A gradual, overuse injury of the Achilles tendon, either at its insertion or midportion.
Presents with heel pain, swelling, stiffness, often worst at activity start. Diagnosis via exam and sometimes ultrasound or MRI.
Non-surgical management includes rest, activity modification, eccentric calf strengthening programs, heel lifts or orthotics, NSAIDs. Injection therapies are generally avoided.
Extracorporeal shockwave therapy has some support. Surgery—such as debridement or bursa removal—is considered for persistent (>6 months) symptoms.
Lateral deviation of the big toe with medial prominence; symptoms include pain, shoe discomfort, calluses. Management includes comfortable footwear, padding, orthotics; surgery indicated when pain affects daily life.
Arthritis at the 1st metatarsophalangeal joint, presenting with stiffness and pain during toe-off in gait. Managed initially with stiff-soled shoes, activity modification, orthotics; surgical options include fusion if conservative therapy fails.
Hammertoes, claw toes or claw toes causing toe pain, pressure, and difficulty with footwear. Treatment ranges from toe wedging and orthotics to surgical correction.
Pain and stiffness in midfoot joints (e.g., navicular, cuneiform). Non-surgical care includes custom orthotics and physiotherapy; fusion surgery may be offered if symptoms persist.
A painful thickening of the nerve between toes (usually 3rd webspace). Presents with burning pain, numbness or tingling, often worse with tight shoes. Managed with padding, orthotics, decreased pressure; excision considered if conservative care fails.
Inflammation of the plantar fascia: sharp heel pain on first-step after inactivity, easing with movement. Managed with stretching, night splints, NSAIDs, orthotics; rarely surgery after persistent symptoms beyond 6–12 months.
Persistent “giving way” after repeated sprains, causing swelling, pain, and instability. Diagnosis includes physical testing and imaging. Initial care includes physiotherapy, balance training, bracing; surgical ligament reconstruction may be indicated in refractory cases.
Removal of diseased tendon tissue or bone prominence (e.g., Haglund deformity), potentially with tendon augmentation.
Keyhole surgery to address ankle cartilage lesions, impingement, or loose fragments.
Surgical fusion of joint surfaces to relieve pain in severe arthritis.
Fusion of the big toe joint to reduce pain and improve function in hallux rigidus.
Alignment procedures to correct hammertoe or claw toe, often with tendon releases or joint fusion.
Fusion of midfoot joints to stabilize and relieve pain in midfoot arthritis.
Surgical reinsertion or reconstruction when tendon degeneration exists, or tears are present.
Repair or reconstruction of lateral ankle ligaments to restore stability.
Realignment of the first metatarsal and toe joint to correct hallux valgus deformity.
Surgical removal of the neuroma when conservative care fails.
