When Does Foot Pain Necessitate an Appointment?

When Does Foot Pain Necessitate an Appointment?

One thing it seems almost every person struggles with at some point in their life is when to pick up the phone and make that dreaded call to schedule a doctors appointment. For some this is easier than for others. However, I believe it’s safe to say no one is excited to make the call. Generally what this means for most people is they’ve finally succumbed to whatever kind of ailment they’re suffering from. Our goal at the Foot & Ankle Specialists of Treasure Coast is to offer a guideline of when pain is no longer acceptable nor considered a routine ache or result of aging. To objectify something such as pain that can seem to be quite subjective we offer a few simple questions to consider when determining whether or not that foot pain is “normal”, and whether or not a call to the local podiatrist is necessary.  To many this may seem like common sense but I can’t stress enough how many patients present with pain that is ten fold due to their blind hope of the ailment spontaneously resolving.  Without further ado…the questions:

1.    Is the pain linked to a traumatic event?

 i.e. did you drop something on your foot? Were you in a car accident? Did you walk through a dark room and severely stub your toe on the bedframe?

2.    Do NSAIDs and icing only dull the pain temporarily?

i.e. has the pain been present for more than 48 hours? Is it sharp and without resolve in spite of minor intervention like NSAIDs and icing?

3.    Is the painful area severely bruised and/or discolored?

4.    Is the area of insult infected?

 i.e. hot, red, swollen, tender, odorous?

5.    Has the issue affected your regular sleep patterns?

6.    Has the issue affected the way you walk and any of your daily activities?

We strongly recommend that if you answered yes to 2 or more of any of the following 6 questions you should seek the evaluation of a podiatric physician. ***With the exception of question 4. In that case this is reason enough to see a healthcare clinician due to the potential for local infections to spread systemically and cause serious sickness and death, especially in the immunocompromised. Please keep in mind that the following is merely a list of questions, and not hard and fast rules.  For many people, any pain at all is more than enough cause to precipitate an appointment -this is never a bad rule to follow.

**This blog, and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years, and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.

Why Corns Aren't Normal

Corns and calluses are so common almost every person on this earth will experience one at some point in their life. Calluses are most often seen on the hands, but also form on the bottom of the feet and other various places. Corns are calluses that are seen on the tops and sides of the toes. These areas of thickened skin caused by focally increased pressure and rubbing are indeed benign. To people that use their hands for a living, calluses can actually provide extra cushion and blister prevention. Considering this, the prevalence of corns and calluses, and their often harmless etiologies many people assume it is normal to have them on their feet, like they do on their hands. However, this is simply not true. As aforementioned, corns and calluses are developed due to increased pressure and friction. While calluses on the hands often indicate manual labor or activities like rowing and lifting weights, on the feet the story is very different. While some people will wear gloves to prevent callus formation on the hands, many people do not, explaining the calluses. In contrast to this, the great majority of people wear socks and shoes during labor and exercise, yet how can areas of hyperkeratosis (thickened skin) be explained if they have a protective barrier (socks and shoes) in place? This is due to an abnormal foot architecture, or poorly fitting footwear.

A classic example of this abnormal architecture is the hammertoe. The actual shape of the toe has changed due to a few different possibilities causing the toes to become contracted in the shoebox, encouraging rubbing, and overtime corn formation. Hammertoes certainly are not the only cause of corns. They are simply one commonly encountered example of an underlying foot problem that has caused an excess of skin formation that may often be disregarded as normal. The recommendation here is to avoid the home remedies that simply treat the corn or callus, and not the underlying cause of the hyperkeratosis itself. A lot of resources can be consumed without even treating the cause.  If you have corns or calluses on your feet and/or toes make an appointment with a Podiatrist like Dr. Michael Garvin. He can evaluate your feet and your footwear, determine the actual etiology, and set up a treatment plan with you.

The following is a short list of conditions that commonly cause corns and calluses on the feet and toes:

Claw toes
Hammer toes
Mallet toes
Curly toes
Bunions
Tailor’s bunions
Pes Cavus
Pes Planus
Haglund’s deformity
Talipes Equinus

3 Great Reasons Diabetics Should Regularly See A Podiatrist

The Mayo Clinic, among other world-renowned health institutions consider diabetes to be an epidemic in America. Not only has diabetes mellitus been proven to shorten an individual’s life, but it also decreases quality of life due to the vast array of complications associated with this chronic disease. What many people who suffer from diabetes don’t realize is that lower extremity care is one of the most important entities of the disease management process. To concisely, and adequately emphasize this thought consider the following 3 facts;

1.  Up to 25% of those with diabetes will develop a foot ulcer.

-Singh, Armstrong, Lipsky.  J Amer Med Assoc 2005

2. People with a history of a diabetic foot ulcers have a 40% greater 10 year mortality than people with diabetes alone.

-Iversen, et al, Diabetes Care 32:2193-2199, 2009

3. Each $1 invested in care by a podiatrist for people with diabetes results in $27 to $51 of healthcare savings.

-JAPMA, 101(2), 2011

Diabetes affects 26 million people in the US and more than 366 million people worldwide. Additionally, diabetes kills more people in the US every year than AIDS and breast cancer combined. The people suffering from it need to understand the importance of receiving proper treatment, and from whom; to have a better outcome. The aforementioned facts clearly demonstrate the importance of proactive care in the disease management and prevention process of diabetes.

