Official Blog of Dr. Peter F. Gregory and his Foot Health Team
Posts for category: Uncategorized
When the nerves are damaged in the extremities such as the feet, it is known as peripheral neuropathy. This ultimately leads to Charcot foot when the bones in the foot are weakened. These weakened bones can lead to fractures that worsen and cause the joints in the foot to collapse. Charcot foot can cause the foot to become deformed, and it can be disabling and even potentially lead to amputation. Common signs of Charcot foot are a warmness to the touch, redness, swelling, and pain. Because of its association to neuropathy and neuropathy’s association with diabetes, diabetic patients should monitor their feet for this condition. Patients who believe that they may have this condition should consult with a podiatrist as soon as possible. A podiatrist will be able to assess the foot and suggest treatment options.
Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with the Foot Health Team of Dr. Peter F. Gregory, D.P.M. The doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.
What Is Neuropathy?
Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by several different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.
Symptoms of Neuropathy Include:
- Sensation loss
- Prickling and tingling sensations
- Throbbing, freezing, burning pains
- Muscle weakness
Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.
To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.
Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.
If you have any questions, please feel free to contact our office located in Livonia, Michigan. at 734-522-7676. We offer the newest diagnostic and treatment technologies for all your foot care needs.
Livonia Toe and Metatarsal Fractures (Broken Toes) Doctor
THE FOOT HEALTH TEAM OF DR. PETER F. GREGORY D.P.M. CAN BE REACHED AT 734-522-7676.
It is commonly believed that there is nothing that can be done for a broken toe. This is not true. Toe fractures that heal wrong will remain stiff and painful. Toes need to be x-rayed to be sure the fracture is not displaced, angulated or gapped. The metatarsals are the part of the foot between the top of the arch and the toes. There are five metatarsals behind each of the toes. These bones are easily fractured. Stress fractures are particularly common. Signs of a fracture include bruising, redness and swelling. Depending on the severity of the fracture, either protected weight bearing, non-weight bearing or surgery may be needed.
The structure of the foot is complex, consisting of bones, muscles, tendons and other soft tissues. Of the 28 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.
What Is a Fracture?
A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.
Traumatic fractures (also called acute fractures) are caused by a direct blow or impact, such as seriously stubbing your toe. Traumatic fractures can be displaced or nondisplaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (malpositioned).
Signs and symptoms of a traumatic fracture include:
- You may hear a sound at the time of the break.
- Pinpoint pain (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
- Crooked or abnormal appearance of the toe.
- Bruising and swelling the next day.
It is not true that “if you can walk on it, it’s not broken.” Evaluation by a foot and ankle surgeon is always recommended.
Stress fractures are tiny hairline breaks usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. They can also be caused by an abnormal foot structure, deformities or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored. They require proper medical attention to heal correctly.
Symptoms of stress fractures include:
- Pain with or after normal activity
- Pain that goes away when resting and then returns when standing or during activity
- Pinpoint pain (pain at the site of the fracture) when touched
- Swelling but no bruising
Consequences of Improper Treatment
Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:
- A deformity in the bony architecture, which may limit the ability to move the foot or cause difficulty in fitting shoes.
- Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or has not been properly corrected.
- Chronic pain and deformity.
- Nonunion, or failure to heal, can lead to subsequent surgery or chronic pain.
Treatment of Toe Fractures
Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:
- Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.
- Splinting. The toe may be fitted with a splint to keep it in a fixed position.
- Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned. Use of a postoperative shoe or bootwalker is also helpful.
- Buddy taping the fractured toe to another toe is sometimes appropriate, but in other cases, it may be harmful.
- Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.
Treatment of Metatarsal Fractures
Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges.
For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Since the big toe is used so frequently and bears more weight than other toes, arthritis in that area can make it painful to walk, bend or even stand.
Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone (behind the little toe). It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your foot and ankle surgeon is an expert in correctly identifying these conditions as well as other problems of the foot.
Treatment of metatarsal fractures depends on the type and extent of the fracture and may include:
- Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone.
- Avoid the offending activity. Because stress fractures result from repetitive stress, it is important to avoid the activity that led to the fracture. Crutches or a wheelchair are sometimes required to offload weight from the foot to give it time to heal.
