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Neal Blitz, DPM

Podiatry Blog


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Your Low Back Pain May Be Caused By Your Feet

Wednesday October 30, 2013

A study published in Rheumatology has shown again that problems with foot function are associated with low back pain.  The study was part of the large 2002-2005 Framingham study and involved 1,930 study participants. Participants were identified as having either low arches (flat feet), high arches, or normal arches. Their foot function was studied while in motion, identifying them as pronators (tendency of the foot to excessively roll-in and flatten while while  walking), supinators (opposite of pronators), or normal-functioning feet. This was done using pressure sensor technology on their feet as they walked, providing insight as to how well the feet are functioning while walking.

What they concluded from the study was that female participants who pronated excessively during walking also had a greater incidence of low back pain. It wasn't exactly clear why the connection between back pain and foot function was more prevalent in women in this study.

Back pain is a complex symptom which has a variety of possible causes. Some back pain sufferers may find relief from identifying and addressing foot problems, especially flat feet. A podiatrist or foot specialist can help identify any problems with foot function, such as excess pronation.  The next step is addressing these problems, which will most often involve orthotics or arch supports.

Orthotics are shoe inserts that support the foot's arch and can help decrease excess pronation while reducing stress on the feet. Some arch supports or orthotics can be found in stores or online. They range from flimsy, offering very little support to better quality brands that offer good support and last longer than a few weeks. Custom-made orthotics from a podiatrist's office generally offer the best support, can be customized to address specific foot problems, and last many years.

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Source: Foot posture, foot function and low back pain: the Framingham Foot Study


Stretching the Calf Muscles and Plantar Fascia

Monday October 21, 2013

Chances are if you've been diagnosed with plantar fasciitis, also known as heel pain syndrome, your doctor may have recommended stretching of the foot and ankle. Tightness of the calf muscles and plantar fascia (long ligament-like band that spans the bottom of the foot) can contribute to plantar fasciitis and other problems such as Achilles tendonitis...Read more

8 Expert Tips for Wearing Heels and Avoiding Pain

Thursday October 17, 2013

Last week I was asked by Meghan Blalock from the fashion and beauty site, Style Caster, about my advice on how women can increase their comfort when wearing high heels. See the article on Style Caster.com: How To Wear High Heels Without Pain: 8 Expert Tips That Work.

For more on health in heels: Common Problems with High Heels: A Guide for Choosing a More Comfortable Pain of Heels.

Rare Skin Infection Caused by Salt Water Bacteria

Monday October 14, 2013

This week a skin infection that occurred after wading in the Gulf of Mexico made headlines,  not only because it had an unusual cause but also that it quickly turned deadly. The wife of the Palm Coast, FL man who died from the infection said that her husband had what looked like a small spider bite on his ankle which began to spread, prompting a trip to the hospital. In just a few days the infection had spread systemically, causing his death.

The cause of the infection was a common type of bacteria found in warm salt water, called Vibrio vulnificus. These are the bacteria behind the warnings to avoid eating raw shellfish, to decrease your chances of contracting a nasty and potentially fatal gastroenteritis.  V. vulnificus can in some cases cause serious skin infections, although this is very rare--to date only 31 cases of V. vulnificus infection have been reported in Florida.

The ankles and feet are common sites for small, unnoticed abrasions or tiny wounds, making them susceptible to any type of infection. Other factors can increase the chance of infection, such as health conditions that compromise the immune system or poor leg circulation. It's also common for infection symptoms to look like small insect bites.

More about how bacterial infections can appear on the foot and ankle: Bacterial Infections of the Feet.

Source: 31 in Florida infected by bacteria in salt water. Fox News.com. Accessed 10/13/13.

Stretching Exercises for Sore Feet

Monday October 7, 2013

Q: What are some stretching exercises that can help relieve my sore feet after a long day in heels?

A: High heels can be tough on the muscles of the legs and feet because they have to work harder to maintain stability as you walk. The calf muscles and Achilles tendon can develop problems with frequent wearing of heels. Toe problems can also develop from the muscle imbalances that occur while wearing heels. A stretching routine can ease soreness and help counter muscle imbalances that are created from wearing heels. Check out Foot and Ankle Stretches to see 5 easy stretching exercises that ease tired, achy feet.

Photo © Getty Images


Laser Treatment for Toenail Fungus

Saturday October 5, 2013

In recent years, the FDA has approved a few different types of laser devices for the treatment of onychomycosis, which is a fungal nail infection that causes changes in the appearance and texture of the nail. Now that laser treatment services for toenail fungus are growing and found in many podiatry offices, people are wondering how this treatment option compares to oral and topical medications.Read more

Toenail Injuries

Tuesday July 23, 2013
Summer activities bring an increase in toenail injuries. Common injuries include  avulsed (loosened) nails and blood or bruising beneath the nail. The tendency to be barefoot or in open-toed shoes in the summer leaves toes vulnerable to blunt trauma injuries that can be as mild as fleeting pain from a stubbed toe to as severe as a bone fracture. Sometimes if an injury to the toenail is severe enough, it can cause permanent problems with the way the nail grows back -- this may mean a thicker or deformed nail. Lots of walking or running in shoes that are unforgiving like cleats or sneakers that don't fit properly can also damage a toenail enough to loosen it or cause an infection.


More About Toenail Problems:

Topical Treatment of Toenail Fungal Infections

Thursday July 18, 2013

Most cases of toenail fungus (onychomycosis) are notoriously difficult to eliminate, mostly because the fungus resides throughout the nail, and even on the nail bed beneath it. The structure of the nail itself is not easily penetrated by topical agents, which makes topical treatments less effective than oral antifungal medicines. But oral antifungal medicines are not for everyone, either due to their cost, side effects, or just personal preference for topical treatments...Read more

What is a Heel Spur?

Wednesday July 17, 2013


A heel spur is a ridge of bone that forms on the calcaneus (heel bone). A spur which occurs on the bottom (plantar) surface of the heel bone is usually associated with the painful heel condition known as plantar fasciitis, also known as heel spur syndrome. Some, but not all, plantar fasciitis sufferers will develop a heel spur...Read more

5 Products for Bunions

Monday July 1, 2013

The symptoms of a bunion--painful bump on the side of the foot adjacent to the big or little toe, widening forefoot, and sometimes redness and swelling--can be unbearable, especially when you can't find comfortable shoes. Since most bunions are the result of changes in bone position and may be complicated by arthritic changes, surgery is usually the only way a bunion can be fully corrected. However, surgery may not be an option for everyone, which is why many people seek OTC products that can offer some relief. See 5 foot products that are used for bunion symptoms.

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