Foot pain may be relieved by selecting and wearing appropriate footwear or even receiving massage therapy that targets the feet. However, there are topical pain medications available in forms such as balms, lotions, gels, creams, ointments, and patches which can alleviate foot pain.

There are distinct types of topical medications, and they fall into one of the following categories:

• Salicylates contain a chemical similar to aspirin and are designed to be absorbed into the skin to relieve pain. These creams are most commonly used for muscle soreness and aches. Common branded products include Ben Gay, Aspercreme, Sportscreme.

• Non-Steroidal Anti-inflammatory Drugs (NSAIDs) such as ibuprofen and naproxen fight pain associated with swelling. They are produced in a gel or cream, like salicylates, designed to be absorbed into the skin. NSAIDs increase the body’s anti-inflammatory response, reducing pain and heat for the injured area. They are available over-the-counter and in prescription form.

• Analgesics are useful in reducing pain in those suffering from mild arthritis. If your pain is focused in your ankle, for example, you might consider the brand name products Capzasin-P, Menthacin, and Zostrix. The cream or ointment works by stimulating and then decreasing the intensity of pain signals in the body.

• Counterirritants create warm or cool sensation over a painful joint or sore muscle. Brand name products include Icy Hot, JointFlex, and Flexall.

• Anesthetics are used to relieve “local pain” to a specific area by disabling the nerve endings in the skin. Brand name anesthetic medications include Lanacane and Xylocaine.

Other topical medications include anti-fungal and corticosteroids. Anti-fungal topical medications come in various forms such as cream, powder, or spray, and are used for treatment of athlete’s foot. Some common brand medicines are Lotrimin, Lamisil, and Desenex. See a podiatric physician if anti-fungal creams you’ve tried do not seem to work or if you have any other symptoms related to the infection, such as fever, rash, or sore throat.

Corticosteroids are the most common topical treatment for psoriasis. They work by reducing inflammation and slowing the growth and build-up of skin cells. Applying topical creams on the infected areas will help soothe the itch and soften the hardened skin. If you have psoriasis on your feet, it is best to treat it as soon as possible to minimize the risk of spreading infection to your leg and even your toe nails. Consult with a podiatric physician immediately if you suspect you have psoriasis.

Corticosteroids can also be used for treating diabetic peripheral neuropathy. These topical medications can be very helpful in temporarily relieving pain, burning, numbness, and tingling sensations in the feet. Some branded products are Nerve Relief Cream and BioFreeze.

The most recent technologies are now changing the way we look at topical medications. Traditional pain medications in pill form or via IV are now incorporated into topicals. Discuss with Dr. Bowman to see if one will suit your problem.

Topical pain medications are helpful to relieve the pain associated with foot problems but should never be used to “mask” pain. Consult Dr. Bowman for suggestions and proper usage of topical medications. We can be reached at 713-467-8886 or www.houstonfootspecialists.com

I have had many patients ask this exact question.  While I think the phrase “toe jam” is rather funny, it could be a serious matter.  The stuff between your toes usually consists of sock fibers, dead skin cells, fungi, dirt, and bacteria.  No, it’s not pretty to look at, but does it require a trip to your foot doctor?

First, wash your feet and in-between your toes with a mild soap and dry your feet well, especially in between the toes.  Next, wear your normal socks for 2-4 hours, then remove the socks and look between your toes.  If no sock fibers or dirt is there but you notice some other substance, it does warrant a visit to your podiatrist.  It could be eczema, psoriasis, fungi, excess sweat, or even a corn or bone spur.

The chance that toe jam is a corn needs to be ruled out.  If you have a thick lump between your toes or a hard knot, it may be a corn, which is made up of dead skin due to extra bone developing under the skin, usually caused by friction or improper shoes.  This can be dangerous and painful.  If you are a diabetic, you need to get it checked promptly before it opens up and causes an infection or ulceration.

The bacteria between your toes may be harmless, but in more serious cases it can cause infections and require prompt attention. If you have severe itching, rash, redness, swelling, odor cracks, drainage, or dead looking skin, it will need medical attention by your foot doctor.  The possibilities of something more serious are always there. Why take a chance?

Though toe jam itself is harmless, excellent hygiene should prevent something more serious.  If you suspect anything else as a possibility, don’t wait. Call Dr. Bowman at Houston Foot Specialists at 713-467-8886 or visit us online to make an appointment at www.houstonfootspecialists.com
   

“Dr. Bowman, My referring doctor told me I had a Paronychia.  What is it?”  I get this question at least once a week.

A Paronychia is a skin infection that occurs around the nails and is often occur with an Ingrown Nail.  This condition is usually caused by an injury to the surrounding tissue of the nail from picking at the nail, improper trimming of the nail and trauma. 

The main symptom of a Paronychia is a painful, red area with swelling to the nail fold.  More often than not pus or drainage is present.  There may be pus filled blisters with a bacterial infection.  Acute Paronychia is typically caused by bacteria called Staphylococcus Aureus.

Treatment is often to perform a minor procedure in the office where the area is drained and a culture will be taken to determine the bacteria.  A small portion of the nail may need to be removed as well.  The patient will be given oral antibiotics and soaks with a topical antibiotic.

