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Monday, 14 September 2020 00:00

Different Types of Diabetic Foot Ulcers

Diabetic foot ulcers are slow healing wounds that appear on the feet of individuals with diabetes and can become a very serious health issue. Almost a quarter of all individuals diagnosed with diabetes will develop a foot ulcer at some point in their life. There are several types of diabetic foot ulcers, and knowing which type you have can help determine the most effective treatment. Neuropathic ulcers occur when nerve damage from diabetic neuropathy prevents the patient with diabetes from feeling pain from an injury. This allows the wound to progress before you are even aware of it, increasing the risk of infection. Ischemic ulcers may be caused by a lack of blood flow to the feet. These types of ulcers are often difficult to heal. Neuroischemic ulcers are the most difficult to heal and occur in individuals who have both neuropathy and poor circulation. Infected wounds occur in half of diabetic patients with foot ulcers, and require close medical attention. If you have diabetic foot ulcers, it is highly recommended that you are under the care of a podiatrist who can help you look after your wounds and prevent severe complications.  

Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Dr. Scott Shrem from Garden State Foot & Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

What Is Wound Care?

Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic. 

What Is the Importance of Wound Care?

While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.

How to Care for Wounds

The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.

If you have any questions, please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Wound Care
Monday, 14 September 2020 00:00

Wound Care

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Tuesday, 07 September 2021 00:00

Psoriatic Arthritis and the Feet

Psoriatic arthritis is a type of arthritis that affects people who have a skin condition called psoriasis. Like other types of arthritis, psoriatic arthritis is characterized by joint pain, stiffness, and swelling. It can affect nearly any joint in the body, but often affects the joints of the feet and ankles. In addition to joint pain, symptoms of psoriatic arthritis in the feet can include pain in the heel and arch of the foot due to enthesitis, an inflammation of the points where tendons and ligaments attach to bones. People with this type of arthritis are also more likely to have nail problems, such as nail pitting and thickening, pain, and lifting of the nail from the nailbed. If you have psoriatic arthritis that affects your feet, a podiatrist can help by prescribing treatments and orthotics that can reduce symptoms and improve mobility. To learn more, please consult with a podiatrist.

Arthritis can be a difficult condition to live with. If you are seeking treatment, contact Dr. Scott Shrem from Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Arthritic Foot Care  

Arthritis is a term that is commonly used to describe joint pain.  The condition itself can occur to anyone of any age, race, or gender, and there are over 100 types of it.  Nevertheless, arthritis is more commonly found in women compared to men, and it is also more prevalent in those who are overweight. The causes of arthritis vary depending on which type of arthritis you have. Osteoarthritis for example, is often caused by injury, while rheumatoid arthritis is caused by a misdirected immune system.

Symptoms

  • Swelling
  • Pain
  • Stiffness
  • Decreased Range of Motion

Arthritic symptoms range in severity, and they may come and go. Some symptoms stay the same for several years but could potentially get worse with time. Severe cases of arthritis can prevent its sufferers from performing daily activities and make walking difficult.

Risk Factors

  • Occupation – Occupations requiring repetitive knee movements have been linked to osteoarthritis
  • Obesity – Excess weight can contribute to osteoarthritis development
  • Infection – Microbial agents can infect the joints and trigger arthritis
  • Joint Injuries – Damage to joints may lead to osteoarthritis
  • Age – Risk increases with age
  • Gender –Most types are more common in women
  • Genetics – Arthritis can be hereditary

If you suspect your arthritis is affecting your feet, it is crucial that you see a podiatrist immediately. Your doctor will be able to address your specific case and help you decide which treatment method is best for you.

If you have any questions, please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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Tuesday, 07 September 2021 00:00

Arthritic Foot Care

During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in each of your feet will lose flexibility and elasticity. Your foot’s natural shock absorbers will wear down as well. Having arthritis added to this mix only makes matters worse. Your joints will become distorted and inflamed, which is why arthritic foot care needs to be something to think about every day.

When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buy well-fitting shoes with a lower heel and good support. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.

Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.

Exercise is another key aspect of arthritic foot care. Exercise not only strengthens and stretches your muscles and joints, but helps to prevent further injury and pain as well. Stretching the Achilles tendon, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.

Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well. You will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together. Then, pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet. Then, try to separate each individual toe, stretching them all.

A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately, there is no complete way to remove all of your arthritic pain. However, following some of this advice can go a long way in staying as pain-free as possible.

