Diagnosis and Treatment of Morton Neuroma, Plantar Fasciitis, and Achilles Tendinopathy

Common Painful Foot and Ankle Conditions

The podcast discusses three common foot and ankle conditions: Morton's neuroma, plantar fasciitis, and Achilles tendonitis. These conditions were chosen because they are prevalent and can be managed without surgery. Morton's neuroma is characterized by pain in the ball of the foot, often between the third and fourth metatarsals. Diagnostic criteria include tests like the thumb index squeeze test and Mulders sign. Treatment options include wide toe box shoes, injections for pain relief, and over-the-counter orthotic inserts. Plantar fasciitis involves heel pain, particularly in the inner aspect of the plantar heel. The primary treatment involves a home stretching protocol and the use of arch support orthotics. Achilles tendonitis affects the mid portion of the Achilles tendon and is evaluated through physical examination tests like the painful arc sign. Eccentric exercises, where the calf muscles contract while lengthening, have shown benefit for this condition. Fluoroquinolones have a slight association with Achilles tendonitis, but the absolute risk is small. Platelet-rich plasma (PRP) and extracorporeal shockwave therapy (ESWT) are two novel treatment options, although the evidence is limited. Non-surgical management and patience are key in treating these common foot disorders.