Can Smoking Cigarettes Cause Foot Pain?

By Dr. Adam Thomas

The answer is to this topic is yes, indirectly. Smoking is well known as a contributing factor to health issues. With respect to the feet and lower extremities, years of smoking can not only lead to the more common issues of breathing complications such as emphysema, COPD and lung cancer, but it can lead to cardiovascular issues and artery disease. The effects of years of smoking can lead to narrowing of the arteries due to the chemicals causing constriction of the arteries repeatedly. If this is combined in an individual more prone to high cholesterol, this can be a very bad mix. The arteries, therefore, can become blocked with plaques. The complications of this most people are aware of is the fact that it can lead to heart disease, CAD (Coronary Artery Disease) and eventually open heart bypass surgery. 

What is less known is the fact that the blockages don’t just happen in one area such as the heart but all through the circulatory system. If the first areas becoming blocked are in the lower extremities, the first signs and symptoms may not be chest pain but rather pain in the legs or the feet. When it starts, it may manifest with simple cramping upon walking a certain distance before having to rest (claudication). This is due to the reduced blood flow getting to the feet and legs as the demand for oxygen goes up with exercise or walking. As the disease progresses, the distance an individual can walk shortens until the pain happens with both walking and resting (rest pain). Theses pains in the legs and feet can be signs of PAD or Peripheral Arterial Disease. 

Peripheral Arterial Disease

Often times in the podiatrist office, the early signs of this disease can be caught and treated before progression. Simple testing can be performed in office and if detected, appropriate referrals can be made to a specialist who treats this disease. Newer technologies are available with minimal invasive techniques to help improve blood flow to the legs and feet which will in turn reduce the pain, improve quality of life, and reduce the chances of amputation which can be a devastating end result of this disease.   

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

High Heels and You

Dr. Belinda Dotter

It's spring and time to wear gorgeous high heeled sandals. Here’s some information and tips to keep your foot in tip top shape when wearing them!

Studies have shown that high heeled shoes create excess pressure on the plantar surface, or sole of the foot, which can lead to metatarsalgia (ball of the foot pain), excess stress on foot joints, and painful calluses. The higher the heel is, the more probability that muscular imbalances are occurring while walking in the shoes — causing certain leg and foot muscles to work too hard. These imbalances can lead to problems such as knee pain, heel pain (plantar fasciitis), and hammer toes.

Common Mistakes:

Find the right fit

1. Incorrect Size:  You may be surprised to learn that your shoe size has changed over the years. A change in foot size can often be attributed to hormonal changes and natural changes in soft tissue that occur with aging. The next time you shop for shoes, be sure to measure your feet for both length and width. Be aware that the right size shoe may not always be a good fit, so it helps to try on a few different styles until you find the most comfortable fit. Shoe sizes can vary to almost 1 size depending on the manufacturer!
   
   
   
2. Extreme Height: One of the most common problems with high heels is pain under the ball of the foot. A higher heel means more stress on the ball of the foot, ankle, and knee, which increases as the height goes up. 
   Try these to minimize pain and possible injury: 



Chunky Heel

• Prefer to wear a platform shoe, this adds height without the extreme slope and pressure on the ball of the foot. 
• Wear a chunky heel instead of stilettos.
• Find a heeled shoe where the heel is positioned more toward the back of the shoe, which is more stable than a heel positioned more toward the center of the shoe.
  
  
  
  
  
3. Not Enough Coverage:  Shoes with very little to no straps on the top of the shoe.  This will allow too much motion on an already unsteady, elevated heel. You can bet that long periods of walking in these shoes will leave you with tired, sore feet and put you at risk for an ankle sprain. Your best bet is to choose styles that fit the shape of your foot well, offering adequate material to hold your foot in the shoe — a good example is a high-heeled boot or a shoe with straps across the toe area, arch, and ankle.
   
   
   
4. Pointy Toed Shoes:  Seeing the way the toes are 

   

   Pointy Toed Shoes

   squeezed into these pointy-toed shoes are painful to observe. Besides the toes being pushed into a cramped space, there is an issue with the shoe's toe material not covering enough of the toes. This forces the toes to work harder at maintaining stability, possibly contributing to toe contractures, such as hammer toes. A better choice is a shoe that has more material across the toes and more of a rounded toe box. Another toe problem that can be aggravated by high-heeled shoes is a bunion deformity.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Noticing a Neuroma?

Dr. Adam Thomas

A neuroma is the swelling and thickening of nerves in the ball of your foot. It is often referred to as a “pinched nerve.” If you feel tingling, burning, or numbness in your toes, pain or irritation in the ball of your foot, or pain between toes while walking, you could be experiencing symptoms associated with a neuroma. People who suffer from this condition also report feeling like there is something inside their foot or feeling like they have a pebble in their shoe. Many factors can lead to the formation of a neuroma whenever the nerves are compressed:

A majority of people who develop neuromas are women.

