December Articles 2014

New Treatment Helps Relieve Heel Pain Caused by Plantar Fasciitis

Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be ineffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one-time outpatient procedure involving a small amount of anesthesia. This technique, known as dry-needling, causes small amounts of bleeding that aid in healing the fascia.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Dr. Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also called tibial nerve dysfunction, is an uncommon form of misfiring peripheral nerves in the foot. Peripheral nerves are the nerves that carry signals from the brain and spinal cord to the other parts of the body. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee, or trauma to the tibial nerve can result in tarsal tunnel syndrome. Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome. However, tarsal tunnel syndrome can appear without an obvious cause in some cases.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of affected leg, with primary problems occurring on the bottom of the foot. The foot muscles, toes and ankle become weaker, and curling toes or flexing the foot becomes difficult. If the condition worsens, the person may develop infections and ulcers on the affected foot because of the lack of sensation. The affected foot can become permanently deformed, and sensation loss, particularly in the toes, is sometimes permanent.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition.

Occasionally, a person with tarsal tunnel syndrome can recover without specific treatment, but over the counter pain medication is still used to reduce the discomfort associated with the condition. Treatments for more severe tarsal tunnel syndrome focus on regaining sensation and strength in the affected toes and foot. Patients may receive physical therapy and prescription painkillers if the pain isn't managed by over the counter pain relievers. A surgery designed to lessen pressure on the tibial nerve can help in some cases. The surgeon enlarges the patient's tarsal tunnel, a ligament and bone structure in the foot that the tibial nerve passes through, relieving some of the pressure on the tibial nerve.

Working on Your Feet

Overworking your feet can put stress on your entire body, so taking care of your feet is an absolute priority for overall good health. Standing all day can cause a myriad of different conditions such as bunions, callouses, and plantar warts. These conditions are all very painful but can be avoided with proper foot care, which includes both proper posture and good shoe choices to contribute to the overall health of your feet.

A good place to start is choosing a show that has a negative heel which places the heel slightly lower than the ball of the foot, as shoes designed this way are best for your foot health. Having a job that keeps you on your feet all day makes it an especially a good idea to spend the extra money on a good pair of shoes. And most definitely purchase your shoes from a reputable manufacturer who puts foot health at the forefront of their goals. Having a job that keeps you on your feet all day makes it an especially a good idea to spend the extra money on a good pair of shoes.

The feet were not designed to be enclosed for hours on end. In fact, incorporating some "barefoot" time into your daily routine is not a bad idea to improve overall foot health. There are some other simple things that you can do to help alleviate pain and pressure on the feet from standing all day.

One of the first things you can do is perform some simple foot exercises and some common yoga moves to improve the function of your feet. Foot work outs that aid in your movement will stimulate blood flow and muscles of your feet. Yoga exercises that stretch your feet out flat on the floor can be very beneficial for you if you work on your feet all day. It can also help stretch and relax the calf muscles and Achilles tendon, both of which can become problem areas if not taken care of. You can perform these exercises every day during your daily routine, at the office, at the gym, or even before you go to bed simply stretching your feet out can do wonders for your foot health.

Foot pain that occurs every day because you work for long hours on your feet may lead you to think that this pain is inevitable. However, it does not have to be. Foot stretches and proper footwear work well in alleviating foot pain and preventing further foot problems.

With a little effort and some education, you can keep your feet healthy and feeling good. If your feet hurt, your whole body will eventually feel the effects over time. Start taking care of your feet today!

Diabetic Foot Care

Millions of people are affected with diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of, or else the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, when diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the die. Additionally, well-fitting socks are highly recommended.

A diabetic’s physician should always monitor their Hemoglobin A1C levels to test how well the blood sugars are being controlled during the past 3 months. It is very important to keep blood sugar levels at normal range, 70-110mg/dl. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with neuropathy of a diabetic patient. It is also advised to see a podiatrist if experiencing any feet conditions. Toe nails may also need to be taken care of by a podiatrist, since some patients may cut too deep around the cuticles, causing infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. When using tools to remove calluses, use caution, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to call a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound gets too bad to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can cause in diabetics that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.