Latest Articles by Austin Manual Therapy http://www.articletrader.com/ Articles at ArticleTrader en-us Physical Therapists Can Help Relieve Pain http://www.articletrader.com/health/physical-therapists-can-help-relieve-pain.html http://www.articletrader.com/health/physical-therapists-can-help-relieve-pain.html Tue, 19 May 2009 10:24:05 -0500
"Many people are looking for alternatives to the sole use of medication to deal with painful conditions," said APTA President Ben F Massey, Jr, PT, MA. "Pain medication may help you get through periods of severe pain, but it won't always help you eliminate the underlying cause of some kinds of pain. For many individuals, it is the underlying causes like poor posture and alignment, weak and/or inflexible muscles, or tight joint structures that actually exacerbate the painful condition," Massey explained. "A physical therapist will perform a complete musculoskeletal examination and design an individualized treatment program to reduce pain and improve function."

There are many types of pain and inflammation that can be reduced by physical therapist intervention. For example, chronic pain in the back, shoulder, or knee or pain associated with certain degenerative diseases such as osteoarthritis, can be reduced with the appropriate combination of medication and exercise. "The physical therapist, in collaboration with the patient and the patient's physician, can help the patient manage his or her health over the long term," explained Massey.
For pain of a "mechanical" origin such as back, shoulder, or knee pain, physical therapist intervention may include therapeutic exercise, manual therapy, and functional training.

"The goal of the physical therapist is to reduce pain, improve your ability to perform daily activities, and help the individual return to doing the things he or she likes to do," said Massey. "It is also true that patients may unknowingly contribute to their own pain, such as by exercising improperly or with poor posture that physical therapists can identify and help to correct." Massey added, "Through the use of home programs designed to fit the individual's needs, the physical therapist can efficiently progress the individual's rehabilitation and teach the patient how to prevent a recurrence of the original condition."

For osteoarthritis, a degenerative disease of the cartilage and bone, physical therapist intervention may include, exercises for strength, flexibility, range of motion, and the use of devices designed to rest or support the joint such as orthotics or splints.


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If you have any questions or would like to schedule an appointment, please call us at (512) 832-9411 or visit us on the web at Austin Physical Therapy

Source: http://www.articletrader.com ]]> Plantar Warts http://www.articletrader.com/health/plantar-warts.html http://www.articletrader.com/health/plantar-warts.html Fri, 31 Oct 2008 00:00:00 -0500
A plantar wart is a small skin lesion that resembles a callus and is found on the bottom of the foot or toes. The term "plantar" doesn't mean only farmers get them. "Plantar" means they occur on the bottom surface of the foot. It is usually under 1 cm diameter, but can occur in clusters and be much larger. Sometimes a single larger wart is surrounded by many smaller warts. In this case, they are called mosaic warts.



HOW DOES IT FEEL?

A plantar wart feels like a lump under the foot. They are only painful is they are squeezed or pinched from side to side, or if you bear direct weight on them. Warts on other parts of the body, such as the hands, grow elevated above the skin's surface. We bear weight on warts on the bottom of the foot, so they get flattened and pushed into the skin. Most people liken this to walking with a rock attached to the foot, as the thickened callous tissue becomes hard and painful as it gets bigger.



LET'S DO A TEST!

A plantar wart can usually be diagnosed by your doctor based on a characteristic appearance alone. When the doctor trims the hard callus tissue from the surface of the wart, a pattern of small black dots that are actually small blood vessels that feed the wart, is usually seen. The doctor will also test the wart by pressing directly down on it, and then pinching it, squeezing it from side to side. Most warts won't hurt when pressed directly down, but are very painful when pinched. If these findings are present, no further testing is necessary to identify a plantar wart.



HOW DID THIS HAPPEN?

All warts are caused by the Papilloma virus, a slow growing virus which invades the skin. The viruses are common in all of our environments and they don't readily grow on intact skin. But if there is a break in the skin, like a scratch or thorn penetration, this gives the virus the opportunity to get in and start growing. The virus only grows in the epidermis, the thick layer of the skin closest to the surface. It doesn't invade the dermis, the deeper layer of the skin. However, the epidermis and the dermis are closely entwined, and the dermis under the wart grows extra blood vessels and nerves in response to the virus infected cells above it in the epidermis. It is because of these nerves that the wart hurts when pinched and because of these blood vessels that it stays well nourished enough to grow. The virus particles can spread from the main wart, along the cutaneous (skin) nerves, to begin growing remote or satellite warts at a distance from the original site. If enough of this spread occurs, mosaic warts result.



WHAT CAN I DO FOR IT?

