Illustration of nervous system with affected hands and feet in peripheral neuropathy.
5Jul

Illustration of nervous system with affected hands and feet in peripheral neuropathy.

The peripheral nervous system is responsible for sending information to the central nervous system (spinal cord) and the brain. Peripheral neuropathy is a result of damage to the peripheral nerves and nerves outside the brain. The cause of neuropathy can be because of infections, exposure to toxins, traumatic injuries, inherited causes, and metabolic problems. These cause pain, numbness, and weakness, especially in the feet and hands.

Cause of neuropathy

Different health conditions causing peripheral neuropathy include

  • Diabetes patients are more likely to develop a kind of neuropathy.
  • Autoimmune diseases such as chronic inflammatory demyelinating polyneuropathy, lupus, rheumatoid arthritis, Sjogren’s syndrome, vasculitis, and Guillain-Barre syndrome.
  • Inherited disorders such as Charcot-Marie-Tooth.
  • Bacterial and viral infections including hepatitis B and C, Lyme disease, HIV, shingles, leprosy, Epstein-Barr virus, and diphtheria.
  • Bone marrow disorders, a form of bone cancer, abnormal protein in the blood, the rare disease amyloidosis, and lymphoma.
  • Connective tissue disorders, hypothyroidism, kidney disease, and liver disease.
  • Other causes of neuropathies include alcoholism, medications, trauma to the nerve, pressure on the nerve, exposure to poisons, and vitamins B and E deficiencies.

If you are dealing with a nerve pain in your legs, you may want to seek help from a foot specialist. Feel free to contact our office to make an appointment with our podiatrist. Our foot and ankle doctor, Dr. Ejodamen Shobowale can provide you with the care you need to keep you pain-free on your feet.

Diagnosing peripheral neuropathy

The doctor first conducts a full medical history, including your family history of neurological disease, drinking habits, lifestyle, and exposure to toxins. The doctor can then recommend a neurological examination to check your sensations, nerve pain in legs, tendon reflexes, muscle tone and strength, coordination, and posture.

Tests used for diagnosis include

  • Imaging test- MRI or CT scans to check for abnormalities such as tumors and herniated disks.
  • Blood tests that effectively detect diabetes, vitamin deficiencies, and abnormal immune function.
  • Nerve function tests – In this test, a thin needle is inserted into the muscles to record the electrical activity of the muscle.
  • Skin biopsy where a small portion of the skin is tested for the reduction of nerve endings.
  • Nerve biopsy involves removing a small portion of the nerve to check for nerve abnormalities through a sensory nerve.
  • Other nerve function tests include an autonomic reflex screen which records how the nerve fibers work, a sweat test to determine the body’s sweating ability, and sensory test to record reactions to different senses such as heat, cooling, touch, and vibration.

Treatment for neuropathy in legs and feet

If you are experiencing burning feet because of neuropathy, it is very important to stop the nerve damage. Treatment of underlying diseases can improve the symptoms of neuropathy, but if not the doctor can focus on treating the symptoms. Some medications that can be administered to relieve symptoms include

Pain relievers: Nonsteroidal anti-inflammatory drugs can be used to relieve mild symptoms, but for severe symptoms, the doctor can prescribe medications.

Anti-seizure medications: these are used to treat epilepsy and very handy in relieving nerve pain.

Topical treatments: this includes the use of capsaicin cream, which contains a substance found in hot pepper. It reduces irritation and burning skin when applied and the symptoms lessen over time. Other topical treatments include lidocaine patch applied to the skin for pain relief.

Antidepressants: Tricyclic antidepressants such as nortriptyline and doxepin relieve pain by interfering with the chemical processes spinal cord and brain. Norepinephrine reuptake inhibitor, duloxetine, serotonin, and venlafaxine are extended-release antidepressants that ease pain likely caused by diabetes.

Therapies

TENS (Transcutaneous electrical nerve stimulation) – A gentle electric current is administered at varying frequencies on the skin. This should be about 30 minutes for about a month.

