Your big toes hurt, you got bunions, and those strappy high heels kill you..
Seems like you got ‘Hallux Valgus‘ and your toes look like the pic below
Well its mostly a combination of genetics and footwear (and a few other causes).
Its almost exclusively a problem of the shoe-wearing races (exceedingly rare in barefoot tribes).
So wear shoes with a broad toe-box or something like the ‘kohlapuri’ sandal (see pic)
..keeps the big toe where its supposed to be eh?
High heels and pointy toes may look great but they won’t do the bunions any good. Wear comfortable shoes to the party, change shoes for the duration of the party and remove the fashionable shoes as soon as possible!
Surgery is indicated only for pain, worsening deformity and difficulty in wearing shoes etc.
Surgery is NEVER to be undertaken for cosmetic purposes.
And before I forget.. Dump those splints; (pic) they don’t work, are expensive and of course, uncomfortable!
Who you gonna call? (HINT: your friendly neighbourhood orthopod..)
Orthopods (like yours truly) frequently advise vitamin D supplements with calcium for healthy bones. However I bet you didn’t know this is turning to be one useful vitamin!
But before you go rushing to buy the super economy size bottle; you can overdose on this vitamin with serious health effects. So talk to your friendly neighbourhood orthopod!
Who you gonna call..?
Midnight of 31st December will ring in 2011 amid much revelry. The bygone year however left much to ponder in medicine. Briefly:
- Propoxyphene, a painkiller, was linked with potentially fatal heart rhythm abnormalities and withdrawn. Drugs like Algaphan, Diagesic, Distalgesic, Depragesic, Femidol, Darvon etc contain propoxyphene and need to be avoided/changed.
- HbA1c is a better test to screen for diabetes according to new guidelines and would lead to earlier diagnosis and fewer missed diagnoses.
- Calcium supplements taken without Vitamin D may increase the risk of heart attack by up to 30%. So take Vit D with your calcium tablet!
- Tramadol (Tramal, Adolan, Campex, Merlon, Tramagesic etc.), a commonly used morphine-like painkiller, is not only habit forming but linked to a higher risk of suicide!
- Chocolate may be good for you! Consumption of chocolate may decrease the incidence of stroke and stroke related death.
- Codeine (Codagesic, Napadoc, Paracod, Paracodeine etc), a common morphine-like painkiller used for 6 months is linked to a higher risk of cardiovascular (heart) events. Use for as little as 30 days is linked to a higher risk of death from all causes. Especially to be avoided in the elderly.
With best wishes for a happy and risk-free new year from your friendly neighbourhood orthopod!
Did you know?
Steroid injection into the knee provides relief for 1 week on average.
3,5 or up to 7 ‘Hyalgan’ or ‘Synvisc’ injections given into the knee at weekly intervals act like oil in a rusty joint and ease symptoms on average slightly longer than steroid injections.
You may not feel the benefit of injection before a week or two. So be patient.
Relief obtained is variable and a minority will admit to no benefit.
Joint injections can be dangerous in the presence of poorly controlled diabetes, tuberculosis or any serious infection anywhere in the body, therefore you will often be asked for a blood/urine test to rule out such diseases before joint injections are given.
Hyalgan/Synvisc is made from chicken ‘combs’ so you may not be able to tolerate them if allergic to chicken or eggs.
Only qualified personnel can safely administer injections into joints.
Disclaimer first: Don’t treat yourself. See your doctor (that would be me) to rule out anything more serious. All interventions assume there are no cardiac or other serious conditions.
Remember: Osteoarthritis damage is NOT reversible by any medicine here or abroad!
Understand: More than 90% management is non-medical and IN YOUR HANDS. Losing weight and exercise will delay disease progress and improve symptoms. Avoid stressing the involved joints – Yes, you can’t play squash or football. Start golf! Switching doctors will only get you different painkillers (and ulcers).
Now take a look at the image:
Interventions in green will prove most effective and carry no risk. Yellow are effective and carry mild to moderate risk in the long term. Red are also either less effective OR carry higher risk.
Bottomline: Lose that weight. Go out for a walk (daily). Wear good shoes for that walk. Take paracetamol/tylenol for the pain and use a painkiller ointment/cream on the joint.
Now switch off this machine and go out for that walk already..!
Now after ‘facebook’ and ‘twitter’, muzammil’s ortho will be blogging here off and on. Stay tuned..