Calcaneus - is the largest bone of the foot, which takes over most of the punches and the main load. Heel spur - a sprawl of the calcaneus. When the plantar fascia stretched, begins the formation of calcium deposits. This leads to the formation of bone spurs - heel spurs. The plantar fascia - a broad band of fibrous tissue located along the entire sole of the foot, from the heel to the forefoot. Heel spurs can cause severe pain in the back of the foot, especially when a person is standing or moving.

Causes

Heel spurs are formed by the abnormal proliferation of tissue heel bone due to the formation of calcium deposits at rupture of the plantar fascia. The plantar fascia is stretched in cases where a person develops flat Flatfoot - help physiotherapy . Also, heel spurs can form in people with very high arches ("hollow foot"). Often suffering from heel spurs women who wear uncomfortable shoes or high heels. Heel spurs may be due to a prior injury, stretching the foot, or the disappearance of fat pad of the foot that occurs in people at an older age.

Heel spurs are also formed in adults who are engaged in jogging, or those whose work is associated with prolonged stay on your feet. But the most prone to the emergence of such problems diabetics, runners, dancers, and overweight people

Symptoms

Symptoms include pain in the front, and the midfoot to heel when walking or long stay on his feet. If you try to bend the knee and pull the foot toward the back of the knee and pain occur. The foot numb, and there is a feeling of weakness and leg.

Treatment

At the first stage in the treatment of heel spurs needs a short-term rest and inflammation control.

• Recreation

To start the patient should avoid strenuous activities that increase the discomfort in the foot. For example, you need to give a few days of jogging or training in which the patient has to be long standing. Simple relaxation helps to reduce the most severe pain and to stop inflammation in the foot.

• Apply ice

Ice helps to remove symptoms that causes heel spurs and reduce pain in the foot. This procedure is particularly effective during exacerbation of symptoms.

• Exercise and stretching

And stretching exercises aimed at relaxing the tissue surrounding the heel bone. The simplest of exercises performed in the morning and evening, to help rapidly improve the condition of patients.

• Anti-inflammatory drugs

Anti-inflammatory drugs help ease pain and reduce inflammation. Usually efficient enough conventional painkillers are sold in pharmacies without a prescription.

• Removable insoles

Removable insoles allow patients to go about their normal activities at the same time do not feel pain and discomfort.

• Night splints

Night splints are designed to hold the heel that stretched during sleep Dreams: how to understand our dreams . This prevents the foot from compression, so getting up in the morning is not so painful.

All of these methods are effective in the treatment of heel spurs. But we need to be pre-prepared for the fact that the symptom of the disease will not disappear immediately. In general, recovery takes about three months, and 90% of patients achieve results for up to one year.

In those cases where the pain is not reduced, injections of cortisone, which reduces the inflammation of the plantar fascia. However, cortisone obkalyvanie heel - it's not too common method of pain relief, because the procedure can cause serious complications. It is issues such as atrophy of the fat pad of the foot and plantar fascia rupture. Such complications are only a minority of patients, but they can cause increased symptoms.

Scientists continue to search for the treatment of heel spurs. The method of treatment called "Extracorporeal shock wave therapy" (ESWT) uses pulses of high intensity, which causes microtrauma tissue around the heel spur. It is assumed that such microtrauma stimulate regenerative processes in tissues. Extracorporeal shock wave therapy is recommended for patients who have failed previous treatments listed and are considering the option of surgery.

As after successful treatment to prevent the re-emergence of heel spurs?

To prevent the return of symptoms of heel spurs, it is important to only wear comfortable shoes on foot. Many to reduce the pressure on the feet using removable insoles. If there are problems of mechanical deformation of the foot, you can use a variety of orthopedic devices. It is also necessary to continue doing the exercises and stretching, which help to maintain the flexibility of the foot and help get rid of pain.

What to do if symptoms of heel spurs do not disappear?

In a small number of cases (less than 5%) after all of the recommendations of patients' condition does not improve. Before, consider this treatment option is surgery, should apply traditional therapies for at least a year. Time - this is one of the main factors of pain relief during heel spurs. It is not enough careful treatment prior to surgery, can cause a variety of complications after surgical procedures. If traditional treatments do not help, your doctor may prescribe an operation - the so-called cut the plantar fascia.

