Friday, March 29, 2013

The 3 things you must know about neuromas

1) You do not NEED surgery.

At FFLC we are always finding new and improved ways to treat this painful lesion in your foot by nonsurgical measures, which are equally as effective as removing the neuroma, and without any of the side effects or risks of surgery. The best part is these modalities can be performed several times without negative consequences, and in most cases even with previous surgery performed, the treatments can be highly effective to reduce pain and improve your day to day walks.

2) After injection therapy (Sclerosing agents) you will need orthotics.

Most patients are under the assumption that once the pain is gone, orthotics are no longer necessary. This is untrue. IN fact, the need for orthotics increases, because your foot will resume previous function after the neuroma pain is gone, and this could predispose you to later recurring pain. In the proper hands, a custom molded device, or an accomodative device off the shelf can improve function in shoegear which will help the metatarsal bones stay apart so that a future nerve impingement can be much less likely to recur.

3) Radiofrequency ablation works. (NeuroTherm)

Many of our patients are presenting to our office with previous treatments attempted, such as numerous cortisone injections, previously fashioned orthosis, and even surgery. This is of no concern to us, as we have been using NeuroTherm for these very difficult cases with excellent results. We use the latest and least invasive technologies to better serve our patients, and I believe we are in the forefront of technology in this area for most foot and ankle pathology in Southwest Florida.


Dr Timm

Tuesday, March 12, 2013

Ankle issues for those who cannot have surgery




Not everyone is healthy enough for ankle reconstructive surgery. In fact, in Naples the average age of our patients is 65, and that can infer more often than not that some form of co morbidity exists in the summation of medical concerns which may complicate  the option to electively undergo any type of surgery. Some patients are fresh off of a myocardial infarction, others are too weak with congestive heart failure and kidney disease. The rest are very poor surgery candidates secondary to leg circulation which cannot be improved by vascular intervention. Yet this category of patient is still able to be treated for ankle and foot pains, because we can make a mold of your ankle and foot, and create a custom molded ankle/foot orthosis. This is the most common nonsurgical treatment to manage chronic pain from abnormal motion and deformity in patients who are just not candidates for any reconstructive surgery, and this allows their relatively limited mobility to be achieved with less pain and allows some patients to avoid needing a wheelchair as a primary modality of transportation. Often times, this brace will take 3-6 weeks to be available, so we offer many off the shelf intermediate bracing options for this cornerstone of patient population, as well as PRP injections and physical therapy options as well. We are not only foot and ankle surgeons at FFLC, we are also very naturalistic and have had good success with nonsurgical management of most of our patient's chief complaints regarding pain in the ankle and foot.

Different ankle concerns will require different bracing options, but we are well equipped to use whichever means are necessary to keep you walking.