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Medicine Is Missing The Boat In Detecting Prediabetic Neuropathy. What Can You Do?

Posted on January 30, 2023June 28, 2025 by admin

Diabetes is becoming more common worldwide. It is known that the number of people with diabetes is soaring. Countries where diabetes used to be rare such as China are seeing a significant increase. Why is that? Many experts would agree it’s the increase in spread of the American diet worldwide which can cause obesity ,one of many risk factors. It is thought that 22 percent of patients with diabetes in the United States are undiagnosed.

What are the symptoms of prediabetic neuropathy?

Neuropathic pain can include burning, tingling and numbness and in more severe cases muscle weakness may also occur. These symptoms occur in the feet and are called peripheral neuropathy. When your glucose levels increase your nerve fibers are damaged. This can lead to Type II diabetes and nerve damage.

How do I know if I’m becoming a diabetic?

The two most common blood studies done are glucose fasting and Hemoglobin A1C. Glucose fasting is taken after you fast and most laboratories will consider anything over 100 abnormal. Hemoglobin A1c will let you know over a period of the last two to three months has your glucose levels have been in an abnormal range. Anything under 5.7 is considered normal with the borderline range going from 5.7-6.4 so anything over 6.4 will be considered diabetic.

Is there a better way to know if you are becoming diabetic?

Yes, there is and the answer lies in two additional tests called insulin fasting and glucose tolerance testing. They can be the leading indicators that you’re progressing towards being prediabetic and having neuropathy symptoms.

Fasting insulin– this test measures your insulin level which will be elevated if you’re prediabetic. This lab result should be low. Under 5 is ideal and when it starts to be elevated to 10 or higher it and indication your prediabetic. When you have high insulin levels its an indicator that you’re attempting to get glucose out to the blood and into the body’s tissues. This can be from a high intake of sugars and carbohydrates.

Glucose tolerance test– This is a test taken after you have fasted. You drink a solution of sugar and the sugar levels are measured one hour after the intake. If you are normal, the glucose levels will elevate but to a reasonable level. If you are prediabetic the sugar levels will be excessively elevated. It’s telling you that you have impaired glucose tolerance meaning you’re becoming insulin resistant. The pancreas is no longer able to create enough insulin and therefore the body’s tissues become unable to respond to the effect of insulin which is to deliver glucose from the bloodstream to the body’s tissues. Therefore, your blood sugars levels are elevated.

These two tests are used infrequently. From personal experience, I find many patients with the beginnings of neuropathy type symptoms will report to me that they have had borderline Hemoglobin A1c for 2,3 or 4 years. This is a frequent occurrence for those of us trained in peripheral nerve surgery. Once Hemoglobin A1c levels get into the abnormal range patients are placed on medication. It’s my opinion this is by design. It’s this doctors concern that Big Pharma has managed to educate doctors that this is how the rules are played. Unfortunately, what some podiatrists see are patients who are developing neuropathy and never had their insulin levels or glucose tolerance tests done. Sadly these test results may have indicated that they are heading towards a diabetic state.

Armed with this information, the patient would have the option to exercise more or modify their diet to either delay or avoid the diabetic state.

What complications can arise from prediabetic neuropathy in the foot?

Complications can include suffering from the symptoms of neuropathy which can interfere with your activities and sometimes makes sleeping difficult. But most importantly complications can include amputations.

Three things you can do to reverse this issue.

Exercise – This does not have to be complicated, just find something you enjoy doing and be consistent with it . Walking 20-30 minutes three times a week alone can help. Lifting weights , swimming, or pickleball.
Modify your diet – avoid as many processed foods as possible. Some of these may be loaded with different types of sugar that you may not be aware of. Many have high levels of fructose corn syrup which may be the worst form of sugar; many juices also contain this.
Reduce your intake of sugar and carbohydrates.
1. Consider eating more fats – Healthy fats in meat and even bacon if it is grass fed are helpful as these fats satiate your appetite and you’ll eat less. Use more grass-fed butter and consider using it in your coffee.
2. Consider intermittent fasting – start by fasting 12 hours and eventually build up to 24 hours. You might be surprised at how much more energy you have and it lets your digestive system rest. This includes your pancreas where insulin is created.

Prevention of Prediabetic Neuropathy

Preventing prediabetic neuropathy involves a proactive approach to maintaining stable blood sugar levels and leading a healthy lifestyle. Making small, sustainable changes can significantly delay or even avoid the onset of neuropathy symptoms. Here are a few additional strategies to consider:

Regular Check-Ups: Routine medical screenings can help catch early warning signs of prediabetes. In addition to blood sugar and A1c tests, discuss adding insulin fasting and glucose tolerance tests with your healthcare provider if you are at risk. Early detection can give you the chance to make meaningful changes before neuropathy becomes an issue.
Focus on Weight Management: Studies show that maintaining a healthy weight is one of the most effective ways to prevent insulin resistance and manage blood sugar levels. Combining a balanced diet with regular physical activity can keep your weight in check and help prevent the progression of diabetes.

By adopting these preventive steps and being mindful of lifestyle habits, individuals can reduce their risk of developing prediabetic neuropathy and related complications.

So if you think you have prediabetic neuropathy, please consider asking for all four tests that we spoke about in this blog. It may give you the advantage of being proactive and avoid being placed on medication. You can visit our locations in Fort Collins Podiatrist in Fort Collins, Colorado and Broomfield, Colorado.

View all our patient testimonials

Do You Have Feet Neuropathy Symptoms? There Is Hope To Reverse The Symptoms!

Posted on January 13, 2023July 12, 2025 by admin

What Is Neuropathy?

Neuro comes from the Greek word neuron, which means nerve, and Pathy comes from the Greek word pathos meaning affliction or condition. So, the word neuropathy simply means your nerves aren’t working properly. You may commonly hear the term peripheral neuropathy. Peripheral means away from the central nervous system, which includes the brain and spinal cord. Although damage to the brain and spinal cord may cause neuropathy, it is much less common. So, all nerves outside of the brain and spinal cord are part of the peripheral nervous system. Finally, doctors may also say you have peripheral polyneuropathy. Poly means multiple nerves, so the term polyneuropathy means many nerve branches are afflicted. Peripheral neuropathy symptoms can affect both men and women of all age groups, but is more common in the middle age and senior population. It is Important to remember the terms we’ve just described do not have anything to say about what is the cause of the condition, but simply describe location and prognosis that something’s not right with your nerves. So, the following will explain what your foot or feet neuropathy symptoms may be.