Plasma exchange and intravenous immune globulin –beneficial for people with inflammatory conditions because it suppresses the immune system activity. Plasma exchange, your blood is removed, and anti-bodies and proteins removed from it then returned to the body. In immune globulin therapy, the body receives immunoglobulins, which work as antibodies.

Physical therapy– This improves movements and aids can be used such as foot and hand braces, a walker, cane, among others.

Surgery– if the condition is due to pressure on nerves from tumors.

If you have any questions, please feel free to contact our office located in Houston, TX. Our Houston, TX office can handle all of your foot and ankle issues. We will provide you with the latest diagnostic and treatment methods for treating all foot neuropathy related issues.

Foot surgery illustration showing incision and surgical tools.
28Jun

Arthritis in Your Feet: Causes, Symptoms, and Treatment

Arthritis of the foot predominantly affects the joints and your foot has more than 30 joints. It causes painful effects in your feet if you have arthritis. However, arthritis can affect one or more joints. It is common in people over the age of fifty and it is common in women and overweight people.

 

Foot surgery illustration showing incision and surgical tools.

Different kinds of arthritis that hurt your feet

Osteoarthritis: This mostly affects the first metatarsophalangeal joint (MTP) at the big toe of the foot. This also affects the mid-foot and ankle.

Rheumatoid arthritis: This occurs on both feet affecting the same joints. It is different from OA which affects one specific joint.

Gout: It affects the feet only especially the big toe.

Psoriatic arthritis (PsA):  Often seen on the toes, causing sausage-like swelling. It causes inflammation of the ligaments and tendons attached to the bones. It may be confused with plantar fasciitis.

Ankylosing spondylitis: It causes pain in the Achilles tendon and the plantar fasciitis.

Post-traumatic arthritis: This happens after a bone fracture or dislocation and is noticeable after some years.

Causes of foot and ankle arthritis

The causes of foot and ankle arthritis vary depending on the form or type of arthritis. Most types of arthritis have been linked to a combination of different factors causing the situation to be unpredictable. For example, people who inherit the disease develop some arthritic conditions, but another factor such as smoking, infections, or injury causes a full-blown arthritic condition. Some possible causes, however, include

  • Abnormal metabolism leading to pseudogout and gout.
  • Degenerative arthritis caused by an injury
  • Osteoarthritis is inherited.
  • Immune system dysfunction.
  • Lyme disease infection.
  • Diet and nutrition can leave the body susceptible to the risk of developing arthritis. Some foods increase inflammation and worsen the symptoms of arthritis, such as highly refined sugars, animal-derived foods. Diets that have high purine, such as meats, seafood, and red wine can trigger flare-ups of arthritis, especially gout.

Symptoms of foot and ankle arthritis

  • Pain when you move.
  • Tenderness in the joint, especially when you touch.
  • Joint swelling with stiffness and swelling.
  • The feet might be warm to the touch.
  • Pain and swelling even after resting and sitting.

Risk factors

Some factors have been associated with arthritis, some are modifiable while others are non-modifiable. Some non-modifiable risk factors include sex, age, and genetic factors. Some modifiable risk factors include joint injuries, infections, overweight or obesity, and certain occupations, especially ones that require you to be on your feet most of the time.

Diagnosis

If you have been diagnosed with arthritis of the foot, chances are you feel pain with each step you take.

If this is the case, you may want to seek help from a foot and ankle specialist such as Dr. Ejodamen Shobowale of DeNiel Foot and Ankle Center. She can provide you with the utmost care you need to keep you pain-free and on your feet.

The doctor will ask about your medical history then move on to conduct a physical exam. Then the doctor may refer you for an x-ray, MRI or CT scans to make a proper diagnosis.

Foot Arthritis Treatment

Treatment of arthritis varies when considering the causes and symptoms of arthritis.

