Taking Oral Medication for a Fungal Nail Problem

Treating the fungal nails can be quite a long term proposition and sufficient expensive as well. In many cases the treatment may not be covered by the health insurance providers as they deem this to be of aesthetic value. Those that are affected by this disease also need to show sincerity in having the medication as having it intermittently can also pose a lot of problems.

In most cases topical applications for this infection do not treat the problem effectively. The topical cream or lotions are unable to reach all the layers of the nails and this makes them wholly incapable of reaching the bottom. For those that are unable to take oral medication, nail lacquers that contain ciclopirox are also available. The FDA has approved of this for usage. It is viable option for those that are unable to take the oral medication. However none of the oral medication can be taken during pregnancy or by those that think they may be pregnant.

There are 2 drugs that have been specifically approved by the FDA for treating the fungal nail problems. The first one is known as Terbinafine and has been approved by the FDA for treating the virus problem. The efficiency of the drug is up to 90% and is usually prescribed for 6 weeks for the fingernail problem. The dosage is usually around 250 mg and the drug does interact with caffeine and cimetidine.

The other drug is known Itraconazole and is also approved by the FDA for treating the problem. This drug is capable and effective in 20 – 80% of the cases of the fungal nail problem. The drug is meant to be taken with food and also reacts with certain medicines. Itraconazole can be taken daily or can be taken in a pulse format. For those who have the fingernail problem, dosage of 200mg is given once a week for about 6 weeks.

Another drug known as Fluconazole has not been approved by the FDA but is quite an effective drug. The advantage that it has over the other drugs is that it lasts in the body for a long time; therefore the drug needs to be taken only once a week. Clinical studies have shown, that the drug is about 70 – 85% effective by those that have fungal nail problems. The dosage for this drug is about 450 mg once a week and should be taken for at least 4 – 9 months.

{ Comments are closed }

Custom Foot Orthotics For Plantar Fasciitis And Other Foot Disorders

Plantar Fasciitis is a common foot condition experienced by thousands of people every year. It is thought to be the result of overuse or abnormal foot mechanics and the pain from this injury to the plantar area of ​​the foot can become debilitating without effective treatment is applied. Custom foot orthotics are the treatment of choice for most people, so that makes them a popular medical device.

Today, there are many options from which to choose when selecting orthotics. There was a time when the only way to receive orthotics was through a doctor specializing in foot care. That is no longer true because now these items can be purchased off the shelf in many retail locations or because custom fit online sites.

The good news is that custom foot orthotics are available for anyone who needs them. Chiropractors, podiatrists and other professionals understand the importance of maintaining proper alignment of the feet and back. This is why they can highly recommend them for patients suffering from plantar Fasciitis and other pain inducing disorders. When the feet are comfortable, it is easier to stand up straighter to properly distribute weight over the feet.

There are many different manufacturers that claim to be the creators of custom foot orthotics. To be truly custom-made an impression of the foot must be taken first. This impression can be accomplished through old-fashioned technology using a mold, or it can be made through 3-dimensional scanners. Either way, a professional should be involved to help obtain the best results.

Although it is possible to get an accurate picture of the foot with a molded model, this process can be messy. This likely explains why most professionals today that focus on foot disorders have turned to orthocare technology. The images produced through this technology can then be used to create custom prescriptions for orthotics to suit individual needs. This process is so much faster and patients prefer it.

Plantar Fasciitis is a painful injury, but there are other reasons custom foot orthotics are prescribed. An example would be diabetics often have problems with their feet. The right orthotics for individuals suffering from diabetes are not the same as those for many other folks. They are softer while at the same time providing excellent support for feet that sometimes sting, tingle or even have little feeling at all.

In addition to that, pediatric patients require different support than adults and athletes have another set of needs. This is the beauty of custom foot orthotics and the reason foot care practitioners are very heavy on them to help those who come to them obtain the comfort they deserve.

No one likes being uncomfortable, and there is nothing that makes you hurt all over like when your feet are in pain. The sooner you receive relief the better, and that is why fast turn-around and great customer service are important when receiving custom foot orthotics. When you order yours, be sure to look for top quality suppliers.

{ Comments are closed }

Home Cure for Bunions

How do you know if you have a bunion? If the joint connecting your big toe to your foot has a painful and swollen bump, you may have a bunion. The enlargement that is seen is actually a misalignment of the big toe joint.

There are many things that can lead to bunion formation. One of the causes is having abnormal biomechanics like overpronation of the foot. Other causes are previous sprains, fractures, nerve injuries, loose ligaments, and low muscle tone. Genetics also plays a role in bunion formation. The risk is increased if other members of the family have bunions. Gout and rheumatoid arthritis is also said to be associated with the condition.

Using poorly fitting shoes is likely to make an existing bunion worse. High heels also cause considering strain on the toe joint because they tend to push your body weight onto the front of the foot.

Below are home treatments for bunions that can ease the pain and discomfort.

Taking nonprescription medications such as ibuprofen or acetaminophen following the recommended dose can help relieve toe pain. Elevating the foot can help reduce inflation. Applying ice to the painful joint is another way to ease pain.

