A 65 year old female patient came to me with severe pain in both heels since 6 months. She has a X-ray with Calcaneal spur. Kindly share your clinical experiences to manage it effectively.
Give supportive management frst
Soft shoes or sandals.. Painkillers., febustat, control blood sugar nd lipids nd most important is regular physiotherapy..
Physiotherapy means.. Active foot movements in all directions nd stretching nd strengthening the muscles of limb... Under water exercises for foot preferred mostly.... Due to inflammation there is restricted range of movement leads to constriction nd weakening of muscles....
Analgesic and anti-inflammatory medicines for 15 days ... Check sr.creat first.
Silicone insole
Change of sleepers to soft one
Hot water fomentation twice a day 20 minutes each
Physio - ankle dorsi and plantar flexion exercises
Give trail of this therapy for 1 month. If symptoms persists, go for excision if non diabetic.
Try conservative measures for around 6 months (upto a year)---> if not better ---> Surgery
Conservative measures
1) Weight loss - Daily walk for 30 min and diet control
2) Well fitting and padded footwear at most times. - like Dr.Scholl
3) Take a tennis ball and roll it below the soles 5-10 min in the morning before bearing weight on the feet. Repeat the same twice a day.
4) Sugar control for diabetes ( will help prevent diabetic foot from minor injuries)
5) Alternate Warm and Cold fomentation of feel in the evening.
Please treat patients the way that you are trained to treat, if you can't get him better thru Ayurveda please refer him to am Orthopedic Surgeon
Online learning of Orthopedics is tricky ????
Needs Physiotherapy.. 90% patients are benefitted if they do physiotherapy religiously.. most of the patient have plantar fasciitis and complains of early morning heel pain that decreases on activity..
Basic physio plan that I advice:
Shld b done 1st thing in morning
1) Dorsi Flex the ankle hold for 10 sec and realese to neutral x 5times
2) Plantar Flex the ankle hold for 10 sec and realese to neutral x 5times
3) Plantar flexion and dorsiflexion at tarsometatarsal joint.
4) Heel raises
5) Rolling of foot over a bottle or ball
Exercise from 1-3 can b performed with foot immersed in warm water..
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