Peripheral neuropathy is a term used to describe damage that has occurred in a nerve, or whole group of nerves. It occurs when the nerve cells of the peripheral nervous system (those outside of the brain and spinal cord) are weakened, and stop working. Peripheral neuropathy will usually arise in older individuals, and may be caused by a number of environmental factors and disease states. Neuropathy may be caused by side effects related to many useful medications such as cancer fighting agents (chemo-therapy), certain antibiotics, and other drugs that can treat everything from HIV to epilepsy. Neuropathy can also be idiopathic – having no known cause. Additional causes include a pinched nerve (carpal tunnel), infections such as Lyme disease, hypothyroidism, pernicious anemia (vitamin B12 deficiency), autoimmune diseases such as rheumatoid arthritis, and most commonly – diabetes.

Tingling or burning in the arms and legs may be an early sign of nerve damage. These feelings often start in your toes and feet. You may also have deep pain that often happens in the feet and legs. The symptoms related to neuropathy can also include a loss of sensation in the hands, feet, and legs, as well as burning, or itching pain. People who suffer from neuropathy can also experience cold feet/hands or hot feet. Some feel a full sensation and make statements like; "my feet don’t feel attached," or "they feel full" or swollen. These symptoms can also be associated with a condition known as Restless leg syndrome. The symptoms of neuropathy are often worse at night and can make staying asleep impossible.

The problem for many patients with neuropathic pain is that there is no cure – only treatment. This does not mean that you should give up on seeking treatment. Take control of your health and seek treatment promptly. An integrated treatment approach to neuropathy is usually required for a successful result. The newest treatments and therapies that are being used successfully to reduce nerve damage, limit symptoms, and reduce prolonged use of side-effect heavy medications. Health care providers well versed in neuropathy management employ combinations of medical, surgical, rehabilitative, and physical therapies. These treatments are designed to keep you healthy and pain free, and seek - where possible - to restore function.

Dr. Waldman performing a diagnostic ultrasound at a recent large factory health fair

Did you know that employers can save $1.65 on health care expenses for every $1 spent on health and wellness in the work place? What a worthwhile investment! Are you looking for vendors for your Milwaukee area employee health fair? Contact us today! We can offer great advice and advanced treatment options on site, including the diagnostic ultrasound pictured above. We can also offer a work site assesment, and offer suggestions and environmental modification that will help to prevent workplace injuries. Don't let your employees suffer injuries, miss work, or simply be less productive due to foot and ankle pain.

The Achilles tendon is the strongest tendon in the body, and it is located in one of the most overused and under-appreciated body parts of the foot. Because the foot is subjected to great amounts of stress every day (while running the pressure on each foot can be four times normal body weight), it is prone to injuries. The Achilles tendon is a thick, cord-like structure that inserts into the back of the heel bone. A common Achilles injury is tendinitis is an inflammation of the tendon. Symptoms usually include a burning pain or tenderness in the area two inches above the heel bone.

There are many causes of Achilles tendinitis but the most common are training errors, calf muscles inflexibility and bio-mechanical abnormalities. Training errors include increasing your workout intensity too suddenly or changing your running terrain too abruptly. Inflexibility of the calf muscles can result from improper or inadequate stretching. This inflexibility can also be due to wearing high-heeled shoes that tend to shorten the tendon.

The Achilles tendon has a relatively poor blood supply and this accounts for the longer time these injuries often take to heal. Early treatment is necessary to prevent chronic injury. Initially, you should reduce or stop your sports activities for a period of time, and ice the back of the Achilles three times a day for 15 minutes. Using heel cups can help take the stress off the tendon, but be sure to place them in both shoes or you may develop an imbalance that can lead to other injuries.

While Achilles tendinitis can be slow to heal, if your pain lingers for more than two weeks, seek the care of a podiatric physician for a more thorough evaluation.

Osteoporosis is a disease of progressive bone loss associated with an increased risk of fractures. It literally means "porous bone". The disease often develops unnoticed over many years, with no symptoms or discomfort, until a fracture occurs. One of the first places one may see the effects of osteoporosis is in the feet. A stress fracture in the foot is often a first sign.

There is a lot you can do throughout your life to prevent osteoporosis, slow its progression and protect yourself from fractures.

Include Adequate Amounts of Calcium & Vitamin D in Your Diet

During the growing years, your body needs calcium to build strong bones and to create a supply of calcium reserves. Building bone mass when you are young is a good investment for your future. Inadequate calcium during growth can contribute to the development of osteoporosis later in life. Whatever your age or health status, you need calcium to keep your bones healthy. Calcium continues to be an essential nutrient after growth because the body loses calcium every day. Although calcium can't prevent gradual bone loss after menopause, it continues to play an essential role in maintaining bone quality. Even if you have gone through menopause or already have osteoporosis, increasing your intake of calcium and vitamin D can decrease your risk of fracture. How much calcium you need will vary depending on your age and other factors. The National Academy of Sciences make the following recommendations regarding daily intake of calcium:

• Males & Females 9 to 18 years : 1,300 mg per day
• Women & Men 19 to 50 years: 1,000 mg per day
• Pregnant/Nursing women up to age 18: 1,300 mg per day
• Pregnant/Nursing women 19-50 years: 1,000 mg per day
• Women & Men over 50: 1,200 mg per day

Daily products, including yogurt and cheese are excellent sources of calcium. An 8-ounce glass of milk contains about 300 mg of calcium. Other calcium-rich foods include sardines with bones and green leafy vegetables, including broccoli and collard greens.

If your diet doesn't contain enough calcium, dietary supplements can help. Talk to your doctor before taking a calcium supplement.

Vitamin D helps your body absorb calcium. The recommendation for vitamin D is 200-600 iu daily. Supplemented dairy products are an excellent source of vitamin D. (A cup of milk contains 100 iu. A multi-vitamin contains 400 iu of vitamin D.) Vitamin supplements can be taken if your diet doesn't contain enough of this nutrient. Again consult with your doctor before taking a vitamin supplement. Too much vitamin D can be toxic.

Exercise Regularly

Like muscles, bones need exercise to stay strong. No matter what your age, exercise can help you minimize bone loss while providing many additional health benefits. Doctors believe that a program of moderate, regular exercise (3 to 4 times a week) is effective for the prevention and management of osteoporosis. Weight bearing exercises such as walking, jogging, hiking, climbing stairs, dancing, treadmill exercises, and weight lifting are probably best. Falls account for 50% of fractures, therefore, even if you have low bone density, you can prevent fractures if you avoid falls. Programs that emphasize balance training, especially Tai Chi, should be emphasized. Consult your doctor before beginning any exercise program.

An ingrown toenail is a painfun condition characterized by the nail digging into the surrounding skin, leading to inflammation and possible infection of the toe. This is a serious condition for people with impaired circulation, diabetes, or other serious diseases.

Causes of Ingrown Toenails?

• Heredity
• Improper nail trimming
• Trauma
• Shoe Pressure
• Poor foot structure

What Can You Do?

• Trim toenails straight across as a preventative measure.
• Select the proper shoe style and size.

What will a Podiatric Physician do for you?

• Perform a physical exam.
• Perfom x-ray evaluation when necessary.
• Remove the ingrown portion of the nail.
• Culture the nail.
• Perform surgical correction of the nail when indicated.
• Prescribe an antibiotic (when an infection is present).