- Immobilization, casting or rigid shoe. A stiff-soled shoe or other form of immobilization may be used to protect the fractured bone while it is healing. Use of a postoperative shoe or bootwalker is also helpful.
- Surgery. Some traumatic fractures of the metatarsal bones require surgery, especially if the break is badly displaced.
- Follow-up care. Your foot and ankle surgeon will provide instructions for care following surgical or nonsurgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return to normal activities.
- Contact the Foot Health Team of Dr. Peter F. Gregory, D.P.M. at 734-522-7676 for any questions or concerns.
Falling can be a devastating experience and may cause pain and discomfort. For people who are over sixty-five years of age, falling can hinder their health and independence. Injuries such as broken toes and ankles can be common if falling occurs. There are methods that can be implemented that can help to prevent falling. These tips may include improving the lighting in the household, in addition to having existing medications reviewed by having regular examinations. It can be beneficial to perform stretching and toning exercises in to help maintain strength in the body. Many patients find falling episodes can be reduced when grab bars are installed in the shower and the toilet area, and bathmats are used while bathing. If you would like more information about how falling can affect the feet, and would like to learn more about preventative methods, please consult with a podiatrist.
Preventing falls among the elderly is especially important. If you are older and have fallen or fear that you are prone to falling, consult with The Foot Health Team of Dr. Peter F. Gregory, D.P.M. Our doctor will assess your condition and provide you with quality advice and care.
Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are several things older persons can do to prevent falls.
How to Prevent Falls
Some effective methods that older persons can do to prevent falls include:
- Enrolling in strength and balance exercise program to increase balance and strength.
- Periodically having your sight and hearing checked.
- Discuss any medications you have with a doctor to see if it increases the risk of falling.
- Clearing the house of falling hazards and installing devices like grab bars and railings.
- Utilizing a walker or cane.
- Wearing shoes that provide good support and cushioning.
- Talking to family members about falling and increasing awareness.
Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.
If you have any questions, please feel free to contact our Livonia office at 734-522-7676.
You've seen them at the grocery store and at the mall. You've probably even seen them on TV and online. Shoe inserts are any kind of non-prescription foot support designed to be worn inside a shoe. Pre-packaged arch supports are shoe inserts. So are the “custom-made” insoles and foot supports that you can order online or at retail stores. Unless the device has been prescribed by a doctor and crafted for your specific foot, it's a shoe insert, not a custom orthotic device—despite what the ads might say.
Shoe inserts can be very helpful for a variety of foot ailments, including flat arches and foot and leg pain. They can cushion your feet, provide comfort, and support your arches, but they can't correct biomechanical foot problems or cure long-standing foot issues.
The most common types of shoe inserts are:
- Arch supports: Some people have high arches. Others have low arches or flat feet. Arch supports generally have a “bumped-up” appearance and are designed to support the foot's natural arch.
- Insoles: Insoles slip into your shoe to provide extra cushioning and support. Insoles are often made of gel, foam, or plastic.
- Heel liners: Heel liners, sometimes called heel pads or heel cups, provide extra cushioning in the heel region. They may be especially useful for patients who have foot pain caused by age-related thinning of the heels' natural fat pads.
- Foot cushions: Do your shoes rub against your heel or your toes? Foot cushions come in many different shapes and sizes and can be used as a barrier between you and your shoe.
Choosing an Over-the-Counter Shoe Insert
Selecting a shoe insert from the wide variety of devices on the market can be overwhelming. Here are some podiatrist-tested tips to help you find the insert that best meets your needs:
- Consider your health. Do you have diabetes? Problems with circulation? An over-the-counter insert may not be your best bet. Diabetes and poor circulation increase your risk of foot ulcers and infections, so schedule an appointment with a podiatrist. He or she can help you select a solution that won't cause additional health problems.
- Think about the purpose. Are you planning to run a marathon, or do you just need a little arch support in your work shoes? Look for a product that fits your planned level of activity.
- Bring your shoes. For the insert to be effective, it has to fit into your shoes. So bring your sneakers, dress shoes, or work boots—whatever you plan to wear with your insert. Look for an insert that will fit the contours of your shoe.
