From the Guidelines
Treatment for talonavicular spurring should initially focus on conservative management, including orthoses, accommodative padding, NSAID therapy, and physical therapy, as these approaches can help alleviate symptoms and improve quality of life. When considering treatment options, it's essential to prioritize morbidity, mortality, and quality of life as outcomes.
- Conservative management is the first line of treatment and may include:
- Orthoses to redistribute pressure away from the affected area
- Accommodative padding for cushioning and support
- NSAID therapy to reduce pain and inflammation
- Physical therapy to improve biomechanics and reduce pressure on the joint
- If symptoms persist, other treatment options may be considered, such as corticosteroid injections, although the provided evidence does not directly address talonavicular spurring, it does mention corticosteroid injections as a treatment option for heel pain 1.
- Surgical options, such as arthroscopic debridement or joint fusion, may be necessary for severe cases that do not respond to conservative measures, but these should be considered carefully due to the associated risks.
- It's crucial to address the underlying cause of talonavicular spurring, whether it be abnormal foot mechanics, arthritis, or repetitive stress, to ensure effective long-term management.
- The provided evidence, although focused on heel pain, suggests that initial treatment options should be continued if symptoms improve, and other diagnoses should be considered if symptoms do not improve within six to eight weeks 1.
From the Research
Treatment Options for Talonavicular Spurring
- Conservative management, including orthotics, manipulation, and fascial stripping, may be beneficial in the treatment of conditions affecting the talonavicular joint, as seen in the treatment of tarsal tunnel syndrome 2.
- Orthotic management can be used to treat diseases that affect the transverse tarsal joint, which includes the talonavicular joint, by controlling the biomechanical role of the joint in standing and gait 3.
- Isolated talonavicular arthrodesis has been shown to provide efficient pain relief and functional improvement in cases of talonavicular arthritis, primary or posttraumatic arthritis, and flexible acquired flatfoot deformity 4.
- There is limited direct evidence on the treatment of talonavicular spurring, but the above studies suggest that conservative management and orthotic interventions may be beneficial in treating related conditions.
- Other studies have focused on the treatment of different conditions, such as chronic venous insufficiency 5 and Achilles tendinopathy 6, but do not provide direct evidence on the treatment of talonavicular spurring.