How to Reduce Foot Pain

Metatarsal stress fractures or a bone spur can cause pain at the top of the foot. A bone spur is an enlarged bone that looks like a bump on top of the foot. The bone spur is likely the result of too much pressure or too tight shoes.

The most common remedy for bone spurs involves wearing a larger size shoe and not tying shoelaces quite so tight so that you take some of the pressure off the bone. Remember, feet swell when running long distances. If you’re a runner, you might want to cut a piece of foam rubber about ΒΌ tick to make a doughnut-shaped pad that will fit over the bone spur. Put it on before you run, or glue it to the tongue of your running shoe.

You can also reduce the pain of bone spurs by keeping your weight under control. You should also try to minimize the shock to the feet from constant pounding on hard surfaces. Choose footwear with some padding or shock-absorbing materials.

A bone spur or overgrowth that develops on top of the bone may prevent the bone from flexing as it should, especially when walking. This results to a stiff big toe also known as hallux rigidus.

Hallux rigidus commonly affects adults between 30 and 60. There are no good explanations as to why this condition happens to some and not others. But one theory suggests that hallux rigidus is the result of an injury to the toe that damages that articular cartilage.

The usual symptom of hallux rigidus is difficulty bending the toe up and down, especially when walking. This type of foot problem is easy to treat in its early stage. Waiting for the bone spur to appear on top of the foot will only make the condition more difficult to treat.

There are many non-surgical options for treating pain on the top of the foot. Using pain relievers and anti-inflammatory drugs such as ibuprofen can help to reduce the swelling and pain. Using ice packs or taking contrast baths may also reduce inflammation and control symptoms for short periods. These measures provide temporary relief, but are not enough to prevent the condition from developing further.

Wearing shoes with plenty of room at the toe may also help in reducing the pressure — and high heels are out I’m afraid. A shoe with a stiff sole, either with a rocker or roller bottom design and sometimes a steel shank or metal brace in the sole maybe required. For supporting the foot and reducing the bend of the big toe this type of shoe is excellent, especially when walking.

A contrast bath might also prove helpful. This technique involves putting your foot in first cold, then hot water to reduce inflammation. There are two buckets required, one bucket containing cold water and the other with hot water (at a tolerable temperature of course). Alternate between the cold and hot water for five minutes ending with a cold session. Surgical options may also be considered for severe foot problems.

If you think you have any of the foot problems discussed here, consult your own doctor for the treatments that will be best for your unique situation.

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Choosing the Right Varicose Vein Doctor

Varicose veins affect a huge part of the population today. Unlike the past, new technology and procedures have revolutionized the treatment of varicose veins and other venous disorders that is the most beneficial to the patient. Treatment no longer requires hospitalization or general anesthesia or down time for the patient. There are many doctors from many different specialties performing these highly technical treatments. The problem is that not all of these doctors are qualified enough to provide the patient with optimal outcomes. How do patients choose a highly qualified vein doctor? They ask certain questions and perform a little research before agreeing to become a patient. Here we will discuss what questions to ask and where to find the information needed to make a sound decision.

Patients, or prospective patients should never be afraid to ask doctors questions. If they feel uncomfortable asking questions a family member or friend could act as a patient advocate. If the doctor is uncomfortable answering or avoids answering any questions it is a good sign he or she does not have the correct answer. When this happens it is definitely time to move on and talk with a different doctor. Chances are pretty good they are not comfortable with the technology or procedures the patient requires.

Question #1 – Is the doctor board certified in Phlebology?

To become an ABPh diplomat, an applicant must complete the requisite training or experience qualifications, meet the continued medical education requisites, and pass a stringent certification examination offered by the American Board of Phlebology. Certification periods are ten years and maintenance is dependent on the ability of the diplomat to display competency in four areas of assessment, evidence of professional standing, evidence of commitment to life-long learning and periodic assessment, evidence of cognitive expertise and evaluation of performance in practice. This certification can be confirmed by visiting the American Board of Phlebology web site and click on the “find a physician” button. This question can be avoided by researching first.

