I see Phil at out of state marathons. He continues to tough out his heel pain. Others I’ve met gave up running or had surgery, and multiple cortisone shots. A new non-invasive “EPAT” ultrasound procedure is now available in the office.
Heel pain is one of the more common injuries we see. Many an everyday runner or weekend warrior at middle age can develop this nagging recurring pain. They don’t get the attention the elite or professional athletes receive. The pain typically comes when getting out of bed or a chair. The direct cause is usually a tight ligament in the arch, a tight Achilles cord or both causing a micro-tearing and inflammation. So we work at stretching the related calve and foot muscles and calming down the inflammation. The inflammation has to be reversed. Rest, ice, and stretching are used if the pain is recent, recent in terms of days or weeks.
More often, I see a patient like Phil, who has had the pain for several months. He blames it on a bruise, but runs anyhow and expects it to go away in couple of months. At this point, the scarring from the micro-tears thickens the ligament (plantar fasciitis) or tendon (Achilles tendinitis). The “tendinitis” digresses to a chronic “tendinosis”.
The thickness of the fascia or tendon is appreciated with an ultrasound exam. Any spur or bone disease is also ruled out with an X-ray. Stretching and a night splint are used, depending on the degree of tightness. Ice therapy is recommended, along with gait analysis and training: “walking through the ball of the big toe”. Shoes, orthotics taping and the use of kinetic tapes are reviewed. If these methods only bring limited relief, a EPAT therapy is recommended. This involves the application of a low frequency shock wave ultrasound treatment. No local anesthetic is required as it was in the recent past. Moreover, the advanced technology makes it possible to do in the office. The procedure takes four minutes and requires about four treatments. Less than 10 per cent of our patients require surgery. So no one has to give up running or like Phil, put up with the pain.
Dr. Landry is a foot doctor practicing podiatry in Overland Park, KS – which is near Shawnee Mission, Lenexa, and Olathe KS. Dr. Landry believes an ounce of prevention is better than a pound of cure. If you are suffering from foot heel pain, don’t wait until the symptoms get worse… call Dr. Landry today for a full foot & heel examination. Dr. Landry is also a board certified foot surgeon and marathon runner.
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.
Our feet are of great importance in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor’s visits. On the other hand, if the feet are cared for and looked after each day, they will perform without pain or complication.
Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly everyday. Remember to get between the toes, and keep the toenails trimmed and short. If the feet feel dry or one can see visual signs of dryness or cracking, use a moisturizer designed for the feet.
When using moisturizer on the feet, try to avoid applying between the toes. If creams or lotions sit in that area, they can cause development of fungi and bacteria. When moisturizer is used between the toes, it can also cause the skin to macerate.
Shoes are also an important aspect of foot care to consider. When one is picking out shoes, make sure that they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if the shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet, and that pad the soles of your feet and support the arches and ankles.
Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture and keep it off the feet. Without socks, the build up of sweat in a closed-toe she can cause fungi problems and athlete’s foot.
The best thing to remember in every day foot care is that shoes do make a difference. If you spend much time on your feet, make sure that your shoes show no signs of wear and offer ample support for the arches and the overall foot. Additionally, try to engage in thorough foot cleaning and maintenance a part of your daily routine. If you keep these things in mind, your feet will stay healthy and safe.
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 inaffective, 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 out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.
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” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive 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.
A recent study published in the journal Annals of the Rheumatic Diseases recently found that a Chinese herb known as thunder god vine may be an effective treatment for Rheumatoid Arthritis. The study used 207 patients and observed their responses to the herb, the pharmaceutical drug methotrexate, and a combination of both.
After six months, the groups were assessed to see which achieved close to a fifty percent improvement in their pain and joint stiffness. Forty-six percent of the patients prescribed methotrexate noticed an improvement. This was lower than the fifty-five percent of participants given just the herb, and seventy-seven percent of those treated with both medications.
Characterized by stiffness and lack of mobility, Rheumatoid Arthritis is a painful condition that needs medical attention. For treatment options, see podiatrist Dr. Mark Landry of Kansas. Dr. Landry can take care of any foot conditions and determine a treatment plan that is right for you.
What Is Rheumatoid Arthritis?
Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.
Rheumatoid Arthritis of the Feet
Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.
– Swelling & pain in the feet
– Stiffness in the feet
– Pain on the ball or sole of feet
– Joint shift and deformation
Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.
For more information about rheumatoid arthritis please follow the link below.
If you have any questions, please contact our office located in Overland Park, KS. We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.