Surgery Not Always Necessary for Bunions by Dr. Dennis Cardone

Surgery Not Always Necessary for Bunions
                       
A bunion is a deformity of the big toe.  The big toe tilts toward the smaller toes and a "bump" develops at the base of the big toe.  In some people the deformity of a bunion grows very rapidly, while in others progression is very slow or not at all.  Bunions are more common in women.
                       
The medical name for a bunion is Hallux Valgus.  Hallux is the term for the big toe and valgus is an anatomic term for the rotation of the toe.
                       
Footwear such as tight-fitting shoes or heels may contribute to the development of the bunion deformity but other factors such as very flexible joints or a family history of bunions appear to be more important risk factors.  Bunions can also be caused by injuries to the foot, various forms of arthritis and certain neuromuscular disorders, such as cerebral palsy.
                       
Shoes that squeeze the big toe or do not fit properly or have an excessive high heel can contribute to the deformity of a bunion in people who are already at increased risk.  Such shoe wear can also cause pain or worsen the deformity of a bunion.
                     
In addition to a bump at the base of the big toe, people with a bunion may notice decreased motion of the big toe and swelling, redness or soreness in the area around the bump.  As the deformity of the bunion worsens, the first and second toes overlap.  Pain symptoms can range from none at all to very severe.
                       
Bunions often require no treatment and surgery should generally only be considered when there is persistent pain or severe deformity.
                       
Nonsurgical treatment to relieve the pain of a bunion include wearing roomy and comfortable shoes, using soft protective pads over the bunions and getting padded shoe inserts or orthotics.
                       
Studies have shown that 15 percent or more of people who have bunion surgery remain dissatisfied with the end results.  Pain can persist even after surgery.  Always discuss with your physician all the complications of bunion surgery.
                       
If you have a bunion and there is no pain associated with it, and the deformity is not severe, I would recommend not having surgery.

This was a recent article by Dr. Dennis Cardone that appeared in The Star Ledger, NJ

Fungus Toenails

Tired of thick, discolored, crusty, painful toenails?  

So are most people. In most cases, this is due to a fungus. The offending fungus is generally the same fungus that causes athletes foot on the skin. The skin fungus is often effectively treated with topical medications. However, when the fungus gets into the toenails,it is difficult for the medications to penetrate the nail plate and reach the fungus.  This is why over the counter treatments have been ineffective.  Prescription topical medications also have shown limited results. The best results of clearing fungus toenails have been from oral medications. Although many people are wary of the side effects of oral anti-fungal medications, they are in fact relatively rare. When considering oral medication for fungus toenails, blood testing is necessary. Laser therapy for fungus toenails have unfortunately yielded inconsistent results.

                         

Within the past few months, there have been some exciting and encouraging news. There have been at least two new topical toenail fungus treatments that have become available.  Studies have shown that although the data has not been overwhelming, the new medication appear to be much more effective than the older topical products.  Also these topicals are completely safe and no blood work is needed.

                         

So don't lose hope, there has never been a better opportunity to have healthy normal looking toenails !

Do You Have Peripheral Artery Disease (PAD)?

Peripheral Artery Disease (PAD) is a serious circulatory problem in which blood vessels that carry blood become narrow or clogged.  It affects millions of Americans, most over the age of 50.  People who have PAD have an increased risk of stroke,and heart attack.  Healing is also impaired in people with PAD.  

Warning signs include;

                         1) Discomfort or cramping of legs when walking

                         2) Foot or toe pain that keeps you up at night.

                         3) Pale skin, shiny skin, or hair loss of legs

                         4) Cold feet

                         

If you have any of theses symptoms and you smoke, it is important that you quit.  A podiatrist can help determine if you have PAD.  With the use of a non-invasive Doppler, our office can identify if there is a circulation problem.  Only then can proper treatment be initiated to save life and limb.

Diabetic Neuropathy can have serious effects by Dr. Evan B. Kelner

  

Diabetic neuropathy is a serious condition that affects 50 percent of people who suffer from diabetes.  Neuropathy can manifest itself as burning, tingling, pain or numbness in the feet.  Often balance is also a problem.

                         

Although the cause is not completely understood, risk factors include control of blood sugar, duration of diabetes, amount of damage to the blood vessels, smoking and diet.

                        

Neuropathy not only can affect the peripheral nerves - those in the arms and legs - but also other nerves that control blood pressure and sweating.

                        

Diabetic neuropathy may lead to devastating consequences including foot deformity, ulceration, stress fractures, and amputations.  Sixty percent of amputations are due to diabetic neuropathy.

                        

This chronic condition is extremely complicated in nature and treatment has always been a great challenge.  There have been many treatments that include drugs that target nerves, glucose and blood flow.  Also topical drugs (drugs applied to the skin), nerve blocks, antidepressant drugs, transcutaneous nerve stimulation, analgesics (pain drugs), Anodyne physical therapy, nerve decompression (surgery) and vitamins.  Still with all these treatments, there is no truly effective cure.  However, medications offer hope that diabetic neuropathy can be controlled.

