Tag Archives: Pain management

Diabetic Nerve Pain Treatment Options and Symptoms

23 Jan
Diabetic Nerve Pain, also known as neuropathy or Diabetic Peripheral Neuropathy, is a nerve disorder common in those who have diabetes. Some people with this nerve damage show no symptoms, while others may feel pain, tingling, or numbness in the hands, arms, feet, toes, or legs.
peripheral neuropathy diabetic nerve pain

Courtesy of NIH

Diabetes is not the only cause of neuropathies – they may also result from vitamin deficiencies (B-12 and Folate), chemical exposures, pressure on nerves, or certain medications, especially those used in AIDS therapies and chemotherapy.

Roughly 70% of people with diabetes will develop some form of neuropathy, including Diabetic Nerve Pain. It can appear at any time during the progression of the disease, but the risk increases with age and the duration of the illness. According to the U.S. Department of Health and Human Services,  The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

The early symptoms of diabetic nerve pain are a slight tingling or numbness in the extremities. As the disease progresses, and nerves are further damaged, the tingling or numbness becomes painful and may be quite severe. When these symptoms appear in the feet, hands, or legs, it’s known as Peripheral Neuropathy, and when caused by diabetes, Diabetic Peripheral Neuropathy.

Symptoms of Diabetic Peripheral Neuropathy include

  • Numbness or insensitivity to pain or temperature
  • A tingling or burning sensation
  • Pains or cramping
  • Extreme sensitivity to touch
  • Loss of balance or coordination

How are nerves damaged by diabetes?

Vascular and neural diseases are closely related. Blood vessels depend on nerves, and nerves depend on blood vessels. Scientists know that prolonged exposure to high blood sugar damages nerve fibers, but exactly how that happens is still a matter of debate. What they know for sure is that high blood glucose interferes with the ability of nerves to transmit signals, and weakens the walls of capillaries (tiny blood vessels) that supply nerves with nutrients. When nerves don’t receive enough oxygen and nutrients from blood vessels, cells begin to die, and nerves don’t function properly. Other risk factors for nerve damage of this type are smoking, alcohol abuse, and certain genetic factors unrelated to diabetes.

What you can do to avoid DPN

The best way to avoid DPN or to minimize nerve damage once it begins, is to keep your blood sugar under control, exercise regularly, and see your physician on a regular basis to test you for symptoms. According to John Hare, MD, Medical Director of Joslin Diabetes Center’s Affiliated Centers program, “people who keep their blood sugars consistently in [a] healthful range can decrease their risk of nerve damage by more than 50%. Getting diabetes under better control also may help limit the amount of damage caused by neuropathy once it’s developed.” 

In addition to a diabetes specialist, a podiatrist should also be a member of your diabetes health team. Early symptoms of DPN typically appear first in the feet, and may go unnoticed by the patient. Podiatrists are experts at detecting these symptoms, and early intervention can avoid further damage to the blood vessels and nerves.

Treatments for Diabetic Peripheral Neuropathy

Early in its development, the pain and tingling of DPN can be managed with over the counter pain medicine like acetaminophen (tylenol), aspirin, or ibuprofen (advil, motrin). Some also find relief with over the counter pain creams which contain capsaicin, an extract of hot peppers like cayenne and tabasco peppers. It’s believed that these creams block pain signals, but they’re not effective for everyone. As the disease progresses and pain intensifies, your physician may prescribe narcotic pain killers, medicines such as Lyrica, or anti-depressants such as Cymbalta, which are also approved to relieve some types of severe pain.

A highly effective treatment used by the podiatrists at PA Foot and Ankle Associates is MicroVas, originally developed by the U.S. military to treat hypothermia in Navy SEALS. This non-invasive, pain-free therapy uses electronic impulses to cause muscle contraction and relaxation cycles which stimulate circulation. The increased blood flow raises the oxygen level in the tissues, which promotes healing in the nerves and muscles which have been damaged. MicroVas is successful in over 85% of the patients treated, who report reduced pain and improved sensation.

*** PA FOOT AND ANKLE ASSOCIATES NO LONGER OFFER MICROVAS THERAPY

Q and A: Do I Have Shin Splints?

11 Sep

Question:

I’ve been a runner for about 30 years.  I average about 20 miles each week. I compete in about 3 marathons each year, usually two halfs and one full. I guess you could say I’m lucky because I’ve had no real injuries. Just the basic sore toes and stuff.  About four weeks ago, I started developing pain in my right shin, and I think it may be shin splints, because the pain goes halfway up the bone, but is not over the bone. I tried backing off during my workouts, but the pain eventually got so bad that I had to stop completely. I’m on day 15 now without running, and I can still feel pain when I walk. How long will the pain last and when can I start running again?

