Garrow Adam P, Silman Alan J, Macfarlane Gary J
Diabetes Foot Clinic, Disablement Services Centre, Withington Hospital, Cavendish Road, Manchester M20 1LB, UK.
Pain. 2004 Jul;110(1-2):378-84. doi: 10.1016/j.pain.2004.04.019.
Previous foot studies have consistently reported high prevalence estimates in self-reported foot disorders. Few population studies, however, have attempted to assess the impact of foot problems in terms of pain and disability so that the burden associated with foot pain is unknown. A cross-sectional postal survey was conducted on a random community sample of 4780 individuals with 3417 (84%) responding. Subjects reporting foot pain in the past month, current pain and marking one item on the Manchester Foot Pain and Disability Index were classified as having disabling foot pain. Those with disabling foot pain and a random sample with no symptoms (matched for age and gender) received a follow-up interview and standardised foot examination. Self-reported nail problems, corns and callosities, swollen feet, foot deformities and recent foot injuries were found to be associated with disabling foot pain. Foot disability was also associated with pain in the shoulder, axial skeleton, hip/upper leg and knee along with other indicators of poor general health. Clinician diagnosed foot problems associated with disabling foot pain were swollen feet, knee and foot joint tenderness. Only 36% of persons with disabling foot pain received professional foot treatment in the 6 months preceding the survey. The results showed that 323/3417 (9.5%) reported symptoms of disabling foot pain and that this condition is likely to be multi-factorial in origin. Further work is necessary to understand more about the extent and type of unmet need and on how patients presenting with symptoms of disabling foot pain should best be managed.
以往关于足部的研究一直报告称,自我报告的足部疾病患病率估计值很高。然而,很少有针对人群的研究试图从疼痛和残疾方面评估足部问题的影响,因此与足部疼痛相关的负担尚不清楚。我们对4780名个体的随机社区样本进行了横断面邮政调查,有3417人(84%)回复。在过去一个月内报告足部疼痛、当前疼痛并在曼彻斯特足部疼痛和残疾指数上勾选一项的受试者被归类为患有致残性足部疼痛。患有致残性足部疼痛的受试者以及一个无症状的随机样本(按年龄和性别匹配)接受了随访访谈和标准化足部检查。自我报告的指甲问题、鸡眼和胼胝、足部肿胀、足部畸形和近期足部损伤被发现与致残性足部疼痛有关。足部残疾还与肩部、中轴骨骼、髋部/大腿上部和膝盖疼痛以及其他总体健康状况不佳的指标有关。临床医生诊断出的与致残性足部疼痛相关的足部问题是足部肿胀、膝盖和足部关节压痛。在调查前的6个月内,只有36%的患有致残性足部疼痛的人接受了专业足部治疗。结果显示,3417人中有323人(9.5%)报告了致残性足部疼痛的症状,而且这种情况可能是多因素导致的。有必要进一步开展工作,以更深入地了解未满足需求的程度和类型,以及如何最好地管理出现致残性足部疼痛症状的患者。