Using orthotics, arch supports, or bunion pads at the bottom of the foot redistributes weight and takes the pressure off the big toe.

If possible, use custom made shoes to ensure proper fit. Another way is to use shoes with a larger toe box. There should be enough space between the tip of the longest toe to the end of the shoe. The shoes should not squeeze any part of the foot and should be roomy enough for the toes. Switching to sandals instead of closed shoes can leave the painful area of ​​the foot exposed.

Pads inside the shoes or foam rubber cut into a donut shape with the hole for the bunion is another easy but effective home remedy.

Avoid activities that put pressure on the foot, especially the big toe. All these can help with bunion relief.

However, bear in mind that the only definitive treatment for bunions is bunion surgery. Bunions that are left untreated will likely get bigger and cause more pain. The purpose of surgery is to fix the alignment of the big toe. If these home remedies fail to provide relief, then it may be time to see a podiatrist. Modern and essentially painless treatments are now available, as well as scarless bunion surgery .

{ Comments are closed }

Tailor’s Bunion: A Big Problem for a Little Toe

What is Tailor's Bunion?

A tailor's bunion, which is also referred to as bunionette, is the medical term for a raised lump at the base of the little toe. During the early stages of a bunion, there will be minimal symptoms with only a slight noticeable alteration in the position of your little toe. Tailor's bunion received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This continuous rubbing was believed to lead to a painful bump at the base of the little toe.


A tailor's bunion is a progressive condition, which means that it will worsen over time. It will develop in the area where the small toe connects to your foot. You will often notice a visible bump on the side of the toe that may be red and swollen. Some symptoms can include:

-swelling and inflammation
-pain on the bump itself
-iritation of the soft tissues underneath the skin
-shoes typically increase the pain


There are 5 main causes of this condition:

1. Tight, ill-fitting shoes that are too narrow in the top of the shoe can put excess pressure on the 5th toe and lead to irritation
2. Structural bone deformity
3. Trauma or injury to the outside of the foot
4. The weakening of muscles and ligaments caused by advancing age
5. Genetics are a common cause of tailor's bunion

Treatment & Prevention

Tailor's Bunions are a progressive deformity, and if left untreated the bump will become larger, causing the little to lie over or underneath the fourth toe. A podiatrist may recommend these treatments:
-Icing: icing the inflated area may help with the pain and swelling. Do not apply directly to the skin, but instead wrap the pack of ice in a thin towel, then apply.

-Oral medications: nonsteroidal anti-inflammatory drugs such as ibuprofen may help to reduce pain and inflammation

-Change your shoes: avoid wearing high-heeled or narrow fitting shoes. Instead wear shoes that have a wide toe box.

-Orthotic devices: orthotics or customized insoles can help protect the joint and correct any structural alignment issues

-Padding: pads placed over the area may help to reduce pain

Tailor's bunions are a common foot abnormality that can result in pain and limit of your daily activities. Call our office to schedule an examination to determine the most effective treatment for you today.

{ Comments are closed }

5 Ways Your Shoes Are Deforming Your Feet

Shoes are not designed to mold to the shape of our feet. Instead our feet are forced to mold the shape of your shoes. Over time, our feet lose their pliability. The interesting thing is that when pliability is lost, it becomes more painful to walk without shoes. Some people interpret this as evidence that walking barefoot is not good for them. Any time the distance between attachments of muscles is changed, weakness takes place. As humans, we abuse our feet a lot. Society has determined that high-heels and the unnatural gait they produce are “sexy.” Overall we are more concerned about fashion than we are about our overall health. As an osteopathic physician, I want to describe some strains that I have found almost universally on my patients. Upon research, I have determined that there are certain designs in most shoes that are sturdy to blame.

