Did you know that your toes and feet are the farthest body parts from your heart?  This means that its takes a lot longer for blood and nutrients to reach your feet and toes.  When you are healthy this is not a problem, but throw in some high cholesterol, high blood pressure, or Diabetes and things could change rather quickly.
High blood pressure used to be called the "silent killer" because many people didn't konw they had it.  Today this is detected easily at most doctors offices.  PVD, or Peripheral Vascular Disease is now the new "silent killer".  This is a disease of the leg circulation which can increase your risk of stroke or heart attack by three times!
Some people may not even know they have PVD, and some may have symptoms.  Leg cramps, spasms, heavy legs, cold feet or toes, shooting pains, or color changes are the most common symptoms.
We suggest that any patient that may show signs of symptoms for PVD to have this test done as this circulation test can save your life.  It is standard on every new patient exam if you either have diabetes or are over 65 years old.

For patients with generalized pain, numbness, or pins and needles of the foot it is often frustrating going to doctors to try to fix a problem that many don't understand.  Many patients with Diabetes, Cancer, HIV, Poor Circulation, Post -Traumatic Injuries,  and many types of Rheumatic Arthritis can develop "Neuropathy".  Neuropathy could be a debilitating disease of the skin (sensory) nerve system that could cause skin infections, wounds, and broken bones.  Today this can be treated with appropriate medicine.  The diagnosis of this problem is a simple sample of skin taken from the ankle.  The individual nerves are counted under a microscope which allows us to tell the patient exactly how good or "bad" their problem is, it also allows us to tell you how things are progressing during your treatment.

This "skin biopsy" is not painful at all, and hurts no more than a pin prick.  the results are far more beneficial as therapy is geared towards "regrowing" the skin nerves over a 6 month to 1 year time frame.

Warts are miserable skin viruses that can attack the bottom of the feet.  They usually develop under pressure points like the heel, the big toe, or under the ball of the foot. We pick up warts by walking barefoot, or in shoes that we may not keep clean.  The virus usually attacks an area of the foot that is dry; perhaps a skin crack or a callus, cut or a scrape. Once the virus is in the skin, it is very VERY difficult to remove it.  Unlike the rest of the skin on your body, the skin to the foot is several times thicker and the wart can get very deep which makes treatment more difficult.

To treat these beasts, it is important to know that a single visit to me is unlikely.  Two to three treatments may be necessary to completely remove the warts.  Treatment may start by freezing (cryosurgery) which is not painful.  If the wart is too deep or too large, I will recommend a medicine I have specially made called Cantharidin (chemosurgery).  This medicine is applied by me and requires you to return in 2-3 days for a check-up.  This treatment doesn't hurt initially, but really stings after the first day or two.  Should your wart still be resistant to these treatments (10% of all plantar warts are resistant to physical destruction) it may be necessary to physically remove them (cold steel surgery).  This may take place in my office, or an outpatient center.

Osteoarthritis of the big toe joint causes severe stiffness and "bumps" around the joint which makes wearing shoes, running, and even walking difficult and painful.  The joint pain associated with this condition, called "Hallux Limitus" or the more severe condition "Hallux Rigidus" can become disabling, often occuring both on the top and the bottom of the foot.

When we walk, our natural stride allows us to walk over this joint and we use it to "push off" which moves us forward.  When this joint doesn't work we have to change the position of our foot which causes even more muscles and bones to work harder and can potentially damage these as well.  This often leads to tendonitis, shin splints, heel pain, and ankle pain.

Usually, orthotics and injections can help the early stages of this problem, and I urge you to see a doctor to have this diagnosed if this is the case.  The later stages of this disease usually requires surgery which remodels the joint, or if there is no cartilage left replaces the joint with prosthetic joint.  These joint implants do very well and the recovery is fairly quick, usually around 3 weeks in a special walking boot.

The point of this blog though, is to prevent the need to replace the joint.  For that matter, we must remind ourselves not to "walk through" our foot pain.  The prevention of this type or arthritis can be accomlished only at the early stages.  I also urge you to seek out a doctor to make this diagnosis, as there are more than 200 other diagnosis around the big toe joint and the foot that it could be!  Keep in mind that more than 25% of the bones in your body are in your feet!

The great thing about Extra-Corporeal Shock wave therapy is that it can be the last ditch effort after shots, orthotics, or stretching to prevent having heel surgery.  Heel surgery does take you out from work at least 3-21 days.  But Extra-Corporeal Shock Wave treatment gets you back on your feet in one or two days!  Granted, it may not be covered by most insurance, but it also saves on money lost from time out from work!

Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.

Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.

People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).

This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 85 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.