Over the counter products that contain the ingredient salicylic acid may be tried if you have good blood flow, good feeling in your feet, and the wart is small. However, their use is slow and frustrating. They are acids which slowing destroy the wart from the surface down. Diabetics or other people with numbness or bad circulation should not use these products, as it can be dangerous for them. You may also try treating the wart by keeping it covered with tape at all times. This seems to prevent the wart from growing as rapidly and may be of some benefit when combined with other treatment. The thick callus tissue can be carefully removed with a pumice stone or file. This must be done in between applications of the salicylic acid medicine.



WHAT WILL MY DOCTOR DO FOR IT?

Your doctor has a number of choices for treating your Plantar Wart. Unfortunately, warts are stubborn entities and even the best methods for removing them allow a high rate of reoccurrence, around 15, reduces post-operative pain and eliminates any bleeding.



CAN I PREVENT FROM IT HAPPENING AGAIN?

Keep your feet clean and dry. Inspect feet frequently for new warts and begin treating small ones immediately, before they increase in size or number.



Information Prepared and Provided By Dr. Craig H. Thomajan DPM



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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Ulcer and Wound Care http://www.articletrader.com/health/ulcer-and-wound-care.html http://www.articletrader.com/health/ulcer-and-wound-care.html Fri, 31 Oct 2008 00:00:00 -0500
When using the term ulcer, we are generally referring to breaks in the normal integrity of the skin. Ulcers are skin wounds that are slow to heal and are classified in four stages, according to which layers of skin are broken through.



Stage 1 ulcers are characterized by a reddening over bony areas. The redness on the skin does not go away when pressure is relieved.



Stage 2 ulcers are characterized by blisters, peeling or cracked skin. There is a partial thickness skin loss involving the top two layers of the skin.



Stage 3 ulcers are characterized by broken skin and sometimes bloody drainage. There is a full thickness skin loss involving subcutaneous tissue (the tissue between the skin and the muscle.)



Stage 4 ulcers are characterized by breaks in the skin involving skin, muscle, tendon and bone and are often associated with a bone infection called osteomyelitis.



HOW DOES IT FEEL?

How an ulcer feels is dependent on the underlying cause of the ulcer. For example, one of the more common types of ulcers is seen in patients with diabetes, who have loss of sensation in their feet. In this type of ulcer, there is little if any pain, due to a condition called diabetic neuropathy. In fact, diabetics typically get this type of ulcer because they've lost their protective pain sensation. Another common ulcer is due to loss of arterial blood flow to the leg, resulting in ischemic ulcers that can be very painful.



So you can see that it very important to have any break in the skin properly evaluated and the lack of pain is not always a good initiator as to the severity of the problem.



LET'S DO A TEST!

There are many different diagnostic tests that can be done in the course of treating an ulcer. If the ulcer appears to be infected, i.e., there is redness, and drainage, then a culture of the wound should be done. The reason for the culture is to identify the type of infection, so that you can be put on the appropriate antibiotic. If there is suspicion of the bone being infected under the ulcer, the doctor will do x-rays and/or a bone scan. If there is suspicion that the underlying reason for the ulcer is poor circulation, then a non-invasive vascular study can be done. This test is to see if you have enough oxygen getting down to the area to heal the ulcer.



HOW DID THIS HAPPEN?

Ulcers occur due to different reasons, so it is very important to determine the underlying medical problem that caused the ulcer. There are essentially four main reasons people get ulcers on the foot.



Neuropathic: This is when a patient has loss of sensation in the feet. It is commonly seen in people with diabetes but it can be caused by other reasons such as chronic alcohol abuse. These ulcers are generally seen under weight bearing areas and often will begin as a callus or a corn.



Arterial: This type of ulcer is due to poor blood flow to the lower extremity. This type of ulcer can be very painful and are usually found on the tips of toes, lower legs, ankle, heel and top of the foot. They can very easily become infected.



Venous: This type of ulcer is due to compromised veins. Veins are the vessels that take fluid out of the legs and back up to the heart. Veins have small valves that allow blood to flow only one way, back up to the heart. The valves normally block the tendency for gravity to pull the blood back down to the legs. Sometimes the valves leak or cease to work at all. If the valves do not work, then the fluid pools down in the legs, causing swelling. This swelling leads to increase pressure in the venous system, producing discoloration of the leg and eventually this lead to ulceration. They are commonly seen around the inside of the ankle and are slow to heal.



Decubitus: This type of ulcer is caused by excessive prolonged pressure on one area of the foot. The most common place to see this type of ulcer is in a person confined to bed and they occur on the backs of the heels.



WHAT CAN I DO FOR IT?