Other sources: American Diabetes association

**This blog, and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years, and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.

Lisfranc Injuries in Athletes

Lisfranc injuries of the foot seem to be stealing the headlines lately. Both Cedric Benson, NFL running back for the Green Bay Packers, and Santonio Holmes, wide receiver for the New York Jets both recently suffered from Lisfranc injuries. Santonio Holmes injury was bad enough the Jets team doctors determined he will not play for the remainder of the season. While Lisfranc injuries may not be as common as ACL tears, they definitely are relevant in traumatic sports injuries, and often go undiagnosed.

So, what exactly is a Lisfranc’s injury? It’s an injury to the midfoot that involves either the transverse joint that spans the midfoot, or the ligament that connects the medial cuneiform and 2nd metatarsal bones. Both the aforementioned joint and ligament are named after French surgeon Jacques Lisfranc de St. Martin. When an athlete suffers a so-called Lisfranc injury, most often times the ligament has been sprained or ruptured due to excessive force with abnormal motion, and/or impact. The significance here is that Lisfranc’s ligament has a huge role in supporting the medial arch of the foot during standing, walking, and running for example, and an injury to the area requires proper rehab, and sometimes surgery for full recovery. Symptoms seen with this injury include midfoot swelling, redness, pain, and inability to bear weight.This isn’t an injury that will heal well on it’s own with simple rest and icing. Lisfranc injuries should be assessed for severity, and treated by a doctor to achieve proper healing, prevent osteoarthritis secondary to the trauma, and avoid loss of joint range of motion.


**This blog, and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years, and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.

Why You Shouldn't Buy Drugstore Orthotics

The human foot is one of the most beautifully engineered vehicles that exists. On an average day each one might endure between 8,000-10,000 steps; each one placing 1.5 times your bodyweight of force on it. Despite these amazing statistics, if we care for them, they can last a lifetime. However, this brings up an important point; care. It only makes sense that proper attention and maintenance be given to such an important part of our body since its responsible for our transportation. To podiatrists dismay, many Americans don’t view their feet from such a perspective. Let’s take for example orthotics. They are a mainstay of conservative treatment for everything from plantar fasciitis to congenital anomalies yet it’s often considered normal to pick up a non-customized pair from the drugstore. This may seem cost effective and efficient but if people understood the gravity behind such a casual decision they’d reconsider this choice. Feet are like snowflakes, there isn’t a single pair out there that is exactly alike. It would only make sense that to receive the greatest benefit from a device such as an orthotic it be totally customized to the exact shape of both your left and right foot. If you told your neighbor you had a hard time seeing due to buying non-prescription glasses from the local pharmacy they’d look at you incredulously. Immediately following with the question of why you wouldn’t see an optometrist to receive a pair designed to correct your unique impairment. Orthotics are very much the same. They must be customized and designed exactly for each of your unique feet to truly get any benefit from them.

If you’re suffering from any sort of pain, or are simply looking for a means of better support during athletics, or long stints on your feet consider a pair of fully customized orthotics. Podiatrists like Dr. Michael Garvin of Port Saint Lucie, Florida have the ability and skill to take the most accurate impressions of your feet possible, and have orthotics made from them. There is a reason orthotics have been a method of treatment for foot pain and support for over 50 years.

PADnet Helps Save Lives

Many people are not aware, but maybe the single greatest determinant of your health is the quality of your vasculature. There isn’t a single tissue in the human body that isn’t severely affected when the blood supply to it is compromised. Peripheral arterial disease is a manifestation of having chronically damaged blood vessels due to a variety of reasons such as diabetes, smoking, high cholesterol levels, over the age of 50, and the African American ethnicity. These are all etiologies that are extremely prevalent in our society. Research suggests that 12-14% of the general population in the United States is afflicted by vascular disease. What’s scary is that 70-80% of this group is asymptomatic, meaning an individual may appear to be healthy enough one day and the next lose their life by way of a heart attack. Peripheral arterial disease is an extremely life altering disease that is very underreported. Simply having a past history of smoking and/or high cholesterol predisposes an individual to peripheral arterial disease.

To truly know the quality of your vasculature more qualitative testing than simple blood panels and pressures needs to be performed. PADnet is a service offered by Dr. Michael Garvin that offers the kind of critical data that could save a patient's life. PADnet is a computerized system that only takes 15-20 minutes to be performed on a patient. It is minimally invasive and offers the patient no discomfort. PADnet is an amazing new technology that can be done in office. Avoid being part of the underreported statistic and have the health of your blood vessels assessed by a physician utilizing PADnet like Dr. Garvin; it could save your life.

To contact Dr. Garvin of Port Saint Lucie, Florida click here.


