What's Really Causing Your Foot Pain?

Your feet bear the weight of your entire body and when they're not properly supported or they're expected to bear more than they're designed to carry, they react with pain. The delicate network of bones that make up the feet and allow us to walk and balance can get pushed out of alignment, which can irritate the joints, skin, nerves and connective tissue. 

Weight loss, proper hygiene, and the right shoes are among of the most common recommendations doctors make when their patients come in with painful feet and ankles. They might also look for medical conditions associated with foot pain like diabetes and heart disease, (which can cause nerve damage and circulatory problems in the lower extremities) or broken bones. But while those conditions do cause feet to become painful, the most common causes of foot pain are:

• Fallen arches, flat feet, or high arches that don't get enough arch support in a shoe
• Bunions, calluses and corns, often caused by poorly fitting shoes
• Hammer toes that curl down into a claw-like shape
• Arthritis, inflammation of the joints in the foot
• Plantar warts, which form on the sole of the foot and become painful when stepped on
• Bursitis or tendonitis of the ligaments, tendons and surrounding areas
• Morton's Neuroma, a bundle of thick nerve tissue between the toes
• Gout, a disease process caused by buildup of uric acid in the toe
• Sprains, especially in the ankle
• Plantar fasciitis, inflammation of the connective tissue in the bottom of the foot
• Stress fractures, caused by pressure, impact, or trauma
• Fungal infections like athletes foot

Foot Pain Prevention

How do you avoid becoming a foot-pain victim? Try these methods:

1. Wear good shoes with low to medium heels and good arch support. Make sure they're appropriate for the activities you engage in. Don't substitute tennis shoes for running shoes or wear your old Keds to play basketball. Instead, consult a sport shoe expert and invest in the right shoe for your sport. Wear high heel shoes and flip-flops as rarely as possible. 

2. Practice good foot hygiene. Wash and dry your feet thoroughly every day, wear clean socks, and contact your doctor if you see any rashes, cuts, sores, or abrasions. Always wear non-skid shoes on wet, slippery surfaces and locker room floors. 

3. Exercise regularly and cross train to keep all the muscles in your ankles, legs, and back strong and to prevent overuse injuries in your ankles and feet.

Have your feet checked as part of your regular physical examinations. If you have diabetes or heart disease, have your doctor examine your feet every time you see him/her and as soon as you notice any alterations.

Cancer Care Guide: Who Are the Doctors?

The diagnosis and treatment of cancer is complex and multiple healthcare professionals play a role in providing comprehensive care to patients.

Oncology physicians

Physicians are either medical doctors (MDs) or osteopathic doctors (OD) and many complete additional training in specific medical conditions, such as oncology. As cancer patients receive their diagnosis and then proceed through treatment, they may see more than one type of oncology physician. Often there are also other oncology specialists behind the scenes providing important services as well.

Medical oncologists are specialized internal medicine physicians and experts in treating cancer with chemotherapy. They care for patients from initial diagnosis through the course of the disease, discussing treatment options, managing pain and treatment side effects, and consulting with other physicians as needed.

Some oncologists specialize in specific types of cancer. The most common specialties are pediatric, gynecologic, and urologic cancers. Hematologists specialize in cancers of the blood (lymphoma and leukemia) and related tissues, such as bone marrow and lymph nodes.

Diagnosing cancer may require multiple diagnostic procedures. Radiation oncologists use x-rays or ultrasound, surgical oncologists remove tissue samples (biopsy,) and pathologists analyze results of lab tests and examine biopsy samples to determine the specific type and nature of a patient's cancer. Radiation oncologists and surgeons also treat cancer by administering radiation to kill cancer cells or surgically removing tumors when possible.

You should choose an oncologist who has experience caring for patients with your type of cancer. Specialists in less common cancers often practice in large cancer centers and medical teaching facilities, rather than community hospitals.

Multi-disciplinary teams

Cancer centers are moving towards a multi-disciplinary team approach to cancer care, which puts the patient at the center of a well-coordinated network of health professionals. A multi-disciplinary approach recognizes that cancer is more than a tumor; it's a disease that touches all aspects of patients' lives.

Multi-disciplinary cancer teams may include medical, surgical, and radiation oncologists; oncology nurses; a physician's assistant; oncology social worker; rehabilitation therapist; dietitian; and chaplain.

You'll likely interact most frequently with your oncology nurse. Oncology nurses provide patient education, coordinate and facilitate care, provide psychosocial support, and may administer chemotherapy. In fact, many cancer programs have designated specialists (who are usually nurses) called Patient Navigators. As the name implies, these professionals are there for patients (and their families) from diagnosis through post-treatment care, providing education, streamlining the process, securing additional patient resources when needed, advocating for the patient, and-most importantly-providing emotional support.

Sources:

National Cancer Institute. "How To Find a Doctor or Treatment Facility If You Have Cancer." Web.
29 June 2009. http://cancer.gov/cancertopics/factsheet/Therapy/doctor-facility

Cancer.net. "The Oncology Team." Web. April 2010.
http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Find+an+Oncologist/The+Oncology+Team/The+Oncology+Team

Cancer.net. "ASCO Expert Corner: The Role of an Oncology Nurse." Web. 23 March 2010.
http://www.cancer.net/patient/All+About+Cancer/Cancer.Net+Feature+Articles/Expert+Information+from+ASCO/ASCO+Expert+Corner%3A+The+Role+of+an+Oncology+Nurse

Cancer.net. "Types of Oncologists." Web. May 2011.
http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Find+an+Oncologist/Type

Can Type 1 Diabetes Be Reversed?