Question #2 – Where did they train to become a phlebologist (vein doctor)?

Believe it or not many of the doctors performing these highly technical varicose vein treatments were actually trained by a sales representative. This is not the best training because the sales representative’s main concern is selling their equipment and supplies. They do not have the patient’s safety or outcome in mind. Other older surgeons are actually still treating veins the same as they did 20 years ago and have not kept up with the advances. The optimal vein doctor has been trained by an experienced Phlebologist who has immense experience in the technology and treatment options. Most of these Phlebologists have actually played a part in developing these new treatments. Their training involves the entire realm of vein care and treatment. They are highly concerned about patient safety and outcomes.

Question #3 – How many varicose vein procedures have they performed and how many complications have they encountered?

This is a very significant question and should be answered with semi-detailed answer. Do not accept answers such as several, some, a lot, or many. A varicose vein doctor should be able to give you an estimated number answer like about 10, over 50, or at least 100 or something like that. This is important because of the learning curve that is essential to become proficient in performing the latest and technical treatment procedures. You want to choose a phlebologist that has perfected his or her technique. This may produce a better outcome. Also is it important to ask about complications and how many they have encountered. This question may very well produce a general answer such as a few but the important fact you need is that they know what complications that may occur and they know how to treat them. Also find out if they would be the doctor treating any complication that may occur or would an additional doctor do this.

Question #4 – Where will venous treatments procedures be performed?

Varicose vein treatments used today are developed to be performed in the doctor’s office or clinic. They do not require a hospital setting or general anesthesia (going to sleep). There are two reasons why a doctor may make use of the hospital to provide these procedures. The first reason is that they do not possess the necessary equipment such as a laser and the ultrasound machine and will utilize equipment and supplies provided by the hospital and/or sales representative. The second reason may be that they do not have the necessary skills to perform the ultrasound examination required and will make use of the hospital ultrasound technician. Regardless of the reason using the hospital facility indicates that this doctor is not fully dedicated to acquire the necessary equipment or skills to provide optimum care for the patient. It also indicates that they do not perform very many of these procedures to make it cost effective to invest in the specialized equipment.

The use of general anesthesia should never be indicated for any varicose vein procedure. This is an unnecessary risk to the patient. Always avoid a doctor who insists on general anesthesia. Insisting on general anesthesia may indicate the doctor does not want you to be conscious during the procedure. This may be because they take a very long time to complete the procedure, usually due to the inexperience, and the patient will become uncomfortable remaining still for so long. Most vein treatment procedures can be completed by a qualified Phlebotomist in about 30 minutes or less. Neither is a good indication of a competent phlebotomist.

Question #5 – What services do they provide?

A phlebotomist who is devoted to the treatment of varicose veins will provide a full regiment of services for diagnosing and treating all venous disorders. Diagnostic services must include the Doppler ultrasound examination necessary to find the root cause of the problem. This ultrasound service is also very important for varicose vein laser treatment so it is significant that the doctor is skillful in using this tool. A vein doctor that is dedicated to the practice of treating varicose veins should provide the full spectrum of the most up to date treatments. Treatments include compression stocking therapy, Endovenous Laser Ablation, sclerotherapy, trans dermal treatment of spider veins and micro phlebectomy. Doctors who do not offer all these services may opt to send the patient to other doctors for specific treatments. Patients should be conscious of this.

Question #6 – Do They Have a Website?

Doctors who are dedicated to the treatment of varicose veins will always have a web site dedicated to vein disorders. This is the place where they can offer patients and prospective patients information about the doctor and their vein practice. Actually a visit to the vein clinic’s web site may also answer many of these questions for the patient before they even set up an initial appointment. A vein doctor’s web site should have information about the doctor, the staff, their location and contact information and the services offered.

In conclusion it is very important that these questions and any other questions patients may have be asked when choosing a qualified and dedicated vein doctor. Again, never be fearful to ask these questions. Qualified vein doctors welcome them because it gives them a opportunity to brag about their qualifications and doctors like to do that. Unqualified or undertrained doctors who do vein procedures may not respond well to these questions and try to evade answering them. Patients should avoid these doctors. With these 6 simple questions and a little research patients can be assured the best care possible with a most favorable result for their vein disorders.