Sources cited: http://www.nhlbi.nih.gov/health/health-topics/topics/pad/treatment.html
       http://www.biomedix.com/products/padnet_plus.asp

Treating Plantar Fasciitis with Platelet Rich Plasma

Plantar fasciitis is inflammation of a sheet-like connective tissue structure that spans from the plantar calcaneus, or heel bone of the foot, to the ball of the foot (metatarsal heads). Plantar fasciitis is the most common cause of heel pain. It is sometimes also referred to as Heel Spur Syndrome (HSS). The causes of inflammation are diverse and can be due to a variety of abnormalities in gait and behavior. The most common cause in the average population is excessive pronation of the foot during walking and/or running. The plantar fascia acts to passively stabilize the arch of the foot, and also assists in propulsion during walking and running. Due to the frequency of use during normal daily activities (climbing stairs, walking, squatting, etc) the plantar fascia is prone to becoming inflamed in many individuals.

Orthotics and stretching have rightfully been a mainstay of treatment for patients with acute plantar fasciitis over the years. They’re safe, healthy ways a doctor can treat the inflammation and keep the patient on their feet. However, often times these methods fail and doctors resort to steroids or other methods such as surgery when the condition turns chronic. Dr. Michael Garvin of Port Saint Lucie, Florida suggests trying something new, and safe that avoids the pitfalls seen with steroid use, and/or surgery. Platelet rich plasma (PRP) injections have been proven by literature and research to help heal chronic wounds and ailments over the years. In fact, research has shown that 70% of patients with chronic plantar fasciitis have seen partial to full resolution of pain with treatment by PRP injections. If you have further questions about receiving this type of treatment for your chronic plantar fasciitis contact Dr. Garvin by clicking here, and also by visiting this informational page here.

**resources: podiatrytoday.com
                    harvesttech.com

Even Steven Tyler Suffers from Morton's Neuroma Pain

In a recent interview, Steven Tyler the Aerosmith frontman admitted that he suffered from severe foot pain due to a Morton’s neuroma he developed from years of entertaining. The pain he experienced from the neuroma was great enough that it was part of the motivation behind his decision to judge on American Idol, as it allowed him to stay off of his feet.

A Morton’s neuroma is classified as a nerve compression syndrome; most commonly involving the digital nerves found alongside the metatarsals, & leading into the toes.  A neuroma is a growth of nerve tissue that can develop due to habitual pressure and irritation. A deep ligament in the foot, and the metatarsals that surround the nerve(s) rub against it, causing what is known as perineural fibrosis. Morton’s neuromas are most commonly seen in the 3rd interspace of the forefoot. This condition is most common in women, and during middle age. In Steven Tyler’s case, the compression or irritation that most likely caused the abnormal growth of nerve tissue was due to overuse, and possibly improper footwear as well. The reason women often suffer from neuromas is due to their choice of footwear with narrow toe-boxes, such as high heels. The narrow toe box doesn’t offer the forefoot proper space; this causes all the structures in the forefoot to become crowded, and cause the ligaments and bones to impinge upon the nerves causing irritation and eventually neuroma development. Not all neuromas are due to footwear choices. Some foot types or individuals with abnormal gait patterns are also more prone to developing neuromas.

The symptoms that generally present with a Morton’s neuroma are pain that radiates to the toes, or more proximally into the foot, burning, numbness and tingling. Additionally, the pain is often times described as sharp. Many patients will describe the feeling or sensation of having a pebble or sock bunched up under the ball of their foot. Pain usually worsens with walking, and is almost always further exacerbated by wearing shoes that cause compression at the metatarsal heads.

The diagnosis of a Morton’s neuroma is based upon clinical presentation. A podiatrist like Dr. Michael Garvin will use a variety of minimally invasive techniques to accurately diagnose this nerve condition, so patients can get back to being pain free as soon as possible. If any of these aforementioned symptoms sound similar to pain you’re experiencing don't hesitate to contact one of Dr. Garvin’s offices in Port Saint Lucie, Florida, or browse through his website for additional information.

5 Suggestions for Keeping Your Feet Healthy

Are you confident that your daily decisions aren’t negatively affecting your foot health? There are a lot of variables that we subconsciously factor into our choices of footwear and care on a daily basis-that we may not even realize are potentially detrimental. Below is a short list of suggestions that will help prevent a trip to the doctor due to your casual decisions.

• Pay close attention to your feet during routine hygiene; this includes noting the skin texture/quality, toenail color, & any irregular lumps and bumps

• If you’re aging, stay on top of keeping the skin on your plantar and dorsal feet moisturized. Dry, cracking skin is more prone to fungal, bacterial and viral infections

• Wear shoes that are well fitting and match your activity levels for each day. I.e. if you’re spending all day walking at a mall, or an amusement park choose a pair of supportive running shoes instead of something fashionable

• There’s a time and place for stilettos and flip-flops. Both can cause a flare-up of plantar fasciitis or achilles tendinitis, so if you know you’re going to have a long day save them for the short and sweet occasions exclusively

• Going barefoot seems so attractive at waterparks, the community pool, and the beach, but sometimes this can be a big mistake. Areas that are high traffic and always wet can be a breeding ground for fungi and viruses. This is the time to grab your favorite pair of podiatrist recommended flip flops and avoid cutting your foot on a shell at the beach, or picking up athlete’s foot in the locker room

**This blog and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.