My Blog
By Dr. Steven Miller
August 30, 2020
Category: Orthotics

Letter about orthotics Previously, I explained what a foot orthotic (arch support) is and who may benefit. Two of the most common indications are heel pain and flat feet.

This letter was written by one of our patients:

Dr. Miller –
Thank you so much for this excellent service you are providing! The orthotics you crafted have been life-changing, allowing me to continue to run and be active. You are easily the best podiatrist I have worked with. Thank you.

By Dr. Steven Miller
June 30, 2020
Category: Injury

Dislocated toe fractureBroken toes are common and can be very painful. They typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. One may feel a “pop” or “crack” when the bone breaks. Common symptoms include pain, throbbing, bruising, swelling, and redness.

If you suspect that you have a broken toe, you should make an appointment immediately. For most people, a combination of taping and protective footwear is sufficient. 

X-rays help determine if broken bones need to be reset. The attached images demonstrate closed reduction in our office without surgery (the x-rays were taken 15 minutes apart). 

If a deformity cannot be corrected easily, surgery may be needed. Broken bones that are not properly positioned, immobilized, and protected may advance into a painful nonunion.

If you sustained a toe injury, please call (847) 675-3400 right away to schedule an assessment.

By Dr. Steven Miller
May 31, 2020
Category: Medicine

Biotin containerBiotin, also known as vitamin B7 and nicknamed vitamin H, is present in many multivitamins. The recommended daily dose for adults is around 30 mcg (30 micrograms, which is much smaller than a milligram). However, some supplements promoted for hair, nail, and skin health contain biotin at much higher doses, as much as 10,000 mcg (over 30,000% the recommended daily need).

Consuming large amounts of biotin can be problematic. Some lab analyzers use an immunoassay that contains biotin. In patients with excess biotin in their blood samples, there is an increased risk of false lab values due to the inability of the patient’s blood to bind properly.

There is insufficient data to know if waiting for hours or days before running lab tests would help. Furthermore, waiting is obviously impractical when running critical lab tests such as for a heart attack or pregnancy.

COVID-19Coronavirus (COVID-19) has changed our world. In the realm of podiatry, two issues were examined.

“COVID toes” is a red discoloration, as if there was a bruise. There may be itching and burning sensation like frostbite. It is not known whether this phenomenon is due to inflammation from coronavirus, an immune response, or increase in blood clotting (or combination thereof). Thankfully, COVID toes heal without a scar and is not seen in most patients.

Although a study from Wuhan, China found coronavirus on shoes, it is unlikely that this is a common way that the virus is transmitted. The virus on shoes would still need to enter the body and may not be viable at that time. The reason this subject became popular may be due to this excerpt from the article: “…the virus can be tracked all over the floor, as indicated by the 100% rate of positivity from the floor in the pharmacy, where there were no patients. Furthermore, half of the samples from the soles of the ICU medical staff shoes tested positive. Therefore, the soles of medical staff shoes might function as carriers.”

Image of heel painWhat causes heel pain?
Plantar fasciitis is the most common cause and spares no one, sedentary or active. This occurs when the thick band (plantar fascia) which supports the foot becomes inflamed and painful. Other causes of heel pain include stress fracture and arthritis.

How do I know if I have plantar fasciitis?
A classic sign of plantar fasciitis is heel pain when stepping out of bed in the morning. It may also hurt when standing up after a period off your feet, such as after a long car ride. If untreated, the condition may worsen. In more advanced cases, the heel may hurt all the time.

What causes plantar fasciitis?
There are many factors: type of activates, load on feet, shoes (or lack of shoes), walking surface, and foot structure. It is common for a combination of circumstances to contribute to a painful heel.

What can I do myself to diminish the pain?
  ●  Change shoes. Use new sturdier shoes with shock absorbing materials. Avoid flip flops, slip-ons, and slippers, even at home. Interestingly, plantar fasciitis often hurts less in high heels.
  ●  Cryotherapy. Apply ice to the painful area. Even better, roll your arch on a cold can or frozen golf ball.
  ●  Ibuprofen or Naproxen. The brand names for these over-the-counter anti-inflammatories are Advil, Motrin, and Aleve.
  ●  Home exercises. The most common are calf stretches and strengthening techniques, which ultimately help the bottom of the heel.
  ●  Arch supports. This may be the hardest to accomplish without professional guidance since there is a delicate balance between support, cushioning, and thickness.

In summary, multiple remedies are usually needed to cure plantar fasciitis. An accurate diagnosis and treatment plan is the first step. For expert care, schedule an appointment with Dr. Steven Miller by calling (847) 675-3400 or clicking here.

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