One in six over-50s suffers painful form of foot arthritis which tends to affect more women then men

 

A painful form of arthritis affects one in six people over 50 – more than previously thought, research has shown.

 

Scientists from Keele University had to revise previous statistics after studying more than 5,000 people with foot osteoarthritis.

Researchers found the condition tends to affect more women than men, and will often hit people who have spent a lot of time doing manual labour.

The problem is caused by inflammation in and around the joints, damage to cartilage and swelling.

And it can be debilitating – three quarters of people with the condition reported having difficulty with simple day-to-day activities such as walking, standing, housework and shopping.

Lead researcher Dr Edward Roddy said: ‘Foot osteoarthritis is a more common and disabling problem than we previously thought, making everyday tasks difficult and painful for people affected.

‘While it’s been known for decades that joints in the foot can be affected by osteoarthritis, much of the previous research has focused on the hip and knee areas.’

He added: ‘Research into the foot has concentrated almost entirely on the bunion joint at the base of the big toe.

‘Looking at the whole foot and the impact on people’s lives, it’s clear the problem is more widespread than we anticipated.

Three quarters of people with the condition reported having difficulty with simple day-to-day activities such as walking, standing, housework and shopping

Three quarters of people with the condition reported having difficulty with simple day-to-day activities such as walking, standing, housework and shopping

‘Doctors and other healthcare professionals should be aware that osteoarthritis is a common cause of foot pain in this age group.’

Call the Athlone Foot clinic in the Primary care centre Clonbrusk to book your foot appointment today.
Taken From: http://www.dailymail.co.uk/health/article-2532422/One-six-50s-suffers-painful-form-foot-arthritis-tends-affect-women-men.html

Read more: http://www.dailymail.co.uk/health/article-2532422/One-six-50s-suffers-painful-form-foot-arthritis-tends-affect-women-men.html#ixzz3KqLC0A31
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Don’t Be Embarrassed About Feet Urge Podiatrists

Visit a HSE Reg Podiatrist Feet are one of the hardest working parts of the body and in a lifetime you will walk in excess of 150,000 miles which is about five times around the world. As a result, foot problems are common and if untreated can cause discomfort and wider health problems.
 
As part of its annual Feet for Life month in June 2013, The College of Podiatry ilooked to raise awareness of common foot complaints. The College is encouraging people to become more foot aware and not be embarrassed about seeking help where needed.
 
Some of the most common foot problems that can cause embarrassment include foot odour, verrucae, corns and callus, fungal infections, ingrowing toenails, bunions and cracked heels.
 
Podiatrist Lorraine Jones said: “Our feet are one of the most neglected parts of our body, but it’s important to keep an eye on them and to know what’s normal for you so you can spot any problems. Feet are not supposed to hurt so if you do experience ongoing pain then you need to have this investigated. Don’t be embarrassed about seeking professional help, it’s a podiatrist’s job to treat feet so there will be nothing we haven’t seen before. Follow our tips to spot some of the symptoms of common foot problems so you don’t have to suffer in silence or hide your feet away in the summer!



Common foot problems
 
Foot odour: to keep foot odour at bay, wash feet at least once a day and dry carefully between the toes. Wear clean socks made from at least 70% cotton or wool. Alternate shoes daily to allow them to dry out. If odour persists try an antibacterial soap.

Verrucae: a verruca is a type of wart that looks like a small, dark puncture mark in the early stages but later turns grey or brown. It’s contagious through direct contact. You can buy over-the-counter remedies from your pharmacy; ask for products with salicylic acid. If at any stage your verruca becomes painful and the surrounding skin goes red, stop treating immediately and see a podiatrist.

- Corns and calluses: corns and calluses occur as a result of pressure on the foot. Corns appear over a bony prominence such as a joint and a callus usually occurs on the sole of the foot. Do not cut corns yourself and don’t use corn plasters or paints which can burn the healthy tissue around the corns. Commercially available cures should only be used following professional advice. Calluses can usually be kept at bay by using a pumice stone or non metal foot file gently in the bath.