Neuropathy Feet Symptoms

Sensory Nervous System
- Sensory nerves may be affected causing symptoms of burning, tingling, and numbness.
Motor Nervous System
- Weakness may also be connected to the motor nervous symptoms which includes the nerve branches that send impulses to your muscles telling them to contract. This can be referred to as motor neuropathy.
Autonomic Nervous System
- The autonomic nerves may also be affected. These are the nerves that control the heart, the bladder, and the skin. So you may have high blood pressure, bladder dysfunction, sexual dysfunction, or skin that is too sweaty or too dry.
Peripheral nuropathy symptoms of the feetcan be caused by two types of nerve damage, large fiber disease, or small fiber disease.
Large Fiber Disease: The nerve fibers affect your ability to feel pressure or touch. This can affect your coordination as you walk or cause you to have decreased balance
Small Fiber Disease: Damage to these smaller nerve fibers may reduce your ability to feel pain or changes in temperature. This may put you at risk for not realizing that you have an injury or infection in a foot. It can make you susceptible to burning your feet if the water is too hot. It is always good to check temperatures with your hands if you tend to have numb feet.
Motor Nerve Damage: This can result in muscle weakness. You may also experience fasciculations which are uncontrollable muscle twitching. Cramping may also take place. Over time you may see a decrease in muscle bulk if the nerve damage is severe. Drop foot is a common presentation associated with muscle weakness and can make it difficult to pull your feet and toes upwards or move your foot sideways away from the opposite foot.

Common Causes Of Peripheral Neuropathy

Diabetes: Many are aware that diabetics can get neuropathy. It’s estimated that 50-70 percent of those with diabetes will acquire neuropathy. It is important to note that people with diabetes are more prone to amputation because of this. With the lack of feeling that may be present, you may not be able to feel what normally would have been a painful callus. With this going undetected, the callous may become so severe that the skin breaks down and results in an ulcer. The ulcer may then get infected and lead to infection in the bone. Thus, an amputation may be required. This is a common tale that is important to understand if you have diabetes. To better understand how we reverse peripheral neuropathy via surgical and non-surgical methods please watch the videos below.
Vascular & Blood Problems: Any disease that may reduce blood circulation may also cause nerve damage. An example of this would be someone with atherosclerosis with arteries in the legs being blocked and therefore less blood flow to the nerves.
Autoimmune Disease: This could include rheumatoid arthritis or lupus. With autoimmune disorders, the body’s immune system mistakenly attacks the body and can damage the nerves or soft tissues around the nerves causing increased pressure on the nerves resulting in damage.
Nutritional Or Vitamin Deficiencies: Examples of this would be vitamin B and Vitamin D deficiency.
Chemotherapy Drugs: Drugs used to treat cancer may be toxic to nerve tissues resulting in temporary but often permanent nerve damage.
Viral & Vaccine: Lyme disease carried by tick bites and HIV can cause neuropathy. More recent evidence supports that the COVID-19 vaccine may cause nerve damage. Watch the video below to learn more.

Neuropathy Caused From Covid Vaccine

Injury: This can be caused by a fracture in the leg or ankle. Also, blunt trauma to the leg or foot can cause damage to the nerves. Too tight of a cast may also be a cause.

Idiopathic neuropathy is one of the most common types. This means neuropathy of an unknown cause. Especially as we get older, if none of the other causes listed are presented, you may be told you have Idiopathic neuropathy.

How Do I Know If I Have Neuropathy?

Presentation: Usually, it will present in a relatively large area, not just in one toe for example. It may involve the majority of the top and or bottom of the foot.

What Will The Doctor Do?

- - Taking a good history of your symptoms and the location is important
  - A good lower extremity examination checking for sensation muscle weakness and balance may be done

Tests – some doctors will order:

- - EMG Testing: This will measure how much of a signal goes into the muscle when the nerve that supplies the muscle is stimulated
  - Nerve Conduction Study: This measures how fast a signal is carried along the length of a nerve when it is stimulated.
  - MRI and Ultrasound: These technologies are used to evaluate the anatomy and look for compression on the nerves. This may be done to evaluate the back as a cause of your neuropathy.
  - Labs: Blood studies may be done to rule out diabetes or other medical conditions such as autoimmune disease which could have a negative effect on the nerves.

Treatments – Conventional medicine:

The treatments can be subdivided into two arenas:

Treat The Back:

For some, treatment of the back may be recommended by their doctor. Neuropathy symptoms are thought to be caused by problems in the back. Chiropractors, neurosurgeons, orthopedic surgeons, and pain doctors may do surgery on the back, or suggest nerve stimulation or pain pumps in some situations. Chiropractors and physical therapists may also suggest stretching and strengthening exercises.

Metabolic Treatments – medication:

Patients are told by their doctors that due to metabolic conditions such as diabetes, chemotherapy and auto-immune disease that the nerves are damaged and the problem is irreversible. Therefore they are told to live with it or medications may be prescribed to reduce their symptoms. Medications such as Gabapentin or Lyrica may be the treatment of choice. Some will even need to go onto narcotics.

How Neuropathy Foot Pain Can Be Reversed!

As a board-certified peripheral nerve surgeon, we consider a different approach. The symptoms are in the feet and legs, so why not consider treating the foot and legs like we treat the hands and arms? When nerve symptoms in the upper extremity are present, many doctors will consider carpal tunnel syndrome as a potential cause, and surgery to reduce pressure may be recommended. Please watch the video below ‘The One Thing You Need To Learn About‘.

Doctors trained in this manner evaluate you for possible nerve compression. Big pharma and medical device companies cannot monetize what we do, and this may have something to do with why you may not be aware of it. If surgeries to decrease pressure on nerves is not appropriate, then other treatments such as ESTIM (electrical stimulation) and laser treatment may be used. When they are employed, the areas where the nerves are compressed are specially targeted.

Non-Surgical Reversal of Neuropathy – ESTIM & Laser Treatment

What We Do That Is Different!

If you visit a peripheral nerve surgeon, many will notice that we take the time to do a very thorough lower extremity examination. Most doctors are poorly trained in the evaluation of the lower extremity peripheral nervous system. It is not only about checking for feet neuropathy symptoms. We check your ability to feel sensation, check for back symptoms, loss of muscle strength, evaluate your gait and do balance testing. We will also do an examination of the five major nerve tunnels in the lower extremity to check for compression. We also may use ultrasound to look for nerve damage consistent with nerve compression.

Surgical Reversal of Neuropathy – How A Peripheral Nerve Surgeon Reverses Neuropathy

Diabetic Neuropathy: You may want to consider looking at our research regarding the surgical reversal of diabetic neuropathy. In these two landmark studies we report the improvement of nerve function after opening tight nerve tunnels that are damaged by doing intraoperative nerve testing. We used EMG to measure the difference in nerve impulses going into the muscles of the legs before and after the nerve tunnels were opened. Within minutes high percentages of improvement were consistently noted. We have the best podiatric clinics when it comes to identifying and dealing with feet and neuropathy symptoms.

RESEARCH TO PROVE YOUR DIABETIC NEUROPATHY IS REVERSABLE.

Surgical Reversal of Diabetic Neuropathy

If you’re looking for a solution for your feet neuropathy symptoms, you may want to consider this approach. We are looking for the best way to reverse your symptoms by treating the root cause of your problem, not just treating the symptoms!

View all our patient testimonials

Frequently Asked Questions (FAQs) About Feet Neuropathy Symptoms

Is Neuropathy Reversible?

