Welcome to Family Podiatry. We put your family’s health and well being first. If you live in the metro area, you can stop by one of our offices for a health and wellbeing consultation. However, don’t worry if you don’t live near us. The majority of our information and services are available on this website. Dr. Bryan Popovici and Justin Hale, LPN pride themselves on efficient and complete patient education so that the patient can make educated decisions regarding their treatment choices. Sara, our all in one office person, will manage the transition into our practice and assure a smooth and complete entry of your information both insurance and medically related with compassion and privacy. She puts the first impression a positive one for our office. We provide the latest healthcare information for families like yours. We strive to offer the best advice and most current news to keep your family as healthy and safe as possible.
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MLS laser is one example of how we invest in proven treatment regimens which act as an adjunct to more traditional treatment regimens. Please take a moment and look at the videos on this page to gain some additional knowledge regarding this option for treatment.
This is a term usually saved for general nerve injuries. Often times by the time I see the patient it is a chronic problem. Although this is not insurmountable it requires patience on the patients part as much as myself. Social issues and mental effects of such chronic pain processes all need to be addressed. The complex nature of the problem does not allow a more through discussion at the web site, however will be elaborated on once the patient is present. The picture to the right demonstrates the nervous system in yellow. There are options for treatment that effective treatment without the need for chronic use of pain medication.
Sorry I had to put on gross picture on the web site. If it helps someone pay attention it is worth it. Numbness is just another version of neuropathy as it can have many different subjective symptoms. Perhaps the most dangerous is the potential of injury without the persons knowledge. The hardest thing for me to demonstrate to patients and have them accept is the fact that they can get injured and not feel it. A simple clinical exam can give a very good picture to what extent there is a problem. The typical response once the numbness is noted with clinical exam and is explained. Is that they have pain when they hit there foot in a cabinet for example. However, the problem is a low level injury or a sharp object would not be felt. Or if it is may not be enough to stop there activites and do a self examination. I have had patients leave watches in there shoes and walk on it all day, combs, toothpicks getting stuck in the foot. Moreover, they might see it but not act on it. Infection sets up and you are left with what we see to the right. It is ok to have numbness and not treat it specifically as long as does not effect stability or is denied by the patient.
The nerve diagram above and to the right is an accurate dipection of your nerve supply to your feet and legs. Any where along its track a nerve can get injured and result in pain. Also in various gradiants and intensity of pain. Typically the longer the injury persists the harder it is to resolve. But combination therapy is usual the key. Simple biomechanical control with local nerve treatment does well on a conservative approach. Simple nerve blocks with local anesthesia is an effective way to determine level and location along with ruling out nerve injury higher up the leg or even the back. More over nutritional issues may need to be addressed. Often times poor dietary choices and chronic pain go hand In hand.
WARNING SIGNS AS TO NERVE PAIN:
1.) you have no signs. Once again it sounds strange however the biggest concern is the lack of recognition of not having normal sense. If you are a diabetic/have vascular disease or have had a traumatic injury you should be evaluated as to the extent of neuropathy
2.) persistent tingling. The onset of constant/intermitant tingling is a dramatic change of nerve supply that needs to be evaluated. Episodes of tingling has been in my experience often associated with biomechanical influences, i.e. how your foot works that is producing local nerve injury.
3.) hot or cold sensation. Each type of nerve does a different job so your complaints of persistently hot or cold feet also indicates there maybe a generalized nerve issues that needs to be evaluated.
4.) Stability. Feel like you are not as sure as you once where on your feet? This is often related to not just getting older if it happens to be implied by other health care providers. But related to significant nerve injury and or damage.
5.) traumatic injury. If you have had a significant foot or leg injury. (ex. burns, fractures which required surgery, crush injury, direct impact ie dropping heavy objects on foot, especially those injuries which has lead to limitation of motion around joint/s) You need to be evaluated and educated as to precautions and treatment regimens available to you.am will support you in building a healthier you. No matter what your health needs are, having a team support you will keep you on the path to meeting them. We work together to connect you with the services you need.
This, in my opinion, is a very poorly treated condition and is a matter of general ignorance as to how to treat biomechanical issues. Injections, physical therapy, or even laser are items to help ease or evaluate the problem but is NOT the primary treatment. A combination of both biomechanical control along with treatment of pain complaints is in order. Fortunately, I have not had to do any surgery on patients over the last 20 years. However, treatment once outlined must be adhered to otherwise recurrence Is certain. The spur, the picture to the right, looks painful, doesn't it? But the problem really is the soft tissue attachment and the spur is the bones response to constant pulling of the tissue/s on that area. You do not have to remove the spur to provide relief.
IF YOU HAVE BEEN TOLD THE PROBLEM IS DUE TO WEIGHT, AGE OR SHOCK ABSORPTION YOU ARE BEING SADLY MISLEAD.
