Cyclo-oxygenase-2 (COX-2) inhibitors, drugs which specifically target the COX-2 isoenzyme, were developed as an alternative to traditional NSAIDs due to their potential for less gastrointestinal toxicity. However, as an increase in cardiovascular disease was seen with certain agents, rofecoxib was withdrawn from the worldwide market in September 2004. The other COX-2 inhibitors and traditional NSAIDs are currently under close scrutiny for the emergence of data suggesting similar effects.2 Intra-articular corticosteroid injections, following joint aspiration, are frequently used with excellent response and minimal side effects. Sepsis must be excluded prior to injection, with urgent Gram stain and culture of synovial fluid if infection is considered a possibility.
As you age, your body changes in many ways, sometimes for the worse. One of the less desirable changes your body may undergo is the development of bone spurs. Bone spurs are not in themselves painful, so you may not know you have one. However, if it compresses your nerves and bones it can cause many symptoms. Knowing these symptoms can help you determine if you have a bone spur and if medical attention is necessary. Spondylolisthesis is a spinal condition characterized by the abnormal slippage of one lower-back vertebra in relation to another. The prognosis (outlook) for the disorder varies with the severity and progression of the slippage present.
A flat foot is the most common foot deformity known. This condition can occur in one or both of your feet. Flat feet is known as pes planus , and simply refers to a loss of the arch on the bottom of the foot. If persistent throbbing pain is present in the arch region, especially during activity, you may be feeling the signs of a weakening arch. The mainstream treatment for flat feet or weak arches is orthotics. Orthotics is artificial arch supports inserted into footwear. These inserts can either be over the counter or made from a custom mold or measurement of your foot.
Flexible flat feet generally do not require any treatment at all. Special shoes, shoe inserts and exercises do not lead to flat foot correction. For children younger than eight, physicians tend to recommend observation only. Doctors may recommend orthotics (shoe inserts) for middle- or high school-aged children with pain which seems to be due to flat feet. Orthotics provide support to the arch of the foot and decrease the amount of pronation (ankles rolling inward). Pes planus (also called flat foot ) is a deformity of the foot where the longitudinal arch of the foot is abnormally flattened. Pathology
Sinus tarsi syndrome is often a clinical finding observed in people affected by trauma to the foot or poor foot biomechanics. The best way to lower the incidence of this condition is to seek medical assistance for proper treatment of ankle sprains or other injuries. Correction or treatment of structural foot abnormalities will go a long way in lowering the risk of this foot problem. This group has devices that offer relief to minor pains and foot injuries. They are usually used to correct problems in children. The devices include night bars and splints. They offer support and promote adjustments for minor abnormalities.
Related to plantarfasciitis is a heel pain or spur. The longitudinal ligament hasit’s origin on the plantar anterior surface of the calcaneum(heel) bone. When the ligament is stretched too far, it pulls onthis attachment area. It can become inflamed and sore. If theproblem persist, the body may try to heal it by reinforcing theattachment area by adding bone. This is just as the body heals afractured bone. A hormone is secreted that is drawn to theinflammation site. Chemically this hormone draws calcium out ofthe blood stream and deposits it in layers over time to theinjured area. If the process continues long enough a spur of bonemay be laid down.
Other terms for over-pronation are ‘fallen arches’, ‘dropped arches’ or ‘collapsed arches’. The term ‘flat feet’ is also often used. However, a true ‘flat foot’ is very rare. In fact, less than 5% of the population have completely flat feet ( Pes Planus ) with no arch present whatsoever. Most of us (90%) have a normal to low arch and only 5% have a high arch. People with a high arch ( Pes Cavus) are also called ‘over-supinators’. This means that the foot stays rigid at all times and lacks its natural shock-absorbing mechanism.
Osteonecrosis (death of subchondral bone of unknown cause) of the femur may present with sudden severe medial compartment knee pain that is constant (day and night). Bone scan shows increased uptake in the femoral condyle. Nerve injuries causing medial joint pain include trauma to the saphenous nerve or injury during knee surgery, especially arthroscopy. Pain can be reproduced with Tinel sign. One case report documents distal tibial pain from entrapment of the saphenous nerve caused by pes anserine bursitis. Medial knee pain associated with back pain also could represent an L3-L4 radiculopathy. Electrodiagnostic testing such as electromyography (EMG) and nerve conduction velocity tests may be useful.
Lateral subtalar dislocation — With proper treatment, most people recover without severe long-term complications or disability. In some cases, there is continuing stiffness in the area of the foot arch, but this does not necessarily cause pain or difficulty in walking. The risk of long-term problems is lowest in people who have at least three weeks of aggressive physical therapy after their casts are removed. Additional Info Pain is the most obvious symptom from these conditions but a doctor may be able to give a full diagnosis and advice on effective treatments. The doctor should also be able to eliminate other problems and identify the root cause after examination.