The best thing you can do for an ulcer is to have it looked at by your doctor, as soon as you can. The earlier that the ulcer is treated, the better chance you have at healing it.



WHAT WILL MY DOCTOR DO FOR IT?

The first thing that will be done is to inspect the wound. The doctor is looking for signs of infection, location of the wound, the color of the tissue in the wound. This is all done to determine the best treatment for that wound. Often the doctor will refer you to another specialist, such as a vascular doctor, to check your circulation. If you are a diabetic, he will want to consult with your diabetes doctor, to make sure that your blood sugar is under control. Once the cause of the ulcer is determined and all the necessary referrals are made, treatment of the ulcer can begin. The treatment will be tailored to the individual ulcer and it is often difficult to predict how long it will take an ulcer to heal. Ulcer care is best treated by a team approach, involving a few different types of doctors.



CAN I PREVENT FROM IT HAPPENING AGAIN?

Yes. The best prevention is treating the underlying cause of the ulcer. That means if you are a diabetic, check your blood sugar daily and inspect your feet every day. If the reason for your ulcer is due to swelling in the legs, then you need to wear support stockings and keep your feet elevated as much as possible.



Ulcers can be a very debilitating problem, causing pain and disability. The best treatment is preventing the ulcer from ever occurring. If it does occur, have it checked immediately by your doctor.



Give your Legs a Rest

ELEVATE your feet above your heart while sleeping and at regular times during the day (elevate foot of bed or mattress).



AVOID work that requires you to stand or sit with your feet on the ground for long periods. Change positions frequently.



TAKE walks to help leg muscles "pump" fluid out of your legs.



Give your legs Support

WEAR professionally made support stockings that apply pressure from ankle to knee or other compression devices (Dr. Thomajan can help you choose the kind that is right for you and send you to a professional who will properly measure your legs for correct stocking size).



HAVE at lease two pairs of support stockings available so you can change them daily. After laundering, hang them up to dry. Do not put them in the dryer.



ALWAYS put on support stockings early in the morning before fluid pools in lower legs WEAR support stockings all day and then remove in the evening when going to sleep. BUY new stocking every 6 months so their strength doesn't wear out. AVOID ACE bandages. It is extremely difficult to wrap them properly to provide the pressure you need.



IF your doctor has prescribed the use of a compression pump, follow the instructions completely. It may take a little time to adjust to the pumping procedure.


Take Care of Your Skin

MAKE sure to wash your lower legs and feet regularly with mild soap and water. This will help to avoid a build-up of lotion. Do not soak your feet.



USE moisturizing creams and emollients after washing. It is important not to use petroleum or lanolin based creams when wearing stockings which contain latex. Your doctor or pharmacist may suggest appropriate brands.



BE particularly careful to avoid activities that are likely to cause injury to legs or feet. Prevention is very important.


Watch for Skin Changes

Pay particular attention to signs of progressive venous insufficiency.

SWELLING that does not go away quickly when you lie down

DISCOLORATION, especially brownish skin discoloration around ankles and lower legs.


DRYNESS and/or itching in the same areas.
ANY WOUND or bruise that doesn't go away within a week.


GUIDELINES If Your Wound Doesn't Heal in One (1) Week


DON'T put off seeing your doctor. Any wound that doesn't heal in a week should be seen by your physician.



REMEMBER You are a vital part of your treatment program and it is essential that you faithfully follow all medical directions.



ALWAYS consult your physician before making any change to your healthcare routine, if you have questions or if your symptoms are becoming worse.



GUIDELINES IF YOU HAVE A WOUND:


KEEP IT CLEAN

Keep minor wounds clean and protect with a bandage



AVOID strong antiseptics. Many antiseptics such as hydrogen peroxide, povidone-iodine (Betadine) and sodium hypochlorite (Dakin's solution) can damage skin and interfere with healing.



DON'T stop wearing support stockings during your daily activities. If it is difficult to wear them over the bandage, put on a knee length nylon stocking first and wear the support stocking over it.



WATCH the wound carefully. You will need to describe any changes to your doctor. Remember that any wound may turn into a chronic wound and early treatment has been shown to be beneficial.



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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Custom Orthotics and Inserts http://www.articletrader.com/health/custom-orthotics-and-inserts.html http://www.articletrader.com/health/custom-orthotics-and-inserts.html Thu, 30 Oct 2008 00:00:00 -0500
Orthotics are shoe inserts that are intended to correct an abnormal, or irregular, walking pattern. Orthotics are not truly or solely "arch supports," although some people use those words to describe them, and they perhaps can best be understood with those words in mind. They perform functions that make standing, walking, and running more comfortable and efficient, by altering slightly the angles at which the foot strikes a walking or running surface.