Fungal infections: fungal infections such as athletes foot can lead to intense itching, cracked, blistered or peeling areas of the skin. If left untreated it can spread to the toenails causing thickening and yellowing of the nail. Fungal infections are highly contagious so avoid handling and do not use the same towel for your feet as the rest of your body. You can buy over the counter remedies but nail infections do not often respond to topical treatments so you may need oral medication. See a podiatrist if your infection persists.

Ingrowing toenails: ingrowing toenails pierce the flesh of the toe and can be extremely painful and lead to further infection. They most commonly affect the big toenail but can affect other toes too. To reduce risk use nail cutters and cut nails straight across and don’t cut too low at the edge or down the side.  If you have an ingrowing toenail, see a podiatrist who can remove the offending spike of nail and cover with an antiseptic dressing. If you have bleeding or discharge, you may require antibiotics.

Bunions: a bunion is a condition where the big toe is angled excessively towards the second toe and a bony prominence develops on the side of the big toe. Contrary to popular belief, bunions are not solely caused by shoes. They are caused by a defective mechanical structure of the foot which is genetic, although footwear can contribute to a bunion developing. Some treatments can ease the pain of bunions such as padding in the shoes, but only surgery can correct the defect. To avoid exacerbating a bunion, try not to wear narrow shoes with pointed toes. If you experience frequent pain, see a podiatrist.

Cracked heels: cracked heels can be extremely painful and occur where the skin has become dry or has experienced excessive pressure. To prevent them moisturise regularly and use a pumice stone or non-metal file in the bath or shower. If the problem worsens see a podiatrist as some severe cases can require strapping of the cracks in order to allow the feet to heal.

Call the Athlone Foot Clinic in the Athlone Primary care centre, Clonbrusk for treatment & assessment. Contact us by email on info@athlonefootclinic.ie or call 0851911271

Taken from UK POD SOCIETY: http://www.scpod.org/foot-health/foot-health-focus/dont-be-embarrassed-about-feet-urge-podiatrists/

Tips to Keep Feet Warm and Cozy All Winter Long

Winter Foot Care

Tips to Keep Feet Warm and Cozy All Winter Long

Snow AngelWhether you’re slogging through deep snow and sub-zero temperatures in the north, or contending with dampness, chill, and muddy conditions in the south, it’s important to take care of your feet all winter long. You’ll want them to be healthy and ready for action when spring finally arrives.

Most Americans will have walked 75,000 miles by the time they turn 50. Is it little wonder, then, that APMA’s 2010 foot health survey found that foot pain affects the daily activities—walking, exercising, or standing for long periods of time—of a majority of Americans?

“Each season presents unique challenges to foot health,” said Matthew Garoufalis, DPM, a podiatrist and APMA president. “Surveys and research tell us that foot health is intrinsic to overall health, so protecting feet all year long is vital to our overall well-being.”

APMA offers some advice for keeping feet healthy in common winter scenarios:

  • Winter is skiing and snowboarding season, activities enjoyed by nearly 10 million Americans, according to the National Ski Areas Association. Never ski or snowboard in footwear other than ski boots specifically designed for that purpose. Make sure your boots fit properly; you should be able to wiggle your toes, but the boots should immobilize the heel, instep, and ball of your foot. You can use orthotics (support devices that go inside shoes) to help control the foot’s movement inside ski boots or ice skates.
  • Committed runners don’t need to let the cold stop them. A variety of warm, light-weight, moisture-wicking active wear available at most running or sporting goods stores helps ensure runners stay warm and dry in bitter temperatures. However, some runners may compensate for icy conditions by altering how their foot strikes the ground. Instead of changing your footstrike pattern, shorten your stride to help maintain stability. And remember, it’s more important than ever to stretch before you begin your run. Cold weather can make you less flexible in winter than you are in summer, so it’s important to warm muscles up before running.
  • Boots are must-have footwear in winter climates, especially when dealing with winter precipitation. Between the waterproof material of the boots themselves and the warm socks you wear to keep toes toasty, you may find your feet sweat a lot. Damp, sweaty feet can chill more easily and are more prone to bacterial infections. To keep feet clean and dry, consider using foot powder inside socks and incorporating extra foot baths into your foot care regimen this winter.
  • Be size smart. It may be tempting to buy pricey specialty footwear (like winter boots or ski boots) for kids in a slightly larger size, thinking they’ll be able to get two seasons of wear out of them. But unlike coats that kids can grow into, footwear needs to fit properly right away. Properly fitted skates and boots can help prevent blisters, chafing, and ankle or foot injuries. Likewise, if socks are too small, they can force toes to bunch together, and that friction can cause painful blisters or corns.