In some cases, yes—neuropathy can be reversible, especially when caused by nerve compression. Treatments such as nerve decompression surgery and electrical stimulation therapy (ESTIM) can help alleviate symptoms and even restore nerve function. By relieving pressure on affected nerves or stimulating nerve repair, these treatments offer hope for improved sensation and mobility.

What Triggers Neuropathy in the Feet?

Foot neuropathy can develop due to various factors, including diabetes, autoimmune diseases, vitamin deficiencies, chemotherapy, and injuries. Diabetes is one of the leading causes, affecting a large number of patients. Other potential triggers include infections such as Lyme disease and, in rare cases, certain vaccines that have been linked to peripheral nerve damage.

What Are the Common Symptoms of Foot Neuropathy?

Symptoms of foot neuropathy often include:

- - Tingling or numbness
  - Burning sensations
  - Muscle weakness
  - Sharp or shooting pain

These symptoms can lead to difficulty walking and performing daily activities due to a loss of sensation and muscle control.

How Is Foot Neuropathy Diagnosed?

Diagnosing neuropathy typically involves:

- - Physical examination to assess sensation and reflexes
  - Electromyography (EMG) and nerve conduction studies to evaluate nerve function
  - Imaging tests like MRI or ultrasound to detect nerve compression
  - Blood tests to identify underlying conditions such as diabetes or vitamin deficiencies

Can Lifestyle Changes Help Manage Neuropathy?

Absolutely! Making certain lifestyle changes can help reduce symptoms and prevent progression, including:

- - Managing blood sugar levels to prevent nerve damage
  - Eating a nutrient-rich diet with essential vitamins and minerals
  - Avoiding alcohol and smoking, which can worsen nerve damage
  - Staying active with low-impact exercises to improve circulation and nerve health

If you’re experiencing symptoms of neuropathy, early intervention is key. Talk to a specialist to explore your treatment options and take control of your nerve health.

What You Need to Know If You’ve Been Told You Have Idiopathic Neuropathy?

Posted on December 16, 2022June 30, 2025 by admin

Idiopathic Neuropathy

Idiopathic neuropathy has similar symptoms to diabetic neuropathy. However, the word idiopathic means that there is no known cause. The sensory nerves can be affected, causing burning, numbness and tingling. Also, the motor nerves may be involved causing weakness oftentimes presenting as drop foot. The autonomic nervous system may also be affected causing cold feet that may look discolored. The symptoms generally are in the feet but may extend up to leg as far as the knee. Both legs and feet can be involved but for others it may only present on one foot or leg. Idiopathic peripheral neuropathy also is more prevalent in the senior population.

Symptoms of Neuropathy

Neuropathy symptoms can vary widely depending on which nerves are affected. Sensory nerves, responsible for sensation, may cause burning, numbness, and tingling, making it difficult to feel changes in temperature or pressure. This can lead to discomfort or even a loss of sensation, which is often most noticeable in the feet and legs.

In some cases, motor nerves are involved, which control muscle movement, potentially resulting in weakness and mobility issues like foot drop—a condition where lifting the front part of the foot becomes challenging. Additionally, when the autonomic nervous system is affected, individuals may experience cold, discolored feet due to poor blood flow. Symptoms typically begin in the feet but can travel up the leg, reaching as far as the knee. Neuropathy can manifest in both legs and feet or may be isolated to one side of the body.

Causes of Neuropathy

While diabetic neuropathy is a well-known type, neuropathy can result from various underlying conditions.

Diabetes is the most common cause, but other factors can include alcoholism, infections, exposure to toxins, vitamin deficiencies, and side effects of chemotherapy.
Additionally, autoimmune disorders, kidney disease, and genetic predispositions can lead to nerve damage. Idiopathic neuropathy refers to neuropathy with no identifiable cause, though it shares symptoms similar to diabetic neuropathy.
For older adults, age-related changes and other health conditions may increase the risk. Determining the exact cause of neuropathy is crucial, as it guides the most effective treatment approach and helps alleviate symptoms.

How is it Diagnosed?

The symptoms that you communicate to your doctor helps the doctor diagnosis this condition. There may be other medical conditions such as diabetes, alcoholism, or cancer treatments that can all cause nerve damage. When these other factors have been eliminated as a cause then you may be told you have idopathic neuropathy. Evaluation and testing may include EMG and nerve conduction studies. Others may also take a biopsy of the skin to measure how many nerve endings under the skin or dying. This is called nerve density testing.

Treatments for Idiopathic Neuropathy

Traditionally treatments have involved the following

Medications– anticonvulsants drugs such as Gabapentin and Neurontin are frequently used. They do nothing to improve the conditions of the nerves but can help with the symptoms.
Lifestyle changes– avoiding carbohydrates and sugars may help along with getting regular exercise and plenty of sleep. Special shoes, or walking aids such as a can may also be suggested.
Physical therapy– If weakness or numbness is present physical therapy may be helpful to decrease themchance of a fall.

Risks to your general health- When the symptoms become more severe the lack of feeling, pain and weakness can have a negative effect on your mobility. This reduction of activity can lead to weight gain and less physical fitness. In the senior population the risk of a fall and a broken hip may also increase.

How Idiopathic Peripheral Neuropathy may be Reversible?

In general, many healthcare providers are poorly trained in the treatment and evaluation of the peripheral nervous system. As a board-certified peripheral nerve surgeon we look at the nerves in the foot and leg differently. For many there may be compression of nerve tunnels in the foot or leg, much like carpel tunnel syndrome in the hand that can allow us to open, decompress, these tight nerve tunnels.

Therefore, what was once thought to be idiopathic neuropathy (of unknown cause), could be nerve compression. This provides hope for many, listen to Judy’s path to relief as she was afflicted with debilitating nerve pain.

Conservative Treatment Options for Idiopathic Peripheral Neuropathy

As a conservative option to surgery, we also offer ESTIM (electrical stimulation) and laser treatments which may also be very effective at reversing symptoms.

It’s important if you suffer from idiopathic neuropathy to learn more about this new way of looking at your nervous system and decide for yourself.

Neuropathy Symptoms of Weakness and Numbness Gone with ESTIM. Listen to Leslie’s Story !

View all our patient testimonials and webinars on ESTIM

Dr. James Anderson is a board certified surgeon with various publications on nerve compression. When considering a local podiatrist near you, review our results from patients and how our state of the art surgical center in Fort Collins, Colorado provides multiple benefits.

Please consider visiting the AENS website to look for a doctor in your area.
It’s important that you see a doctor trained in peripheral nerve surgery.

Jumpy Leg Syndrome Is Irreversible Right? Wrong! Learn Why It’s Reversible!

