Wrestling with Restless Leg Syndrome

(Photo credit: Wikipedia)

Do you ever experience a sensation in your legs that occurs usually in the evenings or during the night that makes it difficult to sleep? You may be experiencing some symptoms of Restless Leg Syndrome (RLS).

Sensations that are experienced include:

• Leg pain
• Itching 
• Burning
• Tingling
• Cramps
• Pulling or tugging

Symptoms have been known to start in the evening usually while seated, and persist and get worse during the night often leading to insomnia. This may lead to typically irritable and tired behavior during the day, especially on the part of children. RLS tends to begin slowly then increase in frequency and severity. Sometimes it affects the arms as well as the legs. There is no known specific cause for RLS, which seems most often to affect people middle aged and up. There may be a genetic propensity, although a specific genetic link has not been identified. Some medications may also play a role.

Other conditions have symptoms similar to RLS, which makes it more difficult to diagnose. In order to clearly define some parameters for this condition the National Institutes of Health specifies four criteria that must be present:

• Symptoms start or get worse in the evening or at night
• Strong desire to move the legs
• Relief occurs with walking
• Symptoms start or worsen during periods of inactivity

You are more apt to have RLS if you suffer kidney disease, diabetes or have an iron deficiency. It is not considered a serious or life threatening condition, but it often leads to insomnia and the inability to stay alert during daytime hours. Often the unpleasant sensations that are experienced can be overcome by getting up and moving, but this can lead to wakefulness and decreased sleep quality.
It is difficult to treat a condition that is so difficult to diagnose because of such ambiguous symptoms that mimic other conditions or diseases, but the following may be helpful at reducing unpleasant sensations:

• Gentle stretching exercises
• Massage
• Warm relaxing baths

If you have annoying symptoms of RLS, call Dr. Blaakman and Upstate Footcare's staff at (877) 941-3338. He is sure to have some recommendations for you to help relieve the effects of RLS.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001810/
http://www.webmd.com/sleep-disorders/guide/restless-legs-syndrome-rls
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001810/

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The Doctor and the Physical Therapist

(Photo credit: Wikipedia)

The primary concern of the podiatrist should be treating the injury, and seeing to the comfort and care of the patient. If rehabilitative services are needed, this would be done by a physical therapist. There is no way to predict the number or frequency of visits that it may require for a patient to recover full use after sustaining an injury, but the primary goal of the physical therapist is to see that function is restored. Some foot and ankle specialists operating state of the art facilities may have affiliation with a physical therapist at their location. This is usually provided for patient convenience so that patients can receive all required services at one location.

Athletes usually appreciate referrals to physical therapists. They know that treatment by a therapist will expedite their recovery and restore their function to pre-injury condition more quickly. The back yard sports enthusiast, or adolescent playing high school sports, may not have that luxury. Insurance benefits may be limited to what coverage is provided, so they may need to spend their available dollars more wisely.

From the perspective of a person on the outside, looking in, the relationship between a podiatrist and physical therapist may be somewhat simplistic in its appearance. The doctor might be the equivalent of a head coach, calling the plays from the sidelines, and the physical therapist is the quarterback, provided with the knowledge, necessary to execute the play.

If you have sustained a foot or ankle injury, make no mistake about it, the doctor is calling the shots. It is his knowledge and diagnostic expertise that is getting to the root of the problem. He may then need to refer his patient to a physical therapist who will carry out his prescription and instructions pertaining to physical therapy that provides the quickest path to recovery for the patient. Call Dr. Blaakman at (877) 941-3338 (feet) if you are having a foot or ankle problem that requires treatment. His knowledgeable staff is there to answer any questions you may have to get you on the fastest road to recovery.

Visit Dr. Blaakman’s website, http://www.upstatefootcare.com/ for more information about the services he provides.

References:

http://www.physicaltherapyschdy.com/ASP_Pages/podiatry.asp
http://www.aapsm.org/plantar_fasciitis.html
http://www.podiatrytoday.com/article/6946?page=1

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Plantar Fasciitis - A Real Pain

children foot - plantar (Photo credit: Wikipedia)

The plantar fascia is a thick and wide band of tissue that connects the heel band to the toes forming the arch of the foot. When this tissue becomes inflamed and irritated due to overuse or over stretching, it is called plantar fasciitis. This is a common complaint and most often affects patients between ages 40-60.

The pain ranges from minor to severe and is usually more noticeable:

• When you first get up in the morning

• After vigorous exercise

• After long periods of standing or sitting

This is a common ailment of distance runners, and can also affect pregnant women, people who are overweight and those who do not wear shoes with adequate support. The pain usually develops gradually.

Treatment for plantar fasciitis ranges from simple non-invasive to surgical in extreme cases. Pain will usually diminish with conservative treatment methods which may include:

• Rest

• Icing

• Heel stretching exercises

• Over-the-counter pain medication

• Shoes with better arch support

• Inserts or orthotics

• Reduce mileage if you are a runner, alternate with swimming and bicycling

Generally pain diminishes with persistent treatment. Occasionally when all other methods have failed, Dr. Blaakman may recommend surgery, but surgery has risks that he will discuss with you.
As with so many foot ailments, prevention is the best medicine. Start early by keeping your weight under control, wear quality and supportive shoes. Just because your shoes look good on the outside does not mean they aren’t worn out on the inside. If you are a runner or walk aggressively, buy new shoes at 300-500 miles. You may think your old comfy shoes are your best friends, but this is not true.

If you believe you have symptoms of plantar fasciitis, see Dr. Blaakman at once. Chances of treatment being successful are greater with early intervention. During your examination, Dr. Blaakman will likely look for swelling, redness and tightness in the bottom of the foot. He may want an x-ray to rule out other conditions and he will ask questions about your medical history, if you have other pain and also ask about your physical activity. The treatment plan he develops for you will take all of this into consideration. Call him at (877) 941-3338 (FEET) so he can get you back on your feet.

