Monthly Archives: August 2011

Phantom Limb Pain

Due to diabetes, peripheral vascular disease and trauma, the tragedy of limb amputation unfortunately continues to occur too frequently.  The fact that complications are common after amputation only adds to the despair and emotional stress of the procedure.  Phantom limb sensations are nearly universal after amputation.  In its most innocuous form, the person with the amputation is merely aware that the limb is still there and at times can even sense movement of the limb.  In approximately 50% of lower limb amputations, this sensation is painful sometimes terribly so.

When is it necessary to get an MRI?

The foot is an extremely intricate and complicated device.  The problems that affect it can be difficult to diagnose and understand.  Radiographic studies such as x-rays, MRI, CAT or CT scan, and bone scans are important ways of visualizing the structures within the foot and ankle.  However, they are expensive and are not a substitute for a careful examination from your doctor.  Radiographic examinations are definitely overused in modern medicine.  So, when are they appropriate?  To answer this, we must look at the problem being examined and the chances that the radiographic study will help answer the questions that help solve that problem.

Platelet-rich Plasma and Plantar Fasciitis

     Although it has been around for over 15 years and has been used with some success in treating difficult-to-heal wounds, platelet-rich plasma (PRP) has come into the literature recently for the treatment of many musculoskeletal conditions including tennis elbow, patellar and Achilles tendonitis. In addition, the successful use of PRP in the treatment of the injuries of many sports figures has been widely publicized. Some physicians that treat these problems are beginning to offer these treatments to their patients, sometimes as a last resort before surgery, sometimes, unfortunately, as an initial  treatment.

Why is the plantar fascia important?

The plantar fascia is a crucial structure in the foot. It is also often painful. Scarring in the plantar fascia near its attachment in the heel is the most common cause of heel pain and is also sometimes referred to as “heel spur syndrome”. When non-operative care for this condition fails to heal it, surgery is sometimes recommended. Although alternatives do exist, surgery on the plantar fascia is usually a cutting or release of the plantar fascia either open (meaning through an incision 1-2 inches in length) or endoscopically (meaning through smaller ΒΌ inch incisions using a fiber optic camera for visualization). This is called plantar fasciotomy.