For myself this is one in the same as heel spur. With the only difference is the Xray findings. But the issue of cause and effect remain the same as does the treatment. If someone is treating you currently with orthotics and no physical changes are occurring to the orthotic to effect the angles at which your foot moves on the ground it will be useless. Likewise if it is being treated with a soft device it will be useless. Now trust me I will be more than happy that such measures may have worked for you but there is no man made material that can absorb repetative shock and rebound to its original shape. The soft device just becomes a flexable compressed non controlling device. So The key is addressing biomechanical concerns which unfortunately is an dead art form of medical treatment. This term is used as it is multiple factors that need to be addressed. Which does not mean the person can tolerate what the doctor maybe attempting to control. We handle and explain all these issues.
this can be in combination with the above problems and often times needs to be addressed by itself. Meaning you have been limping on your foot so long that you injure other areas and are essentially with resolving one set of complaints you find yourself feeling a secondary or even tertiary complaint. All of these complaints need to be peeled away layers at a time. This nerve injury can be on the inside or outside of the heel.
This is an all too common issue that typically develops from chronic fungal skin issues. So, there is a cross contamination issue at hand. I wish we could say we have a magic potion as to resolving such issues. However, there is no such thing. We will describe all options which can include topicals as well as laser treatment. In my experience I have yet to see an over the counter treatments that is effective. Typically they just break down the diseased nail but do not resolve the issue. The photo represents an early onset. Severe deformities can produce an low grade chronic pressure which create wounds under the nail and lead to bacterial infection. Such home remedies as vinegar help inhibit fungal issues but do not destroy. Moreover it can not penetrate into the nail itself.
ATHLETES FOOT INFECTION:
Rarely do I see the typical rash and itching. Typically it will present itself in the chronic form. This is an example on the right. People will think they have have dry skin. Softening skin agents will cover up the symptoms. Treatment is needed for an extended period of time but is tailored to each patient. Usually I see an undertreated condition as people will stop topical once it looks better but not gone. Also if you know of someone who has had infections in there legs with no known injury look at such things as chronic fungal issues. The skin is our barrier to bacteria that we are all exposed to. You can be the cleanest person or the dirtiest and never pick up the infection or get it in a heartbeat.
moles or any skin changes need to be evaluated especially if it presents itself to the bottom of the feet or palms of the hands. They can convert to a skin cancer issue. If you see something ask do not think it is nothing. It is not very common that it will lead to cancer but is easy to evaluate and treat. So do not take the chance. The photo to the right and below are two examples of moles or birthmarks.
CALLUS OR CORNS:
This is a condition that relates to biomechanical factors. Meaning the way we walk and in association with bone positional deformities. Examples of such can be hammertoes and bunion deformities. Which can also be acquired by injury for example or more than likely inherited issues. Weight and or age issues are often blamed for this but more than often it is not the case. At times it can be an influencing factor but NOT the primary cause. Surgery is often not the solution but should be explained as to an option if appropriate.
this is simply treated and provides tremendous relief immediately . At worst a permanent removal of the borders of the nails is in order. Attention is paid to detail so that a cosmetic result is achieved also. You do not want to remove more than is required. On rare occasion the whole nail needs to be excised. Avulsion which is just removing a section of nail is only a temporary fix. However in certain patients this is acceptable for example if the patient is going to be returning routinely for diabetic foot care for example. We will explain everything including potential complications with such procedures. There is a common misconception that the problem is just at the tip. But the deformity begins at the base under and more towards the foot 1/4 inch or so. As indicated by the red line.
COMPLETE BIOMECHANICAL EXAM:
Everyone is made differently. More often than not distinct joint /functional changes will be distinct from one foot to next.
Multiple factors will come into this exam and with 20 plus years of experience it comes with an explanation and demonstration as to functional differences between various joints on one foot. Moreover, the difference in similar joints from one foot to the next is discussed and similarly demonstrated.
RUNNING/OR DAILY USE SHOE EVALUATION:
Your shoe will tell a story. Combination of biomechanical evaluation will be verified with existing wear noted on the sole of the shoe. It is always a good idea if you are presenting for a running evaluation or sports injury to bring your old pair. This can give both myself and the patient additional confirmation of the existing pathology so corrections can be made.
TRAINING REGIMAN RECOMENDATION/EDUCATION:
Putting these concepts together with review of the individuals running regimen. And just as important. Is to discuss the patients short/long-term running or sports goals. You are paying us to manage your case and allow you to maintain a sport or activity that will keep you happy. If a specific goal is in order a realistic pattern of treatment will be outlined along with probable expectations and time frame to achieve such.
LOW BACK/KNEE PAIN/HIP PAIN:
I hope by supplying the videos and taking the time to study them one can appreciate the complexity that exists with walking, much less running or sports. It is commonly mistaken that power from running, or walking is generated primarily from the lower legs where in fact the step is and the power of such is generated from upper body. And supplemented with lower extremity action. All these issues need to be taken into consideration to resolve and control a more normal walking pattern to eliminate local injury that occurs with each step. Orthotics (arch supports) need to be adjusted while the patient is present to address such things. So, if you have had orthotics without success then guaranteed the devices have not been modified to address such biomechanical concerns. Joint replacement procedures have been another factor that needs to be addressed. The functional or actually leg length changes are rarely addressed by the surgeon, but I see all the time its long term influences. Hope you enjoyed some of the information and it is of some help to you. And have the confidence that we will see all such issues through to a pain free walking day.