Tuesday, February 15, 2011

Jennifer Grey Has Foot Surgery

Jennifer Grey of Dirty Dancing and Dancing with the Stars Fame just had surgery to remove a neuroma. If you remember, she consistently complained of foot pain during the show. Neuromas are very common in dancers.

A neuroma is a thickening of a nerve and can occur anywhere in the body, even the foot. Morton’s neuroma describes a neuroma of a specific location in the foot, between the third and fourth metatarsals. This is located on the balls of foot between the third and fourth toes. Clinicians may refer to this benign growth as a tumor. In medical terms this is a correct description but this is not an indication of cancer. The enlarged nerve is benign meaning it will not become invasive or become cancerous. In essence, a neuroma in the foot is really a pinched nerve, where the adjacent bones press on the nerve. Thus, the nerve gets inflamed and very painful. Dancing on the balls of your feet is definitely a cause for this type of neuroma.

Though a morton’s neuroma is not a medical emergency, it can cause severe pain and impede on your daily life. Some patients describe the pain as walking on a marble, but the most often complaint is a burning, sharp pain. Tingling and numbness is also common.

It is thought that the nerve becomes enlarged due to repetitive irritation or pressure. Over time, this irritation leads to a neuroma and pain. Wearing shoes that are tight, too small, or with a heel can aggravate the pain because it causes increased irritation. The pain may also be caused by running or other sports. Flexing and relaxing your toes causes compression on the nerve, and the balls of your foot takes on the most weight during walking or running. Since this is the area where the neuroma is located, doing such activities can elicit a lot of pain.
The podiatric physician will take x-rays of a patient with such pain to rule out a fracture or other foot disorders. The doctor will also attempt to elicit the pain by squeezing the foot. This will not only cause pain, but there the doctor will also hear a clicking sound due to the neuroma shifting between the bones.

There treatment ranges from conservative treatments to surgery. Like all treatment plans, surgery should be a last resort for when all other treatments fail. The pain may be greatly reduced by changing shoe gear, but this is often not enough. It is very common for your podiatric physician to prescribe a custom orthotic. Many patients find relief by not only wearing orthotics but also wearing a pad under the balls of their foot. A podiatric physician can properly fit and provide such padding. Non-steroid anti-inflammatory drugs, such as Advil, can also be used to help reduce the pain but should not be used long term. Your doctor may also suggest a steroid injection which has a greater effect on relieving the pain. Stretching, massages, and icing has also shown to relieve pain.

In addition, cyrotherapy, a prodedure that freezes the nerve, and allows the patient to immediately ambulate in their regular shoes, is a very effective method to eliminate the pain from a neuroma. In most cases today, surgical removal is not necessary because of this procedure

If the pain has increased due to physical activity, it is suggested to take some time off from the activity to allow your foot to rest and heal. It may be better to take on activities that cause less impact on the foot. Excises’ such as swimming or bicycling may be good alternatives.

Neuromas are not life threatening, but they do cause alterations in your life. You should consider wide toed shoes with plenty of room for your toes to wiggle. The pain most often subsides with conservative treatment, but in rare cases surgery is necessary. Unfortunately, the procedure removes the entire nerve and will leave numbness of the effected toes. Thus, you and your podiatric physician should try to avoid surgery if possible.

Monday, February 14, 2011

Smoking Costs Dollars, Legs, and Now Your Job!

With the economy slowly recovering, every smoker is faced with the financial burden of their bad habit. Many still push out the dollar signs for their nicotine. Others are paying a different price for the many cigarette breaks. Smokers are 16 times more likely to have peripheral vascular disease or PVD. This disease leads to decreased blood flow, painful limbs, chronic ulcers, and amputations. But wait there is more. The job market is a little smaller for smokers as many companies are adopting anti-smoking policies.

Hospitals and medical businesses are turning away smokers. Part of the interview is screening your smoking habits and some go as far as instituting a nicotine urine test. Why the crackdown on smokers in the workplace? With health care dollars a growing concern for many employers, they are trying to cut their losses anywhere possible. It is estimated that the average smoker cost greater than $3,000 more to employ than the non-smoking counterpart. This is attributed to the higher health care costs and the lost productivity due to those many cigarette breaks.

29 states, with the help of strong lobbies, have adopted laws that prohibit smoking discrimination. Still many large health institutions have adopted the policy. The Cleveland Clinic has been hiring non-smokers since 2007. Also not hiring smokers is the American Lung Association, The American Cancer Society, and the World Health Organization.

Do you need any more reasons to stop smoking! Smoking continues to be leading cause of preventable death. One in five Americans still smoke. We have all heard the dangers of smoking from cancer to cardiovascular disease, but did you know smoking is bad for your feet? I hesitate doing any surgery on smokers. Got a bunion? If you smoke, you are at higher risk of non-healing, infection, and many other complications. Nicotine causes your blood vessels to constrict and decreases the amount of oxygen and nutrients delivered to your tissues. Years of smoking causes years of damage to your feet and legs.

Too many of my patients come in with ulcers due to poor circulation A number of my patients are missing toes because the blood flow was so poor it could not keep the toes alive. Smokers have thinning skin and are on the verge of losing their legs. Cigarettes will cost you your pocket book, cost you your legs, and now may cost you your job. Quit while you are ahead, because it will get worse the longer you puff.