Most of the currently used procedures for limb lengthening are variations of the Ilizarov method, which in 1951 introduced a Russian doctor Gavriil Ilizarov. Limb lengthening is carried out in three stages: preparation, operation, extension and consolidation phase.

Preparation

At this stage, it will be the first consultation with the patient's physician. The physician should explain all aspects of the operation and the recovery period. Do X-rays feet to make the Ilizarov apparatus in accordance with the characteristics of the patient. In many centers, an assessment of the psychological condition of the patient, to make sure that it can withstand the entire process from beginning to end.

At the stage of preparation it is very important to solve the issue of expediency of limb lengthening. Sometimes it is necessary for medical reasons, but often people simply want to increase your height. In some countries, experts agree conduct lengthening limbs only to women with less growth 161 cm and men whose height is less than 179 cm. In many other states, however, no such restrictions. Nevertheless, the patient should be properly consider the advantages and disadvantages of the procedure and its results before deciding to make such dramatic changes in your appearance.

Transaction

In the next stage of the procedure is performed limb lengthening surgery, during which break the tibia and fibula. Then, to each half of the broken bones by means of passing through the bone tissue and skin metallic spokes attached fixing device.

Elongation

This stage begins about a week after surgery and continued for the next two or three months, depending on how to extend the limb. By means of the fixing device to increase the distance between the parts of broken bones - about 1 mm per day. In the image of the space between the parts of the bones begins to grow bone tissue. All this time the patient moves in a wheelchair, to avoid stress on growing bones. By the end of this phase legs could be 7-8 cm.

Consolidation phase

The next three to six months, the patient continues to move to a wheelchair - until then, until the new bone will not be strong enough to withstand its weight. Locking devices at this time remain on his feet, but do not change the length of the bone. At the end of this phase is carried out a simple operation to remove the fixing device; then the patient is typically able to walk on their own. Sometime during one or two months, the patient has to wear a plaster.

Physiotherapy and the right mood

These two factors are critical to the success of limb lengthening procedures. Throughout the stage extension, patients should daily one to two hours undergoing physical therapy. The importance of physiotherapy for this procedure can not be overstated (not all the centers involved in the elongation of course, offer an adequate physical therapy). Without physiotherapy recovery period instead of the six months, can last up to two years.

The correct attitude is probably the least important. After surgery, the patient will not just wait until the limbs become longer, and the bones grow, but to work actively. It is necessary to pre-prepare ourselves for the fact that for six months or more, you will not be able to move as freely as it used to, and your life will impose significant restrictions.

Pain relief

The whole procedure of limb lengthening is very painful, so pain relief is an important aspect of the procedure. There are certain restrictions in the choice of drugs. For example, anti-inflammatory drugs inhibit the growth of bone and can only be used in extreme cases. Opioid analgesics are addictive pretty quickly, and avoid doctors prescribe them to their patients. Physical therapy often helps to prevent pain.

Risks and complications

Complications are, on average, 25% of patients who undergo the procedure of limb lengthening - a rather high figure. One of the greatest risks is an infection that can penetrate into the body in areas where the skin inserted metal spokes. To avoid this, you should regularly treat the skin antibacterial solution. Other possible complications:

• Infection of the bone (osteomyelitis) may lead to the destruction of bone and joint stiffness. Acute osteomyelitis Osteomyelitis: severe inflammatory disease   It is the result of the penetration of bacteria into the organism. Generally, it is treated with injectable antibiotics Antibiotics - whether they will help you in the foreseeable future? ;
• Damage to blood vessels - can disrupt blood circulation and prevent the normal growth of bone tissue;
• Slow healing of bone - sometimes bone heals very slowly, or not at all grow together. In one of the twelve cases, new bone breaks down within a week after the completion of the consolidation phase;
• The deformation of the bones;
• Damage to the nerves;
• The unequal length of limbs.

Additional extension

In order to be even higher, some patients decide to undergo another procedure of limb lengthening. It can be done when the tibia and fibula are sufficiently strong. In the second procedure in the same way break, and then extend the hip bones of the legs. However, it should be borne in mind that after the body likely will look disproportionate.

In no case do not agree to do limb lengthening by simultaneously increasing bone of the upper and lower legs. Some medical centers offer this service, which is expected to save time and money of the patient, but the risk of serious complications, up to permanent disability, thus too large.