What Are the Various Sclerotherapy Side Effects?

When a person notices an irregularity regarding the veins on their legs, there are a couple of things that he (but usually a she) can do. The first thing is to ignore them, since they are often more of a cosmetic nuisance than anything else. The second thing they can do (especially if the veins are painful) is seek medical treatments.

Sclerotherapy is a treatment that has been used to treated problematic veins for many years, but it is important to be aware of any possible sclerotherapy side effects as well. This procedure involves injecting the problematic veins (usually spider veins) with a sodium chloride solution that is mixed with heparin and lidocaine. Via several sessions over a couple of weeks, the veins start to gradually face.

The sclerotherapy side effects vary from person to person. People who find that the solution does not react well with their body chemistry might experience swelling and a rash. Another one of the sclerotherapy side effects that the patient might experience is dermal staining. This often occurs if the person had taken a certain kind of antibiotic before having the procedure.

Thus, in order to avoid a myriad of sclerotherapy side effects, it is important for the person to avoid taking certain kinds of medication. In addition to various antibiotics, anti inflammatory medication (such as Ibuprofen) should also be avoided, because it affects the efficiency of the injected solution. To find out more about other possible side effects, the person should have a discussion with their doctor.

Top Five Foot Heel Pain Remedies

Years of walking and running can wear down our feet, and can be hard on our heels. Likewise, poor circulation, improperly trimmed toenails, disease and tight fitting shoes all contribute to pain in the heel.

1. Massage with water

This treatment is ideal for any type of foot or heel pain and only needs a container of hot and cold water. Here’s what you do:

a. Soak your foot for 5 minutes in cold water

b. Move the foot to a container of hot water of a tolerable temperature. The temperature of the water should not be cool or even lukewarm

c. Soak the foot in the hot water for 5 minutes

d. Return to the cold water

Repeat the procedure until the pain is gone. This process has a massaging effect that revitalizes feet by opening and closing blood vessels.

It is also a great idea to rub moisturizing lotion into your feet before getting into bed. The lotion makes feet easier to massage and therefore bring relief faster.

2. Put some heat on your feet

Using ointments enriched with capsaicin, an active natural ingredient in hot peppers also helps in relieving foot pain.

These products are excellent in cooling the pain caused by burning feet particularly for diabetes patients. Initial application of the ointment may cause some burning sensation for many people, but when used regularly, the burning effect is likely to lessen.

Moreover, people who been using the capsaicin in treating their burning feet have experienced great improvement and were able to walk more easily compared to those using other types of creams. Best of all, since these are topical medicine, patients tend to avoid a lot of side effects that usually happen when taking pills.

Most ointments are available over the counter, however it is important to talk with your doctor before you begin, as this type of therapy is not right for everyone.

3. Avoid high-heeled shoes

For recreational walkers and runners it is important to temporarily lower how much you’re walking or running when you’re about to use brand new shoes. This will help you to eliminate many of the break-in pains. Advances in shoe development have made modern athletic footwear much less likely to cause a problem than ever before.

4. Stretch out your calf

Stretching the heel cord at the back of the foot can relieve heel pain.

Start by:

a. Standing three feet away from a wall, place your hand on the wall.

b. Lean in to the wall, bringing one leg forward and bending at the elbows.

c. Keep your back leg straight with the heel on the floor and then gently stretch the calf muscle.

d. Repeat for the other foot.

e. Buy shoes that fit the shape of your feet.

Shoe size is considered to be the most important aspect in buying shoes — but the shoe shape is equally important. You read it right; the shape of the shoe is also an important factor to consider.

There three basic foot shapes — curved, slightly curved and straight. Although, there may be some variations, generally those individuals with high arches need a curved shoe; those with flat feet need a straight shoe and those who have neither flat or high arches need a slight curve.

