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Gday Folks

I am a new graduate and I have recently come accross two patients with similiar symptoms which have thus far not responded well to my or numerous other pods treatment. Both patients complain of a burning sensation in the weight bearing areas of their feet when standing for relatively short periods (10 min) on the one spot. Both patients work in proffessions that demand standing on the one spot for extended periods of time. Both patients have tried hard (rigid 4mm p/prop) devices with no success, and any attempt to cushion the foot results in only mild improvements/reductions. Both patients are young, fit and neither have any systemic complaints (Im aware of the DANG THERAPIST acronym). All neuro and vascular assesmnets WNL. Both patients have tried changing footwear with limited (short term/small) reductions. Heel raises and mild cushioning (SCF innersole with MLA fill) seemed to get best result but was ultimately still only a short term 10% reduction in symptoms. Both patients have been to at least two other pods befor me and other pods have all said somethiong along the lines of "you are the 1st patient in ..... years i havnt been able to help" (so Im a little worried )
Im more accustomed to treating the feet in accordance with dynamic biomechanical theory, the static stuff seems to be a bit trickyer. Oh and what orthotic design do you advocate for functional hallux limitus in a runner with lateral For Foot shoe wear (soory am I allowed to ask 2 questions at once)

Regards

MrT :)

The first thing I check in FF pain is tightness of gastroc and soleus (passive dorsiflexion and lunge test). If there is limitation there is more pressure to the FF.

Rebecca

Gday Bec

Thanx for your reply. I believe that a tight GSC has contributed to these patients symptoms, but the pain was not limited to the F/F, it was evenly ditributed accross the entire weight bearing area. Also, the heel raises that provided a small improvement would have placed greater pressure on the F/F. Regardless I have already given the lady some GSC stretches so Ill add some Talo Crural Mobs in and report back :) .
On reflection, perhaps another pertinant statement from one of the patients was that once the pain began there was nothing he could do to alleviate it. I also asked him to trial some cryotherapy after a big night at work (immersion baths) with no reduction in Symp.

Thanx again for your assistance

MrT

Related threads:
Patient with symptomatic 'hot feet'
Reasons for burning feet
Genetically hot, itchy feet
Burning Feet Syndrome
Exercise induced burning toes
Burning Feet
A 'burning' issue...
Another burning foot issue

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Both patients seem to have identical presentations. Are they related in any way? Do they work at the same facility??

gDAY

Absolutely no relation, one is a cleaner the other is a bouncer and they work on opposite sides of the same city. I only really mentioned their similarities as they represent best the phenomenon that Im tryin to unwravel. The reason the treatments are similiar is becuase I employed the things that seemed to work from the 1st guy on the second lady, and eliminated the treatment options of the other pods they had seen previously. But Im still at a loose ends on how to treat the condition.

MrT

I had a few cases just like this and ruled out all medical causes of burning. I was left with a biomechanically induced neuritis and treated them as such with progressive success.

Did you rule out thyroid dx ????

I asked both of them if they had any Thyroid issues as per the DANG THERAPIST acronym (went through em all pretty much) but drew a big blank. How did you treat the biomechanically induced neuritis, and is there somewhere I can get some info on this condition?

Thanx for your assistance

MrT