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Dr. Horlebein will be joining Advanced Regional Ankle & Foot Care LLC as a full time physician in Altoona PA, as of June 1st 2023. Feel free to call our office with any scheduling inquires/questions!

May 2024

Tuesday, 28 May 2024 00:00

Rare Foot Conditions

A podiatrist will be able to address a variety of rare foot conditions, particularly the ones that affect children. The most common are Kohler’s disease, Maffucci syndrome, and Freiberg’s disease. They can be properly diagnosed by having an X-ray taken, but in more serious cases an MRI may be needed. Kohler’s disease generally affects younger boys and bone deterioration may result from an interruption of blood supply. Children who have Kohler’s disease may find relief when the affected foot is rested, and a special boot is worn. Benign growths in the long bones of a child’s foot may lead to the development of bone lesions, and this is known as Maffucci syndrome. People who have this condition find mild relief when custom-made orthotics are worn. Freiberg’s disease targets the ball of the foot and can typically affect pre-teen and teenage girls. The metatarsal bone becomes deteriorated and flattened, and common symptoms include swelling and stiffness. A cast is often necessary to wear with this disease as it can help to reduce existing pain. Erythromelalgia is a rare foot condition, and its cause is unknown. Symptoms of this disease can include intense burning pain and the feet may appear red or feel warm. Relief may be found when the affected foot is immersed in ice water. It can also be beneficial to elevate the foot frequently. If your child complains of foot pain, it is strongly suggested that you consult with a podiatrist who can diagnose and treat rare foot conditions. 

Complex regional pain syndrome, or CRPS, also known as reflex sympathetic dystrophy, is a debilitating condition affecting the feet and other body parts. It often emerges following an injury, surgery, or trauma, although its precise origins remain uncertain. CRPS encompasses a range of symptoms, notably persistent and severe pain disproportionate to the initial injury. Sensory disturbances like burning sensations, tingling, or hypersensitivity are common, in addition to vasomotor symptoms such as changes in skin temperature and color, swelling, and alterations in sweating patterns. Additionally, CRPS can lead to motor and trophic symptoms, including muscle weakness, coordination difficulties, and changes in hair and nail growth. Treatment for CRPS typically involves a multidisciplinary approach, incorporating medication and nerve blocks. Podiatrists help in managing foot-related CRPS symptoms, offering specialized care like custom orthotics and tailored pain management techniques to improve mobility and enhance the overall quality of life for individuals grappling with this challenging condition. If you have symptoms of CRPS, it is suggested that you seek help from this type of medical professional.

Some foot conditions may require additional professional care. If you have any concerns, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Rare Foot Conditions

The majority of foot conditions are common and can be treated by a podiatrist.  Standard diagnostic procedures are generally used to identify specific conditions and treatment can be rendered. A podiatrist also treats rare foot conditions which can be difficult to diagnose and may need extra attention and care. 

There are many rare foot conditions that can affect children. Some of these can include:

  • Freiberg’s disease
  • Kohler’s disease
  • Maffucci syndrome

Freiberg’s disease - This can be seen as a deterioration and flattening of a metatarsal bone that exists in the ball of the foot. It typically affects pre-teen and teenage girls, but can affect anyone at any age. Symptoms that can accompany this can be swelling, stiffness, and the patient may limp. 

Kohler’s disease - This often targets the bone in the arch of the foot and affects younger boys. It can lead to an interruption of the blood supply which ultimately can lead to bone deterioration. The patient may limp or experience tenderness, swelling, and redness.

Maffucci syndrome - This affects the long bones in a child’s foot leading to the development of abnormal bone lesions. They are benign growths and typically develop in early childhood and the bones may be susceptible to breaking. 

A podiatrist can properly diagnose and treat all types of rare foot conditions. If your child is affected by any of these symptoms or conditions, please don’t hesitate to call our office so the correct treatment method can begin.

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
 

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Tuesday, 21 May 2024 00:00

Foot Surgery

In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.

The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.

While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.

Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries. 

Plantar fasciitis surgery is a treatment option for individuals who have not found relief from conservative measures and continue to experience severe and debilitating heel pain. The surgery typically involves releasing or removing a portion of the plantar fascia to alleviate tension and reduce inflammation. This procedure aims to provide long-term pain relief and restore normal foot function. Success rates of plantar fasciitis surgery vary depending on various factors, such as the patient's overall health, the severity of the condition, and the specific surgical technique used. While many patients experience significant improvement in symptoms and quality of life following surgery, it is essential to understand that success is not guaranteed, and there are risks associated with any surgical procedure. If you have this condition and are considering surgery, it is strongly suggested that you speak with your podiatrist who can guide you toward making an informed decision. 

Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your foot and ankle needs.