Posted on December 7, 2022June 30, 2025 by admin

Jumpy leg syndrome is often referred to as Restless legs Syndrome or Willis Ekbom Disease. It afflicts approximately 10 percent of the entire population. It is also thought to run in families – genetically, those with 50 percent of family members suffering from RLS will have someone else in their family who also has Restless Legs Syndrome. While most commonly diagnosed in adults, it can impact all age groups. A common thought is that children aren’t typically at risk, however it is more difficult for children to describe RLS which suppresses an accurate measure. It is also twice as common in women as in men. The symptoms can be very random and minor, but for others, RLS symptoms can be severe causing lack of sleep. Patients may find that they wake up multiple times per night having little chance of sustained deep sleep.

How Do You Know If You Have Jumpy Leg Syndrome (RLS)?

The diagnosis is made simply by the symptoms that you have. There is no test that is done to diagnose Restless Legs Syndrome. However, some doctors may have sleep studies done to confirm that you have jumpy legs. There are multiple symptoms that collectively cause uncomfortable sensations in your legs. One of the most common is the irresistible urge to move the legs. This will be noticed when you’re sitting or lying down. This is relieved when you get up and move. Other symptoms can include:

Cramping in the legs
Creepy-crawley sensations in the legs
Pulling in the legs
Involuntary jerking, sometimes referred to as periodic limb movement disorder
Twitching of your muscles

All these symptoms lead to difficulty sleeping, and that is why Jumpy Leg Syndrome / Restless Legs is considered a sleep disorder. This leads to fatigue, depression, and poor health because of lack of sleep. The health effects from lack of sleep can lead to weight gain, high blood pressure, and diabetes. Studies also indicate it can lead to early death in men and women ¹ ².

YES RESTLESS LEGS ARE A SERIOUS HEALTHCARE MATTER!

Causes Of Jumpy Leg Syndrome

Conventional medicine has been searching for solutions and causes. Currently you will hear that there are no known causes, however the following may help treat the condition.

Iron Levels: Conditions such as Iron deficiencies like anemia may play a role. Some experts would recommend iron supplementation. Iron levels may also be affected by those with kidney failure leading to increased incidents of restless legs.
Dopamine: This is a neurotransmitter and others believe taking medication to improve dopamine levels can help.
Magnesium: Supplementation with magnesium has also been thought to help.
Stretching: Stretching the muscles of the legs and message may also help.

Various medications are used to treat restless legs syndrome, they include:

Gabapentin and Lyrica which are anticonvulsant drugs are also used to treat neuropathy.
Ropinirole and Mirapex help to increase Dopamine (a neurotransmitter) levels in the brain.

Although helpful these medications come with side effects that include weight gain, daytime drowsiness, compulsive addictive disorders.

In severe Restless legs pain medications, narcotic may also be used.

Things You Can Start Doing Today!

When your symptoms are mild, or you’re in the early stages of Restless Legs, consider the following:

Develop Good Sleep Habits: Go to bed earlier, by 10 pm is preferred as from 10-2 is when it’s thought the deepest sleep occurs, and urn off all electronic devices if possible one hour before bed.
Diet: Avoid sugars and carbohydrates as these have a negative effect on the nerves in the legs.
Consider a massage or a warm bath before bed.
Exercise: Preferably early in the day and avoid exercise before bed
Avoid alcohol.

The Most Important Question You Should Be Asking Your Doctor.

If my symptoms are in my legs, why can’t the cause be there, and why isn’t there more research to look into this as the source?

Conventional Medicines Metabolic Approach

Conventional medicine has been searching for ways to treat those suffering from Restless Legs Syndrome metabolically, however, what has been done poorly is looking at the peripheral nervous system. If you search the web, you’ll find a lot of problems that seem to be associated with Restless Legs. Some will say it’s related to Dopamine levels in the brain. Others will claim it is from iron deficiencies. Diabetes, Parkinson’s, kidney and thyroid conditions may increase the chance of you having Restless legs syndrome. Although, most of these patients have one common issue – the issue is in the legs so why can’t the source of the problem be located there?

Introducing the Peripheral Nervous System.

This is an area of medicine that most doctors are poorly trained in and that is why the root cause has taken so long to discover. Also, big pharma promotes more research in the area of medications that can be used and ways to argue their effectiveness. Until recently, very little research has been done to better understand how the nerves in the legs can be implicated. Yes, the symptoms are in the legs and therefore the solution can also be there. Our research and our patients are proof of this alternative.

Why Do We Say It’s Mechanical, Not Metabolic?

As a podiatrist, I was trained 20 years ago to decompress, and open nerve tunnels in the legs to reverse neuropathy – like carpal tunnel surgery. My training was from a professor of plastic surgery and neurosurgery at John Hopkins. Nine years ago, two additional tunnels in the legs were evaluated for compression and tightness. When the legs were decompressed and opened, the symptoms of jumpy leg syndrome / Restless Legs were reversed. Gradually, more patients regionally and nationally are choosing this as an option. Since then, I have published one peer reviewed paper, and we have recently submitted a second paper for publication with more compelling data than the first paper. I’ve also written a book, A Perfect Night’s Sleep regarding my history, research, and patient stories. I’ve also received an Award from my peers for my research.

Evidence tells us tight nerve tunnels in the legs are the problem (mechanical issues)

CLINICAL EXAMINATION

Our clinical findings after doing a lower extremity examination support that nerve damage is present. Patients often have:

Decreased sensation
Decreased muscle strength
Associated symptoms of numbness tingling and decreased balance.
Ultrasound – diagnostic ultrasound may show nerve compression in the involved nerve tunnels.(video)

RESEARCH

We provide research to our patients and the rest of the medical community. We have one published paper with another paper recently submitted to be published.

STORIES OUR PATIENTS SHARE

Our goal at Anderson Podiatry Center is to educate as many people as we can of this other important option. Yes, like you and so many others, we have helped give the opportunity to get your good night’s sleep back. And to improve your mental and physical well-being!

Dr. James Anderson consult your local prodiatrist at the following clinical locations in Fort Collins and Broomfield, Colorado.

References

Prospective study of restless legs syndrome and mortality among men
Yanping Li, Wei Wang, John W. Winkelman, Atul Malhotra, Jing Ma, Xiang Gao
Neurology Jul 2013, 81 (1) 52-59; DOI: 10.1212/WNL.0b013e318297eee0
Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis
James C. Anderson, Megan L. Fritz, John-Michael Benson Brian L. Tracy https://doi.org/10.3389/fneur.2017.00287

Is Your Painful Nail a Toenail Staph Infection? What You Should Know!

Posted on December 1, 2022June 30, 2025 by admin

Ingrown nails are one of the most common problems that podiatrists treat. Oftentimes not only is the nail hurting, but there can be a toenail staph infection accompanying the problem. This problem can occur for anyone, but there can be additional risk when there is lack of blood flow to the foot, especially if the patient is diabetic. The staph infection can spread to the soft tissue around the nail, and in rare cases may spread to the bone adjacent to the nail. If the bone gets infected, the patient may need weeks of intravenous antibiotics. Now that we have your attention, let’s discuss what you need to know if you think your nail is ingrown!

