by | Aug 19, 2019 | BLOG
Peripheral neuropathy is the most common form of neuropathy affecting the peripheral nerves of the feet. Damage to peripheral nerves can alter the ability to sense pain or temperature and may affect muscle control. Neuropathy is a potentially dangerous condition as the individual loses their protection mechanism from pain or injury.
Other symptoms include:
- Numbness, tightness, or tingling
- Shooting pain through the foot
- Loss of balance
- Foot deformities
- Dry feet
Common Causes
- Diabetes (approximately 50 per cent of diabetics suffer from diabetic neuropathy).
- Metabolic disease such as diabetes, chronic renal failure and liver failure
- Autoimmune diseases such as rheumatoid arthritis
- Infections such as shingles (post herpetic neuralgia) or AIDS
- Pressure on a nerve or irritation of the nerve (such as in Mortons neuroma)
- Toxic substances, including alcohol or heavy metals
- Vitamin deficiency, which may or may not be related to other medical conditions such as coeliac disease
- Radiation & Chemotherapy
- Trauma (eg bone fractures)
- Irritation and/or tumours of the spinal cord
- Inherited neuropathies
- However, in many cases, no underlying disorder can be diagnosed.
The best way to treat neuropathy is to control the underlying condition. People with Diabetes must start with getting their blood sugar under control. It is essential that an individual with neuropathy inspects their feet daily for cuts, abrasions, blisters, or swelling.
Your Podiatrist can provide you with an appropriate diagnosis, perform a thorough neurological assessment and outline an appropriate management plan according to your level of risk. Some medications can assist in reducing the symptoms. Exercises may be prescribed to improve function, stability and strength.
There is no known cure for peripheral neuropathy. The goal of treatments are to slow the progression of the disease, to maintain foot health, and to decrease pain (if present) and improve the quality of life.
by | Oct 1, 2018 | BLOG
October is Foot Health Month – an important time for us to remind all Australians about proper foot care.
Over the years, your feet can clock up some serious kilometres, taking a significant toll on the condition of your feet. They can carry a lot of weight and keep you going throughout your day but sometimes we forget how essential it is to take care of our feet.
Untreated foot problems can have a hugely detrimental effect on a person’s lifestyle and livelihood. Whether you spend your day in the office, on the shop floor or on the worksite, your feet have a large impact on how you feel – if your feet aren’t healthy, you can’t perform at your very best.
During Foot Health Month our mission is to remind our patients and the public about the significance of good foot health and encourage people to seek more information and treatment from a Podiatrist sooner rather than later.
Podiatrists take care of all sorts of foot problems such as:
- Skin problems.
- Calluses and corns.
- Nail disorders, like ingrown toenails.
- Foot injuries.
- Foot infections.
- Overuse injuries of the foot and ankle.
- Flat feet
However, one of the most serious foot health issues is lower limb amputation resulting from complications of diabetes. Diabetes prevalence figures in Australia are primarily estimated from findings arising out of the National Health Survey conducted by the Australian Bureau of Statistics. There are an estimated 1.2 million people aged 2 years and over (5.1%of the population) with diagnosed diabetes in Australia. Diabetes Australia recommends the following: “Visit a podiatrist annually for a check-up or more frequently if your feet are at high risk.”
Proper podiatric care has the potential to dramatically prevent amputation for a patient with a diabetic foot condition. Foot issues need to be identified and treated quickly and consistently to stop a minor wound becoming infected, ulcerated and, ultimately, resulting in the loss of limb to save someone’s life.
by | Oct 1, 2018 | BLOG
With the AFL finals being conducted this month we are certainly going to see some rough & tough footy as the 8 final clubs strive to win the 2018 Premiership. At this time many local competitions are wrapping up & the footy at these levels will just be as intense & many players are likely to sustain injuries of the lower limb, especially the foot & ankle which are best managed by your Podiatrist, some of which are possibly preventable with the help of a Podiatrist as well.
Each year the AFL releases data on the seasons injuries and we now have access to many years’ worth of data on injuries. We can assume that the AFL data is quite like what we see at the local club level. Some of this injury data is:
- The Hip/Groin/Thigh is the most commonly injured area (29% of all new injuries), with hamstring strains accounting 14% of all new injuries.
- Injuries to the Hip/Groin/Thigh account for 34.9 (22%) missed games, with hamstrings accounting for 19.1 (12%).