- Try them on. If all possible, slip the insert into your shoe and try it out. Walk around a little. How does it feel? Don't assume that feelings of pressure will go away with continued wear. (If you can't try the inserts at the store, ask about the store's return policy and hold on to your receipt.)
What are Prescription Custom Orthotics?
Custom orthotics are specially-made devices designed to support and comfort your feet. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet, ankles, and legs, so the orthotic can accommodate your unique foot structure and pathology.
Prescription orthotics are divided into two categories:
- Functional orthotics are designed to control abnormal motion. They may be used to treat foot pain caused by abnormal motion; they can also be used to treat injuries such as shin splints or tendinitis. Functional orthotics are usually crafted of a semi-rigid material such as plastic or graphite.
- Accommodative orthotics are softer and meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, painful calluses on the bottom of the foot, and other uncomfortable conditions.
Podiatrists use orthotics to treat foot problems such as plantar fasciitis, bursitis, tendinitis, diabetic foot ulcers, and foot, ankle, and heel pain. Clinical research studies have shown that podiatrist-prescribed foot orthotics decrease foot pain and improve function.
Orthotics typically cost more than shoe inserts purchased in a retail store, but the additional cost is usually well worth it. Unlike shoe inserts, orthotics are molded to fit each individual foot, so you can be sure that your orthotics fit and do what they're supposed to do. Prescription orthotics are also made of top-notch materials and last many years when cared for properly. Insurance often helps pay for prescription orthotics.
When to Visit a Podiatrist
If you are simply looking for extra cushioning or support, you may wish to try an over-the-counter shoe insert first. If you have serious pain or discomfort, however, schedule an appointment with a podiatrist. He or she will assess your overall health and look for any other contributing factors. Today's podiatrists are specially trained to evaluate the biomechanics of the lower extremity.
Your podiatrist will examine your feet and how you walk. He or she will listen carefully to your complaints and concerns and assess the movement and function of your lower extremities. Some also use advanced technology to see how your feet function when walking or running.
The information gathered during the exam will help your podiatrist determine if shoe inserts might be helpful or if you need prescription orthotics. If orthotics are needed, your podiatrist will capture a three-dimensional image of each foot. Those images, as well as any measurements obtained by your podiatrist, are used to create a set of unique foot supports that will improve your foot movement and lead to more comfort and mobility. Your podiatrist might also suggest additional treatments to improve the comfort and function of your feet. Any questions please contact The Foot Health Team of Dr. Peter F. Gregory, D.P.M.
As the Foot Health Team of Dr. Peter F. Gregory, we know that to have healthy feet, you must have a healthy body. Your feet do a lot of work for your body, and they need the proper nutrition to keep it up! Some foot issues can be directly linked to diet. There are two essential nutrients that your body needs at any age: calcium and vitamin D.
These nutrients work hand-in-hand to build and maintain strong bones. Calcium keeps the bones fortified, and vitamin D helps your body absorb that necessary calcium. Bones become brittle and can easily be fractured with an insufficient amount of either nutrient.
Nutrition is important at any age.
Starting children on a healthy, calcium-rich diet early is key to helping them grow strong in the future. Poor childhood diet could lead to complications later in life, including weaker bones. Good sources of calcium come from milk, yogurt, almonds, cereals fortified with calcium, eggs, white beans, kale, and black-eyed peas. Many non-dairy kinds of milk such as almond, soy, hemp, and cashew are fortified with double the calcium than dairy. Even through adulthood and into the golden years of 65 and older, your body needs at least 700mg of calcium a day.
Get some sun!
Although you can get vitamin D through many fortified foods or supplements, such as cod liver oil, it can be tough to get your daily recommended amount. For most people, sunlight is the best way to get this essential vitamin. Sunlight converts cholesterol to vitamin D in your body. This means all you need to do is spend some time outside on a nice sunny day!
Ensuring that you have proper levels of all necessary nutrients in your body will ensure your feet will stay strong and healthy to carry you through the day. If you need help planning a healthy diet for a healthy body and healthy feet, contact us at 734-522-7676.