Presentation – Signs and Symptoms

With an ingrown toenail, the location is most common in the big toenail. It is typical to experience pain when there is any pressure applied along the side of the nail. There may also be redness and swelling including pus in the area where the pain is. When wearing snug or tight fitted shoes, it is again common to experience pain, especially when compared to walking barefoot.

The Basics

It’s important to note that the most common bacteria on the skin is staph, so if there is a break in the skin, then this is the most common bacteria to cause infection. When an infection is present, it can be resistant to a specific antibiotic. Methicillin resistant staphylococcus aureus could be the cause of the infection, and it’s important to know when antibiotic treatment is done.

Causes of Toenail Staph Infection

Congenitally Ingrown Nails: The shape of the nail that can lead to an ingrown nail often is inherited. A nail that tends to curve down on the side into the skin may occur more in certain families. We’ll often hear patients say, “yes my father also had ingrown nail issues!”. Unfortunately, there may be little you can do when faced with such a situation.
Improper Fitting Shoes: Make sure that you size your shoes correctly. This is most important for shoe gear used with more rigorous activity such as running, hiking, skiing or skating.
Improper Trimming of Nails: It’s often been said to trim your toenails straight across and to a degree this is true. However, if you find that the end of the edge of the nail curves slightly and it’s painful, rounding the corner of the nail can work just fine. Try to avoid “bathroom surgery” as digging further back along the side of the nail usually isn’t going to work.
Fungal Nails: Onychomycotic nails frequently become ingrown because the fungal infection deforms the nail. Onychomycosis may also cause athlete’s foot in these patients. The nail may become thicker and cause pressure on the sides of the nail and press the nail into the skin when a shoe is worn. The edges of the nail may also become misshapen causing an ingrown nail.
Trauma: If you have trauma such as dropping a heavy object on the nail, this can deform the nail. The trauma can make the nail more susceptible to fungus or damage the nail bed so the new nail will be deformed. In either situation, the new nail is more likely to grow in. Because nails are dirty, the trauma itself could set you up for staph infection.

Treatments

Before you see the doctor, you can try the following:

Use Epsom salts and water as this may draw out any infection you have
Try over the counter antibiotic ointments such as Neosporin
Avoid the tight shoes that may have started the ingrown nail
Slow down your activities as these can aggravate the tissues by the nail

What A Foot Specialist May Do for a Toenail Staph Infection

If the nail area is swollen, red, and infected, you may be placed on the appropriate antibiotics as a first step.

The most common treatment is to remove the side, or sides of the nail that are ingrown and either allow the nail to grow back, or in most cases a chemical is applied to the area where the edge of the nail is removed. This chemical kills the cells that make the nail, so the edge will not grow back. If the infection is chronic and severe, x-rays may be taken to ensure the bone is not infected.

If the ingrown nail is caused by a fungal toenail, the fungus may be treated. The options for fungal nail treatment include topical treatment, oral medication, and laser treatment. The most effective Is laser treatment. It is safe and highly effective! If the fungal infection is mild, topicals may be appropriate. Many doctors are resistant to oral medication because of the possibility of liver toxicity. If you believe you may have a fungal nail, learn more about laser treatment. VIDEO

For healthy people, ingrown nails are seldom a serious problem. However, this is not true for those with diabetes or poor circulation. For these patients, special precautions need to be noted. Diabetic neuropathy can create numbness in the feet and limit your ability to feel an ingrown nail. Daily inspection of your feet by yourself or someone else is vital. Also, if you suffer from poor circulation, fighting an infection may be more difficult. Don’t wait and self-treat at home. For both diabetics and those with poor circulation, a simple ingrown nail can be the first step before an amputation, and in extreme cases, could place the patient in a life threatening situation.

Dr. James Anderson

Knowing Why Bone Heel Spur Treatment Is Treatment Of Your Fascia, Not The Spur!

Posted on November 21, 2022June 30, 2025 by admin

A common foot complaint you ask? How about heel pain? Most commonly felt on the bottom of your heel bone, it can be pain experienced when you first get up in the morning. For most, this is how it starts. However, after a few minutes, the pain subsides. You think to yourself, “This must be nothing” and move on with your day, but I am telling you now, you don’t have to live with this!

Many patients we see often ask the question, “Do I have a heel spur? Should I seek bone heel spur treatment” The idea that a heel spur is causing your pain, is an old concept that doesn’t seem to go away. It’s actually the plantar fascia causing your pain, and we will explain how and why it’s not a boney issue.

What Is a Heel Spur?

The plantar fascia is tight connective tissue that extends from the ball of the foot, to the bottom of the heel bone. With every step that is taken, your body weight comes down on the foot and your arch flattens causing the fascia to be pulled. Children and young adults are less likely to have pain from the fascia, as their fascia is more flexible, much like a rubber band. When they bear weight, the fascia will stretch and not pull from the heel bone where it attaches. As we get older, the frequency of heel pain is thought to increase because the fascia becomes less flexible as it pulls from the heel. Microtears of fascia may occur at its attachment point on the heel bone. It is thought that a heel spur is the result of the fascia pulling from the heel bone. This may result in more bone formation at its insertion point, resulting in the spur, but the actual spur is not painful.

Why Is It Not The Bone Heel Spur?

1. Surgical Treatment

When surgery is performed the spur is not removed, and patients typically get much better. Starting in the 1990’s, Dr. Steve Barrett was the first doctor to train other physicians on using a minimal incision approach to releasing and cutting the fascia so that it may stretch and elongate. This reduces the pull of the fascia from the heel and is highly successful for pain relief. When the surgery is performed, a scope is placed along the bottom of the heel and if a spur is present it is not removed. Because of the effectiveness of the procedure, it proves the spur does not cause pain. (Barrett SL, Day SV. Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique—early clinical results. J Foot Surg. 1991;30:568-70.) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3117526/

2. Diagnostic Ultrasound Evaluation

When patients are consulted for their heel pain, we evaluate the heel with an ultrasound machine. Studies have shown what the normal appearance of the fascia should be based upon its thickness and coloration. The thicker and darker the fascia appears, the more damaged it is. The appearance is highly correlated with the amount of pain the patient has – whether or not a spur is present.

3. Regenerative Medicine Treatment

For well over a decade, we have been using PRP platelet enriched plasma, and in recent years, umbilical or placental cells to repair the fascia. Using ultrasound guidance, we are able to very accurately inject directly into the fascia. Again, we are not treating the spur and patients have a high success rate.

Causes of Plantar Fasciitis

Overuse: simply doing too much too soon can be a cause. It’s important with any walking or running to start out slow and allow rest days in the beginning to allow your body to heal.
Foot Type: Some foot types may be more prone to the fascia pulling from the heel. More support may be part of the solution by using supportive shoes, or over the counter arch supports.
Lack of Flexibility: If the fascia is tight or the calf muscles are tight, this can also play a role. Daily stretching of the calf muscles and fascia may help.
Trauma: Jumping down on the foot may also cause heel pain. When this occurs, the fascia may partially or fully rupture from the heel bone.

