Do you ever stop and wonder why human beings have aches and pains? The majority of cases are because of nerve interference; however, other factors could include infection, underlying disease, or improper body mechanics. If you think about it, the feet carry the weight of the entire body. The feet are the body’s foundation; consequently, taking care of the feet is extremely important. In this week’s blog, we will discuss the anatomy of the feet, different conditions that affect the feet, and what we can do to help.
Anatomy of the Foot
Composed of bones, ligaments, muscles, nerves, tendons, and blood vessels, the foot provides the body support, stability and movement. The foot consists of 26 bones: a heel bone (calcaneus), an ankle bone (talus), five smaller tarsal bones forming the arch of the midfoot, five metatarsals, and 14 small phalange (toes) bones. Together, these bones bound together by various ligaments and tendons form the arches of the foot allowing for shock absorption and weight distribution.
The Achilles tendon is the largest and strongest tendon in the human body. It is the insertion point for the calf muscles and assists with lifting the heel off the ground when walking. With 29 muscles in the foot, various motions in the ankle, foot, and toes can be performed.
There are 33 joints in the human joint. The ankle joint provides the majority of foot motion including dorsiflexion, plantar flexion, inversion, and eversion movements of the foot. The joints, metatarsals and phalanges allow for flexion, extension, and limited abduction, adduction, and circumduction of the toes.
What Are Some Common Conditions Affecting the Foot?
Many conditions affecting the foot can be managed with chiropractic care, however, there are several conditions such as fractures, sprains, tendon ruptures, dislocations or underlying conditions that are beyond a chiropractor’s scope of practice and require deeper interventions such as surgery or management by a specialist. Many conditions that patients see a podiatrist for can be easily co-managed by a chiropractor. Arthritis and bone degeneration are expected due to the aging process and are treated similarly to the spine by a chiropractor. Below are a few different conditions with a brief description that can be managed or co-managed by a chiropractor.
Metatarsalgia involves pain and inflammation in the ball of the foot often caused by excessive pressure or impact. Wearing unsupportive shoes, arthritis, excessive running, or high-impact sports are just a few contributors to metatarsalgia. Reducing the activity that caused inflammation, adding ice therapy, changing footwear, and wearing orthotics are just a few methods to help relieve symptoms.
Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome (TTS) occurs when the tibial nerve that runs along the inside of the ankle becomes compressed and causes pain and numbness in the foot. TTS can be caused by several conditions ranging from mild to severe. In mild and moderate cases, it can be caused by anatomical orientation such as flat feet, high arches, sprains, or fractures. In more severe cases, it can be caused by bone spurs, cysts, or a benign tumor known as a lipoma. Typically, cysts and lipomas are harmless; however, if they are large enough and continuously grow, they can compress nerves and create debilitating symptoms. In this case, the best option is to remove the growth, but if it isn’t bothersome, no intervention is recommended. Just like metatarsalgia, rest, ice therapy, compression, elevation, changing footwear, and wearing orthotics are just a few ways to help relieve symptoms. Some people have gone as far as physical therapy and/or steroid injections for pain relief that has shown a low success rate.
Neuromas are benign tumors on nerve tissue usually around the toes that will often compress nerves, causing pain and numbness. Neuromas can be caused by improper footwear, flat feet, high arches, trauma, or repetitive stress. Other than the rest, ice, compress, elevate system (RICE), the best home ready to help treat neuromas is getting a proper shoe with a slightly wider frame to avoid excessive pressure on the feet. Finding a pair of good orthotics is also a great option. In more severe cases, surgical intervention may be required.
Anatomical abnormalities such as flat feet, high arches, and bunions can cause debilitating foot pain. These conditions can be congenital or can develop later in life. Flat feet typically occur when the arches don’t develop properly during childhood but can be caused by trauma as well. Most people who have high arches are born with them and they are not a factor due to trauma or repetitive stress. Bunions are typically caused by prolonged pressure that compresses the big toe and begins to push it towards the second toe. Unless it is a severe case, bunions can be treated without surgery.
With all three of these conditions, the best treatment is finding a good supportive shoe, wearing a good pair of orthotics, using cushion pads for bunions, and completing exercises/stretches to help keep the feet strong. Wearing high heels or boots should be limited or avoided altogether if possible. In addition, the RICE protocol can help manage inflammation levels.
What Can We Do to Help?
You may have noticed that we did not talk about plantar fasciitis. Plantar fasciitis is perhaps the most common foot condition that patients present with outside of diabetic neuropathy. We will discuss plantar fasciitis in a separate blog because of the high percentage of people who have it and the high success rate chiropractic treatment has on the condition.
You may have also noticed that we didn’t list chiropractic treatment as a treatment for any of the conditions we previously discussed. We added it to this section because first we wanted to explain that chiropractors can adjust most joints. So if you were wondering if chiropractors adjust feet, the answer is yes.
After we perform our new patient examination, we may dig deeper and look at the feet if necessary. Many cases involving extremity pain are typically caused by nerve interference occurring in the spinal column. In most cases, we may only need to adjust the spine; however, if we are not achieving a good result with foot pain, we will begin to adjust the foot. In addition to adjusting the feet, we offer top of the line orthotics that help with proper foot rotation, comfort, and stability. We also recommend finding a good pair of shoes with good back support and comfort, periodically changing them from time to time. We will be discussing orthotics and proper footwear in a future blog.
For more information or questions about foot pain and management, please call us at (724) 547-3377 and checkout our website at www.drlarrywilkinsspinalcare.com for more content.
Yours In Health,
Larry E. Wilkins, DC
Brian M. Steinert, DC