Finally—and although this one seems like it should go without saying, it bears spelling out—don’t try to tip-toe through winter snow, ice, and temperatures in summer-appropriate footwear. “More than one news show across the country aired images of people in sneakers, sandals, and even flip-flops during the severe cold snap that hit the country in early January,” Dr. Garoufalis said. “Exposing feet to extreme temperatures means risking frostbite and injury. Choose winter footwear that will keep your feet warm, dry, and well-supported.”

 

Taken from:

http://www.apma.org/Learn/HealthyFeetTips.cfm?ItemNumber=11069

Everything you need to know about running shoes We look at the anatomy of a running shoe, how to get the right fit, and other shoe shopping tips.

anatomy running shoe

A few tips this morning from the foot clinic in Athlone. When buying runners have a look for a few key thing. If you need more advise or are having problems visit the Athlone Foot Clinic in Athlone town centre, Co.Westmeath or call us on 0851911271

Anatomy of a running shoe

Midsole

Where you’ll find all of the foam and cushioning (especially under the arch of the foot). A more supportive shoe contains denser foam, which helps absorb the impact on your feet and body from running on hard surfaces.

Heel counter

Where the shoe cups your heel. A lot of stability is built into this spot, says Krista Madsen Baker, a McMaster University kinesiology professor in Hamilton, Ont. Squeeze both sides of the counter — the more it resists, the more support you’ll have on your run.

Outsole

The bottom of the shoe, where tread thickness varies depending on whether shoes are designed for pavement or for trail. Trail shoes have a thicker, deeper tread to better grasp the ground and give you more traction. ‘

Flex point

Where the shoe bends most easily. It should line up with the widest part of your foot. “If it doesn’t bend enough, your foot can’t move through its normal range of motion, which may lead to shin splints and plantar fasciitis,” Madsen Baker says.

Toe box

Where your toes and the ball of your foot fit. “Make sure the toe box is wide enough and doesn’t feel constricting,” says Madsen Baker. “If you feel pressure on either side, it’s a sign you’re setting yourself up for a blister.”

Running Shoe Guide_Feature

Tips for shopping for a running shoe

How much should you pay for the perfect shoe?

Running shoes vary in price, but experts say anywhere from $100 to $150 is reasonable for a quality sneaker.

How long should your shoes last?

German researchers tested more than 150 pairs of shoes and found that high-quality kicks still maintained their integrity after 1,000 km. If you’re unsure, Smith recommends returning to the store and trying on the new version of your shoes about every six months. “If the newer version feels the same, it’s likely not time to change,” he says. “But if you can tell the difference between the two, it may be time to invest in another pair.”

How to shop for shoes:

1. Go at the end of the day, or after a workout, when your foot has swollen to its full size. And don’t forget your socks! Bring the ones you work out in most often.

2. Test drive the shoes on the store’s treadmill, or take them for a quick jog down a hallway.

3. Be aware of friction points. “You should never feel that you need to break the shoe in,” says Madsen Baker, a McMaster University kinesiology professor in Hamilton, Ont. “The shoe should fit perfectly comfortably, and your foot should feel like it belongs there.”