Individuals with Type 2 diabetes are fortunate in that it's possible, with diet and lifestyle changes, to actually reverse the course of the disease. Even if they're unable to reverse Type 2, it's possible for them to avoid going on insulin by losing weight, watching carbs, and getting moderate exercise.

Those with Type 1, however, can't change the reality that they'll always need to take insulin since their bodies no longer make it. Or can Type 1 diabetes ever be reversed?

Very preliminary experiments suggest that it might in fact be possible to reverse Type 1 with an inexpensive vaccine that keeps the immune system from attacking pancreatic cells, reports the Los Angeles Times. Studies in mice already had documented the effectiveness of the tuberculosis vaccine known as BCG in Type 1 diabetes. That vaccine was shown to prevent T cells from attacking the insulin-secreting cells in the pancreas. In mice that got the vaccine, the pancreas began to regenerate and to produce insulin once again, effectively "curing" the mice of their diabetes.

An immune system protein called tumor necrosis factor (TNF) is pivotal in the research. When blood levels of TNF are increased, studies show, the protein blocks other areas of the immune system that attack the body, particularly the pancreas.

Researchers report that humans who got low doses of the vaccine began to demonstrate transient increases in insulin production. At Massachusetts General Hospital, medical experts are getting ready to try higher doses of the vaccine in larger groups of people.

The research is intriguing: if the vaccine works, even those who've had Type 1 diabetes for awhile might have their pancreas function restored, reports the Los Angeles Times. That depends, of course, on whether it's possible to block the beta cell-destroying parts of the immune system. "It's fascinating research," says Spyros Mezitis, MD, Ph.D., endocrinology consultant at Lenox Hill Hospital in New York City. "It's changing the way we think about Type 1 diabetes."

Further experiments are needed with more individuals who have Type 1 diabetes, Mezitis says. "And higher doses of BCG tuberculosis vaccine are needed to confirm these important results," he adds.

Immunology expert Eva Mezey, MD, who directs the adult stem-cell unit at the National Institute of Dental and Craniofacial Research, called the study results "fascinating and very promising," according to the Los Angeles Times. She noted, though, that only a small number of patients had gotten good results, and that vaccinations would most likely need to be repeated on a regular basis.

Source:

Maugh, Thomas H. "Research shows promise in reversing Type 1 diabetes." 25 June 2011. Los Angeles Times.
http://articles.latimes.com/2011/jun/25/health/la-he-bcg-diabetes-20110625

Get Involved: National Diabetes Awareness Programs

Chances are that even if you're not diabetic, you have a friend or relative who is. Some 285 million people worldwide have the disease, and that figure is expected to jump to 438 million by 2030, according to the International Diabetes Federation (IDF), as reported on MedicalNewsToday.com.

If you'd like to get involved in trying to find a cure, raising awareness about the disease, or simply learning more about diabetes, there are plenty of opportunities.

Among the programs aimed at stopping diabetes is Dribble to Stop Diabetes, a large multimedia campaign that is meant to nudge fans into adopting a healthy lifestyle. A collaboration between the American Diabetes Association, Sanofi-Aventis U.S., the National Basketball Association (NBA), the Women's National Basketball Association (WNBA) and the NBA Development League, Dribble to Stop Diabetes has got some big names attached to it. Campaign managers are Dwight Howard of the Orlando Magic, Alana Beard of the Washington Mystics, and NBA legends Walt Frazier and Chris Dudley, according to MedicalNewsToday.com.

The American Diabetes Association also is hoping to spark interest in its Join the Million Challenge. As part of the program, individuals are encouraged take the Diabetes Risk Test  to see if they might be at risk for getting Type 2 diabetes. (The test asks questions about age, family history, and weight, among other factors.) The "Join the Million Challenge" kicked off on Diabetes Alert Day (March 22) and runs until April 22.   

If you're feeling energetic and like to bike, a couple of opportunities await beckon. The Juvenile Diabetes Research Foundation (JDRF)  sponsors Ride to Cure Diabetes. Riders raise money needed to fund treatments, and they also strive to attain a personal training goal as they get ready for a biking experience.

You don't have to be an expert rider: options are designed for riders at various fitness levels. There are various fundraising and mileage options, too.

The American Diabetes Association has been sponsoring its Tour de Cure, a fundraising bike ride, for 20 years. Founded in 1991 with just a few cities, it's now in more than 80 cities around the country. Gold's Gym, a Tour de Cure sponsor, offers a 12-week training plan with assorted cross-training exercises for those who plan to ride.

If you'd rather walk than cycle, the ADA sponsors Step Out: Walk to Cure Diabetes. You can form your own team, join a team, or even be a "virtual walker" by donating money but not actually walking.

And you don't necessarily have to get out there and exercise. Through the American Diabetes Association, you also can become a volunteer. To volunteer close to home, call 1-800-DIABETES (1-800-342-2383).

Sources:
"NBA Joins American Diabetes Association and Sanofi-Aventis U.S. To Support New Dribble To Stop Diabetes Awareness Campaign." 18 February 2011. Medical News Today.
http://www.medicalnewstoday.com/articles/216760.php

"Clinical trial will test whether surgery is the best option for Type 2 diabetes, even for patients who aren't obese." 11 February 2011. Medical NewsToday.com.
http://www.medicalnewstoday.com/articles/216189.php 

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