New Promising Treatment for Diabetic Foot Ulcers

Diabetic Ulcer TreatmentDiabetic foot care is of extreme importance to those managing diabetes. Foot ulcers are a source of sometimes intolerable pain and long-standing medical problems for people living with the disease. If not properly treated, diabetic foot complications can lead to amputation and an obviously drastic change in associated lifestyle. There is, however, hope on the horizon for anyone dealing with such an issue in the form of an emerging alternative therapy.

A recent study conducted by the “Journal of Foot and Ankle Surgery” cited that Hyperbaric Oxygen (HBO) therapy may have significant benefits in treating foot ulcers and ultimately reducing the number of associated amputations involved with them.

The study simply involved 100 subjects, plenty sufficient, with diabetic foot ulcers and compared HBO therapy with the application of standard therapy. The results of the patients receiving standard therapy were that 48 percent of them needed distal amputation and 34 percent of them required proximal amputation. The patients receiving HBO therapy, however, only included 8 percent receiving distal amputation with ZERO patients requiring proximal amputation.

“The benefits of HBO therapy accrue over time, in part due to savings from averted major amputations. The cost of a series of HBO treatments is less than the cost of a major amputation if HBO is, in fact, limb-saving.” (Dr. Caroline Fife, Associate Professor in the Department of Medicine, Division of Cardiology at the University of Texas Health Science Center in Houston)

Dr. Fife goes on to note that the selection of patients for the time being at least, should be restricted to those that would not have properly healed with the treatment of traditional therapy alone. Nor should HBO be used for patients with severe vascular disease because they will not respond properly to the treatment.

Although not perfect, HBO is a new therapy that shows some promise for those dealing with diabetic foot ulcers. If nothing else, the reduced number of amputations involved is a tremendous benefit that deems HBO suitable for further exploration from the everybody involved with the treatment of this common problem.

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Morton’s Neuromas: A Common, Painful Condition

Neuroma TreatmentHave you ever felt excruciating pain in the ball of your foot? Was it enough to make you remove your shoes and check for small, foreign objects? If you didn’t find anything inside of your shoes, you could be suffering from Morton’s neuromas. Here’s a rudimentary summary of the condition and what can be done about it:

If you were to look at the anatomy of a human foot, you would discover what’s known as the intermetatarsal plantar nerve. It traditionally runs from the ankle area to the space in between the third and fourth toes. Certain activities, such as a woman wearing 2-inch tall high-heeled shoes or stiletto-heeled boots, can put extreme pressure onto that nerve. Over time, that continuous pressure can cause severe nerve damage. The extensive nerve damage, in turn, can cause agonizing pain and a burning sensation to occur in the ball area of the person’s foot.

In order to make a Morton’s neuroma diagnosis, a Boston podiatrist will need to conduct a visual and hands-on examination. They may also request X-rays, a MRI, or ultrasound of the area. During the examination, your podiatrist will look to see if the nerve’s diameter has changed. Its size is typically a clear indicator of whether or not the nerve has been damaged.

Should your Boston foot doctor discover that extensive nerve destruction has occurred, they may recommend surgery. The surgical procedure used to treat Morton’s neuromas generally involves making an incision in the soft tissue of the foot to gain access to the intermetatarsal space. Once inside of the intermetatarsal space, the surgical team may opt to remove the damaged portion of the nerve. In cases where minor injury has transpired, other treatment methods may be suggested. Those treatments may involve the use of orthotics, medication, new footwear and cold packs.

To ask questions about Morton’s neuromas or schedule a consultation with the doctor, please contact our Boston foot clinic today.

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Less Than 10% of US Hispanics With Diabetes Have Seen A Podiatrist

Diabetic Foot CareNearly 90% of US Hispanics with diabetes or at risk for the condition have not seen a podiatrist, according to a study by the American Podiatric Medical Association (APMA) about diabetic foot care. The findings are disturbing given that Hispanics are at higher risk for diabetes, and would be expected to benefit from the important role that podiatry plays in managing the disease.

APMA focused its annual national survey on US Hispanic adults to assess health care, diabetes and foot health issues. Twelve percent of Hispanics suffer from diabetes compared to 8% of the general population, and they face a 66% increased risk of developing diabetes compared to other ethnicities.

Expense is the most significant barrier to their seeking proper diabetic foot care given that US Hispanics are also less likely to have medical insurance. Nearly 75% of those surveyed who were affected by diabetes already knew that foot health is affected by the disease.

