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In My Book: Health
Foot Pain is Not Normal
ArthritisUnlike osteoarthritis which follows a predictable pattern in certain joints, rheumatoid arthritis is a system-wide disease. It is an inflammatory disease where the patient’s own immune system attacks and destroys cartilage.
Plantar FasciitisICE: Use ice immediately after sustaining an ankle or foot injury, such as a sprain. Ice should also be used when you’ve re-aggravated a chronic injury, such as plantar fasciitis or shin splints. An ice bath can also help with muscle recovery after running a marathon or long-training run.Heat: Heat should be used on chronic injuries such as tendonitis, or on muscles that are tense.
CryotherapyThere are many different treatments and procedures associated with wart removal. One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75%, compared with 48% for the placebo in six placebo-controlled trials including a total of 376 participants. The reviewers also concluded that there was little evidence of a significant benefit of cryotherapy over salicylic acid or duct tape.
Pediatric CarePodiatrists are defined as physicians by the federal government and in most states. DPMs receive medical education and training comparable to medical doctors, including four years of undergraduate education, four years of graduate education at one of nine accredited podiatric medical colleges, and three years of hospital residency training. Within the field of podiatry, practitioners can focus on many different specialty areas, including surgery, sports medicine, biomechanics, geriatrics, pediatrics, orthopedics, or primary care.
Emergency CareLigament tears, ankle sprains, and fractures of the Foot and Ankle are common both in the Emergency Room and pediatric office.
UltrasoundLocal injection of corticosteroids often gives temporary or permanent relief, but may be painful, especially if not combined with a local anesthetic and injected slowly with a small-diameter needle. Recurrence rates may be lower if injection is performed under ultrasound guidance. Repeated steroid injections may result in rupture of the plantar fascia. While this may actually improve pain initially, it has deleterious long-term consequences.
MRIChronic lower leg pain results from various conditions such as medial tibial stress syndrome, stress fracture, chronic exertional compartment syndrome, nerve entrapment, and popliteal artery entrapment syndrome. These conditions often have many overlapping symptoms which makes a final diagnosis difficult. Therefore, an algorithmic approach was created to help in the evaluation of patients with complaints of lower leg pain, and assist in finding a diagnosis. Confirmation of the diagnosis is key and involves appropriate diagnostic studies including: radiographs, bone scans, magnetic resonance imaging, magnetic resonance angiography, compartmental pressure measurements, and arteriograms.
General SurgeryOver the years, Dr. Miller has been very active in teaching and has served as director of residency programs at Westview Hospital and Winona Hospital in Indianapolis, Indiana. He currently is the Director of Podiatric Medical Education and Surgical Services at St. Vincent Hospital. He is also the Residency Director at St. Vincent for the Foot & Ankle Surgical Training Program.
Ankle SurgeryA D.P.M. wishing to specialize in Foot and Ankle surgery then enters up to three years of residency at an allopathic or osteopathic hospital and related facilities. Residencies emphasize foot and ankle pathology, diagnosis and treatments, but also require clinical rotations and are accredited by JCAHO or AOA.
Bunion SurgeryDepending on the severity of the bunion there are non surgical and surgical treatments available. Non surgical treatments would be, to change your footwear to relieve pressure on the bunion. Shoes with a wide toe and good arch support will help. Also applying ice to the bunion and taking anti inflammatory medications. If these practice do not remove the bunions surgery may be needed. Bunion surgery is designed to realign the toes and so the bunion will not reoccur.
Joint ReplacementArthroplasty Older patients who place few functional demands on the feet may be candidates for joint replacement surgery. The joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion.
Orthopedic SurgeryIn many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases orthopedic surgery may be necessary to correct the deformity. The patient’s doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it.
BunionsA bunion is a bony bulge at the base of the big toe or commonly referred to as a bony bump on your foot. Bunions are more common in woman, due to the wearing of high heels and tight fitting shoes. Bunions often become painful over time and cause the toes to angle towards each other.
Geriatric Foot CareMaintaining feet properly can be difficult for elderly individuals. But proper foot care can lead to an increase in the general health of the feet. It can lead to a decrease in the risk for suffering from certain conditions/diseases. Proper geriatric foot care can aid elderly patients in saying healthy and active. They are more likely to maintain their day to day activities. Individuals of the geriatric group should visit their podiatrist regularly to increase their chances for healthy feet; prevention and proper maintenance are the best treatments for most conditions.
Achilles TendonitisThe achilles tendon is a band at the back of the lower leg that connect the calf muscle to the heel bone. The most common injury to the achilles tendon is achilles tendonitis. Achilles tendonitis is the over use of the achilles tendon, which is found most in runners or sports that require a lot of endurance and intensity.
Ankle SprainTreatment of a sprained ankle are to apply ice and elevate the foot. Also, to apply an ankle brace for stability. In some severe cases surgery could be require, if the sprain has damaged the ligaments.
