March Articles 2013



Bunions

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.



Blisters on the Feet

If you have ever worn a pair of shoes that were two tight or just rubbed you in the wrong place, then chances are that you have experienced the pain of having a blister formed. To better understand how blisters form, what treatment we should apply for blisters, and how we can avoid having them form, we should learn more about what blisters are.

A blister on the foot is basically a small pocket that is fluid filled. This pocket typically forms on the upper layers of skin, because those layers are so thin. The majority of the time, blisters are filled with clear fluid; however, sometimes the blisters may be filled with blood and even pus if they have become infected due to bacteria entering the blister pocket.

Blisters on the feet are almost always a result of a shoe rubbing the foot constantly which results in what is termed a friction blister. These blisters occur after you have walked for very long periods of time or when you wear a pair of shoes that do not fit your feet properly. Blisters also form more easily if your feet are moist.

If you experience the displeasure of having a blister form on your foot, then proper treatment is an absolute must to alleviate pain and to prevent infection. In general the best treatment for blisters that are full of clear fluid is to just leave them alone. Your body will form new skin under the blister and then when the time is right your body will allow the blister to pop. If you try to lance the blister you may introduce bacteria in it that will lead to an infection. If the blister is painful, then you can use a band-aid over it to provide some cushioning which should relieve pain.

If the blister is filled with blood or pus, then the best treatment is to seek out the attention of a doctor. These blisters may need to be further evaluated and you may be given antibiotics to destroy any infection that you may have.

Preventing blisters on the feet is the best way to prevent any pain or infection that could occur. You can prevent blisters by keeping your feet dry and by making sure that you wear a proper pair of shoes that fit your feet well, without being too tight or too loose. If you do feel a place on your foot where your shoe is rubbing, then applying a band-aid to that spot may prevent a blister from forming until you can change them.


Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Orthoses

Orthoses are devices used to correct physical impairment caused by scoliosis, spina bifida, cerebral palsy, or foot deformities. Orthopedic devices control, guide, limit or immobilize body segments. They assist in movement; reduce weight bearing forces and aid in rehabilitation from fractures. They also correct the shape and function of the body.

Orthoses include ankle foot orthosis, thoracolumbosacral orthosis, knee orthosis and wrist hand orthosis. When orthoses were first made, plaster of Paris molds were made of the patient and then materials like plastic, elastic, metal or a combination of those materials. Now braces for participants in contact sports are made from neoprene to allow movement but reduce the range of movement.

The Boston Brace is used to assist scoliosis sufferers. It is also called a low-profile or underarm brace. It fits under the breast to above the pelvic area in the front and below the shoulder blades to the tail bone in the back. By applying three point of pressure to the curve, the lumbar area is forced to flex, the abdomen is pushed in and the posterior is flattened.

The Charleston Bending Brace is only worn at night. A mold is made of the patient’s body bent towards the outward bulge of the curve. The design of the brace is built to correct the curve of the scoliosis. Repeatedly wearing this brace for eight hours should eventually correct the problem somewhat if not completely. The brace is good for patients with a curve of 20 to 36 degrees.

The Milwaukee Brace is used for mid-back curves. This brace consists of a plastic pelvic girdle and a neck ring. The pieces are connected in the front and back by metal bars. Pressure pads are place along the patient’s curve pattern along the metal bars. This brace is rarely used but patients with a curve very high in the spine can benefit from wearing it.

A knee orthosis is a brace worn to give the knee strength. Osteoarthritis can cause significant pain in the knee resulting in immobility. Knee braces allow a person to remain active. Often therapy and drugs are used in conjunction with a knee brace.

Orthoses have changed over the decades. The materials used for the actual orthotic devices have evolved to include hydraulics as it appears in some knee braces that the patient adjusts to compensate for stability. When this is adjusted, it helps the knee by giving the sense of space between the bones which stops the pain that radiates when the bones rub together. Orthoses products stop pain and give patients the ability to move pain free.

  

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