Cheyenne Ellis/Alyssa Pizer

Five questions to ask

The Running Room’s Bryan Smith shares the questions he always asks his shoppers.

1. Is there room at the end of the toe?

Smith, the Running Room’s Toronto-area manager, recommends a half to a full thumb’s width between your longest toe and the end of the shoe. “That will give your foot space to shift forward, so that you won’t damage your foot or bruise your toenails.”

2. Does your heel slip when you walk?

It shouldn’t. The heel counter should be comfortably tight to help you avoid blisters.

3. Does the material rub against your ankle?

It’s important for your entire ankle joint to move easily. The shoe should never get in the way of full freedom of movement.

4. Are you laced up correctly?

Eyelets should be evenly aligned; they shouldn’t touch or be splayed wide open. And always lace shoes to the top or second-highest eyelet.

5. Can you move the front of your foot from side to side?

You should be able to wiggle a bit from left to right. “When your foot expands, you want there to be room so the shoe doesn’t get too tight.”

 

 

Taken from:http://www.chatelaine.com/health/fitness/everything-you-need-to-know-about-running-shoes/?DFIX

Soccer field lights powered by kids’ pounding feet

soccer field lights

© Pavegen

A new project helps give kids a safe place to play soccer in a Rio de Janeiro favela by using kinetic-energy harvesting tiles to produce electricity for keeping the lights on.

Pavegen, a company who has experience capturing the power of human feet from installing tiles to be run over during the Paris Marathon to creating a kinetic-energy powered sidewalk at the London Olympics, built the project through a partnership with Shell.

The field features the tiles underneath a layer of astroturf as well as a few solar PV panels around the perimeter of the field. The two technologies together generate electricity which is stored on site and then used to power the field’s floodlights.

© Pavegen

“We have taken this idea from a bedroom in London to a football pitch in Brazil through our partnership with Shell, encouraging young innovators of the future to make a real difference in their community,” said Pavegen’s 28 year-old founder and CEO Laurence Kemball-Cook. “In the two weeks on site in the community, children helped complete the installation. It was a real life science experiment that didn’t stop when school ended for the day.”

The company estimates that the tiles should provide up to 10 hours of illumination from a full battery, meaning neighborhood kids will always have a safe, well-lit place to kick the ball around. The tile system includes a wireless Application Programming Interface (API) that collects real-time data, which can be transmitted to predetermined web addresses for analysis.

Now throw the kids a Soccket ball — a soccer ball outfitted with an energy harvester that can be used for powering LED lanterns or charging cell phones — and then you’re really talking about the power of play.

See a video about the project featuring soccer legend Pelé below.

http://www.treehugger.com/clean-technology/soccer-field-lights-powered-kids-pounding-feet.html

Debating corticosteroid injections for heel pain

Debating corticosteroid injections for heel pain. Some practitioners find plantar fasciitis patients respond to corticosteroid injection when other treatments have failed, but concerns about complications make others cautious. With evidence-based guidelines in short supply, the decision often comes down to clinical experience.
For the full story go to;

http://lermagazine.com/article/debating-corticosteroid-injections-for-heel-pain

9plantarfasciitis-shutterstock_114613207.jpg

Some practitioners find plantar fasciitis patients respond to corticosteroid injection when other treatments have failed, but concerns about complications make others cautious. With evidence-based guidelines in short supply, the decision often comes down to clinical experience.

By Larry Hand

A seemingly never-ending question continues to exist among practitioners who treat patients with plantar fasciitis: whether to use corticosteroid injections to relieve pain and inflammation, or rely on more conservative nonsurgical modalities. Many practitioners depend on their own experiences, because what also continues to exist is a shortage of evidence-based guidance on use of the injections.

“In clinical practice we observe all kinds of different philosophies by treating doctors in regard to their use of steroid injections for plantar fasciitis,” said Jeffrey Johnson, MD, professor of orthopedic surgery and chief of the foot and ankle service at Washington University in St. Louis, MO. “I feel many of the injections are not indicated, and there are some downsides. The problem in proving the relationship between the injection and the plantar fasciitis rupture is that these cases are so anecdotal.”