  • Compressed Toes: Look at your toes. Do you have space between all of your toes? Chances are you probably do not. Over time people develop toes that overlap or have indentations of their toes if they separate them. This also leads multiple problems including bunions as your big toe is chronically bent towards the middle of the foot. The feet of those who never wear shoes naturally have space between their toes. The rest of us have our toes crammed by our shoes. Shoe makers make shoes pointed at the front because “it looks better.” As your toes become compressed, they become less functional. Most people can not curl their toes without getting foot cramps. I find Correct Toes to have the best spacers to help this problem along with shoes that have wide toe boxes like the Vivobarefoot brand.
  • Narrow feet: A wider base is more stable than a narrower base, but wider shoes are not considered attractive. Therefore, we wear shoes that are narrower than our feet. Over time the small muscles between the long bones of the feet, the metatarsals, becoming permanently contracted. In addition the small bones, the tarsals, in the foot became compressed and lose their range of motion. The result is that we end up with narrowed feet that lack pliability. I have found that releasing the tension in the small muscles between the metatarsals helps to restore some range of motion to the tarsal bones, relax chronically tight calf muscles, and sometimes even into the sacroiliac (SI) joints.
  • Diminished heel range of motion: Because shoes produce a heel striking gait, the heel absorbs the shock of each step. The heel is not designed to absorb shock. Driving your heel into the ground with each step causes the heel to not only become compressed forward into the ankle, but also driven backward. Over time, the heel can get stuck like that permanently. A problem at the joint between the heel bone and the foot bones can refer pain to the bottom of the foot which can mimic and is often misdiagnosed as plantar fasciitis. In addition, the heel has attachments for the plantar fascia and the calf muscles via the achilles tendon. Therefore a dysfunction at the heel will lead to chronic tightening of any muscles associated with it including the calves and problems further up.
  • Tight plantar fascia: The plantar fascia is a tough connective tissue from the toes that anchors into the heel. Because the plantar fascia is associated with the toes and heel bone, it responds to the dysfunctions associated with them like muscles by contracting. Therefore, the more the foot changes its shape, the more the plantar fascia will tighten. In addition improper use of the heel by heel striking can irritate it and lead to inflammation which can be another cause of plantar fasciitis. To make things worse, the arch supports in shoes abnormally stretch the plantar fascia irritating it further.
  • Dropped metatarsals: If you ever watch a woman walk in high-heels, you'll notice that with every step the balls of the feet are driven down towards the ground and the toes driven up at an abnormal angle. Over time this permanently changes the joints at the balls of the feet. What happens is the balls of the feet drop, becoming exposed and painful to walk on. This is called metatarsalgia. This is much more pronounced in high-heels but also occurs with most shoes. If you rest your shoe on a flat surface, more often than not the tip will angle up. This is because shoes, including sneakers, are so rigid and immobilize your feet before the shoe is built with this “rocker” effect. This feature pulls your toes upward constantly when you are wearing shoes and can produce metatarsalgia.

The solution to most of these problems is to work to maintain pliability and strength at your feet and specifically at the structures mentioned above. Chronic shoe wear leads to specific changes in the foot that cause it to lose pliability and function the way it was originally intended to. This can lead to many foot ailments that are blamed on other things.

{ Comments are closed }

Reasons to Go to a Sutherland Shire Podiatrist

Even though sport is recommended to people of all ages, sports injuries happen very often, especially to those who do not wear proper equipment. Everybody knows how it feels to not be able to run properly because there is something wrong with your feet, which is why a visit at the local podiatrist is necessary. Sutherland Shire is a very beautiful region of Sydney, Australia where many people enjoy doing a wide variety of sports. Surf is probably the most common sport in this area at Wanda Beach, Cronulla, but people enjoy doing other activities as well, including marathons and triathlons. This is why if you are a serious triathlon competitor and get injured during a challenge, you will require immediate attention from a Sutherland Shire podiatrist in order to be able to continue the competition. This region has several athletics tracks such as The Ridge Athletics Track on New Illawarra Rd or The Waratah Athletics Track on 40 Rawson Ave, which is why so many people find themselves in need of a skilled podiatrist.

Many people might be tempted to make an appointment with a podiatrist in a larger city, but that can take a lot of time, which they might not always have. When choosing Sutherland Shire podiatrists over the ones in a larger city, you will not have to wait for days until a specialist looks at you and evaluates your condition. By choosing a local podiatrist you will be seen immediately and have the highest chances of recovery. Even if you are not competitive in any challenges, so you are not necessarily in a hurry, it can be very uncomfortable to stay injured before a doctor can look at you and assess you condition. As with any injury, the faster you see a doctor, the more likely you are to get rushed faster. Without the proper care, you will probably have to undergo a more complex treatment in order to get cured and be able to resume your normal activities. Fortunately this does not have to be a problem, considering that Sutherland Shire has excellent podiatrists, ready to help anyone in need.

The best part about going to a Sutherland Shire podiatrist is that you can benefit from the same quality of treatment you would in a large city. The podiatry clinics in this region have all the equipment and specialists needed to assess and diagnose a patient correctly and in the fastest time possible. This way, anyone who suffers an injury and needs the help of a podiatrist can simply look online for the nearest clinician or someone who has enough experience in this field and make an appointment. Sutherland Shire has enough specialists to meet everyone's needs and help them overcome their problems and continue their life normally. So when you think you might need to see a podiatrist, traveling to other parts of the country is not necessary because this region has everything a person might need. Modern facilities and highly qualified specialists, ready to help any patients that may walk through their doors. Regardless of your problem, you will always be able to find an experienced podiatrist in Sutherland Shire, who will make sure you receive the right treatment and therapy to feel better in the fastest time possible.

{ Comments are closed }

Are You Hurting Yourself With Each Step You Take?

Let's face it, you walk and run wrong (if you run). I do not say this to be critical of you. It's not your fault, most people never give any thought to their form as they walk or run on a daily basis. The truth is that with thick padding under our heads, we never learned to ambition correctly. Every time your heel strikes down with every step, you send a terrible shock through your body. It may not cause you direct pain, but chances are it very well could be hurting you and damaging your joints. There is currently not enough research showing this but you can do simple experiments and decide from there. Let's look at how you are designed to absorb shock.