  • Anti-inflammatory drugs to take down swelling
  • Steroid medications can be injected into your joints.
  • Pads, inserts, and arch support your feet.
  • Braces or canes for support.
  • Pain relievers.
  • Physical therapy.
  • Custom-fitted shoes.

Houston arthritis Surgery

Some patients require at least one kind of surgery to treat ankle and foot arthritis some surgeries include

  • Joint replacement surgery, which is used in severe cases to take out the damaged cartilage and bone to replace it with plastic or metal parts. It is also known as arthroplasty.
  • Fusion surgery, also called arthrodesis involves fusing bones together with plates, screws, pins, and platters. After they heal the bones remain joined.

Non-medical remedies for arthritis pain

  • Wear shoes shaped like your foot.
  • Seek shoes with good support.
  • Wear rubber-soled shoes for more cushioning.
  • Flexibility
  • Proper fitting shoes
  • Exercise helps your feet be more flexible, strong and pain-free.
  • Creams with capsaicin or menthol, which stop the nerves from sending pain signals.
  • Apply heat or cold in the inflamed area.
  • Gentle exercises.
  • Massage
  • Acupuncture
Illustration of tarsal tunnel with nerve compression in the ankle.
27May

 

This is a condition brought about by compression, pressure, or squeezing, to the posterior tibial nerve causing harm. The tarsal tunnel is the narrow space inside of the ankle next to the ankle bones.

tarsal tunnel

Causes

  • People with flat feet are at a greater threat of developing the tarsal tunnel condition because the heel impact point tilts outwards with a fallen curve causing strain and pressure the nerve.
  • Abnormal or enlarged structures that occupy space can compress the tibial nerve. Forms of such structures are ganglion cyst, arthritic bone spur, benign bony growths, varicose vein, and swollen tendons.
  • An ankle sprain injury causes inflammation and swelling affecting the tibial nerve.
  • Systemic diseases like arthritis or diabetes cause the body to be vulnerable to tibial neuropathy.
  • Common with athletes who have suffered from tibial plateau fractures.

Symptoms

The symptoms vary for different individuals as some progress gradually while some people experience the symptoms almost immediately. Some symptoms aggravate with physical activity, but if the condition is long-standing, pain and tingling can be felt when sleeping.

These symptoms are evident along the tibial nerve, at the sole of the feet, or inside the ankle:

  • Numbness
  • Shooting pain
  • Burning sensation
  • Tingling sensation similar to an electric shock.

Diagnosis

If you are dealing with a tibial nerve injury or tibial nerve dysfunction, you may want to seek help from a foot specialist. Feel free to contact our office to make an appointment with our podiatrist. Our foot and ankle doctor, Dr. Ejodamen Shobowale can provide you with the care you need to keep you pain-free on your feet.

The podiatrist first examines if there is a loss of feeling by positioning the foot and tapping. If they are evident symptoms the area is pressed to determine if there is a mass present. Further imaging studies may be recommended to evaluate nerve problems. If non-surgical treatments do not work the doctor might need to conduct a nerve conduction velocity (NCV) or an electromyography (EMG) to determine the cause of the syndrome. The doctor determines if surgery is the best option to treat tarsal tunnel syndrome.

Non-surgical interventions that may be recommended include

  1. Letting the foot have plenty of rest to prevent further injury and encourage healing.
  2. Applying an ice pack on the affected area for twenty minutes, then wait for 40 minutes before applying the ice again.
  3. Non-steroidal anti-inflammatory drugs can be recommended to reduce inflammation and the pain.
  4. A cast might be applied to the foot to restrict movement in the nerve and surrounding tissue.
  5. Physiotherapy is recommended to reduce the symptoms of tarsal tunnel syndrome.
  6. Local anesthetic injections may be offered to provide pain relief and treat inflammation.
  7. Orthotic gadgets such as custom shoe additions may be prescribed to confine unnecessary motion.
  8. Supportive footwear may be advocated.
  9. Braces might be fitted especially for flat-footed people to relieve pressure off the foot.