Doctors of podiatric medicine prescribe orthotics as a conservative approach to many foot problems or as a method of control after certain types of foot surgery; their use is a highly successful, practical treatment form.



Orthotics take various forms and are constructed or various materials. All are concerned with improving foot function and minimizing stress forces that could ultimately cause foot deformity and pain.



Foot orthotics fall into three broad categories: those that primarily attempt to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.



ORTHOTICS FOR CHILDREN

Orthotic devices are effective in the treatment of children with foot deformities. Most podiatric physicians recommend that children with such deformities be placed in orthotics soon after they start walking, to stabilize the foot. The devices can be placed directly into a standard shoe, or an athletic shoe.



Usually, the orthotics need to be replaced when the child's foot has grown two sizes. Different types of orthotics may be needed as the child's foot develops, and changes shape.



The length of times a child needs orthotics varies considerably, depending on the seriousness of the deformity and how soon correction is addressed.



OTHER TYPES

Various other orthotics may be used for multidirectional sports or edge-control sports by casting the foot within the ski boot, ice skate boot, or inline skate boot.



BREAK IN AND ENJOY

Like anything in life, it can take a short while to adjust to your new orthotics, You may feel them because they're working with each step to properly position your foot in your shoes. The result comfort and health will have your feet feeling wonderful.


What to expect at first:


When experiencing your custom orthotics for the first time, they should feel firm, but comfortable. The best results come easing into them. We suggest wearing them for two hours the first day, four hours the second day, and six hours the third day, and then full time.



Everyone's feet are different. Give your feet and muscles 10-14 days to adjust to their new support. If you still feel discomfort after this, please call Austin Foot and Ankle Specialists for an appointment.



Mild foot, leg or back discomfort may initially occur when first wearing orthotics. This should decrease with every subsequent day. If pain occurs that was not previously present, wear your devices every other day, and increase wearing time by only ½ hour, until you no longer have pain. (Dr. Thomajan may deviate from these instructions according to your unique condition.)



A low heel shoe such as a gym or tennis shoe should be worn for the first two weeks. After this, the orthotics may be worn in other shoes, providing the heel height does not exceed 1-1/2 inches, or your doctor has specifically prescribed devices for high heels.



Squeaking of the orthotics within the shoes may be eliminated simply by applying powder in the shoes, and applying wax or soap to the front edge of the orthotic. This will help to reduce friction.



Socks should be worn during the adjustment period to minimize any irritation.


Some slipping of the orthotic may occur within the shoe, particularly in women's shoes, but this will usually diminish in about six weeks. If the orthotic does not "seat" properly in the shoe, we recommend you try different shoes or shoe styles.



You may clean the surface of your orthotics with cool water and a mild soap, but do not immerse them in water. Also, never use hot water for cleaning your orthotics, as this may affect the material. Genuine leather orthotic devices may be cleaned with mink oil, saddle soap, or other leather cleaners.


Most importantly, follow your doctor's instructions completely.



Orthotic Wearing Instructions



1.You must gradually adapt to your devices, especially if you have never worn orthotics before. As a rule, wear them one hour the first day, two hours the second day, and increase the wearing time by one hour each day. Normal "break-in" time is from two weeks to two months. Generally, children adapt more rapidly than adults.



Please note: Mild foot, leg or back discomfort may initially occur when first wearing orthotics. This should decrease with every subsequent day. If pain occurs that was not previously present, wear your devices every other day, and increase wearing time by only ½ hour, until you no longer have pain. (Your doctor may deviate from these instructions according to your unique condition.)



2.A low heel shoe such as gym or tennis shoes should be worn for the first two weeks. After this, the orthotics may be worn in other shoes, providing the heel height does not exceed 1-1/2 inches, or your doctor has specifically prescribed devices for high heels.



3."Squeaking" of the orthotics within the shoes may be eliminated simply by applying powder in the shoes, and applying wax or soap to the front edge of the orthotic. This will help to reduce friction.



4.Socks or stockings should be worn during the adjustment period to minimize any irritation



5.Some slipping of the orthotic may occur within the shoe, particularly in women's shoes, but this will usually diminish in about six weeks. If the orthotic does not "seat" properly in the shoe, we recommend you try different shoes or shoe styles.



6.You may clean the surface of your orthotics with cool water and a mild soap, but do no immerse them in water. Also, never use hot water for cleaning your orthotics, as this may affect the material. Genuine leather orthotic devices may be cleaned with mink oil, saddle soap, or other leather cleaners.



Most importantly, follow your doctor's instructions completely.