One way you can see how you are designed to absorb shock is by using your body the way it is meant to be used – barefoot. Now that you have kicked off your shoes. I want you to stand up preferably on a hard surface. Next I want you to jump up in the air. No big deal, right? There's many things your body does to absorb the impact and not all of it takes place at your feet. If you land correctly, you likely landed on the balls of your feet and then your boots came down. When you land on the balls of your feet, the arches of your feet compress to absorb the impact as your boots come down and then subsequently decompress to spring you. Your calves contract as your heels come down to the floor putting tension on your achilles tendon. Simultaneously your quadriceps contract putting tension on your patellar tendons as your knees bend further to absorb the impact. In addition to this your hips should be bent. The higher you jump or the harder the surface, the more exaggerated this position is. You may look like you are in a slight squatting position at the end of this. From this position, your body could use the potential energy it has built up in the arches and tendons due to their elasticity and with less effort, propel you to another jump. Although this is description is not complete, this is the big picture of what takes place during jumping rope or running in place. There is a rhythm one that can get into that is more effortless. Whether you jump forward, back or to the side, you always land this way. This way of absorbing shock is what should also take place when you walk or run.

Now let's consider the alternative. If you are like most, the next experiment is how you are using your body to absorb shock when you heel strike as you walk or run. Many runners are convinced that using this method of shock absorption is correct and are unwilling to change unless there is hard evidence showing it is harmful. So now try this – jump up in the air like you did before, but now land on your heels. Does the idea of ​​doing this make you nervous? It should. Do you realize that even psychologically you are hard wired not to heel strike? Your brain is giving you a signal that landing this way is dangerous. Now, let's imagine you are willing to jump up an inch and land on your boots. Let's look at what has to happen. For one, landing like this is very difficult. You have to make an effort to land like this but the adjustments you have to make are consistent with what is commonly done by heel strikers.

In order to land on your boots, you must shift your feet forward a little bit and bend your feet back. In essence this is locking out the ankle joints. Another important adjustment is that in order to land on your boots, you must straighten your knee locking out your knee joints. What this looks like is a leg that is completely straightened out in front with your foot bent back. This is how your leg looks when you are walking or running if you are heel-striking. So by landing like this, you are preventing the arches of your feet, your calves, your knees and even your hips from absorbing any of the impact. It may feel more stable with padding under your boots but it is not. The muscles and tendons do not play a significant role in absorbing the shock. Instead you may feel your bones starting at your heel jarred all the way up your body even into your head. The interosseous membrane that helps to transfer weight from the tibia to the fibula, is jarred as well in an unnatural way. Constantly doing this could be a reason for shin splints. Your center of balance is also shifted into a less stable position. Once again, this is the big picture and does not cover every detail about how the body is unable to adapt to the shock. Now this is only jumping up an inch or less. Many have vertical leaps much higher than this and I would not recommend anyone jump up as high as they can and land on their heels. This could be damaging.

Using my body's shock absorption mechanisms correctly, I can repeatly jump up in the air as high as I possibly can without damaging my joints. This is true regardless of the surface. Yes, that includes concrete. Jumping forward does not change how I land. I will still never land on my boots without something goes wrong. So the padding under your boots has dampened down your anxiety about landing on your heels and taught you to walk or run incorrectly. The padding has blocked the pain you may feel from heel striking if you did not have it, but it does not block the impact. Why? Because your joints are still locked out unable to adapt to the shock of the impact. It's hard for me to think of many, if any, scenarios when locking out your joints is preferred to maintaining some flexibility in your joints. Ask any martial artist how often it is a good idea to lock out your joints. What if you are jumping rope and landing on your heels repeatedly sending shock waves through your joints in your knees and hips? You will likely be injured regardless of whether you are doing it on concrete or grass. We blame concrete when we should be blaming ourselves for using our bodies in a way it is not designed to be used. It's time we tune back in and start listening to our bodies. The evidence that heel-striking is incorrect is there. Are you willing to listen?

{ Comments are closed }

How Your Shoes And Orthotics Are Weakening Your Arches

If you are like most people, you probably have weak feet and ankles, but you do not know it. This occurs for two reasons. This article will cover only one of the reasons and the other will be explained in another article. People have a hard time accepting the idea that they could have week feet and ankles. However, the reason and the concept is simple. It is called disuse atrophy. If you have not heard of it, let me explain:

Imagine you broke your arm and had a cast put on it for proper bone healing. This cast will be on for many weeks and does not allow your arm to move. Let's imagine that while your arm is in the cast you go to the gym and lift the weights. Perhaps your shoulders and forearms get stronger over that time period. However, when the cast is removed from your arm, the end result at your elbow joint is always the same. The muscles associated with moving the elbow joint will be atrophied and weaker. This concept applies to any joint or joints in the body. Assuming you are smart and would like to avoid injury, you would not over-exercise with your arms right after having a cast removed.

What does this have to do with your feet? Well, your feet are designed as dynamic structures. That means that your feet are designed to move, be pliable, and adapt to your environment. Your toes need to be able to bend and your arches need to be able to compress and expand like a spring. The arches are not meant to be immobilized. Instead of being used as dynamic structures, feet are asked to mold around the shape of the shoe they are in.