Johnson was lead author of an article published in 2011 in Foot & Ankle International,1 detailing the results of a 2007 to 2008 survey by the American Orthopaedic Foot & Ankle Society (AOFAS) on the use of corticosteroid injection in clinical practice.

LER-Resource-Guide-Products-Plantar-Fasciitis

“Rupture of the plantar fascia is a real [issue regarding corticosteroid injections]. The problem is getting a handle on how commonly this occurs. That’s why we did the survey,” he said.

In the article, the authors concluded, “Despite many case reports of complications, our survey indicates that the incidence of complications was perceived to be low and generally related to the injection site (skin depigmentation, atrophy, flare reaction).”

Endoscopic view of the plantar fascia as part of an endoscopic plantar fascia release. (Image courtesy of Daniel C. Farber, MD.)

Specifically, in the survey, AOFAS members reported injection complications and rates of other complications including skin depigmentation (5.1%), atrophy (4%), flare reaction (3.5%), plantar fascia rupture (1.5%), and heel pad atrophy (1.4%). However, the authors noted the survey results reflected AOFAS members’ understanding of the current indications for injections and the perceived complications that the injections may have caused, and that the paper was not a review of patients who had complications from injections.

The American College of Foot and Ankle Surgeons (ACFAS) did include corticosteroid injection among first- and second-line treatments for heel pain in its 2010 revised guidelines,2 based on what the authors called “fair” evidence. However, they also noted, “Plantar fascia rupture has also been reported as a complication of heel corticosteroid injection.”

In a 2013 review article in the Journal of the American Podiatric Medical Association,3 researchers wrote that core literature has wide-ranging outcomes that are largely supportive of short- and long-term benefits of corticosteroid injections for plantar fasciopathy, and cited the ACFAS guidelines including it as a first-line therapy.

For this article, LER interviewed practitioners across a spectrum of specialists to gain a sense of the status quo in the US for use of corticosteroids to treat patients with plantar fasciitis.

Has a place, but …

“It has a place in the spectrum of care for plantar fasciitis,” Johnson of Washington University told LER. “It does not have a role in plantar heel pad pain, because I think the steroid itself can degrade and thin out and atrophy the subcutaneous fat under the heel, wherever you place the steroid. I think it is important to keep in mind that, for most patients, this is a condition that will get better with time, and our role should be to provide treatment that does not cause harm.”

Johnson doesn’t consider it first-line therapy, however.

“You don’t start with an injection into the plantar fascii,” he said. “Typically we start with the traditional things like plantar fascia stretching, icing, anti-inflammatory medication, night splinting, over-the-counter foot orthotics, and soft-sole shoes. All those things are first, and then, if there is minimal improvement over the next eight to twelve weeks, second-line could be injection.”

He uses severity of the disease and location of pain to guide his decision.

“If somebody says, my pain is in this general area, and they draw a circle the size of a tennis ball, there is no way, but if they say it’s right here and it’s the size of a quarter, then yes,” Johnson said. “Having the pain discreet in its location, classic in its presentation—those patients are better ones for the injection. I’m not sure what we’re actually treating sometimes when patients have large areas of pain.”

Quick mechanism

Leslie Campbell, DPM, who practices at the Presbyterian Hospital in Plano and Allen, TX, said she is “fairly conservative” in her use of injections.

“As far as the injection, itself, it can be easily administered, and it’s a quick mechanism to relieve discomfort, without a lot of side effects,” Campbell said. “Benefits can last days to weeks to months.”

She added, “I tell patients that it’s going to relieve localized inflammation in the general area that it is injected. When they’re having acute pain, they generally have more rapid response.”

But it isn’t for everyone.

