By Affiliated Foot & Ankle Care
March 20, 2018
Category: heel pain
Tags: Plantar Fasciitis  

One of the most common foot problems that we see patients for at Affiliated Foot & Ankle Care is heel pain. Heel pain can be extremely disabling, making it difficult to participate in activities you enjoy and even to complete daily tasks. Tracking down the cause of heel pain, however, is not always easy. When pain is not the result of a visual or surface issue such as heel fissures or Haglund’s deformity but is felt deep within the heel, our podiatrists Dr. Varun (Ben) Gujral and Dr. Nrupa Shah will need to do some investigating to get to the source of the pain. The foot doctor will start by examining your feet and ankles and getting your complete medical history, including any previous foot or ankle injuries you may have had. The podiatrist may also want you to have an x-ray, MRI, bone scan, or other imaging studies to get a better look at the inside of your foot to pinpoint (or rule out) possible reasons for your pain. In addition, you may be asked questions about your work, daily, and leisure activities.

In many cases, heel pain is not directly caused by a problem in the heel. Below are three common causes of heel pain where this is the case:

Plantar Fasciitis—the plantar fascia is a long band of tissue that connects your heel to your toes. This band can become inflamed due to arch problems (overly high arches or flat feet), overuse issues, inappropriate shoe choice or being overweight. The strain on the plantar fascia puts stress on your heel, causing pain and discomfort. One telltale sign of plantar fasciitis is sharp, stabbing pain when you first get out of bed or after you’ve been sitting for a while.

Tarsal Tunnel Syndrome—with this disorder a compressed nerve is the source of heel pain. The tarsal tunnel is a structure at the inside base of your ankle that houses the posterior tibial nerve (along with arteries, veins, and tendons). When the tunnel is squeezed (either due to injury, a foreign or enlarged object in the tunnel, such as a cyst or varicose vein, or a biomechanical problem), the nerve gets compressed and causes heel pain.

Back Issues—if you are experiencing pain in both heels and the foot doctor cannot find a problem with your feet or ankles, another possibility is that the pain is being caused by a back issue. Nerves that go down to your heels can be affected by spine disorders.

If you are experiencing heel pain, it’s important to make an appointment at our Edison, Monroe or Monmouth Junction office in New Jersey. We can help you find the cause of the pain and get started on a treatment plan that will alleviate it and prevent permanent damage. Contact us today by calling: 732-662-3050.

By Affiliated Foot & Ankle Care
March 15, 2018
Category: Nutrition

March is National Nutrition Month and at Affiliated Foot & Ankle Care, we want our patients to understand the direct relationship your weight has with the health and wellbeing of your feet and ankles. Being overweight significantly increases the risk and symptoms of many podiatric conditions including plantar fasciitis, arthritis and other joint disorders, flat feet, and metatarsalgia to name just a few. It’s simple: when you reduce your weight, you reduce the stress on all of your lower extremities. In addition, if you maintain a healthy weight, you are more likely to be active, which helps improve circulation, flexibility, and range of motion.

Adopting healthier eating habits doesn’t have to be difficult. Try some of these expert tips and slowly make over your family’s diet:

  • Increase nutrients in your menus and decrease waste by chopping up leftover vegetables and fruits, putting in bags and freezing. Pull out and add to soups, stews, stir-fries, and smoothies.
  • You don’t have to fully give up pasta, rice, and other carbohydrates, but choose whole grain instead of white flour versions and try this trick: place your lean protein and vegetables in the bowl first and then add a serving size of pasta. When you mix all ingredients together you tend to end up eating too much pasta.
  • Avoid the overly large portions at restaurants by ordering an appetizer or a la carte item off the menu and supplementing with a salad or side serving of steamed vegetables.
  • Get children involved by allowing them to pick out different and colorful vegetables, salad ingredients, and fruits at the grocery store. Let them help with preparing them as well.
  • Make some healthy swaps in your snack choices. Instead of puddings or ice cream, try dessert flavored yogurts that don’t have added sugars or artificial sweeteners, dried fruit instead of candy, and popcorn or baked tortilla chips in place of potato or corn chips.

If you are experiencing foot or ankle pain, contact our New Jersey offices in Edison, Monroe or Monmouth Junction. Our podiatrists, Dr. Ben Gujral and Dr. Nrupa Shah, will diagnose your disorder and advise you if weight loss or other lifestyle changes will help improve your condition. Call us at 732-662-3050.

A condition that we treat at Affiliated Foot & Ankle Care that many patients are unfamiliar with is tarsal tunnel syndrome. Below are some questions and answers to help you better understand this often common condition.

Q: What is tarsal tunnel syndrome?

A: Tarsal tunnel syndrome is similar to a condition that you may be more familiar with, carpal tunnel syndrome, which occurs in the wrist. Both conditions are the result of nerves being compressed or squeezed, which produces symptoms of pain, numbness, tingling, or burning.

Q: Where is the tarsal tunnel located?

A: The tarsal tunnel is found next to your ankle bone on the inside of the ankle. In addition to the posterior tibial nerve, it also houses arteries, veins, and tendons. The tunnel is covered with a thick ligament that protects the structures in the tunnel.

Q: How does the posterior tibial nerve get compressed?

