Degenerative osteoarthritis in the hip
Pain, deformity, and limited arc of motion may develop as a result of degenerative bone and joint diseases affecting the hip. Patients often have a limp, and in several cases, a difference in the length of the lower limbs may also develop. In the early phase of the disease, functional treatment is possible. Functional treatment involves the administration of anti-inflammatory medications, creams, therapeutic exercises tailored to individual needs, and injection therapy. The major aim is to maintain the function of the joint. In the young, it is also possible to perform a corrective surgery of the bone. In the elderly or in case of severe degeneration of the joint, only the implantation of an artificial joint (prosthesis) can result in decreased pain and increased arc of motion.
Meniscus injuries
Meniscus injuries are common knee injuries. They usually develop as a result of a twisted movement after adhesion in the leg. The injury might be accompanied by the tear in the transverse or lateral ligament as well. In acute cases, the knee joint may get stuck, and the knee gets locked up in a certain position. In chronic cases, a popping sensation can develop. Besides the nagging pain and popping sensation, damage of the cartilage can be the consequence of such an injury. In meniscus tear injuries, the damaged piece of the cartilaginous ring practically smooths the intact hyaline cartilage and results in severe degeneration of the cartilage. It further deteriorates the function of the knee and increases the pain. This condition needs surgical therapy. In certain cases, the torn cartilaginous ring may be restored and sutured by minimally invasive arthroscopy, but in some other cases, the torn pieces should be removed.
Stiff big toe (hallux rigidus)
Stiff big toe is a painful degenerative disorder of the great toe. The recommended therapy is wearing rocker-bottom shoes, or surgery might be performed.
Tear of the transverse ligament
Tear of the transverse ligament is a common injury of the knee. It usually develops as a result of a twisted movement after adhesion in the leg. Most frequently the anterior transverse ligament is torn, completely or partially. The injury might be accompanied by the tear of the mensicus and the lateral ligament as well. In acute cases, the knee joint may get stuck, and the knee gets locked up in a certain position. In chronic cases, a popping sensation can develop. Besides the nagging pain and instability, damage of the cartilage can be the consequence of such an injury. When the transverse ligament is torn, the torn fibers of the injured transverse ligament smooths the intact hyaline cartilage, and it may result in severe degeneration of the cartilage. It further deteriorates the function of the knee and increases the pain. It needs minimally invasive arthroscopic surgical operation, during which the torn pieces of the transverse ligament can be removed and smoothed. In complete tears, surgical replacement of the transverse ligament is recommended. Surgical therapy should be followed by long-term, professional physiotherapy.
Kneecap (prepatellar) bursitis
Kneecap bursitis develops on the extensor surface of the lower limbs, mostly above the knee. It presents as a painless “squishy” swelling that can be moved on palpation. Redness of the skin can also develop over the swelling. The reasons of developing kneecap bursitis may be chronic irritation, occupational harm, gout, diabetes, trauma, or infection. As a conservative therapeutic option, local or systemic (through the mouth) anti-inflammatories are administered, the extra fluid from the bursa can be drained, and an injection can also be administered. In chronic cases or in the presence of infection, surgical removal is needed.
Baker’s cyst
Baker’s cyst is a fluid filled sac with various size and “squishy” palpation in the hollow part of the leg behind the knee joint. In the majority of the cases, its development is related to the joint. It should be differentiated from a lipoma, tumor or vascular abnormality. Thus, utrasonography is needed to be performed. Removal is needed only in case the patient develops complaints, or if it causes circulatory or innervation disturbances. If the development of the cyst is related to a joint abnormality, the underlying cause should be revealed and treated.
Bunion
Bunion is a static deformity of the great toe. Certain genetic factors (loose ligaments and fallen foot arch) may predispose patients to develop a bunion. External factors may also play a part, such as wearing tight, high-heeled shoes. Conservative therapy includes the administration of painkillers, and the patients should wear shoes with a wider front part or orthopedic shoes. In advanced cases, when the bunion is painful, surgical correction may be needed.
Heel spur (retrocalcaneal exostosis)
Pain affecting the sole surface of the heel bone may be due to a heel spur. It presents as a characteristic bone spur in the X-ray scan. Pain may be present even without a bony deformity. The development of a heel spur is related to extension in the sole ligament and subsequent inflammation of the bursa. The affected patients are recommended to wear a silicone heel pad to decrease the pain. When the complaints do not cease, physiotherapy may be needed or even anti-inflammatory injections can be administered into the soft tissues.
Pain in the Achilles tendon
Chronic pain may develop in the Achilles tendon and on the surface of the back of the ankle joint. Pain may be due to overuse during sport activity or work. Degenerative processes develop in the structure of the tendon; the tendon gets thinner and fibrous. In chronic cases, the Achilles tendon my even rupture. Ultrasound examination should be performed to establish the diagnosis. The therapy involves off-loading the tendon, reducing physical activity, and the administration of local and oral non-steroidal anti-inflammatory drugs. Surgical intervention should be performed if the tendon is ruptured. The healing process is always long-lasting. Physiotherapy tailored to the individual plays an important part in the rehabilitation of the patient.
Degenerative osteoarthritis in the knee
In degenerative osteoarthritis, irreversible biological and mechanical processes occur in the affected joint, which result in degeneration of the joint and severe pain. Patients may have a limp on walking even if they take painkillers and wear knee braces. In the early phase of the disease, functional treatment is possible. Functional treatment involves the administration of anti-inflammatory medications, creams, therapeutic exercises tailored to individual needs, and injection therapy. The major aim is to maintain the function of the joint. In case of axial deformity or mild degeneration, corrective bone operation is recommended. In case of severe degeneration of the joint, only the implantation of an artificial joint (prosthesis) can help decrease the pain and increase the arc of motion.
Flat feet
The most frequent static abnormal posture of the feet. As a result of the weakness in the active and passive stabilizing parts of the foot, the longitudinal and the transverse arches as well as the medial ankle are fallen, and the heel bone is turned inward. Hardened layers of skin develop at the pressure points. In childhood, it is important to do regular foot exercises, walk on uneven surface, and wear orthopedic shoes to achieve the normal anatomical form of the feet. In adolescence and adulthood, an instep raiser or orthopedic shoes should be worn, and corrective surgery might also be performed.
Pain in the sole
Heavy pain may develop in the area of the head of the mid-foot bones (metatarsals) as a result of the fallen transverse arch. Hardened layers of skin can be formed on the sole at the pressure points. Therapy may include the wearing of instep raisers or orthopedic shoes, and in case of unstoppable pain, a surgical intervention may be needed.
Hammer toe
As a result of the falling of the transverse arch in the foot, the flexor and extensor tendons are out of balance, and the toe is fixed in a characteristic position. The deformity causes the toe to bend, and calluses develop on the back (dorsum) of the foot. Therapy may include the wearing of instep raisers or orthopedic shoes, performing regular toe exercises or undergoing a surgical intervention.