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Content in this special section was created or selected by the Everyday Health editorial team and is funded by an advertising sponsor. The sponsor does not edit or influence the content but may suggest the general topic area. We respect your privacy. Low back pain and stiffness are the hallmarks of ankylosing spondylitis AS , but they may not be the first or only symptoms of this inflammatory type of spinal arthritis. The disease can be severe, causing the spine to fuse into a fixed, hunched position, but it can also be less dramatic. Some people with AS may experience only intermittent periods of mild back pain throughout their life.
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Carlson Michael E. Brage It is estimated by the Centers for Disease Control and Prevention that arthritis is the most common cause of disability in the United States and affects nearly 21 million people. The commonest form of arthritis encountered is osteoarthritis OA , but there are more than other rheumatologic conditions that can cause arthritis-related disability in every age group, ethnicity, and sex. As physicians, we must be prepared to not only manage the chronic disabilities that fail conservative care but also recognize systemic disease that presents as an isolated foot problem such as the swollen forefoot that on careful examination reveals peripheral symmetric joint involvement as in rheumatoid arthritis RA. This chapter encompasses the midfoot and forefoot arthritides, such as primary OA and secondary posttraumatic arthrosis as well as the related topics of hallux rigidus, forefoot RA, crystal-induced arthropathy, and turf toe.
Aging and a number of medical conditions can lead to atrophy of the fat pads under the heel and forefoot, which often causes considerable pain. Cushioned footwear and orthoses are mainstays of treatment, but research also supports the use of fat grafting in recalcitrant cases. The plantar fat pad serves as a cushion and a means of absorbing shock, but as individuals age it begins to atrophy. Like the tread of a tire, the heel fat pad can thin over time, often so much that a patient experiences heel pain that interferes with productivity and daily activities. A normal, healthy fat pad measures 1 to 2 cm in thickness.
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Bottom of feet spondyloarthropathies

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Is it growing pains or something else? Heel pain is a very common symptom in adults, but children and teens may also complain of it. Most often the discomfort is short lived, caused by a growth spurt, especially in active kids. However, there are several other conditions that can cause heel pain in young people. Try to determine when it may be normal growing pains and when heel pain may indicate a more serious condition. Left untreated, heel pain can lead to difficulty in walking that will require complicated therapy. If your child is very active, especially if she plays a sport that involves a lot of running and jumping on hard surfaces such as soccer, basketball, or gymnastics , it can put extra strain on her already overstretched tendons.

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