HEEL PAIN - PLANTAR FASCIITIS            
              " PROTECTING YOUR FEET DURING HOLIDAY SEASONS"

With the holiday season upon us, many shoppers will suffer from acute or chronic heel pain.  Each year more than 2 million people are treated for plantar fasciitis, also known as heel spur syndrome.  Plantar fasciitis is an inflammation of the fascia which attaches to the heel bone and helps to maintain the arch of the foot.

As many as 40 million Americans suffer from this condition, which is seen mainly in people who are on their feet.  Each year the number of people diagnosed with plantar fasciitis increases as the holidays approach and shoppers spend increased hours on their feet.

There are many conservative treatments which should be utilized before attempting shockwave therapy.  These include: ice, rest, stretching, orthotics, night splints, cortisone injections, physical therapy and anti-inflammatory medications.

Shockwave therapy is intended for those patients who have failed six months of conservative treatment.  In October 2000, the Food and Drug Administration approved shockwave therapy for chronic heel pain in the United States.  This therapy involves a non-invasive, 30-minute treatment which passes shock waves through the heel causing micro tears that increase blood flow to the damaged tissue.  As a result, it can reverse the chronic repetitive damage and help the body heal itself.

Shockwave therapy is usually performed at an outpatient surgical center by a certified, trained physician. In order to administer the shock waves, patients must either be sedated or undergo general anesthesia.  There is minimal pain involved with the treatment and patients can return to normal shoe gear within a few days.  Any stressful activity such as running or jogging should be avoided for four weeks following the treatment.  Success of this treatment has been reported to be as high as 80 percent.

If you have heel pain and are not sure whether it is chronic or if you have not had conservative treatment, please contact your podiatric physician or a physician in your area who specializes in disorders of the feet.

    David J. Garchar, DPM is a podiatrist with the Ryan Foot and Ankle Clinic in Concord and Charlotte, NC

DIABETIC FOOT CARE

There are approximately 16 million people in the United States diagnosed with diabetes, with 5.4 million unaware that they have the disease.  Every day there are 2,200 people who are diagnosed with diabetes, with an estimated 780,000 new cases diagnosed each year.

Diabetes is a disease in which the body is unable to manufacture or properly use insulin, which impairs the body's ability to convert sugars, starches, and other foods into energy.  The long term effects of the disease can lead to damage of the eyes, heart, feet, kidneys, nerves and blood vessels.

Symptoms of diabetes include:  excessive thirst, frequent urination, extreme hunger, unexplained weight loss, tingling or numbness of the feet or hands, blurred vision, fatigue, slow healing wounds and frequent infections.  People who have these symptoms and have not been tested for diabetes, should see a physician for further evaluation.  Statistics show that the number of new diabetes cases in the world is expected to double in the next 25 years from 135 million to nearly 300 million.

Diabetes is a systematic disease which can affect the entire body from head to toe.  Therefore, a team approach, utilizing a podiatric physician as part of the treatment team, has proven to be effective in preventing lower extremity complications and amputations.

Patients should at least undergo annual foot screenings as part of their yearly examination.  In addition, diabetics should inspect their feet daily and look for warning signs which include skin color changes, swelling, pain, elevation in skin temperature, open sores, ingrown and fungal nails, corns and calluses and dry, cracked skin.

Once diagnosed with diabetes, there are several ways that patients can keep their feet healthy.  Most importantly is daily inspection of the feet and toes.  Checking your feet every day for cuts, bruises, sores or problems with the toenails such as discoloration or thickening.

Socks that are thick and soft should be worn.  Those made of an acrylic blend are best, but make sure to avoid socks which are mended or with both seems, as these can cause blisters or other skin problems.  Use of a daily moisturizer is also important, however, one must avoid getting it in between the toes.

Trimming of toenails straight across is very important.  Do not cut down into the corners as this may trigger an ingrown nail.  If nails are too hard or thick to trim, see a podiatrist to trim them on a regular basis.  Avoid going barefoot or wearing shoes with high heels or pointed toes.  This type of footwear can cause pressure and ultimately lead to ulceration.

New shoes should always feel comfortable and all diabetics should have their feet measured by a professional when going to purchase a new pair of shoes.  Never try to cut or remove calluses, corns or warts by yourself.  This often leads to serious ulcerations and infection.  The best way to keep your feet healthy is by having them checked regularly by a podiatric physician.
      
    David J. Garchar, DPM, is a podiatrist with the Ryan Foot and Ankle Clinic in Concord and Charlotte, NC.

  TOENAIL FUNGUS / ONYCHOMYCOSIS                             
                                      "GETTING YOUR FEET IN SHAPE FOR SUMMER"

With spring in season and summer just around the corner, more people will begin to wear sandals and show off their feet.  However, some people will be embarrassed to go without shoes because of the way their toenails look.

Approximately 3 to 5 percent of the population has toenail fungus or onychomycosis.  Onychomycosis is an infection of the nail bed and underlying nail plate, which is caused by several types of fungi, which are found everywhere in our environment.

Fungi are actually parasitic plant organisms, which do not require sunlight for growth.  Therefore, they can easily attack the nail, living off of the keratin, which is the nail's protein substance.

If the fungus attacks the nail, it can become thicker, yellow or dark in color and foul-smelling.  There may also be debris, which collect underneath the nail, allowing the fungus to spread to other toenails, the skin or even to the fingernails.

People often come into contact with the fungus while walking in damp areas, such as swimming pools, showers, locker rooms and even beaches.  If untreated, toenails may become painful while wearing shoes and may impair one's ability to work or even walk.

A previous injury to the toenail may cause it to be more susceptible to the fungus.  Anyone suffering from chronic diseases, such as diabetes, immune deficiency syndromes or circulatory problems, are also more susceptible.  Anyone who perspires excessively or has a history of athlete's foot is also more prone to getting fungus in the toenails.

Therefore, proper foot hygiene and regular inspection of the foot and toes can reduce or even eliminate the chances of acquiring the fungus.  This would include drying the feet thoroughly and wearing shower shoes when in public places.  Also, socks, shoes and hosiery should be changed daily.

Treatment of fungal infections will vary depending on the nature and severity of the condition.   A podiatrist can detect early fungal infections and determine which treatment may be appropriate.

Debridement of the fungus nail may need to be performed and should only be done by a professional.  There are both topical and oral medications that can be used to treat fungus if indicated.  However, these should only be administered under the care of a health professional.

If you think that you may have a fungal infection in your toes, see your local podiatrist, who can evaluate your condition and start the appropriate treatment.

    David J. Garchar, DPM, is a podiatrist with the Ryan Foot and Ankle Clinic in Concord and Charlotte, NC.