Bunions ProblemsThe great toe (first metatarsophalangeal joint). This is where the first metatarsal connects to the great toe bone (phalange).This is also the area where bunions usually develop.
General PodiatryIn 1983, a group of prominent Indiana podiatrists formed the Achilles Podiatry Group. The need to develop and build an infrastructure for the future of podiatry in Indiana was based on several significant factors that were changing health care management throughout the United States.
HammertoesA hammer toe is a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is a similar condition affecting the upper joint.
Heel SpursA calcaneal spur (or heel spur ) is a radiological (X-ray) finding, and when it is located on the inferior aspect of the calcaneus, is often associated with plantar fasciitis and ankylosing spondylitis. A posterior calcaneal spur may also develop on the back of the heel at the insertion of the Achilles tendon.
Foot InfectionsIf an athlete’s foot infection is more serious, it can take longer than a couple of weeks to get better. In these cases, it’s a good idea to see a podiatrist, who may prescribe a stronger anti fungal cream, spray, or pill.
Ingrown ToenailsElderly individuals (can be called geriatric) are susceptible to a number of foot specific conditions. Some of these conditions can leave individuals disabled if they are not prevented and/or taken care of. Some of these common foot related conditions include: arthritis, ingrown toenails, fungal nails, diabetic ulcers, and corns/calluses. Proper geriatric foot care can minimize these common problems among the elderly.
Pediatric Foot Care
Plantar FasciitisPlantar fasciitis is a painful inflammatory process of the plantar fascia. Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes and is termed, plantar fasciosis. The plantar fascia is a thick fibrous band of tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the five toes. The term fasciitis is a misnomer as studies of the tissue do not demonstrate inflammation. Plantar fasciosis is a more accurate diagnosis. It has been reported plantar fasciitis occurs in two million Americans a year and 10% of the population over a lifetime. It is commonly associated with long periods of work-related weight bearing. Among non-athletic populations, it is associated with a high body mass index. The pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Another symptom is that the sufferer has difficulty bending the foot so that the toes are brought toward the shin (decreased dorsiflexion of the ankle). A symptom commonly recognized among sufferers of plantar fasciitis is increased probability of knee pains, especially among runners.
Podiatric OrthopedicsA majority of podiatrists are board certified. Certification is considered to be an earned credential for those podiatric physicians who have achieved certain levels of skill and ability based upon completion of specific advanced training and clinical experience and examination. The American Board of Podiatric Medicine (ABPM) is the certifying board for the specialty areas of podiatric orthopedics and primary podiatric medicine. The American Board of Podiatric Surgery (ABPS) is the certifying board for the specialty area of foot and ankle surgery. apma
Podiatric SurgeryData obtained from 1.1 million federal employees in the late 1980′s indicated that podiatrists provided more than 60% of all elective foot surgery. A patient-reported medical outcomes study of 3,270 subjects found that D.P.M.’s scored 3.9% higher than other physicians in quality care and had patients with 30% shorter length of hospitalization.
CornsFoam wedges - these may be used for corns on the toes to reduce pressure. Sometimes special silicone wedges may be used.
FrostbiteProtect Your Feet From Hot and Cold. Always wear shoes at the beach or on hot pavement. Put sunscreen on the tops of your feet for protection from the sun. Keep your feet away from radiators or open fires. DO NOT use hot water bottle or heating pads on your feet. If your feet are cold, wear seamless socks at night. Lined boots are good to keep your feet warm in the winter. Choose socks carefully. DO NOT wear socks with seams or bumpy areas. Choose padded socks to protect your feet and make walking more comfortable. In cold weather, check your feet often to keep your feet warm avoid frostbite.
CallusesA callus is similar to a corn in that they are a protective layer of dead skin that comes from the same material, but instead builds up around the balls or heels of your feet. Some of the causes of calluses are poorly fitting shoes, flat feet and walking on hard surfaces.
Sports MedicineSports injuries can be broadly classified as either traumatic or overuse injuries. Traumatic injuries account for most injuries in contact sports such as Association football, rugby league, rugby union, Australian rules football, Gaelic football and American football because of the dynamic and high collision nature of these sports. These injuries range from bruises and muscle strains, to fractures and head injuries. Classification
Orthotics and Prosthetic Therapy
Physical TherapyYour doctor may recommend physical therapy for several months to help you regain strength in your foot or ankle and to restore range of motion. Ordinary daily activities usually can be resumed in three to four months. You may need special shoes or braces.
Tennis ElbowSports injuries are injuries that occur in athletic activities. In many cases, these injuries are due to overuse or acute trauma of a part of the body when participating in a certain activity. For example, runner’s knee is a painful condition generally associated with running, while tennis elbow is a form of repetitive stress injury at the elbow. Other types of injuries can be caused by a hard contact with something. This can often cause a broken bone or torn ligament or tendon. The most severe injuries and all fatalities are collectively known as catastrophic injuries, usually a result of trauma to the head, spine, or spinal cord.
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