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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Ingrown Toenail (Onychocryptosis) http://www.articletrader.com/health/ingrown-toenail-onychocryptosis.html http://www.articletrader.com/health/ingrown-toenail-onychocryptosis.html Thu, 30 Oct 2008 00:00:00 -0500
An ingrown nail occurs when a portion of a toenail on either side of the toe turns downward and presses into the skin. Nails normally are nearly flat, with just a slight arcing downward at the borders. When the border of the nail is turned downward, it begins to injure the skin.



HOW DOES IT FEEL?

Patient's usually feel pressure and eventually pain, as the hard and sharp nail edge creates further injury. Shoes that apply pressure to the toe increase the pain. If an infection develops, the pain becomes intolerable.



LET'S DO A TEST!

An Ingrown Nail is identified by the doctor's physical exam. If an infection has developed, the doctor may send a sample of the drainage to a lab, to identify what bacteria has caused the infection and which antibiotics will most easily cure the infection.



HOW DID THIS HAPPEN?

A progression of events occurs. Routinely cutting the nails improperly, down at an angle instead of straight across, is the most common cause of Ingrown Nails. Wearing narrow or pointed shoes can apply enough pressure to a normal nail to turn the nail edge downward. Once the nail matrix, the tissue where the nail grows from, gets injured in this way, it continues to produce a nail edge that is more vertical than horizontal. From this abnormal nail growth, the nail edge applies mild pressure on the skin over a long period of time. The skin at the nail edge thickens and becomes hardened. You may begin to notice an enlargement or swelling of the skin around the nail edge. This can be accompanied by an increase in pain. The condition can progress as a result of other factors. These factors include: pressure from a tight or pointed shoe, injury such as stubbing a toe, excessive wetness, either from perspiration or application of ointments or creams, or improper cutting of nails If these factors come into play, the possibility increases that the nail edge can then penetrate the skin, just like a knife, and cause an infection. The skin at the nail edge becomes reddened and swollen. You may notice drainage or pus from the area and the pain becomes intolerable.



WHAT CAN I DO FOR IT?

In mild cases, where no infection is present, pain relief can be obtained by applying a standard moisturizing cream to the nail edge and covering with a bandaid. This softens the hard skin and often provides temporary pain relief. In more advanced cases, where redness or obvious infection is present, seek the attention of a doctor.



WHAT WILL MY DOCTOR DO FOR IT?

In the most minor cases, the podiatrist will simply cut the nail to shorten it, and show you how to cut the nail in the future, to prevent ingrowing of the nail again (See below for instructions on proper nail cutting). In more severe cases, but not those in which an infection hasn't developed, the podiatrist may gently remove the ingrown portion of the nail.



This affords considerable relief, but is temporary. After a few weeks, when the nail grows long again, it will again grow in. In cases where the nail has grown in repeatedly, or more critically, when the nail edge has penetrated the skin and caused an infection, the podiatrist will perform a minor procedure called an Ingrown Nail Correction or Matricectomy. The podiatrist will gently numb your toe, reshape the nail edge and finally, apply a medicine which will, in most cases, permanently prevent the nail edge from growing improperly again.



CAN I PREVENT FROM IT HAPPENING AGAIN?

Cutting toe nails properly goes a long way toward the prevention of ingrown nails. Use a safety nail clipper, available at every drug store on the planet. Cut the nails STRAIGHT ACROSS, so that the nail corner is visible. If you cut the nail too short so that the nail corner is not visible, you are inviting the nail corner to grow into the skin.



It is the natural tendency, when the edge of the nail starts to grow in, to cut down at an angle at the nail edge, to relieve the pain. This DOES relieve he pain TEMPORARILY, but it also starts the downward spiral, training the nail to become more and more ingrown. What happens is that cutting down at an angle creates a space at the nail edge. When the advancing nail edge reaches the space, it rolls downward, taking the course of least resistance. The edge becomes more and more ingrown, until it pierces the skin and makes an infection. So, cut the nails STRAIGHT ACROSS and prevent having an ingrown nail again.



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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Infections and Lower Extremity Dermatology http://www.articletrader.com/health/infections-and-lower-extremity-dermatology.html http://www.articletrader.com/health/infections-and-lower-extremity-dermatology.html Thu, 30 Oct 2008 00:00:00 -0500

Diabetes makes it harder for the body to heal. Even minor problems, like a blister, can become infected. If not treated, infections can spread and damage nearby tissues. A hospital stay is then needed to treat it. Serious infections can result in amputations. Prompt treatment by your doctor can help clear up infections and restore your health.



Get Treatment

If your doctor finds a minor infection, you'll be started on a treatment program. The goal is to heal the infected area while keeping the infection from spreading.