When Is Surgery Necessary?

Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:

  • Removing foot deformities like bunions and bone spurs
  • Severe arthritis that has caused bone issues
  • Cosmetic reconstruction

What Types of Surgery Are There?

The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:

  • Bunionectomy for painful bunions
  • Surgical fusion for realignment of bones
  • Neuropathy decompression surgery to treat nerve damage

Benefits of Surgery

Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.

Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Foot Surgery
Tuesday, 14 May 2024 00:00

Neuropathy

Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.

The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.

Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.

Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.

If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.

Peripheral neuropathy, a complication of diabetes, occurs when high levels of fats or sugar in the blood damage nerves throughout the body, particularly in the extremities like the feet and hands. Symptoms include numbness, tingling, pain, and loss of sensation in these areas. Peripheral neuropathy often progresses gradually and can be unnoticed until its more advanced stages. Diagnosis involves a thorough physical examination by a podiatrist to assess reflexes, sensation loss, and skin changes. Additional tests like electromyograms, EMG, or nerve conduction velocity tests, abbreviated NCV, may be required for confirmation. While there is no cure for peripheral neuropathy, managing blood sugar levels is the best way to slow its progression. Treatment focuses on alleviating symptoms and preventing complications, such as ulcers. It is important to seek care from a podiatrist, a doctor who specializes in foot and ankle health, for comprehensive management of peripheral neuropathy. To help maintain mobility and prevent complications like ulcers and amputations, it is suggested that you include a podiatrist in your medical team.

Neuropathy

Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.

What Is Neuropathy?

Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.

Symptoms of Neuropathy Include:

  • Numbness
  • Sensation loss
  • Prickling and tingling sensations
  • Throbbing, freezing, burning pains
  • Muscle weakness

Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.

Treatment

To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.

Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Neuropathy
Tuesday, 07 May 2024 00:00

Blisters on the Feet

Blisters are a common ailment of people who wear shoes that are either too tight or rub against the feet in an uncomfortable way. Knowing the basics of blisters is important for understanding how they are formed and what treatments should be used for them.

A blister on the foot, or any other part of the body, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery-like fluid that usually isn’t cause for concern. However, blisters can fill up with blood if they are deep enough and pus if they have become infected with bacteria.

Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time or when your shoes do not fit you properly. Your feet are also more prone to blisters if they are moist, so keeping them dry and clean is one preventative step you can take.

Preventing infection should be the number one concern when treating blisters, as well as relieving the pain they can cause. Using a bandage to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop. You can also take a sterilized pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics may need to be taken in order to completely eliminate the bacteria inside the blister. See a doctor to have an antibiotic prescribed.

The best way to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a bandage to an area where you think a blister is about to form is another way you can prevent them.

Tuesday, 07 May 2024 00:00

Dealing with Blisters Between the Toes

Blisters between the toes can be a real pain, whether they're caused by friction, insect bites, burns, or infections. These little pockets of fluid can make each step a challenge. Friction is often the main cause of blisters between the toes. When your toes rub against each other or your shoes, the skin becomes irritated and leads to blister formation. Other causes of blisters between the toes include insect bites, burns, and various infections. While most blisters will heal on their own within a week or two, it's essential to resist the urge to pop them. Breaking a blister can increase the risk of infection and prolong the healing process. Instead, keep the blister clean and covered with a bandage. If the blister is particularly painful or shows signs of infection, it's best to seek medical attention from a podiatrist. Preventing blisters between the toes starts with wearing properly fitting shoes and socks. Avoid walking long distances in new shoes, and be sure to change socks if they become damp. If you have persistent or severe blisters between the toes, it is suggested that you seek help from a podiatrist for relief. 

Blisters are prone to making everyday activities extremely uncomfortable. If your feet are hurting, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Foot Blisters

Foot blisters develop as a result of constantly wearing tight or ill-fitting footwear. This happens due to the constant rubbing from the shoe, which can often lead to pain.

What Are Foot Blisters?

A foot blister is a small fluid-filled pocket that forms on the upper-most layer of the skin. Blisters are filled with clear fluid and can lead to blood drainage or pus if the area becomes infected.

How Do Blisters Form?

Blisters on the feet are often the result of constant friction of skin and material, usually by shoe rubbing. Walking in sandals, boots, or shoes that don’t fit properly for long periods of time can result in a blister. Having consistent foot moisture and humidity can easily lead to blister formation.

Prevention & Treatment

It is important to properly care for the affected area in order to prevent infection and ease the pain. Do not lance the blister and use a Band-Aid to provide pain relief. Also, be sure to keep your feet dry and wear proper fitting shoes. If you see blood or pus in a blister, seek assistance from a podiatrist.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Blisters on the Feet
Friday, 03 May 2024 00:00

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