January Articles 2013

Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.




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.



Treating Heel Pain with Shockwave Therapy

Heel pain shockwave therapy is a treatment option that helps to treat plantar fascia, which is a type of heel and foot inflammation that causes pain to the heel area. This type of injury is often caused by overworking and overusing the feet, and normally happens to people that exercise often such as runners, athletes, obese and overweight individuals, and individuals whose profession requires them to stand for long periods of time.

Since heel pain can be caused by a number of problems including poorly fitting shoes, exercise routines, work hazards, and many more, most plantar fascia treatments include very conservative techniques. Simple things like new shoes, taking ibuprofen, doing heel and foot exercises, and resting your feet can treat the problem. However, for the worst cases, using shockwave therapy is often the best treatment option.

For patients that have tried conventional treatment options, and failed at them, and who have been having heel pains for over six months, Shockwave treatment is often the next option. The concept behind this treatment is simple; shockwaves are generated from a device that delivers shockwaves to the outside of the patients body, and the shockwaves will cause the bodies repair mechanisms to work more efficiently and effectively, and in the end, start repairing the damage done to the heel area.

The goal of shockwave therapy is to eliminate the pain in the heel area, and this should happen because shockwaves trigger the body’s natural repair mechanisms. Basically, this therapy speeds up normal tissue healing in the body, and will also lead to a reduction in pain for the patient by working the pain transmission nerves located in the heel area.

The reason this treatment is gaining popularity is because it is less invasive than surgery, and eliminates the risk factors associated with surgery, such as anesthetic usage. Since this technique also works by helping the body to improve using natural healing techniques, the recovery time should be shorter than surgical processes.

This does not mean that there are not some discomfort issues that can arise out of this treatment for patients. Short term issues normally include skin bruising, minor pain during and after treatment, swelling of the heel, and discolored tissue. These side effects of shockwave therapy should be gone in a few days, giving the patient a fast recovery time which makes it easy to return to the routines of their daily life .

Like most types of treatments, surgeries, and medications, there are certain people that should not have shockwave therapy procedures performed on them. Potential patients with heart conditions and people with pacemakers should not be considered for this technique. People on certain types of medications, usually medications affecting blood clotting, would also be ineligible for this treatment option. And lastly, children and pregnant women should avoid this as well.

Overall, shockwave therapy could be a great option for heel pain because it is less invasive than surgery, helps to trigger the natural healing mechanisms of the body, and should be considered by people who have had long bouts of heel pain, who have tried conventional treatment options that failed, and who have the money to afford such a procedure.



Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.


2012
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2013
January