“I initiate treatment with biomechanical control of foot function with shoe therapy and custom prescription orthotics. I usually will start with shoe therapy, a heel lift and taping for people who have mild fasciitis. If people have recalcitrant or long-term pain or it’s very acute, that’s when I involve the corticosteroid injection [for moderate to severe patients],” Campbell said.

She advises caution with some types of patients.

“In people with dark skin, generally it can cause either a lightening of the skin or whitening of the skin right at the injection site subcutaneously. If anybody has a tendency to have any type of bleeding disorder, we have to be very, very careful,” Campbell said.

The injections can also lead to systemic complications, she said.

“We have to be very careful, for instance, in people who are diabetic, because they can temporarily elevate their glucose level.4 So I’ll always tell my patients: Don’t be surprised if they’re monitoring their glucose level, that they might have a spike. [Corticosteroid injection] can cause an increase in HgA1C, so I advise patients to inform their family physician or endocrinologist that they have undergone corticosteroid injection therapy and record the date of injection for their medical record.”

She continued, “Some people can get a facial flushing after injection therapy. Their face will get red. I’ve seen it more commonly in women. Sometimes that flushing will persist for a couple of days. It frightens people; they think they’re allergic to cortisone. But, in essence, it’s just a short-lived or sensitivity reaction. We all produce cortisone, and it’s very rare to have an allergic reaction to cortisone.”

Temporary fix?

The injections are also second-line treatments for Daniel C. Farber, MD, assistant professor of clinical orthopaedic surgery at the University of Pennsylvania Health System in Philadelphia.

“I rarely use it on first visit. I tell patients that the injections for the most part are a temporary fix. I like to use them for patients who are really having such discomfort that they can’t do exercises, the stretching, and [conservative measures] to get better,” Farber told LER. “I tell folks that the risks involved are, rarely but occasionally, rupture of the plantar fascia, and that’s an even longer, more chronic problem that doesn’t have a good solution. The injection is not the cure, so we try to hold that in our back pocket to use when absolutely necessary or when other things are not working.”

He advises stretches, heel cups, and three months of conservative treatment before considering injections, and he often sends patients to physical therapy to learn proper stretching techniques.

He also commonly prescribes night splints.

“I’m somewhat partial to the dorsal night splints as these are better tolerated by patients than the traditional night splints and thus compliance—as well as activity modification measures— are better,” he said.

Prolonged course

Knowing that the disease may just run its course puts some patients at ease.

“Plantar fasciitis follows a prolonged course, and it rarely gets better quickly. But it does usually come to a point of tolerability and manageability. I just try to tell patients that it’s going to take a while,” Farber said.

James Jastifer, MD, an orthopedic surgeon at the Coughlin Clinic in Boise, ID, counsels patients not to expect their symptoms to resolve completely after a month.

But, with good results to conservative treatment, said Jastifer, “generally things are twenty-five percent better after a month, then after several months it’s maybe fifty percent better, and if you can get to that point it tends to burn itself out.”

He doesn’t use corticosteroid injections as a rule.

“In my practice, there is a very limited role for corticosteroids in patients with plantar fasciitis,” Jastifer said. “In fact, that would be far down the list of things to try, while ninety percent of people who will get better within ten months with various other nonoperative techniques such as Achilles stretching, plantar fascia-specific stretching, night splinting, orthotics, and casting. Almost universally patients get better.”

He uses mostly over-the-counter soft orthotic devices such as arch supports, and sometimes heel cups.

Alan MacGill, DPM, a foot and ankle surgeon in Boynton Beach, FL, sometimes uses corticosteroid injection as a first-line treatment for plantar fasciitis.

“If a person comes in with heel pain, and they say that it’s on the milder scale, I tend to hold off on the injection at an initial visit. I would instruct them to do stretching, icing, modify activities and shoewear, as well as avoid walking barefoot on hard surfaces. Occasionally I’ll prescribe anti-inflammatory medications by mouth,” MacGill said. “If a patient comes in with more severe pain, in the absence of any kind of trauma, and I don’t suspect that there’s any kind of rupture of the plantar fascia, then I’m more likely to give them the cortisone injection.”

