Posts for: April, 2013
Mankind has used light to treat diseases and various aliments for thousands of years now, so introducing our new cold laser therapy laser may not be new to some of you. Advanced Foot and Ankle Care has now acquired the Dynatronics cold laser to better our patients’ foot health in treating a variety of aliments including: ulcers (even those caused by diabetes), burns, skin flaps and grafts, broken bones, cartilage, tendon and ligament repair, arthritic pain due to osteoarthritis and rheumatoid arthritis, ankle sprains and plantar fasciitis.
The Dynatronics cold laser uses three types of light therapy: red, blue and infrared.
Red light helps promote the healing of skin wounds at low energy densities. Red light therapy is also one of the oldest forms of treatment ever conceived or used by humans.
Blue light helps kill bacteria and a number of skin infections including: MRSA and staph. Blue light therapy is rapidly gaining popularity because unlike UV, it does not have high propensity to damage normal tissue.
Infrared light is best for deep tissue injuries, pain relief, and resolution of inflammation and reduction of edema. Infrared light therapy is commonly used with red light at the same time.
At this time, cold laser therapy is considered cosmetic, therefore not covered by your insurance company. Advanced Foot and Ankle Care offers cold light therapy for $25 per treatment. Our patients are not required to see the doctor every session, therefore do not have to pay a co-pay at those sessions that they do not see the doctor. Typical treatments require 2-3 session per week until the area is healed.
Call our office and speak to one of our Patient Care Coordinators for more information or to schedule a consultation appointment with one of our four physicians at any one of our four locations: Troy OH, Piqua OH, Sidney OH, Huber Heights OH.
What do Albert Pujols, Kobe Bryant, and Eli Manning have in common? Besides all being athletes, they have all suffered from plantar fasciitis. Plantar fasciitis is the most common cause of heel pain in adults, and has affected many professional athletes during their career. Unfortunately, this condition also occurs in many adults who are not athletes, so read on to learn more about what plantar fasciitis is and how it is treated.
What is the plantar fascia anyway?
The plantar fascia is a thick band of tissue that runs from your heel bone to your toes. It helps support the arch of your foot. Plantar fasciitis results from stress to the tissue, and can be very painful.
What are the symptoms?
Most patients with plantar fasciitis complain of pain in their heels. Often, the pain is worst when getting out of bed in the morning, but gets better as you walk throughout the day. As the tissue stretches throughout the day, it becomes less painful to walk. Resting allows the tissue to return to its pre-stretched state, which makes the pain come back.
What treatments are available?
There are several treatments for plantar fasciitis. Conservative treatments include icing and stretching the plantar fascia. Orthotics and physical therapy might be needed for some patients. Others still might need a night splint, which is a device that keeps your foot in a fixed position overnight to help stretch the tissue.
Many patients know that corticosteroid shots in the heel can help with the pain of plantar fasciitis. While this is true, repeated shots to the plantar fascia can do more harm than good, so not all patients need cortisone shots.
Finally, it is important to talk to your doctor if you have heel pain, because several conditions can cause pain in the heel. If your heels hurt, make an appointment with any of our doctors for an examination and discussion on the best treatment options for you.
You asked for it, we answered! Advanced Foot and Ankle Care has just doubled their shoe selection! Along with our shoe selection through Safestep, we have now picked up shoes made by Dr. Comfort. All Dr. Comfort shoes that are displayed on our walls in each of our four locations are all approved by Medicare and other insurances that cover therapeutic shoes. If your insurance doesn’t cover therapeutic shoes, you are more than welcome to come in, pick out a pair and get them ordered all within minutes.
If you are diabetic and have Medicare or a Medicare supplement plan and haven’t ordered shoes this year, stop by or call our office to make an appointment with one of our four doctors. At this appointment, one of our doctors will evaluate your overall foot health and write a prescription to order a pair of shoes from our office!
If you are diabetic and have any other healthcare plan, give us a call to schedule an appointment, the doctor will then evaluate you and we can contact your insurance company to see if therapeutic shoes are a covered benefit for you.
The 5th metatarsal is the one of the most common bones fractured in the foot. Situated just below the 5th toe, the anatomy of this bone influences the type of fracture that develops. The metatarsal itself is comprised of a base, tuberosity, shaft, neck, and head. The tuberosity, which is the posterior-most aspect of the bone near the midfoot, is clinically evident as it protrudes laterally (some people complain that this rubs in their shoes). Tuberosity fractures, also known as avulsion fractures, can be displaced or non-displaced. The position of the fracture will determine the type of treatment. For non-displaced fractures, the treatment is conservative and focuses mainly on symptoms. This includes protected weightbearing in a hard-soled walking boot or a short-leg walking cast. Pain usually resolves after a few weeks, and healing of the fracture fragment itself on x-ray is evident after approximately 6-8 weeks post-injury. These types of fracture generally heal well with no long-term complications. Larger, displaced fragments are commonly treated surgically, which varies from percutaneous pinning (making a small cut in the skin and inserting a screw without having to expose the entire metatarsal) to open reduction with internal fixation (exposing the metatarsal and placing pins, plates, and / or screws across the fracture site).