– Rob, Macungie, PA

Answer:

shin splints runningRob: Shin splints are one of the worst nightmares for a runner, and it sure sounds like that’s the problem. The pain from shin splints is due to overuse and occurs because the muscle and tissues around your tibia bone are working too hard. And we know from personal experience how excruciating it can be – there’s no pain quite like it.

But if you’ve been running for most of your life, it’s unusual that shin splints would suddenly appear unless you’ve changed your workout in some way, or started wearing athletic shoes which don’t fit or have no padding (we’re sure the latter isn’t the case). The real cause of the pain is overworked leg muscles, which can be caused by a stress fracture, collapsing arches, or something else which is causing you to unconsciously change the way you run. Or perhaps you’ve recently intensified your workout or started running on a hard surface?

You’re going to have to sit on the sidelines until the pain completely (and we men completely) subsides. Use ice for 20-30 minutes when needed, and mange the pain with over the counter pain meds like advil or aleve. Light stretching exercises will help to work the muscles in your legs which will speed healing.

When you get back on the road, make sure you’re doing proper warmups before training and increase your training very slowly to re-introduce your leg muscles to the routine. It’s helpful to run or walk on soft surfaces during this time. And by all means, make sure you’re wearing running shoes which fit properly and have plenty of padding where it counts. If the pain starts up again, make an appointment with our office for an exam, because you might need custom orthotics to properly align your foot, ankle, and leg. Good luck, Rob.

MicroVas Therapy Heals Diabetic Peripheral Neuropathy

28 Nov

*** PA FOOT AND ANKLE ASSOCIATES NO LONGER OFFER MICROVAS THERAPY

MicroVas, also known as Micro Vascular Therapy or MVT,  is one of the treatments used by PA Foot and Ankle Associates to relieve the symptoms of Peripheral Neuropathy in the feet. In most cases, but not all, this condition results from diabetes.

What is Diabetic Peripheral Neuropathy?
diabetic peripheral neuropathy microvas

click for larger image

Neuropathies are the most common side affect of diabetes, occurring in up to 50% of patients. A neuropathy can appear in any part of the body, affecting any organ, the muscles, or sensation, but most often affects the feet and legs, followed by the hands and arms. Symptoms may appear suddenly or may develop slowly over a period of years.

Symptoms of diabetic peripheral neuropathy include:

  • Tingling or burning sensation
  • Sharp pain which may be worse at night
  • Difficulty or pain when running or walking
  • A “heavy” feeling in your legs
  • Numbness in the extremities
  • Reduced ability to feel pain
  • Reduced ability to feel changes in temperature
  • Extreme sensitivity to touch
  • Lack of sensation when touching an object
  • Muscle weakness
  • Ulcers, infections, deformities, bone pain, joint pain in the foot
  • Feeling of wearing stockings or slippers when feet are bare

Peripheral Neuropathy may take years to develop in a diabetic patient, or it may be present at the time of diagnosis. If you’ve been diagnosed with Type 1 or Type 2 diabetes, it’s essential that you’re tested regularly for symptoms of Peripheral Neuropathy to avoid the additional complications which can develop.

What is the MicroVas treatment?
microvas treatment diabetic peripheral neuropathy

A patient undergoing MicroVas Therapy

MicroVas was originally developed by the U.S. military to treat hypothermia in Navy SEALS. It’s a non-invasive treatment which uses electronic impulses to cause muscle contraction and relaxation cycles to stimulate circulation in the capillaries (the tiny blood vessels near the skin surface).  This increased capillary blood flow raises the oxygen level in the tissues in order to promote healing in the nerves and muscles which have been damaged.

Blood flow in the capillaries and the tissues they feed is compromised in many diabetic patients because persistent high blood sugar causes vascular damage and nerve damage, and with the vascular damage comes decreased blood flow to the surrounding tissues. When blood flow is reduced, gas and fluid exchange is reduced, which allows toxins to build up in the tissues, causing further damage. MicroVas stimulates blood flow in these regions to remove toxins, speed healing, and restore balance and proper function.

MicroVas treatments are administered in our office, take roughly 45 minutes each and there are no complications. How many treatments are required will depend on the severity of your condition and will be determined by your podiatrist.

More information on diabetic neuropathy

More information on MicroVas treatment

Is Dancing With The Stars’ Maria Menounos dancing against her doctors orders?

