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.
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 ReplacementAlthough not as common as as total hip or knee joint replacement, advances in implant design have made ankle replacement a feasible option for many people.
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.
Ingrown ToenailsOne study compared patients with ingrown toenails to healthy controls and found no difference in the shape of toenails between patients and controls and suggested that treatment should not be based on the correction of a non-existent nail deformity. Ingrown toenails are caused by weight-bearing (activities such as walking, etc.) in patients that have too much soft tissue (skin) on the sides of the nail. Weight bearing causes this excessive amount of skin to bulge up along the sides of the nail. The pressure on the skin around the nail results in the tissue being damaged, resulting in swelling, redness and infection.
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 InstabilityOur podiatrists specialized on the science and art of medical-surgical management of foot and ankles, and guarantee the foot and ankle health of your family. We concentrate on the prevention and treatment of foot and ankle complications like Achilles’ tendon problems, ankle instability, ankle sprains, arthritic foot and ankle, athlete’s foot and bunions. Our podiatrists will treat your calluses, corns, crush injuries, diabetic foot, toenail fungus, heel spurs, ingrown toenails, and injuries. Our team of experts corrects flat feet, hammertoes, and plantar fasciitis. Other conditions like neuromas, warts and wounds are also given appropriate medical attention. Plus, older adults will benefit from our state of the art geriatric foot care services.
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.
Arthritic Foot Care
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.
Diabetic Foot Care
Fungus ToenailsAnyone is at risk for a toenail fungal infection —it simply takes being exposed in the right kind of environment. Going barefoot in a warm, damp place such as a public locker or a shower, this is just one way to pick up this type of infection. The toenail fungus invades and grows under the nail, it causes the nail to become discolored, thickened, and brittle. Fortunately, there are many methods of treatment including topical ointments, oral medications, and the Toenail Fungus Laser remove that can remove the toenail fungus.
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 ToenailsA more physiologically sound hypothesis is that an “Ingrown Toenail” is actually a problem where there is too much skin around the nail (“ Overgrown Toeskin “) – the nail is not the problem. Vandenbos and Bowers theorized that pressure necrosis of the soft tissues surrounding the nail due to weight bearing is the primary cause of ingrowing toenails. They wrote “the term ‘ingrown toenail’ is unfortunate in that it
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 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.
FungusSometimes nail fungus can be resistant to treatment and nails take a long time to grow out, so it can take several weeks or months for an infection to be fully resolved. You will know that the treatment is working and the infection is clearing up when you see growth of a new, healthy nail from the base of the nail bed. You can work at slowly trimming down the old and infected nail as the new one grows in.
PsoriasisPsoriasis is a skin condition caused by faster-than-normal turnover of skin cells. Normally, new skin cells rise to the surface of the skin once a month; the old surface skin cells die and slough off while the new cells are moving to the surface. In people who have psoriasis, the new cells move to the surface so rapidly that the dead cells build up on the surface in dry, whitish-silver patches.
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.
Stress ManagementYou can’t prevent the development of psoriasis, but you can avoid things that make your psoriasis worse. Stress management techniques may help some people with psoriasis. Alcohol, dry air, and too much or too little sunlight seems to trigger psoriasis for some people, so controlling your exposure to things that irritate your psoriasis may help. Talk to your doctor to find out what you can do to control your psoriasis at home.
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