The decision also depends on what treatments a patient may have already tried.

“Some patients come to the initial visit and they’ve done absolutely nothing. So a lot of times they’re going to get some improvement with aggressive stretching, ice therapy, and some kind of arch support,” he said.

The arch support consists of foot strapping or a prefabricated or custom foot orthosis.

“Most patients with a relatively normal foot type will get a prefabricated orthotic,” MacGill said. “If they have a significant deformity, or I don’t think they’ll tolerate a prefabricated device, then I’ll recommend a custom device.”

MacGill sees less of a risk than some other practitioners for plantar fascia rupture.

“Based on my experience, the risk of rupture after steroid injection is very low,” he said. “What I try to explain to patients is that a rupture in and of itself is not necessarily the worst thing, especially if they have been dealing with the condition for a long time. A rupture achieves the same endpoint as when we intervene with surgery. When we do address it surgically, most of the time we do end up doing a plantar fasciotomy where we’re cutting that ligament, which relieves the tension and some of the pain.”

Patient activity level can also be a factor in MacGill’s decision to perform a corticosteroid injection, he said.

“When I do give someone an injection, I always recommend that they continue to try to stay off the foot. I never want someone to go back to running immediately, even if they have pain relief,” he said. “I think that, sometimes with the cortisone injection, people have less pain and therefore they think that they can do more, and that increased activity can sometimes make them more prone to having a rupture.”

More than whether

Perhaps even more dividing a question than whether to use corticosteroid injections for patients with plantar fasciitis, is how many times to inject over what period of time.

“That’s controversial,” MacGill said. “There’s somewhat of an unwritten rule in our profession that we shouldn’t give more than three in a calendar year. I know practitioners who follow that strictly, and I know practitioners who don’t believe in that at all. I tend to follow that. Most patients of mine will receive one injection. There’s a few who may receive a second. Very, very infrequently do I give a third. And if I do give a third injection, it’s not for many months past the first injection.”

Campbell recommends at least six weeks between injections and no more than three to four injections per year.

“I believe the benefits certainly outweigh the risks as long as this is used very judiciously,” she said.

Farber says he rarely does more than one or two injections, and Johnson says he sees no role for multiple injections given less than three months apart.

“I’m not a big multi-injector of the plantar fascia for fear of rupturing it,” Johnson said. “I’m also concerned about it atrophying the soft tissues in the bottom of the foot.”

A 2010 systematic review of the literature on extra-articular corticosteroid injection found that atrophy was mentioned as a complication in five prospective studies, with a frequency ranging from 1.5% to 40%.5

And how?

Injection technique can also make a difference in the risks of complications, experts say.

“I’ve seen a number of patients who have had nerve injuries from having their plantar fascia injected,” Johnson said. “The needle is placed and it injures either the heel or the lateral plantar nerve. I’ve seen some permanent injuries from that.”

To avoid directly injecting into the substance of the plantar fascia or injuring the plantar nerves around the heel, he recommends injecting from the medial side, rather than from the bottom of the heel, and placing the corticosteroid near, not in, the plantar fascia.

Even advocates of corticosteroid injection believe it is just one piece of a complex treatment puzzle.

“The best treatment for me has always been a multifaceted approach,” MacGill said. “That’s having them do Achilles and plantar fascia-specific stretching, and [use] some kind of support for the foot such as an orthotic or strapping that relieves tension on the plantar fascia. And then also the injection. I almost never give someone an injection without having them do the other things, because I just don’t think that’s the best approach.”

Larry Hand is a writer in Massachusetts.

