Conservative Foot Care

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Not every foot problem requires surgery.

Even structural deformities that require surgery to repair, like bunions and hammertoes, can often be managed conservatively. Tools such as orthotics, braces, and physical therapy may be able to relieve pain and restore biomechanical function, allowing you to live an active lifestyle.

Furthermore, those with high-risk conditions (such as severe circulatory problems) may be poor candidates for a surgical treatment—the odds of developing a dangerous complication are simply too high.

Although our office provides comprehensive and advanced surgical care options, we strive to use non-surgical treatment whenever possible if we believe it will take away your pain and restore your mobility effectively.

Durable Medical Equipment (DME)

Durable medical equipment, or DME, can refer to any sturdy, re-usable medical equipment that provides a therapeutic benefit to a patient struggling with a specific condition or illness. DME is designed to be appropriate for longer-term use in and around the home.

In the broadest sense, you could even consider things like wheelchairs, walkers, or pressure mattresses to be DME. However, in the context of podiatry, when we say DME we’re usually talking about wearable devices that accommodate a source of pain or restore proper biomechanical function and gait to the feet.

For example, this would include treatments such as custom orthotics, diabetic shoes, walking boots, ankle braces, etc. Essentially, we’re talking about devices that shift the bones and structure of the feet and ankles into a healthier position to correct or accommodate a painful problem.

Custom Orthotics

Structural imbalances in feet are at the root of many painful conditions—not just in the feet and ankles themselves, but throughout the body. When your feet aren’t properly aligned, joints, muscles, and bones all the way up your skeleton are pulled out of position and have to work harder to compensate.

Sometimes surgery is required to fully correct these structural problems. However, many cases can instead be managed through the wearing of custom orthotics. These devices are medically engineered and precisely molded to your exact foot shape. They then replace the regular insoles in your shoes, and provide whatever additional arch support, cushioning, or motion control you may need to address your specific foot problem.

In other words, pressure is deflected away from painful areas, and gait and alignment are controlled. This redistributes your weight and biomechanical alignment, relieving tension throughout the body.

Other DME

In addition to custom orthotics, our office prescribes and distributes a wide variety of DME boots, braces, and tools to aid in treatment and prevention. For example:

Stock products

  • Element ankle brace. An ankle brace that helps control excess ankle movement, specifically subtalar inversion and talar rotation. Ideal for sprains, chronic ankle instability, osteoarthritis, and other conditions. A stock ankle brace.
  • Pneumatic walking boot. A heavier-duty ankle brace designed to protect a stable ankle fracture or bad sprain in order to heal. Also known as a trauma boot or fracture boot for acute injuries used to maintain position with or without Weight bearing, used with crutches before casting is indicated.
  • Swede-O ankle brace. The Swede-O is a sports brace that simulates ankle taping. It controls and supports the ankle and locks it into a protecting position during rehabilitation while remaining durable, lightweight, and flexible. Stock ankle brace.
  • Night splints. These devices are worn at night to keep the calves and plantar fascia in an elongated position. This can reduce pain and aid in the treatment of plantar fasciitis. Stock non weight bearing splint.

Customizable ankle-foot orthoses (AFOs)

  • Richie brace. The Richie brace incorporates a custom-casted impression of your foot and ankle—essentially it combines the function of a custom orthotic with a full foot and ankle brace. It is ideal for chronic ankle instability and posterior tibial tendon dysfunction. Used for increased activities when greater control over a longer period of time is required and functional rigid orthotic devices are not providing the relief desired.
  • Arizona brace. This customizable balance brace helps stabilize the ankle and related joints. It can help manage a variety of conditions, and is especially helpful for ankle or foot arthritis or helping those with high fall risk preserve their balance during activity. This has similar stability to a cast with the ability to be worn in a shoe.

Other customizable DME

  • CROW boot (Charcot restraint orthotic walker.) This customizable boot is fully enclosed and features a rocker-bottom sole. Its purpose is to accommodate and support feet with mild-to-moderate deformities related to Charcot foot, midfoot break down during the acute phase to control swelling and pain just as a cast would, although you can remove it when not weight bearing.
  • Drop foot brace. This brace helps people with an inability to raise their foot (due to nerve damage or muscle paralysis) to walk without their foot dragging.
  • Diabetic shoes. We provide prescription footwear for patients at elevated risk of diabetic foot complications. Diabetic shoes are extra depth shoe to accommodate various foot deformities, accommodate shoe liners and help provide stability to the foot and ankle —all of which reduce the risk of ulceration.

Physical Therapy and Advanced Technology

When we say “physical therapy,” most people imagine things like stretching exercises, heat, or massage. While those impressions aren’t wrong—all can be effective components of a physical therapy treatment course—the full definition is much broader and more inclusive.

Physical therapy also includes things like electrical stimulation, ultrasound or Radial shockwave therapy, etc. Essentially, physical therapy uses external, mechanical forces to bring about increased blood flow to accelerate healing, rather than surgery or drugs. And it can be used not only as part of rehabilitation, but as a primary treatment for many conditions.

Some of the advanced physical therapy treatments and procedures we provide include the following.

Shockwave therapy

This non-invasive technology has been proven to increase the healing rate for many chronic soft tissue injuries, such as plantar fasciitis, various forms of tendinitis, and shin splints.

When you develop a chronic injury, the body loses its ability to recognize the problem, and healing mechanisms slow down or stop. Shockwave therapy jump-starts these mechanisms and enables the body to heal itself much faster.

Ballistic soundwaves are generated by a small machine and delivered into the site of injury via a hand-held applicator. The waves penetrate deep into tissues, creating “micro trauma” that triggers a renewed healing response from your body. Your cells releases biochemicals that help build new blood vessels, flood the area with oxygen and nutrients, and regenerate damaged tissues.

Extensive studies show success rates as high as 80% for radial shockwave therapy—greater than many traditional treatments (including surgery), and with far lower risks, fewer side effects, and less downtime.

MicroVas electrical stimulation

MicroVas is an exciting treatment option that improves blood flow, increases oxygen levels to damaged nerves and other tissues, and accelerates healing processes using electrical stimulation of the muscles. It is an especially effective treatment for peripheral neuropathy, and can also help with any injury or condition caused or affected by vascular insufficiency. It can even help wounds heal faster.

MicroVas treatment sessions typically last 45 minutes. We generally recommend 3 treatments per week over a 4-12 week treatment course, though some people may need more or fewer treatments based on their results. The effects of the treatments are cumulative and long-lasting, and many people report that their symptoms continue to improve, even months after the last treatment session.

When to Consider Foot Surgery

Although we will do everything we can to treat your condition conservatively, sometimes surgery simply is the best and most effective option available. We might consider surgery when alternative treatment options fail, or if surgery is likely to provide much better and faster results.

At the office of Dr. Jan David Tepper, you’ll find experienced podiatric experts who specialize in both conservative and surgical treatment for a comprehensive range of foot and ankle problems. We’ll advise you on all your treatment options so you can make wise choices about your medical care and return to full activity as quickly as possible.

To schedule an appointment with us, call (909) 920-0884 today.

Location

984 W. Foothill Blvd, Suite B
Upland, California 91786

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