A chronic Paronychia is one that “comes and goes” or one that clears up on its own but then reoccurs. Chronic conditions can cause permanent damage to the shape of the nail and spread of infection to other areas, including tendons, bone, or blood stream.

If you see pus or drainage from a toenail, contact your local podiatrist right away before the condition spreads.

Dr. Bowman is a Foot and Ankle surgeon with Houston Foot Specialists and can be contacted at www.houstonfootspecialists.com  or by calling 713-467-8886.

When I was young, I dreamed of being an NFL star just like a lot of my friends.   Now, I am glad I never made it that far in football.  Why?  Easy to answer - look at all those injuries. After just watching my home team the Houston Texans, those injuries seem to be even more prevalent this year.  A recently developed treatment has been used on these injured football players and other athletes with very good results.  Texans Mario Williams has used this treatment for foot pain with great results.

Platelet Rich Plasma, or PRP, is used more and more often not just for professional athletes, but for everyday people like you and me.  PRP is performed in the office.  The doctor draws blood from the patient’s arm and spins the blood down to separate the platelets.  Next, the patient’s own platelets are injected into the painful or injured area under a local anesthetic.  The growth factors in the platelets have been shown to have strong anti-inflammatory effects and help in the healing process of both acute and chronic injuries by signaling the body to initiate a healing response. Most patients feel relief within a few days to a few months.  

This procedure is being used to treat chronic and acute plantar fasciitis, arthritis, ankle injuries, tendonitis, cartilage damage, and many more conditions.  Research is currently showing PRP mixed with stem cells may work even better.

Is this procedure for everyone?  No.  It doesn’t help every condition and doesn’t take the place of surgery when needed.  Also, even though research shows it is effective, most insurance companies will not cover the procedure. The cost per treatment is approximately $1,000.  For those wanting to avoid surgery and for those whose foot pain can be treated without surgery (such as with tendonitis), this may be a viable option.  

Discuss the PRP procedure with your foot and ankle pain specialist and see if it is an option for you.

Dr. Jeffrey Bowman of Houston Foot Specialists is trained in the PRP procedure and has used it with good results.  To get more information, contact us at www.houstonfootspecialists.com or call 713-467-8886. One of our friendly staff members will schedule a consultation for you to learn more.

As we enter the holiday and winter season, many of us will be attending Holiday parties, eating and drinking with our co-workers, friends and family.  Soon after these parties many of you will be seeing your podiatrist because of severe pain to your joints in the foot and ankle.

Gout is one of the most painful forms of arthritis that occurs in the foot.  It occurs when too much uric acid builds up in the body from excessive digestion of rich foods and alcohol.  Gout usually starts with a sudden onset of intense pain in one or more of the joints; most common is the big toe. The joint is accompanied by pain, swelling, redness, heat and stiffness in the joints.  For most people the first attack wakes a person from sleep and typically there is no recollection of injury to the joint prior to the onset of pain.

While symptoms usually occur in the big toe joint, any joint may be involved.  Other common sites are the instep of the foot, the ankle and the knee.  When the foot is involved, wearing shoes id very difficult and painful, as are attempts to move the joint or stand on the foot.  Seeking treatment and early diagnosis form a podiatric physician is crucial as gout can cause damage and in serious conditions, disability in the affected area.

If the attack is in the toe, elevate the foot, avoid standing and walking, and wear only a loose slipper until seen by a podiatric physician.  In general, treatment for gout works by reducing the levels of uric acids in the body.  Dr. Bowman’s first line of treatment is administering NSAID’s or Non-Steroidal Anti-Inflammatory Drugs and often a blood test to measure the amount of uric acid in the body.  Some corticosteroids (oral or injection) may be prescribed as well.  Certain medications to lower the levels of uric acid may be also be given.

If Gout attacks continue despite the treatment, excessive deposits of gouty crystals or Tophi within the joint, or if arthritis causes continual discomfort, surgical treatment by Dr. Bowman may be necessary to remove the crystals and repair the joint.

Your Podiatrist may prescribe the following general foot care tips during treatment of gout.  These tips will help in relieving and avoiding pain during recovery.  These will also help in prevention of future attacks from taking place:

    -    Ensure your feet are comfortable by wearing appropriate foot wear.  Shoes with ample space for the toes to move and they should fit properly.

    -    Avoid activities that put stress on the joints such as standing for long periods of time.

    -    Do stretching of the feet regularly; this will assist in strengthening of the affected joints and promote increased blood circulation.

    -    Eating a healthy gout diet; this mainly involves a reduction of foods and alcohol that have a high concentration of purines (i.e. liver, red meats, dried beans and peas, etc.) while trying to substitute them with alternative foods.   Dr. Bowman can give you a list of foods to avoid.

    -    Try to maintain a healthy body weight, as being overweight may result in stress and pressure being exerted on joints located in the feet.  The stress and pressure may also cause pain and slow down the gout treatment you are undergoing.

Gout is one of the most painful medical conditions known.  For further information or to get your questions answered feel free to contact Dr. Jeffrey N. Bowman at www.houstonfootspecialists.com or by calling Houston Foot Specialists at 713-467-8886.