12 Apr maria menounos, dancing with the stars, dwts

maria menounos, dancing with the stars, dwts

It’s been reported in a number of news outlets this week that Dancing With The Stars contestant and TV Host Maria Menounos is not only dancing while suffering pain from two broken ribs on her left side, but now has problems with bones in both of her feet, including a stress fracture in one of them. She’s either a cyborg or the dancing Terminator.

“I don’t want to stop, and that fuels me,” says Menounos. “This has been going on since a week and a half into this. And while my feet really, really hurt, we don’t want to talk about it.”

Okay then, we’ll talk about it. We’ll also talk about how we think she’s treating her feet and that stress fracture.

Take a good look at the picture of Maria in the red dress which was taken on the DWTS set. Look closely at her feet. Do you see the cell-phone looking device near her ankle? We’ve confirmed that’s the power pack for a Biomet Orthopak.

maria manounos, biomet orthopak, dwts, dancing with the stars

The OrthoPak is an electrically charged bone growth stimulator which sends an electrical current to the stress fracture area, helping the bone to heal quickly and avoid potential surgery. Realistically, Maria should be off her feet while she heals, and wearing a “protective boot” to immobilize her foot, but obviously that’s not going to happen. So while Maria rests in between rehearsals and competition, she wears the Orthopak to speed the healing of her stress fracture and to hopefully prevent her from having surgery.

A stress fracture in the foot can turn into a full fledged break very quickly, so Maria has to be very careful about how she treats her feet as long as she’s in the competition.

You might not be dancing for millions of TV viewers, but pain in your foot can indicate that you have stress fracture, or any one of a number of other problems. Don’t put off getting treatment. See East Penn Foot and Ankle for a complete diagnosis of your foot pain. East Penn Foot and Ankle may prescribe an OrthoPak for you!

New Plantar Fasciitis Treatment Could Relieve Foot Condition

1 Mar
English: Medical X-rays

Image via Wikipedia

Are you struggling with pain and inflammation caused by plantar fasciitis?  Have you tried to relieve the pain through cortisone treatments, but have not had much success?  Well you may be interested in a new treatment, which has been effective in treating extreme plantar fasciitis foot pain.  It is called “platelet-rich plasma” therapy and new medical studies have found this type of treatment has helped those individuals who suffer from plantar fasciitis, and have had little success with nonsurgical treatment.

Plantar fasciitis is a common foot condition, where the tissue that connects the heel bone to your toes and supports the arch of your foot, called the plantar fascia, becomes strained and creates extreme heel pain while standing or walking. Common treatments for the condition include rest, supportive shoes and orthotic inserts, or cortisone shots to help with mobility.

However, this newly found treatment takes on a different approach to healing, one that contradicts the common cortisone treatment.  Instead of using cortisone, a plasma and platelet enriched fluid is injected into the foot. These two substances help connect tissue growth and vascular healing, as well as promote inflammation. Subjects who received this therapy showed improvement with foot functioning just after four weeks, which remained consistent up to a year afterward.

This new treatment has some podiatrists hopeful to become widespread as a successful plantar fasciitis treatment alternative.   Mostly because of the lack of success common treatments used today have on people who suffer from the condition. Cortisone shots have become a debated topic as far as if the treatment is beneficial enough for the patient. The reason for questioning is because cortisone is degenerative. Although patients experience pain relief following injections, cortisone doesn’t help heal the strained tissue, and foot pain can return again in only a matter of weeks after treatment.

This new treatment study has yet to be fully medically acquired and approved, but researchers and doctors are hopeful that this injection can better benefit patients in the future by relieving pain that is caused by plantar fasciitis.
So what do you think?  Have you had success with cortisone shots in treating plantar fasciitis?  Would you be open to trying a new treatment?  Feel free to comment below, we would love to hear what you think.  If you have any questions, please contact PA Foot & Ankle Associates today!

When should you visit a podiatrist?

18 Mar

Dr Adam Teichman, Lehigh Valley podiatrist, lehighton podiatrist, bethlehem podiatrist, easton podiatrist, allentown podiatrist

Going to the podiatrist is not just for elderly people. Like other doctors, it’s a good idea to visit early to establish a baseline so you can compare changes in your feet from year to year.

At PA Foot and Ankle Associates we are not just here for you when you have a problem with your foot or ankle.  Having a starting point is a great way to mark the changes in your feet. Three-quarters of Americans will experience some sort of foot or ankle problem in their lifetimes, so starting examinations early is the key to prevention.

Contact PA Foot And Ankle Associates to make your appointment for a complete foot and ankle wellness exam today.

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