                        

If you or someone you know has diabetic neuropathy, help may be within reach.

Orthotics by Dr. Evan B. Kelner

One of the most common questions that I encounter from patients who suffer from heel or arch pain (often a symptom of plantar fasciitis) is the long term solution to their painful condition.  The answer often surprises them.  For many people suffering from foot pain, orthotics are the answer they're looking for.
                    
Orthotics are devices that fit into the shoes or sneakers that correct the positional deficiency of the foot, and provide the proper position that footwear itself cannot provide.  All orthotics though, are not created equally.  Custom made orthotics are fabricated from an impression of the foot in a very specific position.  For some who's condition is not yet severe, off the shelf orthotics may adequately address the problem.  Beware however of claims of "instant custom made" orthotics such as seen in some large stores.  These orthotics are generally very overpriced for what they really are.
                     
A quality custom made orthotic will change the mechanical function of the foot. It works dynamically during weight bearing activities like walking, running and standing.  A good orthotic can prevent pain and deformities such as bunions, plantar fasciitis, corns and hammertoes.  They may even prevent surgery!
                      
Looking for a long term solution for foot pain?  Look into a good quality custom made orthotic.

Walk Your Way to a Healthier Lifestyle by Lindsay Westley

I recently read a good article by Lindsay Westley of "Eating Well" about the benefits of walking.  Following is a condensed version of that article in which Ms. Westley has some great ideas.

                                                                                      

There are days when just the thought of leaving the house seems like a huge effort.  Days when you don't feel like getting off the couch, never mind going to the gym.  But guess what - if you got out of bed this morning, you jump-started your fitness routine just by walking down the hall to the bathroom.

           

Add a little pep to your stride for an activity that feels less like exercise and more like living a normal life- but with the added benefits that exercise provides.

           

Mark Fenton, a health and fitness consultant says "make walking a part of your normal routine and you'll have a much easier time keeping it up".  Set aside time at a specific time of day to walk, or go about your daily tasks on foot.  If you can routinize it, you're more likely to keep doing it.

           

One suggestion is to find a friend who's willing to walk with you.  This will provide better motivation if you come to rely on one another.

           

If you need an extra push, tell yourself that you will only walk for 10 minutes.  Even in such a short amount of time, you will start feeling the physiological effects of walking.  You blood pressure goes down and you feel a flood of positive endorphins, so you feel motivated to go even longer than 10 minutes.

           

Still can't convince yourself?  Get up and move during commercial breaks.  Most 30 minute TV programs include about 8 minutes of commercials, so you'll be 80 percent closer to reaching your minimum by the time the credits are rolling.

Boomers: Caring for your feet as you age by Terrie Todd

Many older adults get frequent checkups, exercise regularly, and in general, try to take good care of themselves. But one aspect of their health that they (and for that matter, younger people) frequently neglect is good foot care. Foot injury, neglect and disease are major factors contributing to mobility, or lack thereof, in older adults. In one study, 71 percent of respondents aged 65 or older reported foot pain and problems, yet only 39 percent of them had sought medical advice and only 26 percent of them believe their foot problems were medical conditions.

Senior adults tend to experience more problems with their feet than younger adults simply because they have used them for longer. Women are four times more likely than men to have foot problems, probably because of the preponderance of high heels. Other conditions, such as diabetes and poor circulation can also affect foot health. The danger of neglecting feet can mean reduced quality of life — problems with coordination, balance and gait, all of which produce an increased risk of falling, and can lead to diseases and infections. Like other parts of the body, however, good care and maintenance can go far in promoting health and ensuring that senior individuals remain mobile and independent.

Healthy seniors should monitor foot health by regularly cleaning and examining the feet for any changes or irregularities. Using mild soaps followed with lotion helps keep the skin from drying out, cracking and itching. Ensuring that feet remain dry helps to fight off fungal infections, and keeping the feet warm can aid in circulation.

Keeping toenails properly trimmed helps prevent problems such as in-grown nails and toe pain. Toenails should be cut straight across, not curved, using clippers designed for toenails, and should be slightly longer than the tips of the toes. Also regularly stretching the legs, calves, and feet by walking, and wearing appropriate shoes, promote foot health and prevent conditions such as plantar fasciitis, which can cause debilitating heel pain.

Caring for feet can become difficult for seniors who may be less flexible or have other impairments that prevent them from reaching, cleaning and examining their feet. Caregivers may need to help in these cases, especially in seniors with medical problems, such as diabetes that can severely impact the feet, to ensure that feet and toenails are properly maintained.

Family caregivers should ensure that feet are kept clean and dry and monitor the toenails for deformities or misshapenness, trimming them as necessary. They should also examine the feet for any fungal infections, sores, cuts or cracking from dryness. These conditions can lead to disease, infection and amputation in seniors with diabetes and other medical conditions, so they need to be addressed promptly by medical professionals. Caregivers can also aid with circulation by providing a stool for senior individuals to elevate their feet, and by providing ample opportunities for the older individual to sit and rest when out walking.

Courtesy of  The Las Cruces Sun-News