When buying running or walking shoes it is best to select shapes that fit the curve of the arch on the inner side of the foot.
Before you try any of the remedies discussed here, consult your own doctor for the treatments that will be best for your unique situation.


Basics Of Foam Sclerotherapy For Varicose Veins Treatment

There are many ways to treat varicose veins. Depending on the circumstances and the surgeon, endovenous laser treatment (EVLT), radiofrequency occlusion, or simple compression stockings may be recommended. Another approach is called foam sclerotherapy.

This method uses a chemical that is injected into the target vein to cause inflammation to the blood vessel. The inflammation produces scarring along the vein’s inner wall, which causes the blood vessel to close. When it closes, blood flow through it is stopped, and the vein eventually disappears. This eliminates the dark, twisted, and bulging appearance that is characteristic of varicose veins.

Below, we’ll describe foam sclerotherapy is more detail, beginning with how the procedure works. We’ll then take a brief look at other chemicals that are used, and explain how they compare to foam. You’ll also learn what to expect during the procedure, as well as some of the possible complications.

How Foam Sclerotherapy Works

As already mentioned, the procedure is designed to inflame the inner wall of the target blood vessel. This causes scarring, which in turn causes the vein to harden and close. The vein disappears, removing the ugly bulging that was once evident on the surface of the skin.

Most variations of sclerotherapy use a chemical (or sclerosant) in liquid form. Foam sclerotherapy uses a formulation that is foamy. The sclerosant (sodium tetradecyl sulfate, or STS) is usually mixed with carbon dioxide to create the right consistency prior to injection. Once the proper consistency has been reached, the solution is injected.

Foam Versus Alternative Sclerosants

Foam offers a couple of notable advantages over other sclerosants. First, because of its consistency, the foam forces blood out of the vein, rather than working around it. This allows it to fill the blood vessel more completely, and thus maintain a higher level of contact with the vein’s lining. As a result, the inflammation and scarring caused by the foam throughout the vein is more evenly distributed.

Second, the foam sclerosant can be observed through ultrasonography. This allows your surgeon to monitor its progress as it fills the target veins. The ultrasound images will help your surgeon determine whether more is needed to cover a blood vessel’s wall. While liquid sclerosants are effective, foam provides better coverage, and thus better results.

What To Expect During The Procedure

Your doctor will apply a local anesthetic on the site over which the foam is injected. The anesthetic will reduce the sensation in the area as the inflammation and scarring occur. While observing the area through ultrasound, your doctor will inject the sclerosant, and monitor its coverage of the target vein’s wall.

The foam is typically injected into the larger blood vessels first. Then, it is introduced into the smaller ones. As it is injected, your doctor may gently stretch the skin to help distribute it more quickly and evenly. If an anesthetic is not used, you may feel a slight burning sensation in the treatment area. But it dissipates quickly. The entire procedure can usually be completed in less than an hour.

Risks Associated With Foam Sclerotherapy

There is a slight risk of complications with foam sclerotherapy, partly due to potential mistakes made by your doctor. The needle may be introduced into the wrong blood vessel, or poorly positioned for the injection of the foam. This can lead to tiny blood clots, bruising, and hyperpigmentation. Also, the Food and Drug Administration has suggested that use of the foam sclerosant may be linked to the development of blood clots.

Varicose veins, caused by incompetent valves in the superficial blood vessels, can appear unsightly. However, they can also be treated with minimally invasive methods, such as foam sclerotherapy and endovenous laser therapy. If you are coping with pain, or simply dislike the appearance of your varicose veins, discuss your treatment options with your doctor.


What Is Foam Sclerotherapy?

Foam sclerotherapy is a treatment for spider veins that works by irritating the vessel lining, causing the vein to shrink, collapse and eventually fade away completely. Spider veins may not be painful or cause heaviness in the legs like varicose veins, but they may be just as embarrassing due to their unsightly appearance. Because they do not cause pain or heaviness, they are generally not considered a medical problem, but rather a cosmetic one. If you’re suffering from spider veins, it’s important to see a doctor to make sure that you are not suffering from varicose veins, but most consider this venous condition a cosmetic concern.