The vast majority of shoe designs are very rigid, including sneakers. This means that regardless of how much cushioning they may have, shoes will immobilize feet similar to being in a cast. Shoes are not quite as rigid as a cast and people spend some time out of their shoes, so the effect is not as fast or as obvious. Casts are temporary but people often spend a good portion of their lives in shoes. It does not matter how much you exercise or run. If you exercise in shoes that immobilize your feet, then the end result is the same – disuse atrophy.

Orhotics immobilize feet even more. Over a long period of time, the resulting weakness in the feet leads to a compromise in the integrity of the structures of the foot. This means that historically feet can become so weak, that they are no longer capable of maintaining their structure. This sometimes shows up as dropped arches or flat feet among other ways. Unfortunately, the current answer for this is to immobilize feet even more by inserting orthotics that lift the arches higher. This just makes the problem worse and a cycle is started.

Often the more rigid a shoe is, the more it is considered a “good” shoe. This is wrong, because it leads to disuse atrophy. This does a disservice to everyone, especially professional athletes and runners. We like to blame concrete, but concrete is not the problem. Your feet and ankles are the base that interfaces with the ground. Would not you want them to be as strong and as pliable as possible? The best thing you can do for your feet is kick off your shoes and do some activities barefoot. Allow your feet to be dynamic and restore some of the natural pliability to your feet.

{ Comments are closed }

Ingrown Toenails: Causes and Treatment

When the a toenail begins to grow into the surrounding skin rather than across the nail bed, it can lead to infection and pain. For patients with circulatory issues, diabetes or toe numbness, ingrown toenails can actually pose a very serious risk of complication, up to and including loss of a limb. The first thing you should do is consult with a podiatrist in your area, and schedule an appointment immediately. An ingrown toenail is more than a painful cosmetic issue and can have a variety of causes.

Causes of Ingrown Toenails
While any toenail has the potential to become ingrown, the most commonly affected digit is the big toe. Traumatic injury to the toe near the nail bed can lead to an ingrown nail, and you're more likely to suffer from one if someone in your immediate family has had one. High heel and tight shoes can compress the toes, with the resultant pressure causing abnormal nail growth which may also result in an ingrown toenail.

In some cases, ingrown nails are caused by fungal infections, which may thicken and widen the toenail and lead to painful, improper growth. One of the more common causes of ingrown toenails, however, is simply improper trimming. Rounded corners can lead to the nail digging into the skin surrounding the nail bed, which can easily progress to an ingrown nail. Be sure you always trim toenails straight across, rather than rounding the edges. Refrain from wearing tight shoes or high heels whenever possible, and keep an eye on any injury which may affect the nail bed.

Spotting Ingrown Toenails
Ingrown nails are reliably easy to spot. In the beginning, reddening and mild swelling of the end of the toe are common. The affected toe may be painful and warm to the touch. If left untreated, an ingrown toenail can very easily become infected. Should an infection develop, you will notice an increase of swelling and may see yellow or white colored drain from the site of infection. In rare cases, you may develop a low-grade fever as the infection takes hold.

Treatment Options
You should immediately seek the attention of a podiatrist if your ingrown toenail develops an infection. If you have infection without signs of infection, its still imperative for patients who tetanus immunization is not up to date, those who have HIV / AIDS, vascular issues and diabetes. Patients undergoing chemotherapy or with increased risk of infection should also seek medical attention as soon as possible.

Your podiatrist may recommend a round of self-care treatments to be administered at home after examining an ingrown toenail. These may include regular soaking in warm water, and attempting to elevate the affected nail. In some cases, more aggressive treatment may be prescribed. This especially holds true if there is a present infection, or if there are no signs of improvement after completing home treatment. Surgical intervention may be necessary in some cases, which will include the partial or complete removal of the affected nail. Your podiatrist may also decide to remove part of the nail bed or destroy the cells which spur nail growth to prevent future issues.

If you think you may be suffering from an ingrown toenail, it's best to consult with a podiatrist as soon as possible in order to being immediate treatment. With proper care, your pain and the risk of infection can be addressed effectively.

{ Comments are closed }

Custom Orthotics For Foot Stabilization

An orthotic is a customer device which is made from lightweight material. It can range from a very complicated device that you have custom made for your use, to a very simple one that you can buy over the counter. The more complicated variety require different methods to create of course. There is a great deal of difference between a custom made orthotic and one that you buy at a general store. The custom variety require that you have custom impressions and casting, a well as the use of computers in order to create them.

The mass made variety dont 'always do the job. The do not necessarily correct the problems that the user may have and in many cases do not offer the support that you need for your feet. Custom orthotics for foot stabilization are required for many different reasons.

The orthotics that you will order custom made are designed to deliver relief from tendonitis, from plantar fascitis, tarsal tunnel syndrome, bunions, and many other issues. If these are conditions from which you suffer, it may be that a custom made orthotic is the right answer for you.

