Dr. Mayer  Salama
Dr. Daniel Salama
Dr. Brendan Johnson

Dearborn MI- (313) 274-0990

Trenton MI- (734) 675-2440

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May Articles 2013

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.


Ankle Sprains

Ankle sprains can be quite the painful experience. Often times the injured person will experience limited mobility, swelling, and, depending on the severity, discoloration of the skin. This type of injury takes place when the ligaments are torn or stretched beyond their limits. Although this can occur in various areas of the body, the ankle is the most common site for a sprain.

There are multiple ways that the ankle can become injured like this. However, the simple act of walking may cause a sprain. If footing is lost or the person is walking on uneven terrain, local damage may occur. This may be especially so for athletes that continually push their limits, or for the person who has suffered from a previous accident involving the lower extremities.

In the majority of cases, medical attention is not required for a sprained ankle. Remedies for self-care at home include propping the ankle up, applying ice packs as needed, and remaining off your feet. Some may also find that wrapping with an ACE bandage and taking over-the-counter pain relievers are helpful. One of the most important things is to avoid further stress to the affected area.

Although rare, complications may arise and obtaining medical treatment may become necessary. A severe sprain can actually tear the ligament and even damage the muscle. When this occurs, the person may have to be off their feet for a prolonged period of time. Depending on the severity and nature of the damage, surgery and physical therapy may be required. Seeking out a podiatrist will help in making these decisions.

Sprained ankles are painful in nature, but those with severe unrelenting pain may have sustained a worse injury than previously though. If walking becomes too painful for the person to take more than a few steps, swelling becomes too severe, or if numbness or tingling is present, immediate medical attention should be sought. Mild to moderate bruising is common with a sprain but redness of the skin or worsening of the discoloration should not persist either.

One of the best treatments for an ankle sprain is to prevent it in the first place. Wearing appropriate shoes for the occasion, stretching before exercises and sports, and knowing your limits can aid in prevention. Those that have suffered from a previous sprain may want to consider additional support, such as a brace and regular exercises to strengthen the ankle.



New Treatment Helps Relieve Heel Pain Caused by Plantar Fasciitis

Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be inaffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one time out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.


Blisters on the Feet

If you have ever worn a pair of shoes that were two tight or just rubbed you in the wrong place, then chances are that you have experienced the pain of having a blister formed. To better understand how blisters form, what treatment we should apply for blisters, and how we can avoid having them form, we should learn more about what blisters are.

A blister on the foot is basically a small pocket that is fluid filled. This pocket typically forms on the upper layers of skin, because those layers are so thin. The majority of the time, blisters are filled with clear fluid; however, sometimes the blisters may be filled with blood and even pus if they have become infected due to bacteria entering the blister pocket.

Blisters on the feet are almost always a result of a shoe rubbing the foot constantly which results in what is termed a friction blister. These blisters occur after you have walked for very long periods of time or when you wear a pair of shoes that do not fit your feet properly. Blisters also form more easily if your feet are moist.

If you experience the displeasure of having a blister form on your foot, then proper treatment is an absolute must to alleviate pain and to prevent infection. In general the best treatment for blisters that are full of clear fluid is to just leave them alone. Your body will form new skin under the blister and then when the time is right your body will allow the blister to pop. If you try to lance the blister you may introduce bacteria in it that will lead to an infection. If the blister is painful, then you can use a band-aid over it to provide some cushioning which should relieve pain.

If the blister is filled with blood or pus, then the best treatment is to seek out the attention of a doctor. These blisters may need to be further evaluated and you may be given antibiotics to destroy any infection that you may have.

Preventing blisters on the feet is the best way to prevent any pain or infection that could occur. You can prevent blisters by keeping your feet dry and by making sure that you wear a proper pair of shoes that fit your feet well, without being too tight or too loose. If you do feel a place on your foot where your shoe is rubbing, then applying a band-aid to that spot may prevent a blister from forming until you can change them.

2013
April - May

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