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Next Step Foot & Ankle Clinic

Frequent Foot Questions: What You Want to Know About Ankle and Foot Health

Exploring medical options to cope with pain can be very overwhelming, and it can be hard to know where to start. Here, we share our most commonly asked questions from people just like you. Whether you are wondering what is causing your pain or trying to find out what treatment options are available to you, find answers here in our frequently asked questions section.

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  • How do you get flat feet as a child?

    Most of the time if you question the family there is some family history of flat feet. Often these people have knee or hip or back pain at an early age. Different types of foot pain can develop. These include pain in the heels, on the balls of the foot or inside or outside of the ankles. It is usually hereditary. Rarely, some injury can play a roll.

  • What is the problem with flat feet?

    The main problem with flat feet is that they are in a poor functional position that creates a lot of stress on the foot, knee, hip, and back. This may take years before the symptoms become present but some signs are easily seen early in life. Usually the child does not like to run or “runs funny.” The child has a hard time keeping up with his peers in sports or play. The child will not usually complain of pain but complains of being tired when required to walk any distance. The child starts unconsciously avoiding playing and gravitates toward sitting activities.

  • Are flat feet in kids normal?

    Yes and no. Almost all children are born with feet that are flat and floppy. They make a full footprint on the ink pad impression that we have all seen. This condition normally continues for the first three years of life. After the age of 3, the foot starts to change and develop an arch. If you have a 7 year old and the feet still make a full foot print on the ground when the feet are wet you may have a problem. Get a good opinion of what is going on. A word of caution: MANY doctors will tell parents “Little Tommy will grow out of it,” but that has not been true in clinical research. After age 6 or 7 the alignment of the foot and leg don’t seem to improve very much.

  • What about surgery for my neuropathy?

    Surgery is not indicated for “neuropathy.” However, many patients (especially diabetics, but many others as well) have nerve compression in addition to neuropathy. You have probably heard of carpal tunnel syndrome in the hand. The same thing can happen in the feet. This is especially true for diabetic patients. In fact I have seen patients diagnosed with neuropathy that only had nerve compression. If a patient demonstrates nerve compression in addition to, or instead of neuropathy surgery to free up the compression on these nerves can be very helpful. We have recently added new equipment in our office so this surgery can be done in a minimally invasive way with a scope. We are very excited to offer this new procedure that requires a shorter recovery and less wound complications to our patients who suffer from nerve compression related pain or numbness!

  • Is electrical signal therapy covered by insurance?

    Our current Electrical Signal Therapy with Integrated Nerve Block protocol is a self-pay model.  We do not bill insurance for these services.

  • What if I am not better in 13 treatments of electrical signal therapy?

    The treatments can be extended if you have not fully responded after 13 treatments. If you have not shown improvement by 20 treatments it is unlikely that this therapy will be helpful for you.

  • How can I tell if electrical signal therapy is working and how fast does it work?

    Some people feel improvement after only one treatment. Most people start feeling different after 4 to 6 sessions. Every person reacts differently. Patients often state they are having sensations in their legs that they have not had in a long time. Some people feel numbness going away, while some have less pain and more flexibility. Many patients state they can walk much farther without pain. Each patient describes the experience differently. The key is being consistent with the treatments. Being patient and consistent makes all the difference.

  • Does electrical signal therapy help with numbness?

    Yes. The results with sensation restoration have been encouraging. About 25% of patients show improved nerve conduction studies after only 8 weeks of treatment. Nerve biopsies show improved nerve densities in about 25% of patients after 8 weeks. So it appears that nerves do, in fact, heal and become more sensitive.

  • How does electrical signal therapy work?

    The exact mechanism of how it works is not well understood. Our best theory has to do with cell membrane “gates.” A nerve cell is just a long chain of gates that open and close when it is stimulated. This allows ions (charged atoms) to pass through the gate. The body normally keeps the gates shut. The EST forces them open for an extended period of time. This allows for increased nutrient import and toxin export in the cell. The anesthetic closes the gates for a long time after the EST. Perhaps this allows time for the cell to heal and use its energy toward cellular repair rather than opening and closing gates or pumping ions.

