More than just "foot pain"

In my profession, I have diagnosed numerous and varying disorders which are not typically something a primary care doctor would initially send a patient to a foot and ankle specialist for. I have screened numerous diabetic patients, and have found a substantially high number of patients with PAD, or peripheral arterial disease. Of these, many have needed vascular surgery intervention to prevent below knee amputations. Through this screening process, we have saved numerous patients from amputations of their legs.

To a greater extent, this disorder may lead to stroke, heart attacks, and even amputations from gangrene. I have had patients ask me why they need to go to the hospital for their rest pain, and thank me after the fact. Today I thought I would give some general guidelines to put to rest many of the confusions regarding this systemic and devastating pathologic process.

"Doctor, my foot hurts me at rest. I take ibuprofen and it doesn't help. I let my leg down and it feels a little better, but when I raise it up it hurts again. I can only walk for a block then I have to rest. My ingrown nail is turning black and I stubbed it 2 weeks ago."

These are just some of the various complaints that a patient may have before they know that they have significant PAD. Slow to heal wounds, and non healing wounds are commonplace in poor circulation sufferers. Pain at rest is usually significant, because it means the tissue is starving for oxygen, and if the blood vessels are too narrowed or closed to deliver, then pain will follow. Trivial injuries which lead to significant pain and color changes of the toes, from blue to black, will also indicate a serious vascular pathology which requires hospitalization. Each patient that we see gets a thorough vascular exam for their legs, and noninvasive dopplar studies are done every Friday at our office.

Pain with consist ant ambulation, "ie intermittant claudication" may need additional interventions from a vascular surgeon. Usually blood thinners, such as plavix or aspirin are needed, as well as a walking regimen lead by a physical therapist to get 30 minutes to 1 hour of daily walking to help open the small vessels and treat this are in order. We also offer MICROVAS therapy for small vessel disease, as this tends to simulate the activity level of walking for 30 minutes, and helps to increase the blood flow to the leg and foot. I always listen to the pulses with the dopplar if I can not feel them with my hands. This is usually the case with diabetic patients, as their vessels are more rigid and difficult to feel with hands and fingers alone.

Athletes Beware: Poor foot mechanics could cost you your edge in sports!

How is this possible?



The results conducted by the American Podiatric Medical Association concluded that a staggering 73 percent of people asked said that they are suffering from foot pain.

The question is: why has foot pain become one of the most common complaints in the examination room?

For many people, this problem can be caused by one of the following: the kinds of shoes they wear, what activities they participate in, or how their feet are formed. Wearing poorly-fitting shoes can turn minor problems into major ones. People who engage in athletic activities are another segment of the population that are mostly affected by foot pain. Factors such as fallen arches, overpronation, and poor support can all be contributing factors to lower extremity pain. Parents can also be the cause of foot-related problems, because genetics play a role how the foot was formed in the womb. This can enhance the likelihood that someone will suffer from an array of painful foot conditions.

The Mechanics of the Foot
Flat feet can cause abnormal rotation of the feet when walking or running. Our feet handle balance, stability, and bear the weight of the body. The parts of the foot that help to keep the foot in harmony with the body include the arch, heel, tarsals and meta-tarsals. The arch provides stability by the following structures: the tendons, ligaments, and muscles. Pain can result from raised arches or abnormally-low arches, which can cause the foot to rotate abnormally. With high arches, the body’s weight is abnormally emphasized on the outer edge of the foot (oversupination). Conversely, overpronation happens with fallen arches because the weight of the body is concentrated on the inside of the foot, causing the ankles to roll inward .

Serious Foot Issues May Occur with Flat Feet A quick way to see if fallen arches or high arches are an issue is to find a good area where a foot impression can be made, such as on concrete. Immerse on foot in cold water and then stamp your foot onto the dry surface. Then, lift the foot off the ground and see the impression that is left by the foot. A flat foot with overpronation will leave a complete mark where the entire foot has touched the ground. A high arch will leave just a part of the ball of the foot’s outside portion, and heel of the foot. Either of these arch conditions can cause painful bony growths in the heel because the foot has to deal with too much pressure in places it is not intended to handle.

Orthotics Provide Effective Relief for Therapy For Plantar Fasciitis
People suffering from fallen arches, heel spurs, or who need plantar fasciitis treatment can get relief by using the best orthotics available in their shoes. They offer the needed support to fix the weak structures in the foot, such as those that make up the arch. They also offer cushioning in areas where too much pressure occurs, such as in the heel or ball of the foot. Orthotics are available in an array of sizes and types and are made to keep up with anyone’s activity level.