REFERENCES
  1. Johnson JE, Klein SE, Putnam RM. Corticosteroid injections in the treatment of foot & ankle disorders: an AOFAS survey. Foot Ankle Int 2010;32(4):394-399.
  2. Thomas JL, Christensen JC, Kravitz SR, et al. The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg 2010;49(3 Suppl):S1-S19.
  3. Kirkland P, Beeson P. Use of primary corticosteroid injection in the management of plantar fasciopathy: is it time to challenge existing practice? J Am Podiatr Med Assoc 2013;103(5):418-429.
  4. Kim WH, Sim WS, Shin BS, et al. Effects of two different doses of epidural steroid on blood glucose levels and pain control in patients with diabetes mellitus. Pain Physician 2013;16(6):557-568.
  5. Brinks A, Koes BW, Volkers ACW, et al. Adverse effects of extra-articular corticosteroid injections: A systematic review. BMC Muculoskelet Disord 2010;11:206.

Athlone Foot Clinic

New opening times at the Athlone Foot Clinic. We are delighted to announce that the Athlone clinic

 

We are now open Monday & Friday 9:30 to 6pm. Location of Clinic

 

Please call 085-1911271 or email info@athlonefootclinic.ie

What are your feet trying to tell you????

 

foot health photo

Our feet hold us up. They carry us through the world. But minus a pedicure every so often, our feet can be disregarded. Covered in shoes and socks and often out of our sight, it’s easy to lose track of them. Until they start to bother us. Issues with your foot health, may not just be confined to your extremities, they may actually have larger health implications.

6 Foot Health Signs: What are Your Feet Trying to Tell You?

1. Cold Feet

It’s not just a figure of speech for not wanting to walk down the aisle, cold feet are a real foot health issue. If your feet are constantly cold, it may mean that you have circulation issues. Specifically, conditions like COPD reduce your lungs ability to fully absorb oxygen and can cause cold feet.

2. Itchy Feet

Itchy feet are a sign of a fungal infection. It could be athlete’s foot or some other fungal variety that causes a distracting itch. Fungal infections can often be treated with over the counter anti-fungal creams. Itchy feet can also be the result of psoriasis, an immune condition.

3. Swollen Feet

Swollen feet can be caused by a variety of conditions. Sometimes your feet will swell simply because you’ve been standing for too long. Swollen feet can also be the result of a more serious condition caused by fluids like blood building up in toes including congestive heart failure and kidney disease–or pregnancy!

4. Hairless Toes

From a vanity perspective hairless toes may seem like a good thing. They look elegant in your strappy sandals. But hairless toes may be a side effect of serious circulation problems. It’s worth talking to your doctor.

5. Frequent Foot Cramping

Frequent foot cramping can be the result of nutrient deficiencies like potassium, magnesium, and calcium. They may also be the result of dehydration. In some rare and more serious cases, it may be the result of nerves issues.

6. Enlarged Big Toe

If you have a suddenly enlarged big toe, it may be the result of gout. It could also be an infection or inflammatory arthritis

Call the Athlone Foot Clinic today on 0851911271 

 

Taken from:http://www.organicauthority.com/6-foot-health-signs-what-are-your-feet-trying-to-tell-you/?utm_source=rss&utm_medium=rss&utm_campaign=6-foot-health-signs-what-are-your-feet-trying-to-tell-youWhat

Special Olympics Limerick 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Well Done to All the Participants of the 2014 Special Olympics in Limerick.

3 Gold Medals Next time with these new feet!

3 Gold Medals Next time with these new feet!

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014

Fix Feet Special Olympics 2014 5

Foot Pain when walking???

walking

 

Summer time has arrived and we all want to make the most of it! Make sure you are pain free this summer, and don’t let your feet hold you back. If you live in Athlone, Westmeath, Roscommon, Longford, Offaly or Galway and you are having problems with your feet- Today is the day to make that call!

Call the Athlone Foot & Ankle Clinic and book an appointment to see Joe Egan our Podiatrist and talk to him about your aliments.

If you find your feet are holding you back- well then you need to call the Athlone Foot & Ankle Clinic today and say goodbye to your foot pain.

Call 085 1911271 or email info@costapa.ie

walking summer