over time. The “lymph pump” you describe can provide temporary relief early on, when fluid accumulation is less severe. The primary treatment for lymphedema remains the use of good elastic stockings. Various surgical procedures have been tried, generally with little lasting benefit.
Question: I am a 75-year-old woman. Last year my feet and legs became so swollen that 1 couldn’t get into my shoes. My doc-tor said I had “water retention ” and gave me a seven-day supply of Maxzide [triamterene and hydrochlorothiazide], which eventually relieved the swelling. What causes water retention, and how can I avoid it?
Answer: There are several reasons for leg swelling. One of the most common is varicose veins, in which damage to valves in the large veins of the legs hinders the return of blood to the heart. Blood plasma, which is mostly water, pools in nearby tissue, causing swelling of the legs and feet. Excess dietary salt, sitting or standing for long periods, and hot weather can aggravate the swelling. Exercise such as walking or cycling helps. So does resting with your legs elevated. Water retention can also be caused by more serious problems, such as heart, liver, and kidney disorders. A medical checkup to rule those out would be wise.
Health handbook introducing you to read the article: EYE CARE: CONTACT LENS INFECTIONS?
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