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

My wife and I recently hosted a baby shower for the daughter of dear friends.  In addition to our friends’ daughter, there were three other pregnant women there.  When they found out I was a foot doctor, the questions came flying!  One of the most common complaints during pregnancy is foot pain and swelling of the feet and ankles.  During the nine months of pregnancy, your baby grows and your feet grow along with the baby. It’s very common to see an increase in shoe size from 1/2 to 1 full size. Wearing shoes that fit is the first rule.

Your feet swell due to the weight and position of the baby.  They also swell due to the added weight gain of a normal pregnancy.  All of these things contribute to the ligaments and tendons in the feet stretching.  Many women following delivery will be able to get back into their normal size shoe; however, that’s not the case for all women.  To reduce swelling there are a few things you can do. Wear compression hose, rest, elevate your feet, and massage your feet.

The natural weight gain during pregnancy is the major reason for change in the feet.  Often, your weight gain will cause you to walk differently or compensate by tilting inward, decreasing the height of the arch.  The decrease in arch height can cause arch pain, heel pain, and, most commonly, plantar fasciitis - an inflammatory response to the stress on the ligament holding up your arch.  The good news is that for many women, your feet will return to normal after the delivery, but what to do in the mean time?  A custom device called an orthotics will help hold that arch in its proper position and alleviate the pain you feel.

When pregnant, it is normal for an increase in your blood volume, and some pregnant women will have a mild increase in their blood pressure.  Blood vessels dilate to decrease the flow and pressure, which can lead to a decrease in oxygen to the muscles and often cause foot and leg cramps.  To relive the cramps, it is best to get more blood to the area by simply walking around, and it’s a great way to keep your muscles toned as well.

I wish I had the big secret to keep pregnant women comfortable throughout pregnancy.  All women will experience the ups and downs; however, we can keep your feet comfortable!  Now that your feet and ankles are comfortable, all you need is the answers to the ‘terrible two’s” and the teenage years.

Please feel free to contact Dr. Jeffrey Bowman for more details or any questions by 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!

Do you feel a stabbing pain in your heel with your first steps out of bed in the morning? You’re not alone! Every day, thousands of Americans suffer from this condition. Plantar fasciitis, more commonly known as heel pain, is by far the most common complaint patients bring to podiatric physicians.

Aching heels can truly affect your lifestyle and disrupt essential activities and prevent you, to a large extent, from playing sports or simply going for a walk. An accurate expedient diagnosis of the cause of your symptoms will help you receive the appropriate treatment.

There are several causes of heel pain. The most common include:
*Plantar Fasciitis – Inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar) surface of the foot, from the heel to the ball of the foot. Both heel pain and heel spurs are frequently associated with plantar fasciitis.
*Heel Spurs – A bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. Heel spurs can result from strain on the ball of the foot and repeated tearing away of the lining or membrane that covers the heel bone.
*Excessive Pronation – Excessive inward motion can create an abnormal amount of stretching and pulling on the ligaments and tendons that attach to the bottom back part of the heel bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back.
*Achilles Tendinitis – Pain at the back of the heel is associated with Achilles tendinitis, which is inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone.
*Tarsal Tunnel Syndrome – This syndrome causes a large nerve in the back of the foot to become entrapped, or pinched. Similar to carpal tunnel syndrome in the hand, tarsal tunnel syndrome can cause heel pain.

Other possible causes of heel pain include rheumatoid arthritis and other forms of arthritis (e.g., gout); Haglund’s deformity (a bone enlargement at the back of the heel bone in the area where the Achilles tendon attaches to the bone); inflamed bursa (“bursitis”), a small, irritated sac of fluid; neuromas (nerve growths) or other soft-tissue growths; and bruises or contusions, which involve inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.

Some contributing factors associated with heel pain are age (with increasing age, often there is decreasing flexibility); any sudden change in activity (particularly activities that increase weight bearing or pressure on the foot); flat, pronated feet or high-arched feet; a sudden increase in weight; pregnancy; stress from an injury; a bruise incurred while walking, running, or jumping on hard surfaces; or medical conditions such as tarsal tunnel syndrome.

If you have any questions on heel pain, contact Dr. Bowman at Houston Foot Specialists.

As we get back into the cooler temperatures of the fall season, everyone puts away the sandals and  brings out the shoes again.  As you start looking for new shoes, you might be wondering if one brand is better than another.  If you are looking for a good shoe for everyday use or a good shoe for activities – there is a great solution.  At Houston Foot Specialists, we recommend New Balance.  “But aren’t all shoes just pretty much the same?” you might be thinking.  The answer is actually no, they aren’t.  Just like with many products out in the world, there’s always a difference in brands and if you chose a cheaper brand you will also get lesser quality.  For many of the less expensive brands, the companies use cheaper, less supportive and low quality materials to make their shoes.  Then of course there is the crazy expensive brands, some have a good quality shoe and some may not but are relying on their brand name to charge more. 

New Balance is a great mid-priced shoe brand that makes quality shoes.  They are durable and supportive, all while being comfortable shoes.  New Balance even makes shoes to help protect people who pronate, meaning they walk with most of their weight on the outside of their feet, or supinate, which is people who walk with most of their weight on the inside of their feet.  It protects their ankles from spraining by forcing their weight into the middle of their foot. The employees in New Balance stores have been trained to fit your feet correctly to ensure the right fit for you.  They even have been educated by podiatrists to fit shoes with orthotics too. 

If you are interested in visiting a New Balance Shoe store, you should search for the one closest to you on either Google Places or go to the New Balance website, which is http://www.newbalance.com.  Also if you are in the Houston area, there is a store on Post Oak near the Galleria.  We strongly urge you to go check it out.  If you have any questions on buying shoes, need to get a professional fitting for shoes, or have any additional questions as to which shoe would be right for you or your children, give us a call at 713-467-8886 or visit our website at http://www.houstonfootspecialists.com/.  Make sure you walk, run and play pain free!