Orhotics can help to restore your ability to walk without pain or discomfort. They may also help you to be able to run, to walk and to even jump more effectively and without pain. They can help to lower the pain, to help increase your mobility and stability on your feet, to offer you better support for arches and even lower the swing that takes place from affected areas.

Custom orthotics for foot stabilization can help to keep the foot seated in the shoe in the way that it should be. This can help to keep you more stable on your feet and to protect your other joints. When the foot is not sitting as it should be and is not immobile in the shoe, the foot can move around and sit in a position which is not good for you or for your other body parts.

Just a few of the custom foot orthotics that you may see in use include the heel flares, that help to resist foot inversion or eversion, the extended heels, which provide arch support, the heel elevator that lifts one foot a bit higher to help it match the other leg, and the heel wedge that can promote inversion. There are others, including metatarsal bars, sole flares, toe crests and many others, each of which can offer you the support that you need to help you to have more active and to help you move around with less pain and problems.

The custom orthotics for foot stabilization may be just one of several ways that your medical provider recommends to help to keep you more mobile and pain free.

{ Comments are closed }

GOUT, GET OUT!: Causes, Symptoms, Treatment

Gout is one of the most painful conditions in the foot. It is a disease caused by the buildup of uric acid in the joints. Uric acid is a normal substance in our bodies, but when we have too much of it, it can crystallize in joints. Over time, uric acid in the blood crystallizes and settles in the joint spaces, causing swelling, inflammation, stiffness, and pain.

Gout affects approximately 2.1 million people in the United States and is more common in men between the ages of 40 and 50, according to the National Institute of Health (NIH). Although men are more susceptible, menopausal women are also at risk. So, what are the symptoms and causes, and how can you prevent gout?

Programs of GOUT

Many people who have never suffered from gout often believe that they have broken their big toe when first experiencing an attack. Touching or moving the toe may be intensely painful with even so much as a bed sheet over the toe increases the pain. Symptoms of gout develop rapidly and typically occur in only one joint at a time, most often in the big toe but can afflict other parts of the body including the ankle and knees.

• Severe pain and a hot feeling in the affected joints, usually appearing first in the big toe.
• Throbbing pain in the big toe
• Red skin in the area around the joint
• Fever
• Stiffness in the joint
• Itchy skin around the joint
• Small lumps may appear around the elbows, hands, or ears


• Obesity
• High alcohol consumption, especially beer
• Low calorie diets
• Rapid weight loss
• Overuse of aspirin
• High blood pressure
• Surgery
• Exposure to lead in the environment


Prevention is the best defense against gout. Avoiding alcohol and purine rich foods such as scallops, sardines, shellfish, red meat, gravy, and cream sauces may also help to prevent the condition. Be sure to drink plenty of water, exercise regularly and maintain a healthy diet and body weight. If you already have uric buildup in your joints, medication may be taken to prevent continued accumulation.


The symptoms of gout may stop completely a week or so after an attack without any intervention. However, it is important to be diagnosed and treated by a Podiatrist in order to avoid attacks of increasing severity in the future and to prevent permanent damage to the joints, kidneys and other organs. Treatment focuses on relieving pain and inflammation.

Gout attacks are extremely painful. If left untreated, the pain can last for many days or weeks and can recur frequently causing permanent joint damage. If you think you have gout, please visit Dr. Abraham for a quick diagnosis, and treatment will rapidly eliminate your pain.

{ Comments are closed }

Plantar Fasciitis Myths and Misconceptions, Effective Treatment for Plantar Fascitiiis

As I do research around the internet including social media sites, forums and blog posts there is an abundance of information about plantar fasciitis. Unfortunately much of it's outdated and just regurgitated principles, theory's and treatment options that simply have been proven wrong or do not work.

As a hand and foot chiropractor in Melbourne, FL I have spent the past 15 years studying foot conditions, especially plantar fasciitis. What was taught as temporary in school has now been proved to be outdated and ill logical. What I am going to express are not just my views but, are all backed by scientific literature. I am constantly evolving in my quest of offering the best possible treatment options for my patients and therefore research is essential. The knowledge I have gained from this research has altered the treatment I now use today to treat a patient with plantar fasciitis compared to what I used early on in my practice.

So what are these outdated principles, theories and treatment options I continue to read about. Lets start with the name itself. Plantar Fasciitis. In medical terms this tells us that the plantar fascia (actually it's called the plantar aponeurosis) of the foot is inflamed. It is common knowledge on the internet that the plantar fascia is implied naturally at the insertion on the heel. The latest research research suggests that infection has very little to do with plantar fasciitis. Initially there may be some inflammation despite the condition becomes more of a degenerative disorder as opposed to an inflammatory condition. So what does it matter whether it is inflammatory versus degenerative? It is important because it changes the kind treatment that should be administrated. An example. If a patient has infection they would be treated with over the counter anti-inflammatory medication (NSAIDS) such as Advil, prescriptive anti-inflammatory or with an anti-inflammatory injection such as a steroid. These may be effective treatment options for reducing infection however, they will not help much if there is little or no pollution present such as in degenerative conditions.

