Treatments and Devices
Many podiatrists utilize both conventional and highly-specialized methods that could include both conservative and surgical techniques. X-rays and other diagnostic tests may be performed by a podiatrist. Surgery on an out-patient basis may involve the use of traditional open or minimal incision surgery. Custom orthotics may be prescribed to correct certain biomechanical imbalances and occasionally custom shoes may be prescribed. Therapeutic modalities such as ultrasound, serial taping, padding and paraffin wax baths are often used.
Foot problems are often associated with abnormal conditions in other parts of the body, both systemic and skeletal such as in back disorders. Your podiatrist specifically looks for signs of diabetes, kidney ailments, anemia, among other disorders that may require consultation with your family physician or other specialist.
Early diagnosis and treatment of foot problems are worthwhile investments in overall good health. Unfortunately, major foot problems can result when people attempt to diagnose and cure their own foot ailments or neglect their feet altogether.
Below is a list of some of the foot ailments your Podiatrist will diagnose and treat:
| GENERAL | Corns, calluses, infections, Athlete's Foot, dermatitis, warts, ingrown nails, and trauma. |
| SURGICAL | Corns, ingrown nails, hammertoes, bunions, bone spurs, cysts and tumors, warts, enlarged joints, misaligned metatarsals, calluses and skin lesions.(See "Why Surgery") |
| PODOGERIATRICS (Foot Care for the Elderly) | Muscle weakness, imbalance, nail disorders, arthritis, corns, calluses, vascular related disorders, bony prominences, diabetic ulcers, poor circulation, skin rashes, loss of sensation, weight bearing imbalance and skeletal deformities (that can have an effect on the back as well as ankles, knees and hips). |
| ORTHOPAEDIC BIOMECHANICS | Arch pain, tendonitis, fallen arches, rigid high arches, muscle cramps, neuroma (nerve tumor), foot imbalance, heel pain, foot fractures, bursitis and sports related disorders, related low back pain. (See Orthotic Devices) |
| PODOPEDIATRIC FOOT CARE (Children's Foot Care) | Flat feel, in toeing, Athlete's Foot, warts, growth plate inflammation, ingrown nails. |
| PODIATRIC SPORTS MEDICINE | Heel spurs, plantar fasciitis (arch or heel pain), Achilles tendonitis, muscle strain, high arches (pes cavus), flexible low arches (pronation), knee pain secondary to improper foot function, leg pain (shin splints), related low back pain. |
| DIABETIC | Ulcers, poor circulation, nail problems, skin rash, loss of sensation, weight bearing imbalances. |
| PERIPHERAL NEUROPATHY | Peripheral Neuropathy is the primary cause of diabetic ulcers and the most predictive diagnosis for an eventual amputation. See Peripheral Neuropathy Abstract |
Approximately nine out of ten people suffer from a troublesome foot problem at some point in their lives. Contrary to popular belief, the majority of foot problems do not resolve without medical intervention. Fortunately, for those people who suffer from painful feet, podiatrists may properly diagnose a foot problem, recommend and/or administer treatment. If conservative therapy is not successful for a particular problem, surgery may be performed.
There are basically three reasons for having foot surgery:
The majority of Podiatrists will perform surgery in their office which is a much more pleasant atmosphere than the hospital. Overnight stays in hospitals are avoided as is prolonged pain and disability. Local anesthesia, considered the safest form of anesthetic, will be used to make your surgery painless. You can walk out of the office following the procedure.
Minimal Incision Surgery may be one type of surgery your Podiatrist may decide to use for your particular problem. Minimal Incision Surgery (MIS) was developed in the early 70's and is now in widespread use.
Using MIS, your Podiatrist will anesthetize the particular area of concern on your foot. A small incision will be made (approximately 1/4") and a fine precision instrument will be used to perform the surgery. Usually no stitches are required. Pins, screws, wire or staples are not used and soft bandaging takes the place of casts and crutches. You may even be able to wear your own shoes immediately after the surgery!
As with any architectural structure, if the foundation is not stable then the structures above can suffer. This applies toyour feet, the foundation of your body.
Imbalances of the bones of the feet can result in abnormal foot motion which, besides playing havoc with foot function, can result in rotation of the legs and sometimes the knees, hips and back.
Feetdocs use F-SCANŽ to determine the exact specifications of the Orthotic. F-SCANŽ provides bipedal plantar pressures using a paper-thin, disposable sensor placed in the patient's shoes. The F-SCANŽ sensor detects, displays and records plantar forces while they take place.
3-D graphics gives the podiatrist a split-second perspective on plantar pressure distribution through all phases of the gait from almost any angle.
Sample computer screen shots of pressure points and imbalances of the foot using F-SCANŽ
Please refer to the FAQ page for more information about Orthotics.
PERIPHERAL NEUROPATHY
Improved Sensory Perception in Diabetics
THOMAS J. BURKE, ALAN KOCHMAN, DALE CARNEGIE
Abstract#: 1798-PO
BACKGROUND: There is no therapy for peripheral neuropathy (PN) which occurs in more than 50% of long-term diabetics.
PN is the primary cause of diabetic ulcers and the most predictive diagnosis for an eventual amputation.
As part of the therapeutic approach to post operative incisions and disease induced wounds experienced by diabetic patients, physical therapists at TMCA and DHMC routinely use a medical device, the Anodyne Therapy System (ATS). The ATS is FDA cleared for pain reduction and improving circulation. It emits monochromatic, near infrared photo energy (MIRE) from a series of 60 diodes in a flexible array that is placed in contact with the skin. Occasionally, diabetic patients report improvement in sensory perception in the feet although feet were not directly exposed to the MIRE.
PURPOSE: We instituted a prospective study of 49 diabetics (Type I, n=25; Type II, n=24) each of whom received treatment with the ATS to determine if there was an improvement of sensation.
METHODS: At baseline, all patients had absent or impaired protective sensation as measured by the Semmes-Weinstein (SW) monofilament test (range 4.56-6.45). 42 of 49 patients had clinically-determined SW values exceeding 5.07, reported to be the single most predictive diagnosis of diabetic foot ulceration. The ATS diode array was placed in contact with the skin on the lower leg/foot for 30min./day, 3X/week for one month and SW tests were repeated at two and four weeks.
RESULTS: After two weeks, 48/49 patients exhibited improved sensation. After 12 treatments, all 49 patients had improved sensation and 65% of the patients demonstrated a restoration of protective sensation (SW at 4.17 or below). No patient had a SW value above 4.93
CONCLUSION: The ATS may be a safe, non-invasive therapy for the consistent and predictable improvement of foot sensation in diabetic patients with PN.
What is Radial Shockwave Therapy? Radial shockwaves are high-energy acoustic waves. They are transmitted through the surface of the skin and spread radially (spherically)
into the body. The body responds with increased metabolic activity around the site of the pain. This stimulates and accelerates the healing process. Radial Shockwave Therapy is currently used to treat: For further information on any of the contents of this
page, please contact us 