A: The compression of the nerve can be caused by a number of different scenarios. Sometimes injuries to the ankle or systemic diseases, such as diabetes or arthritis, can lead to inflammation and swelling, resulting in the nerve getting squeezed. In other instances, an abnormal or enlarged structure may be taking up space in the tunnel, which causes the nerve to become compressed. These can include a ganglion cyst, varicose vein, bone spur, or swollen tendon. Patients with flat feet have a higher risk of tarsal tunnel syndrome due to pressure placed on the nerve from the outward rotation of the heel that is characteristic of this deformity.

Q: How will the podiatrist know if I have tarsal tunnel syndrome?

A: Our foot and ankle surgeons, Dr. Ben Gujral and Dr. Nrupa Shah, will start by examining your foot and ankle. Since tarsal tunnel syndrome can be caused by many different things, the foot doctor may order nerve conduction or imaging studies to try to determine what is causing the compression.

Q: What are the treatment options for tarsal tunnel syndrome?

A: In some cases, our podiatrist may recommend surgery to decompress the nerve. There are, however, a wide range of conservative options as well, including bracing, orthotics, injections, and physical therapy.

If you are concerned that you may have tarsal tunnel syndrome, schedule an appointment at our Edison, Monroe or Monmouth Junction office in New Jersey today by calling: 732-662-3050.

By Affiliated Foot & Ankle Care
February 27, 2018
Category: Heart Health
Tags: Plantar Fasciitis  

February is American Heart Health Month. At Affiliated Foot & Ankle Care we believe in a total body approach to podiatric health. Taking care of your heart benefits your feet and vice versa. That’s why we want to focus on an issue today that can greatly impact your health—avoiding an excessive amount of added sugar in your diet.

In a startling study published in the Journal of American Medical Association Internal Medicine, it showed that the chances of dying from heart disease rose in tandem with the percentage of sugar in a person’s diet—regardless of age, sex, body-mass index or physical activity level. The study also showed that the average American adult consumes 22 teaspoons of sugar a day—more than 3 times the recommended amount! In addition to raising your risk for heart disease, sugar plays a large role in weight control. Our podiatrists, Dr. Varun Gujral and Dr. Nrupa Shah can tell you that being overweight or obese can put excessive strain on your feet and ankles and can cause or worsen many foot conditions such as chronic ankle pain and plantar fasciitis.

It’s clear that cutting down on added sugar is a good idea. Below are some tips on how to do it:

Learn the Lingo—when you check the nutrition label on foods the line for sugars contains both natural sugars (those that occur naturally in foods like dairy products and fruits) and those that are added, so that number doesn’t tell the whole story. Read the ingredients and look for any types of sugar (brown, malt, raw, invert), sweeteners, syrups (including corn and high-fructose corn) and any words that end in “ose.” Dextrose, glucose, lactose, maltose, and sucrose, for example, are all types of added sugar. The further near the top of the list they are, the greater the amount contained in the food.

Cut it In Half—whatever sugar you put in your coffee or tea, sprinkle on your cereal or use in recipes, try to use half the amount you currently do. Chances are you won’t notice the difference.

Find Sweet Substitutes—put fresh or dried fruits in your oatmeal, add flavorful extracts (lemon, almond, orange) or spices such as ginger, cinnamon or allspice to recipes in place of sugar. Switch from sodas (one of the worst added-sugar offenders!) to flavored seltzers and other low or no sugar drinks. Choose zero-sugar yogurt over ice cream and pudding.

To learn more ways to improve your heart and foot health, contact our Monroe, Edison or Monmouth Junction office in New Jersey by calling: 732-662-3050.

By Affiliated Foot & Ankle Care
February 21, 2018
Category: Foot Care
Tags: Diabetes   swelling   toenails   ulcer  

At Affiliated Foot & Ankle Care, we know patients don’t exactly look forward to coming into the Monroe, Edison or Monmouth Junction office for evaluation. Sometimes patients are unsure if a symptom really requires the doctor’s attention. However, we would prefer you err on the side of caution and contact us rather than wait until minor symptoms develop into serious medical conditions. To help you decide if you should make the call, ask yourself the following questions:

How’s the pain? No foot pain is normal, but we get it if you went on a strenuous hike or spent all day shopping and now your feet are a little sore and you think they just need a good night’s rest. Here are some signs the pain needs the attention of our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah:

  • Pain came on suddenly and for no reason or after a recent injury or fall
  • Pain is intermittent but has been coming and going for a while
  • Pain that is increasing in intensity or duration

Do your feet look different? Have you noticed any swelling, bruises, lumps or toes that appear to have moved out of place? What about your skin—red or discolored, flaky, any signs of rashes, cracks or blisters? Do any toenails appear to be thickened, crumbly or yellow/ another abnormal color?

Do you notice any change in sensation? Do you feel any burning or tingling anywhere on your toes or feet? Is there any numbness or lack of feeling in your feet?

Are there any signs of infection? Redness or red streaks and warmth in a localized area of your foot can signal an infection. If you see these symptoms and you have a fever you should contact the doctor right away.

One other important note: if you have diabetes you should definitely get in touch with the foot doctor immediately if you notice any of the above symptoms. For diabetic patients, foot irritation can quickly develop into a dangerous wound or ulcer and possibly serious infection that will have devastating consequences.

In the end, we’d rather be able to say: “It’s nothing to be concerned about,” instead of “you should have come in sooner.” Contact us at our New Jersey offices at 732-662-3050 if you have any questions or concerns about your feet.

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