Tuesday, February 26, 2013

New Neuropathy Treatments Available!




The Micro-Z™ and The Micro-Z MINI™ is a small, lightweight stimulator that allows patients to receive electrotherapeutic treatment in comfort. It is programmed for two treatment protocols, the first is a 30-minute daytime treatment and the second is an eight-hour nighttime treatment that is administered while the patient sleeps. The Micro-Z™ and The Micro-Z MINI™ can be used to treat acute and chronic injuries, to treat sources of pain, to increase circulation while improving range of motion, and to minimize soft tissue atrophy and injury. Its compact size and ease of use increases patient compliance and when used with Prizm's Electro-Mesh, Silver-Thera, and Stim-Support garment electrodes, they offer opportunity for rapid patient recovery.

It is estimated that nearly 75% of all amputations caused by neuropathy and poor circulation could be prevented with proper care. The National Institute of Diabetes and Digestive and Kidney Diseases recommends control of blood sugar, relief of pain (typically achieved through use of medications and or electrotherapy), and special care of the hands and feet as treatment for diabetic neuropathy. Recommended care for the feet includes frequent visual inspection, good hygiene, use of protective lubricants and wearing of special shoes. There are no commonly recommended courses of therapy that aim to both reduce pain and increase circulation in order to treat the pain associated with neuropathy and, at the same time, help reduce the risk of developing foot ulcers. PRIZM has established a clinical research program with leading specialists in the fields of endocrinology, diabetology, and podiatry at major medical universities. A pilot clinical study demonstrated benefits of the Silver-Thera™ Stocking coupled with the Micro-Z™ pulsed direct current neuromuscular stimulator in treating diabetic foot neuropathy, tissue perfusion and wound healing which resulted in a clinical publication (see research). The convenient, easy to use Micro-Z™ can be worn to bed for easy nighttime use, a factor suggested by studies as effective in alleviating subjective, burning diabetic neuropathic pain as well as dramatically increasing circulation which leads to increased tissue perfusion.

Ask one of our providers today about this new treatment, and it IS COVERED by insurance. We DO OFFER this treatment through an outside company who can get this to your home directly without more than a 7 day delay. We are always looking for improved ways to treat our patients, and this is another treatment modality which can be undertaken without any side effects.

Dr Timm

Tuesday, February 19, 2013

Big Toe Joint Aches and Pains - What you need to know:




Often times patients will present with what they consider to be a "Bunion" in their big toe joint, and they attribute this to their pain. Many times, this is false. A bunion is an actual deviation or dislocation of the big toe joint, whereas the painful prominence which are often gradually increasing in size after many years removed from an injury can be related or directly attributed to progressive "bump" production which has the general buzzword "Arthritis".

Arthritis is actually a misnomer, because many times the inflammation of the joint is only noted initially in the disease process and over time the cartilage wears away forming spurs and bone prominence which leads to the pain and inability to move the joint fluidly. This is actually an "arthrosis" which is the end result of the condition. Arthritis is not usually visualized directly on a radiograph but arthrosis is easily visualized.

A clinician will find effusions whenever arthritis is active. This is the "Swelling" that patients often note is painful and warrants medical attention. This is often including joint space widening in the case of inflammatory arthritis but narrowing over time with osteoarthritis, and reduction of ability to move the joint without pain and with eventual grinding.

Patients will often times not recall the traumatic event which sparks the progressive wear down of this area on their foot, but many times this is not necessary. Patients will also note that the "bunion" is growing and is usually located on top and side of the joint. This is not a bunion, as these tend to only be located on the side of the joint and not at all on top.

What do you need to know to determine what to do next??

1) If the pain is at the end of the day you should see a foot and ankle specialist.

2) If the motion of the joint is limited or not similar to your other foot, you need to see the specialist.

3) If you have been given 2 or more cortisone injections in the same joint, you need to see a specialist.


There is a common theme here. A foot and ankle specialist is paramount to help a patient achieve a good result in treating first toe joint arthrosis. Often times, this is progressive and may limit treatment options depending on the stage of the pathology. There is no actual cure for any form of arthritis, but there are means to treat and accommodate the condition in order to reduce pain and limitation with walking.  We are adept in treating all forms of arthritis, from the initial swelling stage, to the end stage limited motion in the toe joint.  There are many times several good options depending on the stage of the disease process, and we will be able to give you a definitive solution in many cases.

Dr TIMM.