In Home Treatments

Stretching: This can be done to help reduce tightness of the calf muscle and the fascia.
Anti Inflammatories: In the early stages of heel pain, these may also be helpful.
Icing: Icing may help, especially if used after an activity.
Support: When fitting into a shoe, more supportive shoes and using over the counter arch supports are helpful.

Treatments That Your Podiatrist Would Offer

Physical Therapy: This may come in the form of using an ultrasound.
Orthotics: Orthotics from a podiatrist are made from a non-weight bearing positioning of your foot which is unique to what most health care providers do. They are very precisely made and more likely to help.
Laser: This treatment promotes healing of the fascia by helping the mitochondria of your body repair the fascia. The mitochondria is what creates energy in your cells.
Regenerative Medicine: We were one of the first clinics to offer this option. Studies have shown that the fascia is not inflamed but rather degenerating. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003 May-Jun;93(3):234-7. doi: 10.7547/87507315-93-3-234. PMID: 12756315. https://pubmed.ncbi.nlm.nih.gov/12756315/

That is why stem cell treatment has a much higher success rate than cortisone.

Shockwave Treatment: Commonly referred to as ESWT, this treatment sends powerful sound waves into the foot and usually involves three treatments. The sound waves damage the fascia tissues which then stimulates your body’s ability to repair. It’s thought to increase your body sending growth factors and stem cells to the area to repair.

Dr. James Anderson your local experienced and internationally acknowledged podiatrist serving Fort Collins, Broomfield and the greater Rocky Mountain Area.

Foot Soak for Toenail Fungus Options As Home Remedies – Do They Work?

Posted on November 14, 2022June 30, 2025 by admin

Toenail fungus is common and persistent, but foot soaks for toenail fungus may help relieve symptoms—especially when started early. Known medically as onychomycosis, toenail fungus often causes the nail to turn yellow, become thickened, or crumble. Less frequently, it may appear white or chalky.

This type of infection often comes along with athlete’s foot (tinea pedis), caused by the same fungus. It can spread from floors, showers, or shoes. While many people assume it’s highly contagious, the truth is that your immune system plays a significant role in whether you develop a fungal infection. People with diabetes or compromised immune systems tend to experience fungal nail issues more frequently. Interestingly, one partner in a household might have toenail fungus while the other never gets it.

How to Prevent Toenail Fungus

Preventing toenail fungus involves good foot hygiene and environmental awareness. Avoid walking barefoot in public showers or locker rooms. Keep your feet dry at all times, and make sure to dry thoroughly between the toes after bathing.

Choose breathable footwear, especially if your feet sweat often. Using baking soda and hydrogen peroxide inside your shoes can help keep them fresh and less inviting to fungus. Learn more about our diabetic foot care recommendations to reduce your risk of infection.

Start Early With Treatment

Start treating toenail fungus as soon as you notice symptoms. Early treatment improves your chances of success, especially with home remedies. However, toenails grow slowly—it can take 9 to 12 months for a full nail to regrow. Be patient, and monitor for results.

If you don’t see improvement after 3–4 months of at-home care, make an appointment with a podiatrist near you. If you have diabetes or see cracks, thickening, or pain in the nails, seek medical advice right away.

Why Nail Fungus Shouldn’t Be Ignored

Toenail fungus can distort the shape of your nail, making it more prone to becoming ingrown. If you notice yellowing, thickening, pain, or an odor around the nail, don’t wait—these are signs of worsening infection.

Professional care can prevent complications, especially for patients with circulation issues or weakened immune systems. Visit our foot and ankle conditions page for more details.

Home Remedies and Foot Soaks for Toenail Fungus

Soaking your feet daily can be a simple and soothing way to support fungal nail treatment. Here are some of the most recommended foot soaks for toenail fungus:

Listerine Foot Soak

Some people believe that Listerine has antifungal properties. To try it, mix 30–50 ml of Listerine in 2 cups of warm water and soak your feet for 30 minutes daily.

This soak may also improve dry, scaly skin. If you have sensitive skin, test a small area before doing a full soak.

Apple Cider Vinegar Soak

Create a soak using:

1/3 cup white vinegar
2 cups warm water
1/3 cup Epsom salt

Soak your entire foot for 30 minutes once a day. Some even take apple cider vinegar orally for potential internal antifungal benefits. The acetic acid in vinegar may help kill fungus.

Additional Topical Remedies

Tea Tree Oil

Tea tree oil is a natural antifungal essential oil. Clean the nail with rubbing alcohol, then apply a few drops of tea tree oil directly. Other essential oils like peppermint or cinnamon oil may offer similar effects.

Olive Leaf Extract

Known for its antifungal, antibacterial, and antiviral properties, olive leaf extract can be taken orally or applied topically. You can find it online or in health food stores.

When Home Remedies Aren’t Enough

If your toenail fungus doesn’t improve, it’s time to seek professional treatment. Podiatrists offer options that have been clinically tested and often work more quickly than home remedies.

Medical Topical Treatments

These include over-the-counter and prescription creams or solutions. Our clinic offers a proprietary topical treatment that penetrates the nail more effectively than most.

Oral Antifungal Medications

Oral treatments like Lamisil can be effective, but they may affect the liver. We rarely recommend them unless absolutely necessary and always advise liver function testing beforehand.

Laser Nail Treatment

Laser toenail fungus treatment is our most popular option. It uses painless, pulsed energy to heat and destroy fungal cells inside the nail. For thick nails, we often grind them down first to improve results and appearance.

Foot soaks for toenail fungus are a helpful starting point, but medical treatment may be necessary for full recovery. Our staff and podiatrists were the first to bring this type of treatment for nail fungus to the Colorado region. Our clinics in Fort Collins and Broomfield locations were among the first in the region to offer this advanced laser therapy. If you’ve searched for a “local podiatrist near me,” we’re ready to help.

What to Expect During a Podiatrist Visit

During your visit, the podiatrist will:

Examine your feet
Review your symptoms
Take nail samples to identify the fungus
Recommend a treatment plan

They may suggest prescription medications, laser nail fungus treatment therapy, or other targeted approaches. They’ll also guide you on preventing future infections, so you can maintain long-term foot health.

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Frequently Asked Questions: Foot Soaks for Toenail Fungus

How Do You Get Rid of Toenail Fungus?

Treatment may include over-the-counter antifungal products, prescription meds, or nail removal in severe cases. Regular trimming and filing help the treatment reach deeper.

What Kills Toenail Fungus Instantly?

No treatment kills it instantly, but laser therapy and medications like terbinafine are highly effective over time.

How Do You Know If Toenail Fungus Is Dying?

Signs include less discoloration, thinner nails, reduced odor, and healthy nail growth from the base.

Is Hydrogen Peroxide Good for Toenail Fungus?

Yes, it has antifungal properties. Use it alone or in a soak. However, it’s generally not strong enough for severe cases.

What Are the Best Home Remedies for Toenail Fungus?

