Chronic Tendinopathy And Altered Pain Processing: What You Should Know

Kristine Hoffman DPM | 1,547 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.

Modifying Orthoses To Help Decrease Hallux Limitus Pain

Larry Huppin DPM | 1,351 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.

Principles In Pain Management For Wound Care Patients

Kazu Suzuki, DPM, Ryan Lockhart, BS, and Zoe Birnbaum, BS | 3,101 reads | 0 comments | 07/26/2016

A significant number of wound care patients may present to your office with chronic pain present for more than three months. These authors provide a guide to treating patients with mild, moderate and severe pain, and review key principles in prescribing and monitoring opioid use.

Keys To Prescribing An Orthosis To Address Calcaneocuboid Pain

Larry Huppin DPM | 1,916 reads | 0 comments | 06/03/2016

A client recently called regarding a patient with pain at the calcaneocuboid joint. He apparently has a fairly stable foot with mild eversion of the heel in stance. The pain consists of aches with activity and there is a little pain to palpation dorsolaterally. Radiographs were negative.

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

Larry Huppin DPM | 1,053 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 | 2,986 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

Can Orthoses Help Patients With Low Back Pain?

Panelists: Joseph D'Amico, DPM, Kevin Kirby, DPM, and George Trachtenberg, DPM | 5,694 reads | 0 comments | 05/19/2016

These expert panelists delve into the relationship between custom orthoses and low back pain, sharing key pearls on examining these patients and how to determine whether orthoses can be beneficial.


In your clinical experience, have you found a relationship between custom orthotics and the relief of low back pain?

Can Acupuncture Have An Impact In Postoperative Pain Management?

Kristine Hoffman DPM | 2,686 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

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

Larry Huppin DPM | 1,155 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.

What You Can Recommend To Athletes For Patellofemoral Pain Syndrome

Richard Blake DPM | 1,357 reads | 0 comments | 05/10/2016

In athletes, patellofemoral pain syndrome can be a common injury, making it vital to have a treatment plan for athletes presenting to your office. Here are some initial treatments you can recommend to these patients.

1. Ice the knee 30 minutes three times daily.

2. Start quadriceps strengthening painlessly on day one.

3. Stretch the quadriceps and hamstrings three times daily. Avoid knee flexion over 45 degrees (this is too much knee flexion for kneecap pain).

4. Use a knee brace like the Bauerfeind GenuTrain Knee Brace for patellar stabilization.