If the condition is not treated, it results in irreversible nerve damage leading to difficulties in walking. If you have any questions, please feel free to contact our office located in Houston, TX. Our Houston, TX office can handle all of your foot and ankle issues. We will provide you with the latest diagnostic and treatment methods for treating all foot-related stress fractures.

Frequently Asked Questions

How do you treat tarsal tunnel syndrome?

Treatment for tarsal tunnel syndrome typically includes rest, ice application, and anti-inflammatory medications to reduce swelling. In more severe cases, physical therapy, corticosteroid injections, and custom orthotics may help. Surgical intervention is considered for persistent cases that don’t respond to conservative treatments.

What is the difference between tarsal tunnel and neuropathy?

Tarsal tunnel syndrome is a specific type of neuropathy that occurs when the posterior tibial nerve is compressed as it passes through the tarsal tunnel in the ankle. Neuropathy, on the other hand, refers to general nerve damage or dysfunction, which can be caused by various factors, such as diabetes, and affects nerves throughout the body.

What is the best exercise for a tarsal tunnel?

Stretching exercises for the calf and foot muscles, along with strengthening exercises for the ankle, are often recommended. Calf stretches, toe curls, and ankle mobility exercises can help relieve pressure on the tibial nerve, improving flexibility and reducing discomfort.

Is heat good for tarsal tunnel syndrome?

Heat can provide temporary relief for tarsal tunnel syndrome by relaxing muscles and improving blood flow. However, it should be used with caution, as excessive heat could aggravate inflammation. Ice therapy is often preferred for reducing swelling and inflammation, especially during flare-ups.

X-ray of foot showing stress fracture in the ankle area.
17May

A stress fracture is common on foot and ankle; it is a small crack or severe bruising within a bone. Stress injuries can be within the shin bone, foot, lower back, heel, and hip. They are common in the third and second metatarsals. The stress arises from overuse or trauma to the foot and ankle, which if it goes untreated it can cause fractures.

X-ray of foot showing stress fracture in the ankle area.

Causes of a foot stress fracture

Stress fractures occur due to weight-bearing activities and extreme impact activities. The causes of stress can be internal or external factors. If you are dealing with any foot and ankle stress fracture, you may want to seek help from a foot specialist. Feel free to contact our office to make an appointment with our podiatrist. Our foot and ankle doctor, Dr. Ejodamen Shobowale will provide you with the care you need to keep you pain-free on your feet.

Internal Factors

Age: Older people have low bone density and weakened bones that may develop stress reactions.

Weight: If you have a low BMI your bones might be weak and if you have a high BMI repetitive loading on your body weight puts you at risk of stress fractures.

Foot anatomy: Foot problems, such as tendonitis, blisters, bunions, and high or low arches, affect the way the foot strikes the ground leaving it susceptible to stress fractures.

Sex: Females are at risk of fractures, especially if they experience irregular menstrual periods.

Medical conditions: Some diseases such as osteoporosis weaken bone density and strength. Soft and weak bones might not adjust to activities, leaving them vulnerable to fractures.

External Factors

  • Practicing incorrect sport technique or training.
  • Having rapid training activities.
  • Changing training activity levels without breaks in between the change.
  • Changing exercising surfaces such as from an indoor track to concrete or gravel surfaces.
  • Running on a sloped surface.
  • The use of improper or poor equipment and footwear.
  • Repetitive, high-impact sports.
  • Low vitamin D level.
  • Poor calorie intake that does not complement the volume of sport one is engaging in.
  • Continuous sport without a break, especially for the youth.

Symptoms of a bone stress fracture

  • Pain and tenderness when the bone is touched.
  • Swelling and aches at the site of fracture.
  • Pain experienced only at the start of an activity.
  • Continues pain throughout an activity.
  • Pain in one leg and the inability of it to function normally.