Shin/ankle/foot is also commonly injured and accounts for 26% of all new injuries. These injuries account for 42.4 (27%) of games missed. - Knee injuries, whilst only accounting for 5.3 (14%) of injuries account for a significant number of games missed (37.4 games or 24%).
- Lower limb injuries account for 68% of all injuries.
- Many of the remaining injuries are thought to be secondary to contact, for example fractures of the forearm, wrist and hand.
- Concussions have been on a steady rise in recent years. This is thought to be due to increased recording and raised awareness of the effects of concussion.
SO, WHAT CAN BE DONE FOR AN INJURY BY YOUR LOCAL PODIATRIST?
As 68% of all footy injuries are of the lower limb your Podiatrist is best placed to take care of these. If you, a family member, friend or team mate do happen to get a lower limb injury on the footy field having the injury assessed & treated as quickly as possible by your local Podiatrist will give you the best chances of a speedy recovery & get you back on the field playing the game you love.
When you attend the clinic, your Podiatrist will take a thorough history & may even ask you to mimic the injury sustained on the field as this will help to achieve an accurate diagnosis. A detailed physical assessment will follow with a focus on the injured area, but an exam of the foot is always part of a standard Podiatry examination & may include video treadmill analysis & scanning of the feet to determine the correct foot alignment. Once the diagnosis is reached & if no further referral is required the treatment of the affected lower limb joint, muscle, or ligament will vary depending on the type & severity.
Treatment may include:
- Ice or heat depending on how long the injury has been present.
- Strapping of the affected area
- Massage
- Dry needling
- Peripheral joint mobilisation & adjustments (FMT)
- Advice on rest, day to day modifications, time away from footy, what training is OK to perform that will not exacerbate the injury.
- Customised orthotics may also be issued to assist with correct foot alignment & this will also help with injury prevention & even better performance on the field.
Most footy injuries take several weeks to recover & post recovery a program of strengthening & prevention will also be prescribed to keep you playing the sport you love.
by | Aug 27, 2018 | BLOG
Forefoot pain (the ball of your foot), presents quite commonly in a Podiatry practice like ours. Generally, forefoot pain is associated with aging. Individuals with this condition present and experience pain of varied intensity and discomfort and find difficulty in activities like walking, running, playing, and several others.
Symptoms:
If you have this condition you will usually experience a sharp, aching or burning pain in the ball of your foot. The pain usually worsens during standing, walking, running or when the affected foot is flexed. Some may have numbness or tingling sensation in their toes. In most cases, the skin overlying the affected area becomes thickened. Some people may notice changes in the shape of the feet or toes depending upon the cause of pain.
Causes:
There are many causes of forefoot pain. Some common causes include:
- Overweight
- Overuse
- Shape of the foot
- Big toe arthritis
- Gout
- Stress fractures
- Morton’s neuroma – A thickening of the tissue around a nerve leading to the toes
- Sesamoiditis – Irritation of the small bones in the forefoot
- High foot arch
- Loss of fat pad under the ball of the foot with aging
- Poorly-fitting shoes
Treatment:
Early treatment is critical to relieve pain, so you must consult your Podiatrist when symptoms initially arise. Mild to moderate cases of forefoot pain can be managed by conservative treatment by your Podiatrist using a combination of the following:
- Rest and ice
- Dry needling
- Soft tissue therapy
- Foot mobilization (FMT)
- Adaptation to a weight loss dietary regimen
- Activity modification
- Use customized orthotics to support and protect the foot. This also helps cut back the pressure placed on the metatarsal bones.
- Extra-fit toe pads, softening or gel pads can be placed inside the shoes to help cushion the shock while walking. Simple footwear modifications include using low-heeled shoes and broad toe box shoes with silicone gel pads to minimize discomfort at the tip of the toes.
by | Jul 14, 2018 | BLOG
A fracture of the heel bone (calcaneus) is the most commonly fractured foot bone. It is most often caused by high impact to the heel such as, when a person has fallen from a height or been in a car accident. Injuries can range from a bone crack from a new vigorous exercise plan to a shattered bone from a high fall. Heel pain, bruising, swelling, limping, or difficulty walking are the main symptoms.
The most common symptoms of a calcaneus fracture are:
- Pain
- Bruising
- Swelling
- Heel deformity
- Inability to put weight on the heel or walk
It is important that your Podiatrist knows the circumstances of your injury. It is just as important for your Podiatrist to know if you have any other injuries or medical problems, such as diabetes. After discussing your symptoms and medical history, your Podiatrist will do a careful examination. He will look for other injuries and for areas where the skin is damaged or punctured. Your Podiatrist will check to see if there is a good blood supply to your foot and if the nerves to your foot are working properly.