  • Is electrical signal therapy safe?

    If you have a pacemaker you cannot have EST. But otherwise it is very safe. Injection site problems have been reported but they are very rare.

  • What do I have to do for electrical signal therapy?

    The treatments are twice a week and last about 30 minutes. You cannot miss treatments, or the procedure does not work. If you are unsure you can consistently come for the therapy then wait until you are sure. Wear loose pants or shorts to the treatments. We then have to put electrodes on your skin. Don’t put any lotion on your legs or feet the day of your therapy, as the electrodes won’t stick.

  • Are other treatments involved in addition to electrical signal therapy?

    Yes. We also implement nutritional supplements and nerve testing. Some patients may have nerve compression and require surgery. Nerve testing is performed before and after treatment is involved. The tests we use are not painful and measure sweat response and sensation. Neuropathy is usually caused by multiple factors: biochemical, mechanical (nerve compression like carpal tunnel in the hand), cellular, and biomechanical. We try to address all of these. We believe this is why we have success in treating most patients.

  • Is electrical signal therapy treatment effective?

    We have seen patients who had neuropathy for 25 years experience significant improvement in their symptoms. Clinical studies with more than 100 patients demonstrate about a 90% success rate at significant or total pain relief if the patient follows the full course of therapy. In this same study, patients who were followed for a year maintained pain relief in 25 of 26 cases (Practical Pain Management April, 2012).

  • What is electrical signal therapy?

    Electric signal therapy is a treatment used for neuropathy. Using an electro-medical device, electrodes are attached to your skin in your legs. Local anesthetic blocks are also used. This involves multiple injections in your legs. For about 30 minutes, electrical signal will be generated in your legs following the course of your nerves. Most of the time, he will not feel this electrical signal because the frequencies are so high that the nerve does not detect the stimulation. The frequency and amplitude of the electrical signal is varied throughout the entire treatment. This keeps the nerves guessing and responding to therapy. It should not be painful. However, patients may experience sensation and even some discomfort. This is usually only a very short period of time during the treatment.

    If you suffer from painful sensations caused by diabetic neuropathy, Dr. Darren Silvester of Next Step Foot & Ankle Clinic in Pleasanton and Universal City, Texas. Call our Pleasanton office at 830-569-3338 or our Universal City office at 210-375-3318, or write to us online, to learn more about electrical signal therapy and schedule your first appointment with us.

  • Is Charcot foot treatable?

    Charcot foot is treatable, though the extent of the therapy you need will depend on how much damage your foot sustained. Some Charcot foot treatment is conservative. Your foot will need to be immobilized in a cast or special boot. This helps reduce the swelling in your lower limbs, as well as keep the damaged bones in the proper place so that they heal correctly. You’ll need to avoid all weight-bearing on the affected foot for a time. Once the bones have healed enough, you will also need to wear special orthotic shoes to support your lower limbs and protect them from ulcers in the future.

    More severe deformities will need surgery to reconstruct the collapsed arch, remove bony prominences, and lengthen tightened tendons. After your foot is surgically repaired, it will be casted and allowed to heal. This whole process takes several months, but without it, your foot will be permanently deformed. If you have diabetic foot problems and are concerned about Charcot foot, let Dr. Darren Silvester at Next Step Foot & Ankle Clinic in Pleasanton, TX, know. Call (830) 569-3338 or use our website form to request an appointment.

  • What is osteomyelitis?

    Osteomyelitis is an infection in bone tissue. It usually develops when bacteria travels through the blood stream or migrates from neighboring tissues. Your bones can also be infected directly if an injury exposes the bone tissue to pathogens. The bacteria can quickly destroy the bone and become deadly if it’s not treated promptly. Diabetic feet have a particularly high risk for this infection. Diabetes increases your chances for wounds that open up the foot to pathogens. The disease also impairs your immune system, so your body has a hard time fighting any bacteria. The pathogens are then able to migrate from the soft tissues in your lower limbs to your bones.