Tuesday, 31 August 2021 00:00

What Causes Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a condition in which the posterior tibial nerve located at the back of the ankle becomes compressed. This leads to symptoms such as pain, burning, tingling, or numbness in the sole and heel of the foot. In about 40-50% of cases, the cause of tarsal tunnel syndrome is unknown, and it appears to arise spontaneously. In other cases, tarsal tunnel syndrome may occur due to a ganglion cyst, bone deformity, twisted and enlarged veins, tenosynovitis, and flat feet, among other causes. Tarsal tunnel syndrome can be diagnosed through ultrasound and MRI and usually responds well to conservative treatments, such as anti-inflammatory medications and orthotics. To learn more about this condition, please consult with a podiatrist.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Dr. Scott Shrem of Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

  • Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
  • If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

If you have any questions please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Tarsal Tunnel Syndrome
Tuesday, 31 August 2021 00:00

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.

To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.

Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.

Wednesday, 25 August 2021 00:00

Why Live with Pain and Numbness in Your Feet?

Suffering from this type of pain? You may have the foot condition known as Morton's neuroma. Morton's neuroma may develop as a result of ill-fitting footwear and existing foot deformities. We can help.

Tuesday, 17 August 2021 00:00

Why Does My Heel Hurt?

Heel pain is one of the most common issues treated by podiatrists. While about 7% of adults over the age of 65 experience some form of heel pain, it can affect individuals of all ages. There are many possible causes for heel pain. Plantar fasciitis, an overuse injury of the ligament that runs along the bottom of the foot, is on of the the most common causes. Other reasons heel pain may occur can include an Achilles tendon injury, stress fracture, bursitis, or bruises to the bone and heel pad. Infections, though rare, can also occur in the heel bone, as can various nerve disorders. Heel pain can be associated with systemic diseases, such as diabetes or arthritis. Regardless of the cause of your heel pain, a podiatrist can diagnose the problem and find the right treatment for you. If you are experiencing heel pain, please seek the care of a podiatrist.

Many people suffer from bouts of heel pain. For more information, contact Dr. Scott Shrem of Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Causes of Heel Pain

Heel pain is often associated with plantar fasciitis. The plantar fascia is a band of tissues that extends along the bottom of the foot. A rip or tear in this ligament can cause inflammation of the tissue.

Achilles tendonitis is another cause of heel pain. Inflammation of the Achilles tendon will cause pain from fractures and muscle tearing. Lack of flexibility is also another symptom.

Heel spurs are another cause of pain. When the tissues of the plantar fascia undergo a great deal of stress, it can lead to ligament separation from the heel bone, causing heel spurs.

Why Might Heel Pain Occur?

  • Wearing ill-fitting shoes                  
  • Wearing non-supportive shoes
  • Weight change           
  • Excessive running

Treatments

Heel pain should be treated as soon as possible for immediate results. Keeping your feet in a stress-free environment will help. If you suffer from Achilles tendonitis or plantar fasciitis, applying ice will reduce the swelling. Stretching before an exercise like running will help the muscles. Using all these tips will help make heel pain a condition of the past.

If you have any questions please contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

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Tuesday, 17 August 2021 00:00

Heel Pain

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.

Broken ankles are a common injury characterized by a break in one or both of the lower leg bones, the tibia and fibula, that make up the ankle. Ankle fractures are painful, typically swell, and make it difficult or impossible to bear weight on the affected ankle. When going to the doctor for symptoms of an ankle fracture, you will likely be asked for your medical history, undergo a physical examination, and have an X-ray of your ankle taken. Broken ankles are treated by pushing the bones back into the correct positions if they have become misaligned and wearing a cast or splint until the broken bones heal. This usually takes about six weeks. Surgery may be necessary if the break is severe. If you think that you may have broken your ankle, it is suggested that you see a podiatrist as soon as possible.

Broken ankles need immediate treatment. If you are seeking treatment, contact Dr. Scott Shrem from Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet. 

Broken Ankles
A broken ankle is experienced when a person fractures their tibia or fibula in the lower leg and ankle area. Both of these bones are attached at the bottom of the leg and combine to form what we know to be our ankle.

When a physician is referring to a break of the ankle, he or she is usually referring to a break in the area where the tibia and fibula are joined to create our ankle joint. Ankles are more prone to fractures because the ankle is an area that suffers a lot of pressure and stress. There are some obvious signs when a person experiences a fractured ankle, and the following symptoms may be present.

Symptoms of a Fractured Ankle

  • Excessive pain when the area is touched or when any pressure is placed on the ankle
  •  Swelling around the area
  •  Bruising of the area
  • Area appears to be deformed

If you suspect an ankle fracture, it is recommended to seek treatment as soon as possible. The sooner you have your podiatrist diagnose the fracture, the quicker you’ll be on the way towards recovery.

If you have any questions, please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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