Your healthcare provider will examine and clean the infected area.


You may be given antibiotics to fight the infection. Take your antibiotic according to the instructions on the bottle. Take all the medications you are prescribed, even if the sore begins to look better. If you don't, the infection will not go away and may spread.



In certain cases, you may be told to keep your feet elevated or to limit walking.



Follow any instructions you are given regarding changing bandages or soaking your foot.



Follow-up Visits

Even with antibiotics and other treatments, a foot infection may take a long time to heal. For best results, be sure to keep all your follow-up appointments. These help ensure complete treatment. They also allow your healthcare provider to make sure you're healing properly.



When to Call Your Doctor

With diabetes, problems with the feet can easily lead to an infection. Get your doctor's advice if you have any of the following at any time:



A foot infection, sore, or bruise that does not heal in 1-2 days

Corns, calluses, or bunions on your feet

An ingrown toenail

Itching or cracking between your toes

Constantly cold feet

Pain or cramps in your legs or feet

Skin color changes



Diabetes: Treating Severe Foot Infections

Diabetes makes it harder for the body to heal. Even minor foot problems can develop into serious infections. If not treated, infections can lead to amputation. They can even become life-threatening. Prompt treatment by your doctor is needed to protect your foot and restore your health.



Get Treatment

In some cases, infections can spread through the feet and up the leg. To treat a severe infection, you may be hospitalized and give intravenous (IV) antibiotics. You may also be referred to healthcare providers who specialize in treating infections. If the infection is a serious risk to your health, surgery may be recommended.



The Goals of Surgery

The goal of surgery is to remove the infection and protect your foot or leg. Some surgeries remove a small amount of dead tissue from the infected area. In some cases, toes or larger amounts of tissue may be removed. Surgery may be done in a hospital or wound care facility. The length of your stay depends on the surgery and how well you're healing. During recovery, you will likely need to limit activity for a while. You may also have visits from a home healthcare nurse. Be sure to see your doctor for follow-up appointments.


Wound Care



Regular wound care after surgery helps keep your foot free of infection and aids healing.



Change your dressing every 6 hours



You may need IV (intravenous) antibiotics to help control the infection. Other medications may be used to help your foot heal more quickly.



A home care nurse may shorten your hospital stay by helping with your dressings or IV antibiotics at home.



If needed, your doctor may refer you to a wound care facility. These are medical facilities that specialize in treating ulcers and infections that are hard to heal. While you're there, you may work with several kinds of doctors. You may also be given antibiotics or other medications that help fight infection. Part or you treatment also included learning to care for the wound at home.



You may be told to keep your foot elevated as much as possible. You may also be told to avoid putting weight on the foot.


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About Author
Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle


Source: http://www.articletrader.com ]]> Neuropathy and Vascular Conditions http://www.articletrader.com/health/neuropathy-and-vascular-conditions.html http://www.articletrader.com/health/neuropathy-and-vascular-conditions.html Thu, 30 Oct 2008 00:00:00 -0500
Peripheral neuropathy is a disease of the nerves in your feet. It may make you unable to sense pain. Lack of pain makes you more likely to injure yourself without knowing it. But you can learn ways to protect your feet from injury.



When Nerves Are Diseased

Nerves in your feet carry signals to your brain. Your brain reads those signals and interprets them as sensations. When nerves in your feet are diseased, signals may never reach the brain. Or, signals may be confused. The result may be a lack of feeling in your feet or other symptoms of peripheral neuropathy.



Symptoms Mask Pain

Symptoms of peripheral neuropathy begin in your toes. The symptoms slowly spread up your feet and legs as more nerve is affected. These symptoms may decrease sensation in your feet or mask pain. Without pain, you may not notice a cut or even a bone fracture. Cuts may become infected. Fractures may heal poorly and lead to foot deformity.



Treating Peripheral Neuropathy

Learn ways to protect your feet. Check your feet daily for wounds you may not have felt. Avoid burns by testing bath water with your elbow before stepping in. Also, to prevent injury, always wear shoes.



Regular Foot Care

If you have foot numbness, you may not notice cutting yourself while trimming your nails. To prevent problems, your doctor may ask you to visit for nail and callus trimming. See your doctor for foot care as often as suggested.



Check Your Feet Daily

Catch problems early by checking your feet every day for changes. Look at the top and bottom of your feet, your heels, and between your toes. It may help to use a mirror. If this is hard, ask someone to check for you. Call your doctor if you notice a wound, ulceration, ingrown nail, or any changes in your feet. This includes increased heat, swelling, and redness.



