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 watched the Oscars and the annual fashion show on the red carpet.  While all the women were glamorous from head to toe, by the end of the night most of them were either barefoot or carrying their shoes looking for a place to sit.

Although high heels and stilettos may make women’s legs more shapely and elegant, they are not an everyday shoe.  Most of these shoes offer little to no support for your feet and can cause pain because all your weight is forced to the balls of your feet, pinching the toes together. In some cases, the imbalance can lead to sprained ankles or even worse - ankle fractures from falling.

A lot of these shoes may make foot problems worse and speed up the formation of such problems as bunion’s, hammertoes, corns, callous, pinched nerves, and many more deformities.

So, the question I get is, “How can I wear heels and be comfortable?”  First thing is find out what is causing the discomfort.  If all the weight of your body is forced onto your forefeet, you need to wear a lower heeled shoe of about 1 ½ inches in height.  A completely closed-in shoe will give more support than a sling back, peep-toe shoe, or sandal.  Padding and wider shoes will often help, but wider shoes may slip off the back of your heels.  A custom device called an Orthotic can be made to fit into heels that will keep the muscles, tendons, ligaments and bones in a proper position and prevent the imbalance and discomfort.

Stretching your toes both toward the leg and down helps to strengthen your feet. Stretching the calves and the arch will also help.  Your Podiatrist can show you Exercises specific for you to ensure correct form and position.  Your foot doctor will go over the pros and cons of different styles of shoes to determine what is best for you.  Be sure to bring a pair of high heeled shoes that you frequently wear to your appointment to be evaluated for wear patterns and unequal weight distribution.

I will not tell you to give up high heels.  I will simply help you achieve the comfort you desire so you may wear high heels on occasion.

For more information on high heels and your feet, feel free to contact Dr. Bowman at Houston Foot Specialists by either calling 713-467-8886 or at our website www.houstonfootspecialists.com

Seeking medical attention from your podiatric physician is the first line of defense in treating heel pain. However, there are several steps you can take to avoid heel pain in the first place:

*Wear shoes that fit well and have shock-absorbent soles, rigid shanks (the part of the shoe that supports the foot and helps give a shoe its structure), and a supportive heel counter (the rear-most part of the shoe, at the back of the heel above the sole).

* Wear the proper shoes for each activity.

* Do not wear shoes with excessive wear on heels or soles.

* Begin exercises slowly. Consult with your podiatric physician before beginning a new exercise program.

* Wear athletic shoes with good shock support in the heels.

* Purchase shoes that fit.

* Avoid activities that may put constant strain on the foot.

* Avoid going barefoot on all surfaces.

* If obese, lose weight.

A variety of treatment solutions are available to provide short and long-term pain relief. Begin treating heel pain by avoiding all sorts of pressure or tension on the inflamed area, giving your feet ample rest. Applying ice and heat packs in alternating fashion will greatly accelerate the process of healing. Another option is the use of custom insoles that may be created by your podiatric physician. These may assist with treating active conditions of heel pain and likewise reduce the risk for reoccurrence. The custom insole will restore body balance and prevent the plantar fascia from experiencing strain when you walk. If all non-invasive treatment solutions do not work, surgery is probably the best next option, and often Endoscopic procedures or minimally invasive procedures are an option.

Regular exercise for calf muscles and the plantar fascia is necessary to alleviate pain and improve flexibility of the affected muscle. These exercises are advised for both legs even if the pain is in one heel only. Some of the most beneficial exercises are:

*Towel stretches – This exercise should be done every morning before you leave your bed. Make a loop with a towel and use it to pull your toes toward your body, while keeping the knee straight. Stretch each foot three times, and hold each stretch for 30 seconds, if possible.

*Stair stretches – Stand tall on a staircase with the balls of both feet on the edge of the step. Place hands on the railing or the wall for balance and support. Slowly lower heels toward the floor until you feel a stretch in your lower leg and heels. Maintain the stretch for 10 to 15 seconds. Repeat this exercise six times, and perform the stretches twice every day.

*Wall-Leaning Stretch – Stand an arm’s length away from a wall, place both hands on the wall at shoulder height, with the feet slightly apart and one foot in front of the other. Your front knee should be bent, but the back knee should be straight while you lean toward the wall. Hold the position for 10 seconds at a time for up to 15 or 20 repetitions per leg.

If you are unsure of the cause of your symptoms, if pain is severe, or if you have the following symptoms, call a podiatric physician immediately:

*Inability to bend your foot downward.

*Inability to rise on your toes.

*Inability to walk comfortably on the affected side.

*Swelling or discoloration of the back of the foot.

*Heel pain that occurs at night or while resting.

*Heel pain that persists beyond a few days.

