Treatment For Cavus Foot Pain
Overview
In the absence of pain it is possible to overlook the architecture of this foot type that may eventually lead to more severe conditions. One of the reasons that pes cavus garners less attention is the lack of a standard definition. It is generally recognized as a foot with an abnormally high arch, but mild forms can be asymptomatic and fall within the normal band of function. A cavus foot can be readily identified from a pedigraph imprint: There will be no ink under the medial arch and obvious weight bearing along portions of the lateral border. Pressure maps sometimes demonstrate the classic ?tripod? characteristic of cavus feet showing a concentration of lasting weight reduction bearing at the first and fifth metatarsal heads and at the heel. This clear imprint of high-pressure spots can also serve as a basis for orthotic treatment.
Causes
Pes cavus may be hereditary or acquired, and the underlying cause may be neurological, orthopedic or neuromuscular. Pes cavus is sometimes, but not always connected through Hereditary Motor and Sensory Neuropathy Type 1 (Charcot-Marie-Tooth disease) and Friedreich's Ataxia; many other cases of pes cavus are natural.
Symptoms
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. There may be associated discomfort within and near the ankle joint. The knees, hips, and lower back may be the primary source of discomfort. Pain in the ball of the foot, with or without calluses. Heel pain.
Diagnosis
Identifying the underlying reason for a high arch is important to help your doctor plan the right treatment. Some neurological conditions can cause high arches to worsen progressively. Your doctor will ask about family history of high arches and neurological conditions. In examining your foot, he?ll look at arch height and any calluses, hammer toes and claw toes. The doctor also will watch how you walk (your gait). To help discern bone conditions and see if degenerative arthritis is present, your doctor may refer you for foot and ankle X-rays. An X-ray of your spine also might be needed to determine if a tumor or other spinal problem exists. If clearer images of your spine are needed, your doctor may order an MRI (magnetic resonance imaging). In this diagnostic test, a magnetic field and radio waves are combined via computer to produce exceptionally detailed images. Electromyography determines the health of muscles and the nerves controlling those muscles. A needle-shaped electrode is inserted into the muscle and an oscilloscope displays the muscle?s electrical activity. Nerve-conduction studies measure the speed of signals traveling through nerves. Several electrodes are placed on the skin above a nerve. An electrode emits a mild electrical impulse to activate the nerve. The activity then continues down the length of the nerve. The distance between electrodes and the time it takes them to move from one electrode to the next determines how fast nerve signals travel.
Non Surgical Treatment
If in fact you do have pes cavus, there are a handful of treatment options available to you. To overarching goal of treatment is to allow the patient to walk comfortably without symptoms. Your medical profession will determine whether surgical or non-surgical methods should be pursued. In the event that your doctor prescribes a non-surgical treatment you may be asked to undergo physical therapy to stretch out the tightened muscles. Besides stretching, your doctor may prescribe an orthotic solution.
Surgical Treatment
The aims of surgery are threefold. To correct deformity, thereby placing a balanced, stable, plantigrade foot on the ground with even plantar pressures between heel, first ray and fifth ray. To relieve pain due to overloaded or arthritic joints, while preserving joint motion where possible. To re-balance muscle forces, aiding in gait and preventing progression or recurrence of deformity. In principle, these aims are achieved by means of Joint releases and tendon lengthening. Tendon transfers, taking over-powerful, mechanically advantaged tendons and transferring them to weaker, disadvantaged tendons. Osteotomies, dividing and re-aligning bones, and stabilising with plaster or internal fixation. Arthrodeses, fusing stiff, painful joints.