Wear Proper Footwear

Always wear shoes and socks, even indoors. Ask your doctor how to choose the right shoe. After buying shoes, bring them to your doctor to be checked for fit. Take new shoes off every hour or so to check for red pressure areas on your feet. Each time you put on your shoes, use you fingers to feel inside for foreign objects.




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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Rear Foot and Ankle Surgery http://www.articletrader.com/health/rear-foot-and-ankle-surgery.html http://www.articletrader.com/health/rear-foot-and-ankle-surgery.html Tue, 28 Oct 2008 00:00:00 -0500 Tarsal Tunnel Syndrome


Compression neuropathy of the Posterior Tibial Nerve, similar to Carpal Tunnel Syndrome of the wrist




WHAT'S THE PROBLEM?


Compression neuropathy of the Posterior Tibial Nerve, similar to Carpal Tunnel Syndrome of the wrist? This nerve is called the Posterior Tibial Nerve and passes through a fibrous tunnel located behind the bone on the inside of your ankle, known as the Tarsal Tunnel. This syndrome is similar to the Carpal Tunnel Syndrome, a painful condition which affects the wrists of so many computer typists.




HOW DOES IT FEEL?


This nerve is very sensitive to pressure once it becomes compressed or squeezed and can cause a variety of sensations or feelings. Often times, the feeling of "pins and needles", burning or numbness may be felt. Pain may be felt when the area behind the inside ankle bone is pressed. The feeling of pain and numbness may also be felt when running or standing for long periods of time or even wearing tight shoes. These painful feelings or sensations are often worse at night.




In addition to pain directly over the nerve patients often experience pain, tingling, burning or other unusual sensations through the arch, around to the bottom of the foot or radiating to the toes.




LET'S DO A TEST!


Tarsal Tunnel Syndrome may be diagnosed by a careful history and physical examination by your doctor. They may touch the course of the nerve with a vibrating tuning fork, or tap the nerve gently with a rubber percussion hammer. If a tingling or shooting pain is felt moving towards the toes, this is called a positive Tinel's Sign and is a positive indication that a nerve compression is present. Your doctor may utilize more sophisticated tests to help determine if you have this syndrome. Such tests may include a Nerve Conduction Velocity Test (NCV), that measures the speed of conduction of nerve signals as they pass through the tunnel. In the case of Tarsal Tunnel Syndrome, the nerve impulses pass through the tunnel more slowly than normal. Magnetic Resonance Imaging( MRI) may also be done, to provide an accurate image of the nerve in the tunnel.




HOW DID THIS HAPPEN?


The Posterior Tibial Nerve, along with the artery and vein, course behind the inside ankle bone, in a tunnel formed by bone (your heel bone) and a fibrous band (the Flexor Retinaculum). This tunnel is called the Tarsal Tunnel. Since the Posterior Tibial Nerve is very sensitive, especially to pressure, it can become compressed within this tunnel. Tarsal Tunnel Syndrome may occur after an injury to your foot or ankle. Such injuries include ankle sprains or fractures of certain foot bones. The compression of the Posterior Tibial Nerve may also occur with certain illnesses such as diabetes or rheumatoid arthritis. Varicose veins in the Tarsal Tunnel may also compress the nerve. An excess of a certain otherwise normal motion of your foot, called pronation, where your feet roll towards each other, stretch and flatten, may also compress or stretch this nerve.




WHAT CAN I DO FOR IT?


Rest and over the counter anti-inflammatory medication, like ibuprofen, may help calm the inflamed nerve. Over the counter shoe inserts may also help control any excessive motion of your foot that is contributing to the injury. Avoiding certain types of shoes that may be too tight or too flimsy may also help.




WHAT WILL MY DOCTOR DO FOR IT?


Your doctor will carefully examine the cause of compression of the nerve and direct the treatment accordingly, to reducing or eliminating it. Your doctor may give you prescription strength anti-inflammatory medication or a cortisone injection may also be given to provide relief. If the cause is abnormal motion of the foot, custom molded orthotics may be provided. If all conservative treatments fail, then surgery may be recommended to release the Posterior Tibial Nerve.





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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Flat Foot Correction and Reconstructive Surgery http://www.articletrader.com/health/flat-foot-correction-and-reconstructive-surgery.html http://www.articletrader.com/health/flat-foot-correction-and-reconstructive-surgery.html Mon, 27 Oct 2008 00:00:00 -0500


What Causes Charcot Joints?



Feet with or without feeling, experience injury or trauma everyday as a normal part of walking. The difference between the insensate foot and one with feeling is that injury will cause the person with feeling to stop walking, to rest or protect the injured foot. The person with insensate feet will continue to walk, causing further injury with possible bone and joint destruction.



