Newsletters

A collection of articles prepared and presented over time by Dr. Horsley and other contributing authors.

Neuropathy

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How many of us have ever had the sensation of pins and needles poking under your skin? Have you ever sat in the same position for so long that maybe your leg or foot went numb? You may have experienced neuropathy. "Neuropathy?" you say. Yes, this is the term used when there is some kind of short or long-term damage or injury to a nerve. There are many causes of neuropathy and depending on the cause and extent of injury, the damage may or may not be reversible. In this article, we will review some of the different types of neuropathy, some causes of neuropathy, and various recommended treatments.

Nerve injury can be classified into three main categories using the Seddon system. This classification system is based on the type of damage done to the nerve and its ability to heal.

  • Neuropraxia is the mildest form of nerve damage. The wrapping around the nerve (myelin) is damaged by some type of compression or direct hit trauma. Usually vibratory sensation and fine point touch is lost when this happens. Neuropraxia is usually healed anywhere from days to months as long as the myelin around the nerve heals.
  • Axontmesis is a disruption to the fibers in the nerve (axons) and the wrapping around the nerve (myelin). A special term has been given when the axons are damaged but not severed - Wallerian degeneration. Axontmesis can be caused by stoppage of blood flow (ischemia), toxins, or prolonged compression. Recovery is possible with axontmesis, but chances of healing decreases if the injury to the nerve is far from the organ that the nerve supplies.
  • Neurotmesis is the worst type of nerve injury. Not only are the wrapping (myelin) and axons disrupted, the supporting tissue is injured as well. You would see neurotmesis in gunshot wounds, lacerations, puncture wounds, and open fractures. The nerve is usually severed in neurotmesis and the chances for healing are basically little to none.

Nervous System

A healthy lifestyle can lessen the chances of developing neuropathy. Vitamin B-12 deficiency has been linked to myelin decay. Vitamin B-12 can be found in many sources such as seaweed, soy, dairy products, and eggs. If you are diabetic, glucose is key to controlling the symptoms of neuropathy. Studies have shown that excess sugar in the blood produces an alcohol, which destroys the nerves. Prevention of neuropathy is one reason why nutritional guidelines have been established for diabetics. Surgical procedures can be a cause of neuropathy. Avoidance of nerves is a top priority during surgery; however, sometimes they cannot be avoided. Usually the nerve injury is temporary and subsides with active range of motion and healing of the surgical site.

Depending on your specific cause of neuropathy, there are many treatments available.

  • One treatment would be to protect the already damaged nerve from further damage by wearing protective gear that the doctor may give you.
  • Medications such as gabapentin or preglabin can be prescribed by your doctor to help alleviate the symptoms of neuropathy.
  • Cryoderm, available on footDrHorsley.com, has been proven to be effective in the treatment of neurological pain.
  • Your doctor may choose to have you use capsaicin. Capsaicin is a topical agent that helps reduce the pain and tingling associated with neuropathy.
  • Surgical treatment, external neurolysis, also exists for certain types of neuropathy depending on the location of the nerve.

If you or someone you know has existing neuropathy, please know there is help and options available. Visit FootDrHorsley.com to schedule your appointment with a podiatrist to review your specific treatment plan and other possible remedies available.

Asteotic eczema (winter itch)

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The weather is changing and we hate to admit it, but winter is near. Not only does "Old Man Winter" bring frost, he loves to deliver chills, chapped lips, and brittle hair. In addition to the most obvious things, many people can acquire skin abnormalities such as asteotic eczema (winter itch), fissuring of the skin, or their xerosis can be worsened. In this article we will explore the abnormalities and possible solutions to them.

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Cold Feet

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Brrrr it's not winter but it sure makes me shiver.

What is Cold Feet you might ask? Well, Cold Feet is a common condition that affects many patients from all walks of life. The body responds to cold temperatures by reducing the blood flow to the extremities leaving the feet vulnerable. Chronic cold feet are often a result of impaired circulation (peripheral neuropathy) and lack of mobility. Patients with Muscular Dystrophy, Multiple Sclerosis, Diabetes, Arthritis and Cerebral Palsy are at risk of this condition. One of the major causes of cold feet is peripheral neuropathy which can affect the feet and hands trying to protect core temperature.