So what does the scientific literature have to say? A 2003 review of 50 cases performed by Lemont et al. Stated that plantar fasciitis is a “degenerative fasciosis without inflammation, not a fasciitis.” 1. In medical terms a suffix of – itis means inflammation where – osis means degenerative. Andres et al. written in the journal Clinical Orthopedics & Related Research “Recent basic science research suggests little or no infection is present in these conditions”. 2. An article titled Overuse tendinosis, not tendinitis, part1: a new paradigm for a difficult clinical problem published in Phys Sportsmed states “Numerous investigators worldwide have shown that the pathology underlying these conditions is tendonosis or collagen degeneration.” 3. I can go on citing many more although you can see that the experts agree that the theory of inflammation is present in plantar fasciitis no longer valid.

Another common mis-conception is that Plantar Fasciitis is caused by bone spurs . When a patient presents to my office with Plantar Fasciitis and a heel spur is noted on an x-ray I say something which may sound very strange to the patient “A heel spur is your friend”. I always get the look of “Did you just say what I think you said?” I then continue with “Let me explain …”. I then continue, “Plantar fasciitis is caused by chronic irritation of the plantar fascia, typically at the insertion on the heel where the bone is present. Over time the plantar fascia begins tear away from the bone. The body responds by calcifying (hardening) the tendon and keeping it intact preventing it from teasing off the bone! “. Thus, why it is refenced as a “friend”.

Even though spurs are common with plantar fasciitis the spur itself does not cause pain but, the fascia or surrounding soft tissues actually cause the pain. 4. Surgery typically is not successful for relieving the pain and the spurs often return since the root of the problem has not been eliminated. 5

What about flat feet (pronation-often found with flat feet) or tight calves . I believe these do place increased stress on the plantar fascia and contribute to plantar fascitis although I do not believe they are a root problem of plantar fasciitis. There are many people with dropped arches , pronation and tight calves that do not have plantar fasciitis. There are also many people with plantar fascitis that do not have flat feet, pronation or tight calves. Early on in my career I treated patients with plantar fasciitis who were flat footed by fitting them with a custom orthotic to restore the arch. Although this did help reduce the pain very often it did not eliminate it. If flat feet was the cause then the patient should have been cured. It's been my own clinical experience that has show me that high arches and supination are just as problematic as being flat footed or having a foot with pronation.

So as a hand and foot chiropractor what do I believe is the root cause of plantar fasciitis? In most cases I believe it is a foot that is not properly functioning. This may be from a bone out of place such as the Talus or Calcanical (which I see all too often) a traumatic injury or a congenital deformity. The human foot has 26 bones, 33 joints, 107 ligaments, 19 muscles and tendons and is very complex. When all these parts are not working properly in sync it places undue stress on the foot and causes degeneration to occur.

  1. Lemont et al . Plantar fascitis: a degenerative process (fasciosis) without infection Journal of the American Podiatric Medical Association . 2003.
  2. Andres et al . Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clinical Orthopedics & Related Research . 2008.
  3. Khan et al . Overuse Tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem.m Sportsmed . 2000.
  4. Tountas et al . Operative Treatment of subcalcaneal pain. Clinical Orthopedics & Related Research . 1996.
  5. Fishco et al . The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review. Journal of the American Podiatric Medical Association . 2000.

{ Comments are closed }

Your Bunion Surgery: What to Expect

Many have heard the term bunion, or hear others complain about painful bunions, but that does not always insist that the medical definition is known or fully understood. For those suffering from painful bunions or requiring surgery for bunions, it may be said the true understanding only comes with experience. However, bunion surgery is becoming more and more commonplace. A basic knowledge of the working of the foot and what to expect after bunion surgery may be helpful for both patient and caregiver.

By definition, a bunion is a type of foot deformity where the big toe turn outward. The first joint, where the toe meets the foot, turns out while the tip of the toe turns into the other toes. The now outward turned joint is made of soft tissue and bone and over time may be subjected to additional wear and tear, and with this, may become larger in size. This prominent and enlarged joint, which is considered deformed due to its outward turn, is the bunion.

Bunions are mainly caused by the wearing of ill fitting and narrowed toed shoes over long periods of time. In a minority of cases, bunions are due to joint diseases such as arthritis or to hereditary causes. Knowing that ill fitting and narrowed toed shoes are the most common culprit, it is not shocking to learn that most sufferers of bunions are women. High heels, narrow toed shoes and shoes that are too tight or too small are often the culprit. For some podiatry patients, bunion pain and relief can come from non surgical remedies, but for others, surgery is a must.

Cues that surgery is the recommended course of action may include pain that is not associated with non surgical measures, a big toe that is overlapping the smaller toes, constant and consistent pain that affects mobility, decrease in foot motion. Depending on the cause and severity of the bunion, the surgeon will determine the proper type of bunion surgery. There are six main types of bunion surgery: osteotomy, resection anthroplasty, exostectomy, arthrodesis, tendon / ligament repair. Regardless of the type, surgery for bunions is driven by the cause to treat pain, correct deformity and realign the joint as needed.