• Repeated stress on the foot from activities (like running)
• Improper footwear that squeezes the toes together (ie: High heeled shoes that force the forefoot into a narrow space) 
• Foot deformities like flat feet, hammertoes, bunions, or a high-arched foot 
• Inflammation of the nerve as a result of trauma

There are some home treatment options if you have a neuroma. You can rest the foot, massage the affected area, or apply an ice pack to lessen the pain. Or you can take anti-inflammatory medicine to reduce pain and swelling. Another alternative is to keep pressure off of the foot by using over-the-counter shoe pads or wearing shoes with thick, shock-absorbent soles. Also, as a preventative measure, wear shoes that have room for your toes and if a high heeled shoe is higher than two inches, you should probably avoid it.

The pain associated with a neuroma should not be ignored. Visit your local podiatrist for diagnosis and a treatment plan because if a neuroma is left untreated, it tends to get worse. Some treatment options include padding shoes, anti-inflammatory medicine, cortisone injections, or custom orthotics (shoe inserts). If conservative treatments fail, your podiatrist may consider surgical intervention.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Bunions

 Bunions, also called Hallux Abducto Valgus (HAV), are a deformity characterized by a lateral deviation of the great toe (hallux) with a subsequent medial prominence ("bump".) The medial prominence is from the underlying deviated prominent bone (not a growth), and sometimes can form an overlying bursitis which may add to the prominence (usually very painful and red.) Bunions form when your big toe pushes up against your other toes, forcing your big toe joint in the opposite direction. Over time, the abnormal position enlarges your big toe joint, further crowding your other toes and causing pain.

The main causes of bunions can be from genetics, tightly fitted shoes, or foot injuries. Bunions are more common in women. Bunions may be associated with various forms of arthritis, including inflammatory or degenerative forms, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause. Bunions can not only affect the inner foot but also the outside of the foot at the base of the little toe.

Here are some treatment options for your bunions one is to have well-fitting wide enough shoes to give your feet more room. Another way is to have some padding to alleviate shoe pressure on "the bump." You can take oral or topical anti-inflammatory treatments to alleviate pain associated with the inflammation and bursitis. You can purchase orthotics to help control contributing biomechanical forces to reduce the rate of progression (especially important in kids). If none of these work you may consider surgery to correct the underlying deformity/deformities (important to also correct any contributing biomechanical forces at the time).

Bunions can be very painful and discomforting. Ways to prevent bunions are choosing footwear that fits correctly, especially low heeled shoes with plenty of space for the toes, is one of the main ways that bunions can be prevented. Getting orthotics if your prone to flat-footedness- this can prevent or delay bunions. If you think or know you have bunions get them checked out by your doctor or a specialist. 

Watch GOUT, they'll get ya!

Gout is a condition that is unknown to many, especially those of the younger generations. But, for those of us who do know what Gout is, we definitely know that it is, by no means, pleasant or enjoyable. Gout is a form of arthritis that typically develops when a substantial amount of uric acid builds up in the blood. Uric acid releases shard-like objects into your joints, thus cause them to inflame.  Gout most frequently “attacks” the big toe, often showing redness and swelling in the joints associated with that toe.  Although the big toe is the most likely victim of Gout, this condition can also affect the ankle and knee. 

                How can I tell if it is Gout? Although you should see a doctor to be certain, these are symptoms that are associated with Gout:

• Redness
• Swelling
• Tenderness of joints
• The pain is acute and develops rapidly
• Typically the pain increases exponentially overnight

What can I do to prevent Gout Attacks?

There is a plethora of things that you can do to help prevent Gout. One of the most prominent ways of stopping gout attacks before they develop is by maintaining a well-regulated diet. As we mentioned before, Gout is caused by the buildup of uric acid, so you should stay away from food that increases this acid, and instead look to eat foods that decreases uric acid. Foods that increase uric acid are, but not limited to : Meats, that is meat with high purines such as beef kidneys, liver, lamb, bacon (pork in general) and veal;  Fish, that includes, cod, sardines, shrimp, and scallops; Vegetables  such as asparagus, cauliflower, spinach and mushrooms (I know what you’re thinking, “now you’re going to tell me that vegetables are bad!?” but the truth is some vegetables, like the other categories mentioned, can trigger gout attacks).

Gout attacks are the most common among men that are over the age of forty. With this in mind, we know turn the conversation to Alcohol. God forbid that we do a regression (correlation) between American men over the age of forty and alcohol consumption—you get where the discussion is going now? The truth is, alcoholic beverages increase uric acid, which can cause gout attacks, so we urge you to keep your consumption low or avoid it completely—especially if you are over the age of forty.

Whether you have or have not experienced a gout attack, we hope that this information can help you. Although maintaining a well-regulated diet can help decrease your chances of having a gout attack, there are plenty of other ways; you should consult your doctor. For more information on Gout, check out these websites:

1. http://www.gout.com
2. http://www.livestrong.com/article/279756-foods-that-increase-uric-acid/
3. http://www.arthritistoday.org/conditions/gout/all-about-gout/what-is-gout.php
4. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gout.asp

The Ugly Truth About Uggs!