In other findings, 80% of all respondents complained of at least one foot ailment. The majority said they used over-the-counter products while 20% reported visiting a podiatrist. Those who had personal experience with a podiatrist were most likely to rate their care as very good or excellent in receiving a clear diagnosis and effective treatment.

The study raises concerns because specialized medical care is vital to assessing risks and managing the effects of diabetes. Boston podiatrists can often detect early signs of diabetes through foot examinations which have been proven to lower the chances of ulcers and amputations. In fact, APMA reports that foot examinations can reduce amputation rates by as much as 85%. Podiatrists can also educate patients on how to select and use appropriate footwear, and avoid traumatic events such as stubbing a toe which can lead to ulcers.

Diabetes is an important issue for everyone and especially for Hispanics. Contact our Boston podiatry office to schedule a consultation with the foot doctor, so you can learn how to protect your foot health and your overall wellbeing.

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Understanding Tarsal Tunnel Syndrome

Tarsal Tunnel TreatmentDo you have numbness, tingling, shooting pains or a burning sensation in your foot? If that’s the situation, you may have developed tarsal tunnel syndrome. As you may have guessed, it is a health problem that is connected to the tarsal tunnel. Here’s an overview of the condition and how it is treated:

For those unfamiliar with the tarsal tunnel, it is a section of the foot that is located on the inside of the ankle adjacent to the ankle bones. Within that area are several key components. They include the flexor retinaculum, posterior tibial nerve, veins, arteries and tendons. The two main elements involved in tarsal tunnel syndrome are the flexor retinaculum and the posterior tibial nerve.

The flexor retinaculum is a ligament that is designed to protect the posterior tibial nerve from compression. The nerve’s function, on the other hand, is to assist in muscle control and provide sensation to certain areas of your foot. It is situated behind the ligament and stretches from the sole to the medial malleolus. The medial malleolus, in case you were wondering, is that little outcropping that exists on the inside of your ankle.

Even though the posterior tibial nerve is generally protected by the ligament, there are situations that can cause it to become compressed. That list of situations includes ankle injuries, the development of systemic diseases, fallen arches, obesity or other health concerns.

When those situations arise, symptoms like the ones we mentioned earlier may start to appear. If they do, it is very important to schedule a visit with your Boston podiatrist right away. Otherwise, the prolonged compression may cause irreversible damage.

Once tarsal tunnel syndrome is officially diagnosed, there are several courses of action that your Boston foot doctor may recommend. They include, but are not confined to, the use of orthotic devices, physical therapy, corticosteroid injections, a foot brace and custom footwear. In some instances, ankle surgery may also be prescribed.

To learn more about tarsal tunnel syndrome and the myriad of treatment options available, please contact one of our Boston foot clinic today.

At Matthew P. Butler, DPM, LLC we pride ourselves on providing you with the highest quality treatment for tarsal tunnel syndrome available in the Boston, MA area. Call us today to schedule a consultation.

Ingrown Toenails Need Not Make You Groan

Ingrown Toenail TreatmentIngrown toenails curve and grow into the skin. This can create pain, redness and swelling in the toe. As long as no infection is apparent and you do not have a high risk medical condition (diabetes, nerve damage or poor circulation) ingrown toenails can initially be treated at home.

Home Treatment

  • Soak toe in room temperature water and gently massage the nail fold to relieve inflammation
  • Wear properly fitting footwear
  • Avoid activities that involve repeated pressure on the toes such as kicking or running
  • Do not attempt “bathroom surgery” by clipping, gouging or picking at the nail or skin

If ingrown toenails fail to improve or become infected, it is time to seek treatment from a Boston podiatrist.

Podiatric Treatment

  • Oral antibiotics may be prescribed to treat infection
  • A minor surgical procedure can be performed in the office to remove the ingrown toenail – this involves applying a local anesthetic and removing the nail’s side border and possibly the nail root
  • After care involves keeping the bandage clean and dry and completing any course of medication prescribed

Although ingrown toenail removal may seem daunting, with proper aftercare, some people resume normal activity within 24 hours and experience little to no post operative pain. As with any potentially painful ailment, prevention is always the best policy. There are a few simple things you can do to avoid ingrown toenails.


  • Cut toenails in a straight line
  • Leave enough length that you are able to get your fingernail under the end of the nail
  • Avoid shoes that are too short, tight or loose in the toe area
  • Most importantly, see a Boston foot doctor for regular foot care

Don’t wait until you have a problem. Your feet are one of the most important and overlooked parts of your body. Give them the attention they deserve and they will be happy feet!

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