References:
 
http://www.mayoclinic.com/health/plantar-fasciitis/DS00508/

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Sky High Fashion

Image via WikipediaAs you watched the Oscars a couple weeks ago, what amazed you more, the dresses or the shoes? Remember when the fashion news included who the stars’ dress designer was?  Well now the commentary isn’t complete unless we know who the shoe designer is also. This is all well and good, but to spend so much money on something that you can’t stand to be in for more than a few minutes, seems extravagant, even for Hollywood.  On February 26th, our favorite girl next door, Sandra Bullock, attended a pre-Oscar party wearing black pants, a black lace top, white jacket and a pair of black and white stilettos.  A couple of hours after arriving at the party, she was seen leaving, with shoes in hand.  She was walking the concrete carpet in her bare feet!  Now that makes more sense.

It really doesn’t make sense to become such a slave to fashion. Women are willing to undergo hours of torture and torment by cramming their feet into ill formed, poorly fitting shoes that force them to mince along, teetering like they are walking a cliff’s edge.  All attention is focused on how to maintain an unnatural balance, with a fake smile glued to the face, which covers the pinched expression the face would make and give away the painful feeling in the feet.

Understand that Hollywood egos are all about glamour and one-upsmanship, but really, can’t a shoe designer make an attractive pair of shoes with a two inch heel?  Why do heels have to be six inches high?  The foot is forced into such an unnatural position, all of the weight bearing being done on the ball of the foot.  Feel the neuromas developing now.  Oh, the burning pain from the friction.

The logical thing to do would be to start a new trend.  A designer who could actually make a shoe with a modest two inch heel and one that is elegant enough to wear with haute couture.  Now that designer could really create a niche for himself in the marketplace.  Until that happens, though, women will probably continue to stumble and trip along the red carpet, complain about their sore, tired feet and doff their shoes at the first opportunity.  Meanwhile, Hollywood podiatrists can continue to offer post-Oscar specials.

Do you love wearing high heels, but struggle with foot pain afterward?  What do you do to relieve the pain?  Comment below, we would love to hear from you.  Also, if you would like more information about foot pain and high heel wear, please contact Dr. Blaakman at (877) 941-FEET (3338).

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Haglund’s Deformity-A Walking Nightmare

Image via WikipediaHaglund’s deformity, sometimes referred to as the “pump bump” is a bony protrusion in the heel area, which is thought to be caused primarily by pressure from shoes, although there may be other factors involved. Between the bone and the Achilles tendon is a small sac of lubricating fluid which allows for easier movement. A prominent heel bump can squeeze the soft tissue between the bone and the shoe. This can cause inflammation and a build-up of tissue that creates even more pressure.

The most notable symptom of Haglund’s deformity is pain in the back of the heel. The tissue that thickens in this area and forms a callus type buildup doesn’t usually impede function or interfere with walking, but the bursitis, which causes swelling and inflammation, can create a great deal of pain when shoes are worn.

Diagnosis of Haglund’s deformity can usually be made visually, but our office will probably want to get x-rays to have a better picture of how the heel bone is shaped, and rule out other possibilities that might cause your heel pain.

Treatment can be either non-surgical or surgical. However, much of that depends upon your diagnosis.  Below are some non-surgical options, which include, but not limited to:

    •    Taking over-the-counter medications - such as Ibuprofen to reduce swelling and discomfort.

    •    Icing the area – you can use a towel between ice and skin, and apply it  to the inflamed area for 20 minutes, then wait at least 40 minutes before applying again.

    •    Exercising – this will help relieve tension in the Achilles tendon.

    •    Heel lifts or heel pads – these may help relieve pressure and lessen irritation.

    •    Changing your shoes – wearing a backless shoe will help to avoid irritation.

You can find more information by clicking here.

If non-surgical treatments fail to provide relief, surgery may be required. Dr. Blaakman will determine what course of treatment best suits you.

If you have swelling and pain in one or both heels, call our office at (877) 941-FEET (3338).

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EPAT - What do it do?

Image via WikipediaWhen going to the podiatrist office, you might hear the term “EPAT” thrown around.  What is “EPAT” exactly?  It stands for “Extracorporeal Pulse Activation Technology.”  See why it’s shortened down to EPAT?  The EPAT therapy was introduced to Upstate Footcare by Dr. Hans Blaakman and it’s designed to treat a number of different foot and lower leg issues. 

The way the EPAT system works is to promote your natural healing processes by stimulating chemical processes to get your blood circulating in the area you are experiencing pain.  This allows the blood to get new blood cells into the area as well as remove things that might be causing the pain from those areas.  This system was created because a number of people were still experiencing pain after a number of treatments did not prove effective.  By promoting the bodies natural healing processes, it is safer than surgery and the results are faster, without the long recovery period.  If you are familiar with Shockwave Therapy, EPAT uses the same technology but does not require anesthesia.

The great thing about the EPAT system is that it is relatively inexpensive.  In fact, if you have a Health Savings Account or a Medical IRA, you can have your costs covered one hundred percent!  You should check with your medical insurance to see if they cover this or not.  It will only take four sessions in four weeks, meaning one session every week for four weeks.

If you have heel pain or achilles tendonitis or another pain in your feet or ankles, EPAT therapy could be the best option for you, especially if nothing else has worked to rid you of the pain.  If you are interested, you should contact Upstate Footcare so that you can schedule an appointment to discuss the EPAT process with Dr. Blaakman so that you can start to get rid of that pain as soon as possible.

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