Foam sclerotherapy utilizes a foam chemical sclerant that is injected into the treatment area. A topical anesthetic may be applied to ensure comfort throughout the procedure. The specialist will inject the area being treated with the sclerosing foam and may use ultrasound to ensure that it spreads effectively in the treatment area. It may require more than one injection to treat the entire area to be treated, and most foam sclerotherapy procedures take between 30 minutes and 45 minutes to perform.

One of the more attractive benefits of foam sclerotherapy is that it does not require a lengthy recovery period. Most patients are able to return to work or other normal activities immediately following treatment with foam sclerotherapy. If veins in the legs are treated, patients may be encouraged to wear compression stockings during their recovery to aid in the healing process and promote healthy blood flow.

As with most medical procedures, there are also certain risks and complications that have been associated with foam sclerotherapy. These may include microembolisms, which are tiny blood clots that may form in the treatment area. Itching, redness and bruising have also been associated with foam sclerotherapy, although these should resolve on their own after a couple of days. Patients are always encouraged to consult their doctor regarding side effects and risks associated with this or any procedure.

As mentioned earlier, spider veins are typically considered a cosmetic concern. Therefore, most insurance companies do not cover the cost of treatment, although in cases where large veins are involved, insurance may provide coverage. It is important to consult with your doctor and insurance company to learn whether this procedure will be covered. Most procedures range from around $200 to $500, although this may vary depending on geographic location and the extent of the area being treated.


A New Treatment Approach To Heel Pain

Heel Pain, often referred to as plantar fasciitis and heel spur, is one of the most common complaints presenting to a Podiatry clinic and is frequently a more complex problem than many first believe. Plantar fasciitis is an overuse injury affecting the sole or plantar surface of the heel. A diagnosis of plantar fasciitis means you have chronic degeneration of the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes. Often patients are told that they have a heel spur. The heel spur is simply a reflection of excessive tension at the attachment of the fascia to the heel bone; there is no correlation between a spur and the onset of pain. It is the degree of degeneration of the fascia that causes the pain.

The condition starts gradually with mild pain under the heel often referred to as a stone bruise. You’re more likely to feel it after (not during) exercise. The pain classically occurs on taking your first few steps in the morning and again after a period of rest. If you don’t treat plantar fasciitis, it may become a chronic condition resulting in additional symptoms of foot, knee, hip and back problems as your walking pattern changes due to the pain.

Traditionally treatment has included ice massage, orthotics, calf stretches and sometimes Cortisone injections. Whilst these treatments may still have a place in treating heel pain, excluding ice massage, a new treatment approach has emerged that has the ability to yield faster more long term resolution of symptoms.

More recent treatments are aimed at improving the function of the supportive muscles of the foot so that the ligament is better protected and has more chance of repairing. This is important as, although the plantar fascia is one of the main supportive structures in maintaining the upright posture of the foot, there are at least 2 other muscles in the foot that have a similar role. Therefore if the plantar fascia is injured, the other structures will have to overwork and compensate resulting in over-sensitive muscles that fatigue early and develop knots (known as trigger points) further stressing the injured plantar fascia. If ignored, the cycle will continue.

A relatively new treatment that addresses this muscle dysfunction is Dry Needling (Not traditional Eastern Acupuncture) whereby a very fine acupuncture needle is inserted into the skin and muscle directly at a trigger point. The aim is essentially to reprogram the muscle, break up the knots and improve function. This is often done in conjunction with other therapies such as heat massage, joint mobilisation/manipulation and orthotics, to address the underlying cause of plantar fascia injury and subsequent trigger points.

Another treatment option is Prolotherapy, which is the injection of small volumes a local anaesthetic/glucose solution using very fine needles to promote the production and release of growth factors that can aid in the repair of the plantar fascia.

Many of the above treatment options are used in combination rather that in isolation as all of the factors affecting the healing capabilities of the plantar fascia need to be addressed including muscle and joint dysfunction, foot posture, activity levels and type and footwear.


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