Heel pain does not always subside quickly after medical attention is received. Unfortunately, it may take several months before the pain is actually gone. In most cases, heel pain can be treated at home under a podiatric physician’s supervision. If you are in need of a podiatrist, check out Houston Foot Specialists, we'd love to help you get rid of that heel pain!

Having foot or ankle surgery is not as bad as some make it out to be if you are prepared.   In this blog, you will learn some tips from foot and ankle surgeon Dr. Jeffrey Bowman and Houston Foot Specialists.

First, and most important is to ask your podiatrist before the procedure any questions you may have.  If your podiatrist has written orders for lab work, X-rays, or MRI, have them done in advance so your foot and ankle surgeon is prepared -  and, yes, surgeons have to prepare just like the patient.

Tips for Before Surgery:

Have a cooler set up by the bed or couch with ice packs and food and drinks so you don’t have to get up and down.

Have a waterproof cast cover to keep your foot dry when you bathe.  Trash bags with tape do not work, and if your bandage gets wet your chance of infection increases.

If you are on blood thinners, aspirin, or ibuprofen, stop taking it at least 5 days prior to surgery unless your doctor specifically authorizes its use.

If your surgery requires crutches, get them in advance to practice using them.  Your podiatrist or staff can show you how to get used to them.

If given a post-op shoe or a walking boot, make sure you bring it with you to surgery.

Have all prescriptions filled before the surgery.

Remember, do not have anything to eat or drink after midnight the day before the surgery.

Tips the Day of Surgery:

It is normal to be nervous the day of surgery.  The surgery center or hospital will give you something to help with this.

Wear loose fitting clothing.

If advised, take any medications you normally take with just a sip of water.

Do not wear any jewelry, makeup, nail polish, body piercings, contacts leases, or dental appliances.

If you have any metal in your body, make sure you tell the pre-op nurse.

Leave all valuables at home.

Bring photo ID (such as your driver’s license) and health insurance card with you.

Bring your post-op shoe or walking boot if given one.  Some doctors have them at the surgery center or hospital for you.

Have a friend or family member with you to drive you home.

Most foot and ankle surgeons will have written post-operative instructions with do’s and don’ts.  Make sure to read these before your surgery and have them handy after.  If you follow the instructions carefully, you will have much less post-operative pain, swelling, and chance of complications.  Every patient is different, so your instructions may be tailor-made for you.

Your recovery will go more smoothly if you are prepared before surgery. If you have any questions, it is important to ask before surgery.   Dr. Bowman is available to answer any questions you may have.

You may have recently seen television ads regarding “Minimally Invasive Bunion Surgery” or “Mini Bunionectomy.”  This is a procedure available at Houston Foot Specialists performed by Dr. Jeffrey Bowman.

The first step in evaluating whether the Mini Bunionectomy is right for you is to understand what causes the bunion or “Hallux Abducto Valgus” deformity. The space between the first and second metatarsal bones (the long bones in your foot) is called the Inter-metatarsal angle or “IM angle”.  As the angle increases, so does the growth at the base of the big toe (Hallux) from shoe pressure.  The big toe usually drifts toward the second toe, sometimes overlapping or underlapping the second toe.  Some of the factors causing this include weak ligaments, trauma, improper fitting shoes, tight high heels, flat feet, and hereditary factors.  When bunion pain first starts, it should be treated conservatively.  If this fails, then surgery is usually indicated.

There are numerous bunion procedures, and your podiatrist will take X-rays and perform a biomechanical exam to determine which procedure is the one that is correct for you.  The bone enlargement is removed in all procedures and the big toe is placed in a straighter position.  

Most bunion procedures are named after the surgeon who developed them.  One procedure that isn’t named after a doctor is the minimally invasive procedure called the “Mini-Tight Rope” procedure.  It is extremely important that a patient realize this procedure is not meant for everyone.  As with any surgical procedure, complications could develop.  Your podiatrist will determine whether you are a candidate for surgery and whether the “Mini-Tight Rope” procedure is right for you.  What does the “Mini-Tight Rope” procedure involve?  Two small incisions are made: one to remove the enlarged bone at the base of the big toe, and the second incision is placed over the second metatarsal.  Next, a very strong type of suture is placed into the first metatarsal then passed through the second metatarsal to pull the first metatarsal over toward the second, in essence narrowing the foot.  This is secured in place by two small “buttons” on either side of both bones.  A shift is needed in all procedures to help minimize any return of the foot deformity and again, your podiatrist will determine if this procedure or another is better to correct your bunion.

If you suffer from pain at the base of the big toe or Bunion Deformity, please see your podiatrist.  At Houston Foot Specialists, we perform and are experienced in all types of bunion procedures.  Contact us at www.houstonfootspecialists.com for details and ask a question on our “Contact Us” page.  Or, you may call Dr. Bowman at 713-467-8886, and one of our caring and friendly staff members will be glad to help.  Our goal is to stop your foot pain and get you back into all the shoes you want to wear with comfort!