Typically the surgery is performed as an outpatient surgery and the medical team will determine if local or general anesthesia is needed. Once the surgery is complete, there is typically a brief recovery in the hospital before heading home. The surgeon will normally prescribe several homecare routines, which will normally include instructions on changing the dressing, staying off the foot, pain medication, when shoes may be worn again and even some home exercises. Post surgery there are normally visits to the surgeon's office to assess the healing and progress of the real joint.

Bunion surgery does not have a high occurrence of complications, but they may occur. Typically they are related to poorly maintained dressings or reactions to pain medications. Once the surgery is over and the healing begun, the surgeon and podiatrist will evaluate the approval for return to normal activities such as sports, wearing fashion shoes, etc. Of course, as with any medical condition or concern, surgery for bunions should always be discussed with a medical professional and no treatment undergone without such a conversation.

{ Comments are closed }

Uses And Health Benefits Of Foot Massagers

A foot massager is basically a machine which is used to relax and massage the muscles of the feet with use of heat, rollers, vibration and water. Massaging the feet is one of the best ways to relax the entire body as there are specific reflexology points in the feet which are connected to the organs and tissues of the body. Today there are various types of foot massagers available with different features, benefits and prices.

The simplest type of device includes a set of half circle wooden rollers which can be placed on the floor. This type of massager is not electrically powered and it can be used easily. The roller targets the reflexology points on the feet and massages it accordingly. The user simply needs to rub the feet on the device.

The electric-powered massager is one of the most popular devices which are used often. There are different types of electrically powered devices in different designs and sizes. Some of these devices are designed as slippers so that the sides and the top of the feet can be massaged easily. Another variety of massager is shaped like a boot which can massage the entire foot, ankles and legs.

Another type of device is the foot bath which is basically a small tub filled with warm water. The users can soak the feet easily in the water. These tubs include jets which circulate the water gently so as to massage the feet properly. It is also possible to add medicinal ingredients to the water.

There are many health benefits associated with the use of these massaging devices. The technique of massaging certain areas of the body helps to alleviate pain and relieve the muscles of the body. Some of the most common benefits related to the use of these massaging devices include the following:

Post Operative Pain: One of the most significant benefits of using these devices is lowering the heart rate of patients who have undergone surgical procedures. Massaging the feet helps to handle pain in a better way and relax the entire body.

Daily Pain: Another significant benefit of using these devices is to reduce the pain in the legs and feet due to stress.

Hormonal Reactions: It is also quite helpful in reducing several discomforts associated with hormonal reactions such as hot flashes in women. It helps to reduce the stress related to hormonal imbalances.

Arterial Diseases: Feet massages help to increase the circulation of blood throughout the body and this in turn helps to alleviate pain.

Cancer Therapy: Foot massagers are also used for cancer therapy as a support treatment as it helps to reduce stress level, nausea and fatigue among the patients.

Lower Blood Pressure: It also helps to reduce blood pressure and increase blood circulation in the body.

Different types of massaging devices can be bought from various reputed online stores at affordable price rates. There are online stores which offer machines at wholesale price rates too.

{ Comments are closed }

What to Do If Your Foot or Ankle Hurts

There are over a hundred different muscles and tendons in your feet. There are almost 60 different bones and joints in your feet. It's not surprising that in such a complex system, things can sometimes go wrong. So, what can you do if your ankle or foot starts to hurt?

Identify the Source of Pain

According to the National Institutes of Health, not treating a pain in your foot could lead to long term disability and permanent damage. That's why it's essential that you quickly identify what's causing the pain.

Is it a strained or twisted ankle? Was it a sudden impact? Make sure you look at your shoes as potential culprits. According to the Mayo Clinic, ill fitting shoes are the # 1 cause of foot pain. If the pain is dull and comes on gradually over days, it may be because of your shoes.

Protect the Injured Area

The first step to treating any foot pain is to protect the injured area. This helps prevent the foot from getting injured again. Do this by applying a brace or splinter to the injured area to hold the foot in place. If the injury is small, like a stubbed toe, you can just use tape to hold the injured area still.

Once you've protected the injured area, stop moving it. Keep it as still as possible through the recovery. If possible, walk with one left, with crutches or with the help of railroads. If you absolutely must put weight on the injured foot, try to put the weight as far away from the injured area possible.

Apply Ice, 4 to 5 Times a Day

Ice causes blood vessels to constrict. This in turn reduces swelling. Reduced swelling can help reduce the pain, as well as speed up the healing process. The earlier you can start applying ice, the faster the injury will heal. The first few hours after the injury are the most important.

Apply ice to the injured area for 20 to 30 minutes, 4 or 5 times a day. In between sessions, apply light pressure to the injured area. A wraparound bandage is an effective tool to apply continuous light pressure.

Keep the Foot Raised

Keep your foot raised when you're sitting. Try to keep the foot above heart level. This reduces the blood flow to the foot, which also helps reduce the pain.

Following these steps will help ease the recovery for most types of ankle pain. If the pain persists, or if it's more serious than the conditions discussed here, see a doctor right away.

{ Comments are closed }