 

Peripheral Neuropathy

The most common type of peripheral neuropathy damages the nerves of the limbs, especially the feet. Nerves on both sides of the body are affected. Common symptoms of this kind of neuropathy are:

  • Numbness or insensitivity to pain or temperature
  • Tingling, burning, or prickling
  • Sharp pains or cramps
  • Extreme sensitivity to touch, even light touch
  • Extremely hot or COLD feet

These symptoms are often worse at night.
Wow that's amazing! Now that I know what it is, are there any complications?
Why yes, there are. The following are some of the complications that can occur:

  • Abcess and Celulitis: Localized pockets of infection under the skin.
  • Dry Skin or Cracked Skin: As a result of cold feet, dry skin or cracks in the skin can lead to severe infection when inadequate blood flow is present. Individuals who are affected by peripheral neuropathy are particularly vulnerable to cold and are at risk of serious complications due to poor circulation to the feet and legs. It is extremely important to keep the patients feet warm and to keep the skin moisturized.
  • Loss of Sensation: Chronic cold feet can result in a loss of soft and sharp touch to the feet.
  • Loss of Sleep: Recent studies have found that cold feet can result in disrupted sleep patterns.
  • Gangrene: In severe cases gangrene can occur. Gangrene is death of tissues (necrosis) which usually requires surgery.

Golly, I'm sure glad I know about this "illness", -its serious stuff. Now how is it treated?

Well, lucky for you there isn't any surgery required. You should purchase Lamb's wool insoles for your feet. They fit in just about any closed-toe shoe and turn your feet from shivering Sherry's to party time Pete's! They're comfortable and warm, and specifically treat cold feet!

So get ready to treat those cold feet to a summer vacation! Can't wait to see YOU back next week with more on the latest Foot 411.

Onychomycosis

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Have you ever gone over someone's house and been ashamed to take off your shoes? Ever gone to the beach and buried your feet in the sand? Do you wear closed toed shoes because you are ashamed of toenails? Don't worry, you are not alone. This is what millions of Americans experience. If you have dry, yellow, brittle, and discolored toenails, you may have Onychomycosis, better known as fungus nail. With Onychomycosis, the nail has been penetrated by bacteria or some type of fungi. In this article we will discuss Onychomycosis and treatment options.

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A Primer on “Footology”

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Welcome Back!

Hey everybody!
Welcome back to this week's discussion on foot facts -what you need to know.

The foot could easily be argued as one of the most important structures of the human anatomy. It provides us with balance, allows us to be mobile, and is an excellent indicator regarding the functionality of the many systems of the body. Though a very complex structure, the foot can be explained and divided into regions making "footology" fun and interesting. To begin exploration of the foot, we will begin with the building blocks for all structures of the body, bones.

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Gait Cycle

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Welcome Back!

Hey everybody!
Welcome back to this week's discussion on foot facts -what you need to know.

It's been a while, but I'll get you up to speed on the 411!

Most of us do it everyday. Babies do it as well as well as adults late into their life. So little thought is put into this process that it can sometimes be taken for granted. It is so important in our lives that without it, one would have to change many aspects. What is this common complex function I'm talking about? The art of walking-the Gait Cycle.

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Morton’s Neuroma

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Hello again from Amelia White

Welcome back to Foot Facts. The Universal Portal to the wide world of feet.

This week's topic is Neuroma, Morton's Neuroma. What is Neuroma? I'll tell you.

A neuroma is a benign tumor of a nerve. Morton's neuroma is not actually a tumor, but it is a thickening of the surrounding tissue of the nerve that leads to the toes. The thickening occurs as the nerve passes under the ligament that connects the metatarsals (toe bones) in the forefoot. Morton's neuroma typically develops between the third and fourth toes, usually due to irritation, trauma or excessive pressure. The risk for Morton's Neuroma is eight to ten times greater in women than in men.

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Diabetic Foot Infections

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Any time a break in the skin occurs, bacteria, fungi, and other pathogens can enter and cause an infection. The foot is an especially rich source of bacteria and invading microorganisms, because your shoes provide them a perfect environment in which to live. Therefore, any time you notice a lesion, ulcer, cut, or sore on your feet, you need to take prompt action to prevent infection. A foot ulcer is the most likely source of infection in the foot. When an ulcer becomes infected, microorganisms can eat through layers of skin and bone tissue to create a deep hole. When the infection spreads or becomes too deep, amputation may be needed.

Symptoms

Symptoms of an infected ulcer include fever, redness, swelling, warmth around the wound, and any sort of drainage or oozing of pus-like material. There aren't as many symptoms for infections as there are for other foot problems, but they are still as serious.

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Pain Relief

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Happy Easter!

This is the time of year for new suits, brimmed hats, and new shoes, but be warned -with new shoes can bring new pain. To deal with this pain,most people go straight to the medicine cabinet and grab a pain reliever. In this article we will educate you on pain relievers. Do we really know howpain relievers work? What's the difference between NSAIDs and Acetominaphen? Can everyone take pain relievers? When should I not take pain relievers? Get ready for some fascinating facts.

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