Calcaneus fracture treatment may include:
- Rest from weight bearing, often with crutches
- Thorough padding of the heel
- Splinting or casting to protect the heel bone
- Pain relievers
- Surgery
- Physical therapy
- Specific exercises can improve the range of motion in your foot and ankle, and strengthen the supporting muscles.
Rehabilitation
Whether you have surgery or not, your rehabilitation will be very similar. How long it takes to return to daily activities depends on the severity of the injury. Some patients can begin weight-bearing activities a few weeks after injury or surgery; some patients may need to wait 3 or more months before putting any kind of weight on the heel.
- Early motion. Many Podiatrists encourage motion of the foot and ankle early in the recovery period. For example, some patients are instructed to begin moving the affected area as soon as their pain allows. Patients who have had surgery are instructed to begin moving the affected area as soon as the wound heals to the podiatrist’s satisfaction.
- Weight-bearing. When you begin walking, you may need to use a cane and wear a special boot. It is very important to follow your podiatrist’s instructions for walking on your foot. If you place weight on your foot too soon, the bone pieces may move out of place and you might require surgery. If you have had surgery, the screws might loosen or break and the bone may collapse.
These fractures can be potentially very debilitating, Podiatrists have a strong knowledge of the anatomy of the calcaneus, which is paramount to understanding the fracture patterns one may see with this injury.
by | Mar 2, 2018 | BLOG
A tailor’s bunion, also known as a bunionette, is a bump or prominence on your fifth metatarsal bone, at the base of your little toe. Your metatarsal bones are the five long, thin bones in your mid-foot that attach to your toes. Tailor’s bunions are less commonly experienced than regular bunions, or prominences that develop on the inside aspect of the base of your big toe.
Causes and Symptoms
Inappropriate footwear, especially shoes that are improperly fitted, is a main cause of tailor’s bunions. The tapered toe boxes of most conventional shoes push your fifth toe toward your fourth toe, immobilising your little toe in this deformed position. Your fifth toe, when it is held in this position, is more susceptible to trauma from your shoe. Most shoes available to consumers are not sufficiently wide for the average foot, especially in the toe box.
A tailor’s bunion also may be caused by inherited mechanical problems in your feet. Alterations in your foot’s bony alignment may cause the enlargement that characterises this health problem; that is, your fifth metatarsal bone begins to protrude on the outside aspect of your foot while your fifth toe shifts toward your foot’s midline, creating a bump in this area that is irritated when your shoe rubs against it.
A tailor’s bunion causes the same symptoms as a regular bunion. Common signs and symptoms associated with a tailor’s bunion include:
- Pain at the site of your enlargement
- Redness
- Swelling
Tailor’s bunion-related symptoms are often made worse by wearing shoes that possess narrow toe boxes, which rub against your prominence and irritate the soft tissues underneath your skin in your affected area.
Treatment
Most tailor’s bunions can be treated conservatively by restoring proper alignment of your foot bones. Some strategies for resolving this health problem include:
- Avoid footwear that squeezes or pinches your forefoot. Choose shoes that possess a wide toe box and little or no heel elevation. Ask your Podiatrist for footwear advice.
- Incorporate a toe spacing product: A toe spacer, places your fifth toe in a proper orientation, in-line with your fifth metatarsal and splayed away from your fourth toe. When worn regularly over a period of time, a toe spacer can reduce your Tailor’s bunion. When using a toe spacer, it’s imperative to wear only footwear with a wide enough toe box to easily incorporate your splayed toes.
- Icing: Icing your affected area may reduce your pain and inflammation. Always wrap your ice pack in a thin towel when icing your problem area.
- Padding: Pads, especially bunionette pads, may help decrease your pain.
- Over-the-counter oral non-steroidal anti-inflammatory medications such as Ibuprofen (Advil) can help reduce the pain and inflammation of the bunion.
- Injection therapy: Corticosteroid injections may help reduce inflammation around your affected joint.
- If your podiatrist believes it is necessary to remove the deformity or if conservative treatments options have not provide adequate symptom relief, surgery may be recommended. Surgery can be straight forward, such as shaving or reducing the bone prominence in order to lessen pressure on your bunion from footwear. In some cases, cutting or separating the 5th metatarsal (small toe) so it can be properly realigned is the best way to improve your overall foot mechanics.
