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Answer to your Health Question

Question (10/10/2011):

Title: Pain on top of the foot | Pain can be felt from ankle to toes.

Dear Sir,

Recently for last one month, I am getting pain on top of the right foot.

Pain can be felt from right ankle to toes.

It pains more while I am walking when the toes fingers are bending.

I am 36 years old female -housewife.

There is no other health problem.

I am absolutely normal.

Please advice.

Thanks & Regards


Answer:

It may be a stress fracture.

Stress fractures are injuries from prolonged bone use that usually affects individuals physically active.

It tends to occur in the medial metatarsals (90%) and less frequently in the tarsal navicular.

The most important complications of this injury include chronic pain and non-union (fracture areas relatively avascular).

It is important to rule out other conditions such as posterior tibial tendonitis, stress fracture of the talus and tarsal tunnel syndrome.

The treatment of metatarsals fractures consists of rest and use of rigid-soled shoes for four weeks to prevent the extension of the metatarsals during walking, and then progressive rehabilitation, in case of displaced fractures foot should be plastered for four weeks.

Tarsal navicular fractures occur most often in the sagittal plane in the central third of bone, causing more insidious pain, located on the inner side of the midfoot, it radiates to the first or second metatarsal, and it gets worse with running or jumping and improves with rest.

In both types of fractures, the clinical history is essential. The fracture of the metatarsals can be confirmed by radiography (X-rays) of the foot (visible at 3 weeks). Technetium bone scan is a sensitive but nonspecific test positive at 24 hours.

The bones of the feet cannot withstand repeated stresses beyond a threshold above which microscopic bone cracks may produce that may extend to form evident fractures.

Repeated stress causes an imbalance in bone remodeling, so the periosteal resorption occurs faster than bone formation, resulting in a weak bone cortex that break to the effort.

It can be the first manifestation of osteoporosis or osteomalacia.


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