Tea Tree Oil: Apply directly after cleaning
Vinegar Soaks: Use apple cider vinegar and water
Baking Soda: Absorbs moisture, preventing fungal growth
Garlic: Apply crushed garlic or take it in supplement form
Hydrogen Peroxide: Mild but useful antifungal soak

Sports Injuries of the Foot and Ankle

Posted on November 9, 2022June 30, 2025 by admin

How to deal with foot and ankle surgeries?

When it comes to sports injuries, your foot and ankle are areas at highest risk of injury. Within sports themselves, injuries are common. A foot or ankle injury could result from the repetitive stress of running on hard surfaces, or from the stress of side-to-side activities in sports such as tennis or soccer. Other injuries may not be from overuse, but from trauma such as an ankle sprain. Commonly seen foot and ankle surgeries are listed below:

Plantar Fasciitis
Achilles Tendonitis
Peroneal or Posterior Tibial Tendonitis
Neuromas
Stress Fractures
Ankle Sprain
Ankle Fracture

Below, read through the descriptions of the most common foot and ankle overuse injuries.

Plantar Fasciitis: This will cause pain on the bottom of the heel. It usually hurts most in the morning when you take your first step out of bed. The fascia is a very strong binding tissue that originates in the ball of the foot and connects to the bottom of the heel . As we get older, it tends to lose flexibility. A common attempt for relief is stretching of the fascia and the Achilles which is attached to the large calf muscle called the gastrocnemius muscle. We often use custom orthotics precisely designed for your feet to reduce pulling of the fascia from the heel. Regenerative medicine has also worked very well to eliminate the pain by repairing the fascial tissue which has become damaged.

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Achilles Tendonitis: Here, the pain can be located where the Achilles attaches to the heel. Sometimes referred to as a Haglund’s deformity, this is when additional bone may be created from the tendon constantly rubbing against the heel. The pain may also be along the tendon above where it attaches to the heel. The tendon will also become swollen as time goes on. The more chronic the condition, the more painful the condition. In early stages, rest, icing, and stretching may help. Custom made inserts and orthotics are very successful in treating Achilles tendonitis as they help reduce tension on the tendon by reducing rotation of the heel bone where the tendon attaches as you walk or run. Regenerative medicine has also been a game changer in eliminating this sometimes-persistent problem.

Peroneal and Posterior Tibial Tendonitis: The peroneal tendons (peroneus longus and peroneus brevis) run along the outside to the foot and ankle. However, the tendon that runs on the inside of the ankle and the foot is the posterior tibial tendon. These tendons function to help stabilize the foot from moving side to side. I refer to them as stirrup tendons. Pain will present along the inside of the arch by the ankle or on the outside of the foot around the ankle joint. Treatment may involve rest, and icing in early stages. However, more foot support is often the best treatment. The podiatrist will often recommend custom inserts or orthotics to reduce the stress placed on these tendons, as the support of these inserts will counter this. This tendon can also develop tears, which can require surgical repair. However, the advent of regenerative medicine has drastically reduced the need for surgery.

Neuromas: The pain with neuromas typically present as a swollen nerve in the ball of the foot, between the second and third toe, or between the third and fourth toes. Often you’ll feel like your sock is wrinkled because of the swollen feeling. This is caused by the transverse metatarsal ligament that runs along the bottom of the foot compressing on the nerve. Support with orthotics and cortisone injections are frequently used. We will also use lasers, but at times, conservative measures fail. If so, there is surgery to release and decompress the ligament that is rubbing the nerve may be needed.

Trauma Injuries: These are injuries that if you suspect you have need to be seen by a professional

Stress Fractures: These can be caused by overuse. The constant repetition from the activity will gradually stress the bone. These fractures rarely occur in the bones that are part of the ankle joint area or rearfoot. However, they are frequent in the long metatarsal bones. These are the bones that extend from the midfoot area down to the ball of the foot. They are the longest bones in the foot and subject to a lot of stress. Pain will often present along one of these bones and will be accompanied by swelling.

Ankle Sprains: These are very common and usually the pain will be on the outside of the ankle. The injury can stretch or tear the ligaments that support your ankle, so sometimes immobilization in a cam boot may be necessary to access in healing

Ankle Fractures: In certain situations, it may be obvious that you broke your ankle. But in other situations, it could be confused with a bad ankle sprain. Again, it’s important not to assume you just sprained your ankle.

If you’re suspicious of these, a professional opinion from a podiatrist should be considered sooner rather than later. And finally, to counter what you may have heard, you can walk on a broken bone! If you need a foot doctor fort collins, make an appointment today!

Dr. James Anderson

Call us today at our Fort Collins location (970) 329-8158, Broomfield location (303) 997-2795 or Surgery Center (970) 329-8158.

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Having Pain in the Ball of Your Feet? Maybe it’s a Morton’s Neuroma

Posted on October 27, 2022June 30, 2025 by admin

One of the most common foot and ankle complaints I see in my patients is pain in the ball of their foot. The feeling of your sock wrinkled, or something in your shoe? Maybe an uncommon burning or tingling in your toes? You could have experienced an increased pain while in your tight shoes, high heels, or ski boots? These are the stories we hear from those suffering from Morton’s Neuroma.

What is a Neuroma?

The foot is built with a ligament that runs across the ball of the foot which we bear weight upon. This is called the transverse metatarsal ligament. Between the ligament and skin on the bottom of your foot is where the problem starts. It is thought that the ligament can rub on the nerve which irritates it. The nerve may even become swollen, which is what causes that “full” feeling so many people describe. Neuromas most frequently occur between the third and fourth toe called a Morton’s neuroma, or between the second and third toes. The word neuroma may imply a tumor, but it is not. No need to fear, the nerve is simply swollen from the pressure of the ligament.

What Causes a Neuroma?

Neuromas may just happen! There is no correlation with certain foot types. There may be little evidence to suggest that flatfeet or high arch feet are problematic. However, one exception is called Morton’s Foot. This is a foot that has a short first metatarsal bone that is the bone for the great toe joint. When it is too short, it places more weight on the second or third interspaces.

Additional Causes

High Heel Shoes: These put more weight on the ball of the foot.
Tight Fitting Shoes: This may squeeze the metatarsal bones on the foot on the nerve and injure it.
Trauma: When something is dropped on the foot, or the toes are extended upward in the case of stubbing your toe.
Bunions: Having a bunion deformity will make your foot wider, and this can make shoes tighter causing a neuroma.

How Do You Know If Your Foot Pain is From Morton’s Neuroma?

X-rays: Taking x-rays can rule out other bone or joint problems that can mimic a neuroma. But a neuroma cannot be seen on x-ray, as it is a soft tissue problem.
Ultrasound: Using ultrasound imaging can often show that the nerve is swollen
MRI: This form of imaging may also be useful.

Out of all, the most important step to knowing is a doctor’s clinical examination and your specific symptoms.

When it comes to treatment, you may find relief by doing the following: Avoid wearing shoes that are too tight, and wear shoes that have plenty of width. Avoid high heels, as this puts more weight on the ball of the foot. Use ice packs, especially in the early stages. Try over the counter shoe inserts.

