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Saturday, 17 December 2016 13:16

Heel Pain

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heel painHave you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessens, allowing you then to resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Wednesday, 01 February 2017 15:29

Nondiscrimination Policy

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Summary: Final Rule Implementing Section 1557 of the Affordable Care Act

The Department of Health and Human Services (HHS) issued the Final Rule implementing the prohibition of discrimination under Section 1557 of the Affordable Care Act (ACA) of 2010. The Final Rule, Nondiscrimination in Health Programs and Activities, will help to advance equity and reduce health disparities by protecting some of the populations that have been most vulnerable to discrimination in the health care context. The final rule explains consumers’ rights under the law and provides covered entities important guidance about their obligations.

Section 1557 prohibits discrimination based on race, color, national origin, sex, age or disability in certain health programs and activities.

Section 1557 builds on long-standing and familiar Federal civil rights laws: Title VI of the Civil Rights Act of 1964 (Title VI), Title IX of the Education Amendments of 1972 (Title IX), Section 504 of the Rehabilitation Act of 1973 (Section 504), and the Age Discrimination Act of 1975 (Age Act). Most notably, Section 1557 is the first Federal civil rights law to prohibit discrimination on the basis of sex in all health programs and activities receiving Federal financial assistance.

Section 1557 has been in effect since enactment of the ACA in 2010 and the HHS Office for Civil Rights (OCR) has been enforcing the provision since it was enacted.

Coverage of the Rule

The rule covers:

− Any health program or activity, any part of which receives funding from HHS (such as hospitals that accept Medicare or doctors who accept Medicaid);

− Any health program that HHS itself administers;

− Health Insurance Marketplaces and issuers that participate in those Marketplaces.

Attention: If you speak any of the listed below languages – language assistance services, free of charge, are available to you.

Please call:   State Health Insurance Assistance Program Language Line 800-792-8820

 1 Spanish
 2 Chinese
 3 Korean
 4 Portuguese
 5 Gujarati
 6 Polish
 7 Italian
 8 Arabic
 9 Tagalog
10 Russian
11 French Creole
12 Hindi
13 Vietnamese
14 French
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Friday, 10 February 2017 15:17

Custom Orthotics

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orthotics5Ankle and foot orthotics, known as AFOs, are custom-made inserts, shaped and contoured to fit inside a shoe and used to correct an irregular walking gait or provide cushioning. Orthotics come in a variety of different models and sizes, including both over the counter and customizable variants. Customizable ones should be prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

AFOs are often used by athletes including track and field runners, cyclists, professional dancers, ice skaters, and even golfers. They benefit a lot from custom made AFOs by preventing injuries from occurring and provide cushioning to keep pain levels down to a minimum. Ankle foot orthotics allow for the correct positioning of the feet and also act as shock absorbers to help keep pressure and stress off the foot and ankle. They can also relieve back pain and hip pain while restoring balance and improving an athlete’s performance.

The way they help alleviate pain is by controlling the movement of both your feet and ankles. They are custom designed by a podiatrist or orthopedic specialist to help treat foot problems such as flat feet, spurs, arthritis of the ankle or foot, ankle sprains, weakness, and drop foot, a condition in which the patient cannot raise their foot at the ankle joint.

With custom orthotics, a patient will go through a complete examination of the foot and ankle, followed by the ankle and foot being cast and fitted for the proper orthotic. Depending upon the final result of the tests, a stretching treatment is created with specific shoe fitting in mind. After they have been fitted to the shoes, adjustments can be made in order to get the perfect fit and completely fill out the shoe. Evaluations are then usually set up to monitor the patient in the coming weeks to see how they are adjusting.

AFOs are also available over the counter and are more common than custom fit ones. Athletes that have generally low aches and pains in the foot, ankle, or lower back area can use an over the counter version of these orthotics. Weight is still distributed evenly throughout the bottom of the foot thanks to the arch support they give, but when an injury or ailment occurs, it is usually not enough to try and remedy it with an over the counter version. In either case, a podiatrist will be able to offer the best advice and treatment when it comes to foot and ankle orthotics and handle all your foot care needs.