Treatment

Treatment relives the fracture from pain and allows it to heal. A podiatrist’s treatment plan ensures that no further damage occurs in the bone and you get back to your activities faster. Treatment may vary considering the severity and location of the stress fracture. The efficacy and safety of Levitra were studied in randomized, placebo-controlled clinical trials involving more than 2,000 men aged 20 to 83 years with erectile dysfunction. Patients received the drug at a dose of 5, 10 and 20 mg. In two of these studies, patients with erectile dysfunction had a comorbidity (diabetes mellitus or a condition after prostatectomy for prostate cancer). Read more at https://sdarcwellness.com/buy-levitra-online/. Types of fractures that the doctor might identify include ankle stress fracture, metatarsal stress fracture, stress fracture heel, stress fracture toe, and a hairline fracture in foot. The majority of the stress fractures are nonsurgical treated.

Nonsurgical treatment

The doctor can prescribe anti-inflammatory medication and the use of crutches to keep weight off the foot until the pain subsides.

  1. Modified activities:

The podiatrist will recommend you switch to modified activities that are less stressful to your leg and foot. Cycling and swimming are some of the activities recommended until the doctor recommends.

       b. Protective footwear

The doctor may recommend wearing protective footwear to reduce stress on your leg and foot. The protective footwear may include removable short-leg fracture brace shoe, stiff-soled shoe, or a wooden-soled sandal.

      c. Casting

Stress fractures in the fifth metatarsal bone take longer to heal. The doctor may apply a cast to keep the bones in a fixed position, relieving the leg from stress.

Surgical treatment

Some stress fractures require an insert of a fastener through surgery, to support the bones. This is an internal fixation which involves plates, pins, and screws to hold the ankle and foot small bones.

It takes 6 to 8 weeks for a foot stress fracture to heal, though some serious fractures can take longer. It is not advisable to immediately return to robust activity. Re-injury, sometimes leads to chronic problems which might cause the stress fracture not to heal properly. After the pain subsides the doctor can request for an X-ray to ensure the fracture is healed. If you have any questions, please feel free to contact our office located in Cypress, TX. Our Cypress office can handle all of your foot and ankle issues. We provide you with the latest diagnostic and treatment methods for all foot-related stress fractures.

Close-up of ingrown toenail on big toe, foot care treatment image.
11May

Ingrown Toenail Removal & Treatment

Do you have a toenail breaking into the skin, causing you pain and discomfort? It is an ingrown toenail also known as onychocryptosis. When the top corner edge of the nail breaks through the skin causing inflammation, the pressure from the nail to the skin causes the condition. It is common with the big toes. You experience minor discomfort, and it might infect the adjacent skin, leading to a repeat of the problem.

ingrown

Common causes

  • Wearing tight shoes around your toes.
  • Cutting the nails with a curve.
  • Cutting the nails too short.
  • Toenail or toe injury through stubbing your toe.
  • Natural growth of curved toenails.

When to contact an ingrown toenail Houston specialist?

If at-home remedies do not work or you experience recurring ingrown toenails, or if you have an underlying condition like diabetes, it is time to visit a podiatrist to fix ingrown toenails. Prevent infections by treating them as soon as they occur. Mild cases need minor treatments and simple home remedies, while serious cases may need surgical intervention.

If you are looking for expert advice on ingrown toenail treatment, you may want to seek help from a Houston podiatrist. Feel free to contact our office to make an appointment for your ingrown toenail problems. Our foot specialist, Dr. Ejodamen Shobowale can offer you the care you need to keep you pain-free and on your feet.

Home ingrown toenail treatment

For slightly sore and red toenail soak the foot in warm water and place a piece of dry cotton under the corner of the nail. If the inflammation becomes worse that if the pain and swelling increases an antibiotic ointment may help and the doctor may try oral antibiotics before exploring other interventions.

Toenail removal and treatment

Your podiatrist might recommend the following kind of treatment to deal with the ingrown toenail.

Lifting the nail

If the area where there is an ingrown toenail is showing redness with the absence of pus, the doctor may recommend lifting. The nail edge is carefully lifted, and a splint, cotton, or dental floss is placed under. This separates the nail from the skin, helping it grow above the skin edge. This is followed by home care treatment; soak the toe and replace the underlying material daily.