If these options fail for Morton’s Neuroma, the options that your podiatrist would consider could be:

Cortisone Injections: A series of two or three of these may resolve the pain permanently
Custom Shoe Inserts: This can be highly successful as they get to the root cause of the problem. This treats the source by supporting the bony structures and ligaments so irritation to the nerve is reduced. The orthotics are made from a non-weight bearing neutral position of your foot to optimize support and control.
Laser Treatment: Lasers may also be very successful. It works on the concept of helping the mitochondria in your nerve cells. In every cell of your body, there is an area called the mitochondria that creates energy for the cell. Laser helps the cells to repair.
Regenerative Medicine: We have had success with regenerative medicine (stem cell). This shows some promise for neuroma pain that is not severe after other conservative treatments failed.

Two Surgical Options for Morton’s Neuroma

Nerve Decompression Surgery: The surgeon will make an incision on the top of the foot and release (decompress) the ligament above the nerve, so it no longer irritates the nerve.
Nerve Resection: When this surgery is performed, not only does the surgery cut the ligament to get access to the nerve, but also then removes a section of the nerve

Pros and Cons of These Two Options

This surgeon prefers the nerve decompression technique because of its high success rate, and you’re keeping your nerve. The foot tends to feel more normal after this surgery than if the nerve branch is removed. When nerve resection is performed, the foot may not feel as normal but also the nerve stump that is left behind can cause another issue called “amputation neuroma” or “nerve stump”. This can cause another issue for the patient. Along with this, the Associations of Extremity Nerve surgeons who arguably are the best trained doctors for lower extremity nerve evaluation and treatment, support nerve decompression and advise against neuroma resection.

Nerve Ablation and Alcohol Injections: These options are less common amongst podiatrists. The drawback to both options is that they are destructive to the nerve. Alcohol injections gradually kill the nerve over a series of injections. Nerve ablation uses heat to kill the nerve. If alcohol injections or nerve ablation fail, then it makes the option of nerve decompression less optimal as the nerve has been damaged, and nerve section will more likely be suggested by the surgeon. That’s why this surgeon does not suggest these treatments as my philosophy is to keep the nerve.

When either of these surgeries is performed, the patient may walk immediately, and most patients are back to regular shoes in 3 weeks. The good news is that many patients we see can avoid surgery. Early treatment is important. If you take the steps we’ve discussed and the pain persists, make sure to contact your podiatrist.

Dr. James Anderson

Diana shares her experience of getting 100 percent pain relief!

Sever’s Disease – Try Stretching to combat the growth plate inflammation!

Posted on October 19, 2022June 30, 2025 by admin

What can you do if your child complains about heel pain?

Sever’s disease is a problem that afflicts many active children worldwide ¹. Sever’s Disease is when the growth plate on your heel bone becomes inflamed and swollen, causing pain. Another name for this condition is calcaneal apophysitis. Typically, active children ages 8-13 are at highest risk for this disease. Stretching for sever’s disease is highly recommended.

What To Look For

Usually, the pain is centered around the back of the heel where the Achilles Tendon attaches. However, you may also experience pain around the sides of the heel bone. Pain is typically present during heavy activity, but goes away when activity stops. Pain will often be noticed when the heel is squeezed, which is termed the “squeeze test”.

Sever’s Disease Causes

Calcaneal apophysis is the medical term for the growth plate on the heel bone. This serves as the attachment site of the Achilles tendon. It also is the attachment site of soft tissue structures that run from the ball of the foot, back to the bottom of the heel bone. The pulling of these soft tissue structures on the heel is thought to be the primary reason for pain. Children often go through growth spurts, and when the bony structures grow quickly, the muscles and tendons create tension causing the soft tissue structures such as the Achilles tendon to become too tight. Additionally, any weight bearing activities such as running, jumping or landing on the heel bone can cause Sever’s disease. It is usually caused by repetitive trauma rather than an injury. The pulling of the soft tissues such as the Achilles tendon on the growth plate can cause it to become inflamed which is why stretching for sever’s disease is important.

Treatments for Sever’s Disease

Stretching for sever’s disease can be important in the early stages, as it is thought that the soft tissues that attach to the heel may become too tight. The Achilles tendon has two muscles that attach to it. One muscle group is called the gastrocnemius muscle and its origin is above the knee joint on the femur bone. Its primary function is to lift the heel off the ground and propel the body forward while running or walking. The other muscle is the soleus. This muscle is a stabilizer and helps support the ankle joint while standing. The soleus originates below the knee. The anatomy of these muscles is important to understand so that stretching is done properly.

When stretching the soleus muscle, the knee can be in a flexed position. However, when stretching the gastrocnemius muscle, the knee must be extended as the gastrocnemius muscle passes above the knee joint. When stretching is done the stretch should be held for 30 seconds each time. It may also help to stretch the soft tissues on the bottom of the foot that go out to the toes by pulling the toes upward. The child should actively stretch when the problem first starts to decrease the chances of the pain becoming worse.

Along with stretching, additional treatment options include icing the area, heel cups in shoes, over the counter arch supports, and anti-inflammatory medications.
Often parents that we see have made the attempts outlined above, and the pain still persists. Many are wondering if the child should be taken out of the activity that is causing the pain. I want to reassure you that there is no need to worry. The short answer is no, because typically when the child is at play, they will not cause any permanent injury.

What to do When Your Attempts Fail?

Whenthe the above approcaches fail, then orthotics become – what I would consider – the gold standard treatment. These are not the typical arch supports that are purchased in drug or shoe stores, but rather an insert made precisely for the child’s foot. Some podiatrists may take a non-weight bearing cast impression of the foot, or many of us now use a digital scanning technique. Either way, we are positioning the foot where it should be, not where it is when bearing weight.

Why Are Orthotics so Successful?

With every step you take running or walking, the heel will roll side to side. This is called pronation and supination. When this occurs the soft tissue structures are pulling on the heel bone (growth plate) where they attach. By reducing the side-to-side motion with an orthotic precisely made to the child’s foot, the pain can quickly go away. This also eliminates the need for stretching, icing, and resting. Many children will have significant improvement within days. Using orthotics is directly addressing the cause of the problem by reducing the pull on the soft tissue on the heel bone. Often, we see children who have no issues with flexibility, so stretching will have little to no effect. Finally, it’s important to understand that there is a very low risk of your child creating a permanent problem with their foot if they continue activity while having pain. So, try the band aid approaches in the beginning, but if they fail after a few weeks, move on with your treatment to custom orthotics from a podiatrist in Fort Collins!

¹Fares MY, Salhab HA, Khachfe HH, Fares J, Haidar R, Musharrafieh U. Sever’s Disease of the Pediatric Population: Clinical, Pathologic, and Therapeutic Considerations. Clin Med Res. 2021 Sep;19(3):132-137. doi: 10.3121/cmr.2021.1639. PMID: 34531270; PMCID: PMC8445662.

Dr. James Anderson