Muscle strength in the feet and legs or a person without sensation is usually decreased as part of the disease process. This loss leads to a muscle imbalance affecting how a person walks and the way the foot functions. The foot will strike the ground harder during walking, resulting in greater impact to the bones and joints, causing greater and more frequent injury. Twists or sprains of the foot and ankle are more common, and even though there is significant injury, the person without sensation will continue to use the foot.



Another complication occurring with the insensate foot is a loss of muscle tone in the blood vessels supplying blood to the feet.



This results in increased blood flow which can remove some of the minerals which normally keep bones strong. Weakened bones are more likely to break when stressed.



What Does This Mean to you as a Person With An Insensate Foot?



In the insensate foot, pain that would warn a person with normal sensation of injury is not present. You need to be aware of other signs that an injury has occurred. If a bone is broken or a Charcot joint has occurred, you will have one or all of the following signs:



Swelling (mild or great).

An increase in skin temperature in the area.

Redness in the area.

A lack of sweating resulting in dryness of the skin over the area.


Some patients wait until a fifth sign appears... Destruction and Structural change (the foot appears shorter and wider). An untreated Charcot foot develops a "rocker bottom" shape much like a rocker on a rocking chair. The arch of the foot collapses and joints are destroyed.



TREATMENT

The best treatment is prevention:



Insensate feet need special attention, visit your doctor regularly.


Insensate feet need support, protection and cushioning to help prevent fractures and movement of the bones. This includes special footwear, extra depth shoes, molded insoles, special custom made shoes.


Inspect your feet daily.



If prevention fails and the signs of charcot joints appear, seek medical attention IMMEDIATELY to determine the severity. If a fracture has occurred, healing will include protecting the foot from further injury. Forms of protection may involve any of the following:



Casts

Wheelchair

Crutches

Bed rest



Sometimes joint destruction is severe enough to result in a permanently misshapen foot with bony bumps or prominences. This condition will always require special shoes. Sometimes surgery to fuse broken joints or remove bony prominences may be necessary.



CHARCOT JOINTS - WHAT IS IT?



In the late 1800's, a French physician, Dr. J.M. Charcot, first described the destructive changes in the joints of people with decreased feeling in their legs and feet. Today the term Charcot joint is used to refer to any joint in the insensate foot that is destroyed or dislocated. The term Charcot foot is used to refer to a foot with many Charcot joints and which has actually changed shape.



There is usually not a single event or major injury to the insensate foot which causes fractures or destruction of the joints, but an accumulation of many small injuries which result in Charcot joints or a Charcot foot.



THE FOLLOWING FACTORS WILL INCREASE THE CHANCE OF DEVELOPING A CHARCOT JOINT



Loss of protective sensation.

Activities or conditions which put increase stress on the feet.

Shoes which do not provide support.



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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle

Source: http://www.articletrader.com ]]> Heel Pain http://www.articletrader.com/health/heel-pain.html http://www.articletrader.com/health/heel-pain.html Thu, 23 Oct 2008 00:00:00 -0500


What is Plantar Fasciitis?

Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed-resulting in heel pain.



The symptoms of plantar fasciitis are:


Pain on the bottom of the heel



Pain that is usually worse upon arising



Pain that increases over a period of months



People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they've been sitting for long periods of time.



After a few minutes of walking the pain decreases, because walking stretches the fascia.



For some people the pain subsides but returns after spending long periods of time on their feet.



Causes of Plantar Fasciitis

The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches-either overly flat feet or high-arched feet - are more prone to developing plantar fasciitis.



Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when a person's job requires long hours on their feet. Obesity also contributes to plantar fasciitis.



Diagnosis

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis.



In addition, diagnostic imaging studies such as x-rays, a bone scan, or magnetic resonance imaging (MRI) may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.



Treatment Options

Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:



Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.



Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.



Ice. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. Limit activities. Cut down on extended physical activities to give your heel a rest.



Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot.



Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help reduce pain and inflammation.



Lose weight. Extra pounds put extra stress on your plantar fascia.


If you still have pain after several weeks, see your foot and ankle surgeon, who may add one or more of these approaches:



Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia.



Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.


Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.



Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.



Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.



Physical therapy. Exercises and other physical therapy measures may be used to help provide relief.



Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you.



Long-Term Care

No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. If you are overweight, it is important to reach and maintain an ideal weight. For all patients, wearing supportive shoes and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.




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Dr. Craig Thomajan is a podiatrist at Austin foot and Ankle Specialist located in Austin, Texas. If you would like to learn more about a variety of foot and ankle aliments, you may visit him online at Austin Foot and Ankle



Source: http://www.articletrader.com ]]>