    Osteomyelitis is a dangerous infection that needs aggressive treatments. If you develop a deep, painful foot infection and fever, especially after an injury, contact Dr. Darren Silvester and our team at Next Step Foot & Ankle Clinic in Pleasanton, TX, promptly. Call (830) 569-3338 to make an appointment to take care of the problem.

  • How long will my child have to wear braces for clubfoot?

    Using braces for clubfoot correction is one of the most effective ways to manage the condition, but the process takes a long time to make sure the feet stay in the correct position. Your child uses braces once his or her feet have been stretched and realigned and the casting process is over. For the first three months, your child should wear the braces all the time. This helps prevent the feet from regressing into a clubbed position. After those first months, your baby will only need the braces when he or she sleeps. This stage of correction will last until your child is three to five years old.

    Though this seems like a long time, it is necessary to allow your little one’s feet to heal and grow in the right way. Stopping the braces early risks a relapse that will require additional treatment to heal. If you’re concerned about your baby’s clubfoot, or anything with the treatment, let Dr. Darren Silvester know by contacting Next Step Foot & Ankle Clinic in Pleasanton, TX. You can call (830) 569-3338 or submit a request online for an appointment.

  • Congenital Illness or Deformity

    If you’ve ever heard the word congenital used to describe an illness or a deformity, you may have wondered “what does congenital mean?” It’s a medical term used to describe a condition that is present at birth. Sometimes it’s an inherited issue, while other times it develops in the womb as the result of an infection or environmental problem. These anomalies can be mild, like curly toes or intoeing from flexible metatarsus adductus, or severe, like a neuromuscular or heart defect.

    The important thing to know is that most congenital issues in the lower limbs can be managed conservatively and early in your baby’s life. By carefully monitoring your child’s growth and applying treatments when and where they are needed, you can counteract negative effects and help your child grow a strong, stable foundation.

    If you’re concerned about trouble with your little one’s lower limbs or your baby has been diagnosed with a congenital anomaly, contact Dr. Darren Silvester here at Next Step Foot & Ankle Clinic in Pleasanton, TX. Call (830) 569-3338 or submit a request through our website to make an appointment with us.

  • Are bunions painful?

    Anyone who has wondered “are bunions painful” should know that they typically are, but they don’t have to prevent you from participating in your regular activities. As your big toe dislocates more and more from its natural position, creating the bulge at its first joint, your shoes rub against the bump and irritate it. The incorrect alignment in the toe also changes the way your foot pushes off the ground and can create additional conditions. The longer the problem exists without being treated, the worse it tends to get, increasing any discomfort you may be experiencing.

    Fortunately, there are conservative treatments that can help you manage the issue. You can slow the progression of the problem and decrease your pain so that you can do the activities you enjoy. If you or someone you care about is struggling with bunions, seek help for it sooner than later. Contact Dr. Darren Silvester here at Next Step Foot & Ankle Clinic in Pleasanton, TX, for an appointment by calling (830) 569-3338 or using our website request form.

  • Do I need special shoes for bunions?

    You may or may not need special shoes for bunions, depending on the pain you experience from your condition. You should avoid footwear that will exacerbate the problem, like high heels and shoes with a pointed toe box. Otherwise, any supportive styles you have that don’t cause discomfort should be fine to wear.

    If the bump is aggravated by your footwear, however, you may want to invest in special shoes for bunions. These have wide, deep toe boxes that accommodate your foot shape. They also have support through the midsole to help prevent exerting unnecessary pressure on the ball of the foot. They are often stretchable as well, so they decrease irritation in your joint.

    If you’re struggling with a bunion, don’t just hope it will get better on its own. Contact Dr. Darren Silvester at Next Step Foot & Ankle Clinic in Pleasanton, TX, to make an appointment that will take care of the problem. Fill out our website contact form or call (830) 569-3338 to reach our office.