Part V Foot Disorders And Ailments

Raynaud’s Phenomenon

Raynaud’s Phenomenon is characterized by a cyanotic (bluish), white coloration of the toes and fingers. This is linked to arterial vasospasms, in which the vessels constrict blood flow to the extremities. There are two different types of this disorder, primary and secondary.

  • Causes may be exposure to extremely cold temperatures, tobacco smoking, increased stress levels, carpal tunnel syndrome, atherosclerosis (plaque buildup in the peripheral arteries), and Buerger’s disease. Chemotherapy agents can also cause Raynaud’s Phenomenon.
  • Symptoms include cyanosis of the toes and fingers, with a coldness to touch. Some individuals may complain of a numbing and prickly sensation, during warming or other treatments.
  • Treatments will need to start with lifestyle changes including smoking and caffeine cessation, wearing warm socks and mittens, and calcium channel blockers.
  • Risk Factors are cold climates, hereditary factors, repetitive injuries, and individuals that work in trade professions are at a higher risk.
  • Complications may be severe, if left unattended or treated. Gangrene is a rare complication, but has been noted in severe cases. In these cases amputation is the only treatment.

Restless Leg Syndrome

Restless leg syndrome is characterized by the urge to move the legs. This can occur, during sitting and lying. There is no true cure, but a lifestyle change and medications can help reduce the symptoms.

  • Causes are iron deficiency anemia, renal failure, diabetes, and Parkinson’s disease. Medications (anti-depressants, antihistamines (Benadryl), anti-psychotics, antiemetic (vistaril, reglan), and Nyquil) are also linked to this disorder.
  • Treatment caffeine and smoking cessation, exercise, warm and ice packs, and messages. Dipaminergic (Requip), OTC analgesics (Tylenol), and anti-convulsants (Neurontin).

Synovitis

Inflammation of the ankles and other foot joints that are repetitively used, during running and jogging.

  • Causes are repetitive movement and trauma.
  • Treatment includes NSAIDs (Ibuprofen), ice packs, cortisone injection at the joint, and surgery, but only in severe cases.
  • Diagnosis may begin with an x-ray, magnetic resonance imaging, and synovial fluid aspiration and analysis.

Talar Dome Lesion

Talar dome (osteochnondral) lesion is characterized by trauma or injury to the talus.

  • Causes are ankle sprain
  • Symptoms include calcaneus pain, grinding noise during ambulation, periods of edema, and poor ROM.
  • Diagnosis may begin with an x-ray and if undetected a magnetic resonance imaging will be ordered.
  • Treatment includes braces, physical therapy, NSAID (Motrin), and orthotics. Surgery is most often only required if a piece of the bone or cartilage breaks off and prevents healing or causes severe pain.

Tarsal Coalition

Tarsal coalition is characterized by abnormal connection (complete or partial connection) of two or more tarsal bones (calcaneus, fibula, tibia).

  • Causes are congenital defects.
  • Symptoms are flat foot, pain on the lateral portion of the foot, and formation of a bump on the lateral ankle.
  • Treatment is braces, orthotics, and potentially surgery to remove the connection (bar). Physical therapy and rehabilitation will be required post-op.
  • Diagnosis begins with a physical examination, x-ray, and magnetic resonance imaging.

Turf Toe

Turf toe is characterized by sprain of the big toe, which normally occurs during repetitive movement or exercises.

  • Symptoms include big toe pain, edema, and poor ROM.
  • Treatment includes ice, elevation, and immobilization.

Webbed Toes

Webbed toes is characterized by two or more toes are fused together by skin.

  • Causes may be linked to primary genetic disorders including Down and Miller Syndrome.
  • Treatment is normally nothing, unless it affects mobility.

To see the foot anatomy click here.