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Compounding Meds For Diabetic Neuropathic Pain: Can They Have An Impact?

Allen Jacobs, DPM, FACFAS | 14,880 reads | 1 comments | 02/23/2015

Topical compounded medications may play a key role in the armamentarium of treatments for diabetic neuropathy, particularly patients who have multiple comorbidities and polypharmacy issues. Accordingly, this author demonstrates how compounding can optimize drug concentration at the site of pain with a lower risk of adverse sequelae.

Why It Is Important To Evaluate Shoe Heel To Toe Drop In Patients With Equinus

Patrick DeHeer DPM FACFAS | 3,910 reads | 0 comments | 05/19/2015

The role of equinus in lower extremity pathologies is well documented in the literature. In fact, Foot and Ankle Clinics of North America dedicated its entire December 2014 edition to “The Gastrocnemius.”1 Much of the literature has been directed to the surgical and non-surgical management of equinus, conditions associated with equinus, and the evaluation of equinus. Little attention has focused on the role of shoe gear on equinus with the exception of the anecdotal literature on high heels.

Why Heel Strike Gait May Not Increase The Risk Of Overuse Injuries In Runners

Kristine Hoffman DPM | 1,030 reads | 0 comments | 07/10/2015

A recent study presented at the 61st Annual Meeting of the American College of Sports Medicine showed that United States Army personnel who ran with a heel strike pattern did not suffer significantly more overuse injuries than those who ran with a forefoot or midfoot strike pattern.1

Sharing The Recipe For Managing Patients With Chronic Pain

Stephen Barrett DPM FACFAS | 1,388 reads | 0 comments | 11/26/2014

It could have been the biggest group psychology session, perhaps in history but at the very least, the most prolific among extremity nerve surgeons. Not only was this “session” attended by most of the attendees at the 2014 Association of Extremity Nerve Surgeons (AENS) Annual Meeting in Scottsdale, Ariz., but everyone wanted more “therapy.” Well, guess what? They are going to get it next year in Denver, same time next year.

How Did Heel Spurs Become Public Enemy Number One?

Stephen Barrett DPM FACFAS | 3,435 reads | 0 comments | 03/05/2014

The cool, dark west Texas night sky was nearly silent. It was almost like I had been placed into some type of surreal soundproof chamber. There was a big silence, except for the occasional coyote howl, and of course the regular cracking and popping of the roaring campfire. But that was like white noise. You never heard it unless you really concentrated. There is nothing like being out on a roundup, resting by the flickering fingers of the orange and yellow flames of the fire, being bone aching tired from herding cows all day. Then the silence ended.

Treating Posterior Medial Ankle Pain In A Juvenile Patient After An Ankle ‘Sprain’

Annie Nguyentat, DPM, and Meagan Jennings, DPM, FACFAS | 6,569 reads | 0 comments | 03/31/2015

These authors detail the diagnosis and treatment of a 10-year-old, who presented with posterior ankle pain that urgent care clinicians originally diagnosed

Treating Iatrogenic Calcaneal Osteomyelitis 
Following A Plantar Heel Injection


Michael Canales, DPM, FACFAS, Michael Bowen, DPM, and John Gerhard, DPM | 12,838 reads | 0 comments | 06/30/2014

Addressing questions of how to proceed when a calcanectomy is inappropriate, these authors detail how to treat a 24-year-old who experienced the rare complication of calcaneal osteomyelitis after an injection for plantar fasciitis.

The Cocktail For Long Lasting Local Anesthesia: Mitigating Chronic Post-Surgical Pain

Stephen Barrett DPM FACFAS | 4,275 reads | 0 comments | 09/03/2014

Swirling the opaque garnet wine around the edges of the Riedel glass allowed for the complex interaction of its fruit to escape from its mixture. After the wine hit the palate, I knew due to the structure, mouth feel and astringency that this was a superior blend of high grade, very stressed berries of different varieties. I would need more exploration to attempt forensic identification but so be it. Someone has to do some work.

When Living With Foot And Ankle Pain Is Preferable To Surgery

William Fishco DPM FACFAS | 6,215 reads | 1 comments | 09/25/2014

It is always a frustrating situation when a patient presents to your office with foot pain and you know right away there is not an easy solution and the likelihood of getting the patient pain-free is slim.

There are certain conditions of the foot that we all dread to manage. For example, the patient with a high arch and curved forefoot (pes cavus with metatarsus adductus) often presents with chronic dorsal foot pain. Typically, there is an element of degenerative joint disease of the tarsometatarsal joints, exostosis and neuritis. I have a case in point to share with you.

Current Insights On Differentiating Vascular Pain From Neuropathic Pain

Allen Jacobs DPM FACFAS | 36,751 reads | 0 comments | 01/13/2014

Not infrequently we face patients who have diabetes or other comorbid conditions with which vascular disease and neuropathy are both associated. At times, differentiating vascular pain from neuropathic pain can be difficult. In a patient with diabetes, vascular pain secondary to loss of blood flow may result from ischemia, vasculitis, vasospasm or vascular compression. Neuropathic pain may result from diabetic neuropathy, nerve entrapment such as tarsal tunnel syndrome, or spinal compression syndrome.