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Modifying Orthoses To Help Decrease Hallux Limitus Pain

Larry Huppin DPM | 1,293 reads | 0 comments | 09/22/2016

I had a patient come in who is a runner and for whom we had made orthotic devices to treat hallux limitus pain. Overall, she has done very well. This was a very controlling orthotic that conformed closely to the arch of the foot. We designed the orthotic for the full width of her foot and inverted it several degrees to allow first ray plantarflexion.

Chronic Tendinopathy And Altered Pain Processing: What You Should Know

Kristine Hoffman DPM | 1,481 reads | 0 comments | 10/04/2016

A recent study by Tompra and colleagues examined whether central pain mechanisms play a role in chronic tendon pain.1 This study assessed the conditioned pain modulation effect in people with and without Achilles tendinopathy. Conditioned pain modulation reflects the activity of the descending pain modulation system and a decrease in its function has occurred in several chronic pain disorders.2-5 The study showed a significantly smaller conditioned pain modulation effect in the Achilles tendinopathy group in comparison to controls.

Can Acupuncture Have An Impact In Postoperative Pain Management?

Kristine Hoffman DPM | 2,504 reads | 0 comments | 01/20/2016

Acupuncture is one of the oldest forms of natural medicine. Practitioners have used acupuncture in the treatment and management of numerous disorders including acute pain, chronic pain and musculoskeletal disorders.1

Developing A Plan To Treat Chronic Forefoot Nerve Pain

Richard Blake DPM | 2,468 reads | 0 comments | 11/23/2015

I recently received an email from a 57-year-old male, who was active and in good health. While recovering from bilateral quad tendon issues, he injured both forefeet in 2012 while hiking for two days in a an area with caves. To protect the quads, he went up many, many stairs using his feet and calves. Think of it as doing 4,000 calf raises.

When There Is Considerable Splay Of The Toes And Significant Toe Pain With Steel Toe Boots

Larry Huppin DPM | 876 reads | 0 comments | 03/09/2017

A patient presented with painful fourth and fifth toes on the right foot in the steel toe boots he must wear for work. He had tried a number of brands and always developed rather severe pain by the end of the day. The left foot was fine.

He had an interesting foot with considerable splay of the toes. He had a hallux varus right along with adductovarus in the fourth and fifth metatarsals with lateral splay of the fifth metatarsal. The pain was coming from pressure on the fourth and fifth metatarsals both dorsally and laterally.

Wearable Intensive Nerve Stimulation: Can It Have An Impact For Chronic Lower Extremity Pain?

Artinder Nanrhe, BS, and Stephanie Wu, DPM, MSc, FACFAS | 2,769 reads | 0 comments | 01/03/2017

These authors discuss the use of wearable intensive nerve stimulation, an emerging form of transcutaneous electrical nerve stimulation, and provide a few illuminating case studies.

Pain is a substantial and common complaint for millions of Americans, and is one of the most common reasons for visits to the doctor. Epidemiological data suggests that the prevalence of musculoskeletal and neuropathic pain increases with age until at least late midlife, and over half of these patients experience pain of a chronic nature.1

How To Modify Orthoses When The Heel Is Slipping Out Of The Shoe

Larry Huppin DPM | 1,121 reads | 0 comments | 09/23/2015

I had a consult call from a colleague whose patient was complaining that his heel was slipping out of his shoe when he wore his orthotics. This was a polypropylene orthosis with an ethylene vinyl acetate (EVA) rearfoot post.

When A Patient Gets Relief From Low Back Pain With Orthotic Devices

Richard Blake DPM | 1,147 reads | 0 comments | 04/14/2016

A patient with severe lower back pain and disc disease recently contacted me. He noticed his lower back at the sacrum is twisted to the left and his left hip sways to the left. His right ankle pronates with nerve pain between the right first and second metatarsals. He is walking with a cane in the morning. The patient notes he got a diagnosis of scoliosis as a child and has always pronated.

Addressing Longtime ‘Big Toe Pain’ In A Younger, Active Patient

Richard Blake DPM | 3,634 reads | 0 comments | 06/05/2015

I recently heard from a 27-year-old active male, who noted big toe pain in his left foot for the last seven to eight years. Exercise seems to exacerbate the pain and it calms down when he rests the foot. The patient noted the pain does not seem to be getting worse although it does tend to be quite tender after running. He has no bone spurs that he can feel and retains the same range of motion as the other foot. The patient had X-rays about seven years ago when he noticed it and the podiatrist suggested hard sole shoes and orthotics, which he didn't follow through with using.

Can Changes In Running Form Help Address Achilles Tendonitis Pain?

Nicholas A Campitelli DPM FACFAS | 4,305 reads | 1 comments | 05/01/2015

“John” is a 44-year-old male who presented to my office with a year-long history of Achilles tendonitis. He had evaluation and treatment by a previous orthopedic surgeon, and used custom orthotics and stretching exercises. The patient’s pain had never resolved. He is a novice runner averaging about 10 to 15 miles a week and noted that the pain was more associated with his running. The patient’s pain would improve when he took a break from running but as soon as he returned to running, the Achilles became inflamed and painful again.