Another common type of 5th metatarsal fracture is known as a Jones fracture. The location of this injury is slightly more anterior to the tuberosity (1 cm from the joint, closer to the toes than the tuberosity fracture). The Jones fracture takes a longer time to heal because of the poor blood supply at this particular location in the bone. Treatment can be either conservative or surgical, depending on the patient's age, health, and activity level. Conservative treatment involves 6-8 weeks of strict non-weightbearing cast immobilization, followed by a few additional weeks of weightbearing boot or cast immobilization. Surgical treatment, which is similar to that described for tuberosity fractures, is generally recommended for athletes and more active individuals and allows shorter periods of immobilization with faster healing times.
Common to both types of fracture are soft tissue attachments found at the base of the 5th metatarsal. A muscle tendon (peroneus brevis muscle) from the lateral leg compartment courses down into the foot and attaches at the base. The lateral band of the plantar aponeurosis (which can occasionally be the culprit of infamous heel pain known as "plantar fasciitis") also attaches here. These two soft tissue structures have the potential to pull at the fracture fragment, thus causing possible displacement and, unfortunately, complicated fracture healing. This is why it is extremely important to seek treatment with myself or one of our doctors immediately at Advanced Foot and Ankle Care if you suspect that you have sustained a 5th metatarsal fractures.
“Don’t knock the weather. If it didn’t change once in awhile nine out of ten people couldn’t start a conversation.” ~Kin Hubbard
One thing I didn’t know about Ohio until I moved here is that the weather is crazy. It’s unpredictable. It’s interesting. It can go from 60 degrees and sunny to 30 degrees and snowy in one afternoon. I am still in awe of these peculiar meteorological conditions, and I find myself discussing them with my patients daily. This winter has seemed looooonnnnggg and chilly, and I have seen a record number of patients with a common foot problem that has ties to this cold weather. It is a condition known as Raynaud’s (pronounced ray-NOHZ) disease, and 1 out of every 10 Americans suffers from it.
The reason most patients with Raynaud’s come to my office is that they have noticed their toes turning colors. In this condition the toes first turn white, then blue, then red. These color changes can be associated with discomfort like tingling, burning, numbness, stinging, or throbbing. The reason for this is that in Raynaud’s the small blood vessels that supply blood to your skin clamp down in response to cold temperatures or stress. Often just one or two toes or fingers are involved, and not everyone experiences all three colors. In most patients Raynaud’s is more of an annoyance than a disability.
Raynaud’s can be broken up into two types, primary and secondary. Both types are nine times as likely to affect women. Primary Raynaud’s is the most common type and is not associated with any other type of disease. This type is usually discovered between the ages of 15 and 30 and may have a genetic link (a parent, sibling or child may have it as well). It occurs more in people who live in cold climates (think Ohio from October or November to April or May).
Secondary Raynaud’s (aka Raynaud’s phenomenon) is associated with certain diseases, occupations, and chemicals. Autoimmune diseases like Lupus, Scleroderma, Rheumatoid arthritis, and Sjogren’s syndrome are linked with Raynaud’s as are other conditions such as carpal and tarsal tunnel syndromes, and thyroid dysfunction. Jobs that involve working with vibrating tools and repetitive motions like playing the piano for long periods of time can also cause a type of the phenomenon. Smoking and caffeine are also known triggers. I wonder how many of my patients on a blustery winter day find solace in a cigarette and a nice hot cup of coffee?
Most of the time people with Raynaud’s don’t really develop any complications, but occasionally I will see patients who develop blisters or sores on the tips of their toes. Very rarely Raynaud’s can lead to gangrene and result in amputation.
If you think you may have Raynaud’s come visit our offices at Advanced Foot and Ankle Care. First of all, we will try to find the reason you have this condition whether it be smoking, your body’s response to stress, a compressed nerve, or an underlying autoimmune disease. We may rule out causes of secondary Raynaud’s with vascular testing, blood tests, and nerve blocks. You may be referred to a rheumatologist or your primary care physician if we feel that your problem is serious enough that you could benefit from medication to open your blood vessels and promote circulation.
Most of the time Raynaud’s can be treated by dressing warmly and avoiding situations in which your hands and feet come into direct contact with the cold. Wearing a hat outside in the winter is important because a lot of body head escapes through your head. I recommend that my patients wear socks to bed and put an extra blanket at the foot of the bed. I may recommend that they avoid over the counter cold medications that contain pseudoephedrine, birth control pills, and beta blockers (for the latter two, after consulting their ob-gyn and family physician). And then there’s everyone’s favorite recommendation: Moving to the Caribbean. On Doctor’s orders, of course J