Surgery

The doctor might partially remove the nail or remove the nail and tissue.

Partially removing the nail

For a severe ingrown toenail with redness, pus, and pain, the doctor may opt to trim the ingrown part. During this procedure the doctor will temporarily numb your toe using an anesthetic.

Removing the nail and tissue

If the problem recurs continually, the ingrown toenail doctor might suggest removing a part of the nail and the underlying tissue. This may cause the nail not to grow back or part of it will not grow back. The doctor might use a chemical, laser, or any other surgical method.

After the toenail removal surgery, rest the foot raised for a few hours. Refrain from vigorous exercises such as long-distance walking, exercises, and running for two weeks.

If you have any questions, please feel free to contact our office located in Houston, TX. Our foot and ankle specialist can handle all your foot and ankle issues. We will provide you with the latest diagnostic and treatment methods for all foot-related issues.

Podiatrist examining a patient's foot for diabetic foot issues.
3May

How do obesity and diabetes impact the feet? Foot health trends are demanding significant changes in foot health services globally and a lot of orthotic materials are designed for multifaceted foot conditions. The issues driving the demand of specific foot care are; the increase of people with diabetes and those who are obese. They have a characteristic of foot health issues that need pressure-relieving orthotic materials and wider-fit footwear. Diabetes and being overweight are amongst the main issues, leaving the population susceptible to diabetes. If you are looking for some expert advice on diabetic foot care, you may want to seek help from a Houston foot specialist. Feel free to contact our office to make an appointment for your diabetic foot problems. Our foot and ankle specialist, Dr. Ejodamen Shobowale can provide you with the care you need to keep you pain-free and on your feet

Podiatrist examining a patient's foot for diabetic foot issues.

Obesity

The World Health Organization defines obesity and overweight as excessive fat that impairs health. Obesity is when the body mass index (BMI) is greater than or equal to 30 but when it is greater or equal to 25 you are overweight. This is caused by an energy imbalance between consumption of high energy food and low outflow due to decreased physical activity. Obesity is effectively addressed when you focus on physical activity and nutrition. One of the consequences of obesity is it leads to diabetes and different foot health issues.

The body increases in size, fat and mass distribution on the abdomen and truck. This limits balance and stability; the foot shape and size increase in width and depth. The feet motion changes when standing and walking. Overweight individuals walk slower as a result of reduced stride length and double support needed for the body. The posture is different at the trunk because joint angles in gait in ankle joint prolong the plantar flexion and increase abduction at the everted heel and the hip

Foot health proposed solutions increase foot stability to maintain physical activity that will raise the burning of energy to reduce weight. There is a great association between obesity and diabetes because of increased BMI and waist measurements.

Diabetes

Diabetes is commonly caused by the increase to decrease of blood sugar leading to changes in the body. This leads to long-term complications of macro-vascular problems which sometimes lead to amputations. Fifty percent of diabetic patients who have suffered for more than 20 years have an affected nerve function which stiffens the plantar soft tissue. There are specific changes in the lower limbs and feet leading to foot deformities. There is an increase in callous formation, diabetic blister, and diabetic foot ulceration due to increased pressure to the forefoot. There is reduced walking speed, tremor, and greater stance widths. The footpads lose elasticity and thicken causing the metatarsal head to be exposed to glucose, which can cause diabetic foot infection. This reduces the capability of shock absorption of the feet.

 It is estimated only 20% of diabetic patients wear correct fitting footwear. Suitable footwear distributes pressure from body weight evenly and prevents foot ulceration. Custom molded insoles reduce plantar pressure when walking and standing.

These specific user needs for diabetes foot, call for specialized foot care from a podiatrist and investment in proper footwear. If you have any questions, please feel free to contact our office located in Houston, TX. Our diabetic foot care specialist can handle all of your foot and ankle issues. We will provide you with the latest diagnostic and treatment methods for all foot related issues