Buyers beware - the trendy Ugg brand sheepskin boots and their generic counterparts may be hurting your feet!  While they may look soft and cuddly, studies have shown that the slipping and sliding going on inside the boots combined with the limited arch support they provide is putting unnecessary strain on muscles, tendons, ligaments, and bones.

The makers of Ugg boots maintain that their boots provide more support than the knockoff variety, but many experts see no real difference between the two. 

If you want to continue to wear the popular boot, Dr. Allen Guehl, a Dayton-area podiatrist at Community Foot Specialists recommends that you do so sparingly and when you aren’t going to be doing a lot of activity.  They aren’t the type of boots you want to be wearing if you are walking or standing all day.  You may also want to add supportive insoles to help cushion your feet and provide more support. 

Feeling the Pinch this Autumn? Bunions May Be to Blame

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With the curtain closed on summer and sandal season, fall is the season during which Community Foot Specialists sees an upswing in patients whose feet are feeling the pinch in their closed-toe footwear. This seasonal phenomenon seems to focus on women, although there are men who have this issue. The common culprit? Painful bunions that were given room to breathe during sandal season, but now face close quarters of a fall boot or shoe.

Bunions are abnormalities that form on the joint at the base of the big toe in the form of a bony bump. They occur when the big toe pushes against the other toes, which force the big toe joint in the opposite direction. As time passes, the abnormal positioning of the toe enlarges the joint. This further crowds the toes of the foot and causes pain and discomfort.

Bunions can occur for a variety of reasons. One of the most common causes is tight shoes, although they can also come about as a result of an inherited structural or mechanical defect, a stress to the foot, or a medical condition.

To help avoid bunions, don’t wear pointed shoes. Choose footwear with a wide foot box to give all of your toes plenty of room. If bunions become so painful that they impede daily activities, the American College of Foot and Ankle Surgeons recommends discussing surgical options with your podiatrist. However, please note that Community Foot Specialists firmly believes in exhausting the most conservative foot care treatment options first before considering surgery.

Community Foot Specialists can be reached at 937-426-9500. Or you may visit our website to request an appointment, view common conditions we treat, or get any other info you might need.

Children's Heel Pain: Not Just Growing Pains!

(source)

If your child complains of heel pain, you should definitely take their complaints seriously. Children particularly those who are athletic/ physically active- may have what is called Sever’s disease. This condition occurs in children during their growth stages when the growth plate in the heel is injured. In early puberty, bones grow faster than muscles and tendons. Muscles and tendons become tight as a result and the heel is less flexible. When the child stands or bears any weight on his or her heel, injuring the heel and causing Sever’s disease. 

Signs that your child may be suffering from Sever’s disease include pain in one or both heels that usually occur with activity (usually around the time your child would begin a new sport or season), A tendency to tiptoe, walking with a limp, increased intensity of pain when running or jumping. Another sign is if your child’s heel hurts when you squeeze both sides toward the very back of the heel. The good news about Sever’s disease is that it is highly treatable with non-invasive methods. The first thing to do is to stop or limit any activity that causes the child pain. Treat the injured heel with ice for 20 minutes at a time, 3 times a day. Stretching exercises can also help lessen the pain of Sever’s disease: particularly those that stretch the hamstring and calf muscles and tendons on the back of the leg. These stretches should be performed 2 or 3 times a day and held for about 20 seconds in both legs, even if only one heel is experiencing pain.

If your child is having heel pain, contact Community Foot Specialists serving the Greater Dayton area in 6 convenient locations- 937-426-9500

Diabetic Foot Care Guidelines

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• Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your Community Foot Specialist in Springfield and Dayton at 937-426-9500 if you notice anything
• Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. But only use lukewarm water—the temperature you’d use on a newborn baby.
• Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting—and make sure to carefully dry between the toes.
• Moisturize your feet—but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes—this could encourage a fungal infection.
• Cut nails carefully—and straight across. Also, file the edges. Don’t cut them too short, since this could lead to ingrown toe nails.
• Never trim corns or calluses. No “bathroom surgery”—let your doctor do the job.
• Wear clean, dry socks. Change them daily.
• Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).
• Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.
• Shake out your shoes and inspect the inside before wearing. Remember, you may not feel a pebble—so always shake out your shoes before putting them on.
• Keep your feet warm and dry. Don’t get your feet wet in snow or rain. Wear warm socks and shoes in winter.
• Never walk barefoot. Not even at home! You could step on something and get a scratch or cut.
• Take care of your diabetes. Keep your blood sugar levels under control.
• Don’t smoke. Smoking restricts blood flow in your feet.
• Get periodic foot exams. See your podiatric foot and ankle surgeon at Community Foot Specialists in Dayton and surrounding areas on a regular basis for an examination to help prevent the foot complications of diabetes. Call us today if you have any questions, 937-426-9500

Check out one of our podiatrists, Dr. Thomas at Community Foot Specialists talking more about diabetes and your feet!

Did you know we have a book on diabetes and how it affects your feet? Get your FREE copy today by clicking here. From your friends at the Community Foot Specialists!