 

Saturday, 04 March 2017 17:53

Neuropathy

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Millions of people are affected with diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of, or else the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, when diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain. You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the die. Additionally, well-fitting socks are highly recommended.

A diabetic’s physician should always monitor their Hemoglobin A1C levels to test how well the blood sugars are being controlled during the past 3 months. It is very important to keep blood sugar levels at normal range, 70-110mg/dl. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with neuropathy of a diabetic patient. It is also advised to see a podiatrist if experiencing any feet conditions. Toe nails may also need to be taken care of by a podiatrist, since some patients may cut too deep around the cuticles, causing infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. When using tools to remove calluses, use caution, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to call a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound gets too bad to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can cause in diabetics that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Friday, 26 July 2013 14:00

Morton's Neuroma

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neuromasMorton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.  Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.
If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

 

Friday, 26 July 2013 13:57

Ankle Sprains

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ankle sprainAnkle sprains can be quite the painful experience. Often times the injured person will experience limited mobility, swelling, and, depending on the severity, discoloration of the skin. This type of injury takes place when the ligaments are torn or stretched beyond their limits. Although this can occur in various areas of the body, the ankle is the most common site for a sprain.

There are multiple ways that the ankle can become injured like this. However, the simple act of walking may cause a sprain. If footing is lost or the person is walking on uneven terrain, local damage may occur. This may be especially so for athletes that continually push their limits, or for the person who has suffered from a previous accident involving the lower extremities.

In the majority of cases, medical attention is not required for a sprained ankle. Remedies for self-care at home include propping the ankle up, applying ice packs as needed, and remaining off your feet. Some may also find that wrapping with an ACE bandage and taking over-the-counter pain relievers are helpful. One of the most important things is to avoid further stress to the affected area.

Although rare, complications may arise and obtaining medical treatment may become necessary. A severe sprain can actually tear the ligament and even damage the muscle. When this occurs, the person may have to be off their feet for a prolonged period of time. Depending on the severity and nature of the damage, surgery and physical therapy may be required. Seeking out a podiatrist will help in making these decisions.

Sprained ankles are painful in nature, but those with severe unrelenting pain may have sustained a worse injury than previously though. If walking becomes too painful for the person to take more than a few steps, swelling becomes too severe, or if numbness or tingling is present, immediate medical attention should be sought. Mild to moderate bruising is common with a sprain but redness of the skin or worsening of the discoloration should not persist either.

One of the best treatments for an ankle sprain is to prevent it in the first place. Wearing appropriate shoes for the occasion, stretching before exercises and sports, and knowing your limits can aid in prevention. Those that have suffered from a previous sprain may want to consider additional support, such as a brace and regular exercises to strengthen the ankle.

Friday, 26 July 2013 12:30

Diabetic Foot Care

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diabetic footDiabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.

Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers, and cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear will-fitting socks.

Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet such as ingrown toenails, which in more severe cases can cause infection.

Diabetic foot care at home is possible if a patient is provided with instructions from their physician. Patients can cure dry heels with creams or ointments. If trying to remove a callus with a tool, practice caution as severe diabetics may not be able to feel pain. Improper removal may cause a wound to develop.

Diabetic feet must be inspected on a daily basis. Set up regular visits with your podiatrist since proper diabetic foot care is necessary. If you suspect that you have a wound, notify your doctor immediately. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.

Friday, 26 July 2013 11:32

Contact Us

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Friday, 26 July 2013 11:32

Our Doctor

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Jonathan M. Kletz, DPM, PA

Dr. Kletz received his undergraduate education at The University of Maryland and attended medical school at the Pennsylvania College of Podiatric Medicine. After graduating in 1989, he completed two years as a surgical resident in Dallas, Texas. Dr. Kletz is board certified as a foot and ankle surgeon by the American Board of Foot and Ankle Surgery.  He is also a fellow of the American College of Foot & Ankle Surgeons. Dr. Kletz specializes in the medical and surgical treatment of foot and ankle conditions and has been in practice since 1991.

 

 

 

 

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