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Complex Regional Pain Syndrome: The Story You’re Not Hearing

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Complex Regional Pain Syndrome CRPS

Complex regional pain syndrome (CRPS) is a form of chronic pain that could affect the parts of the body, mostly the arm, leg, hand or foot. It is not fully understood what causes complex regional pain syndrome. By reading this blog you should be better informed if you have this condition as early treatment can be very important. Another term that is often used is called reflex sympathetic dystrophy which has similar symptoms but tends to be a more severe state of complex regional pain syndrome.

The signs and symptoms of Complex Regional Pain include the following

  • Changes in skin temperature – the affected area may be warmer or cooler.
  • Changes in skin color – the skin may be whiter or have a purplish or bluish discoloration.
  • Muscle spasms and weakness in severe cases.
  • Burning and/or throbbing pain.
  • Sensitivity to touch or cold temperatures.
  • Decreased ability to move the affected limb.

It is important to note that occasionally CRPS can spread elsewhere in the body including the opposite limb. The symptoms of CRPS may go away on their own but for many the symptoms may persist for months or years and early treatment is most effective to reverse the symptoms.

Causes of Complex Regional Pain Syndrome

Conventional Medicine categorizes CRPS into two types:

  • Type 1 – this is often referred to as reflex sympathetic dystrophy and may occur after an injury or an illness but there may not be any direct damage to the nerves of the affected area. Most people are thought to be type 1.
  • Type 2 – this is often referred to as causalgia. The symptoms of this type are similar to type 1; however, type 2 occurs after a specific nerve injury.

The following are examples of what may cause the symptoms of CRPS. They include a crushing injury, fracture, ankle sprain, heart attack, strokes, and for others, it may be a result of surgery on the hands, feet, or legs. With more chronic CRPS, treatments may be more challenging as it may start to affect the central nervous system also. Whereas in the beginning, it was a localized issue in the lower extremity. The full mechanism between the central and peripheral nervous systems is not well understood as it relates to CRPS.

How do doctors diagnose CRPS?

  • Patient’s History – The patient will report an illness, injury, or surgery where symptoms started for many people.
  • Specific tests to diagnose CRPS include Ultrasound or Magnetic Resonance Imaging (MRI) which may be used to identify underlying nerve damage.
  • EMG may also be used for testing nerve function.

Conventional Treatment Options

For many, the treatment of CRPS involves seeing a doctor who specializes in pain management, and the pain management doctors may use the following treatments.

  • Physical Therapy/Occupational Therapy
  • Psychological and Behavioral Therapy
  • Medications – this can include nonsteroidal anti-inflammatory drugs, anti-depressant drugs that may be used, and also anti-seizure drugs such as gabapentin and pregabalin. These medications are usually prescribed to treat CRPS.
  • Narcotics – If other medications fail, narcotics may be used and carefully monitored by the prescribing doctor.
  • Topicals – topical analgesic creams can be used such as lidocaine.
  • For severe symptoms, the use of spinal cord stimulation.
  • Sympathetic nerve blocks – these blocks involve injections to the lumbar area of the back which can offer pain relief but is usually temporary.
  • IV ketamine infusions – this is another treatment option.

Things that you can do at Home

  • Exercising on a daily basis is important to move the affected body part and it may help repair the damaged nerves.
  • If there is swelling present, compression stockings may also help.
  • If there is a swelling in the limb, elevation while resting may also be helpful.

The game-changing approach that peripheral nerve surgeons are using to discover the root cause and reverse CRPS.

The Non-conventional Treatment Options

Demystifying the cause of Complex Regional Pain Syndrome: Why you should consider consulting with a peripheral nerve surgeon

With the advancement of the knowledge of the peripheral nerve system in the lower extremities, a subspeciality of doctors has been created that specializes in the evaluation and treatment of peripheral nerve disorders including neuropathy, restless legs, and chronic pain. From our knowledge and experience, we are now able to reverse the symptoms of CRPS by evaluating and treating the injured nerve. This has helped many patients avoid the need for spinal cord stimulators and has allowed others to get off narcotics.

What are the options a peripheral nerve surgeon would offer?

  1. Injections – Injections may be used in the early stages to reverse the symptoms of the damaged nerve but are also helpful in identifying which nerve branches are damaged.
  2. Laser Treatments and Electrical Stimulation Treatments – These treatment modalities can be used if in mild cases.
  3. Surgery– Surgery may involve the removal of the damaged nerve branch and also burying the nerve in the muscle to prevent regrowth.

The goal of a peripheral nerve surgeon is to discover the specific nerve that has been damaged and address treatment locally in the foot or leg. Thus, eliminating the need for medication or spinal cord stimulators for many. If you would like to learn more about these options, please consider visiting https://www.aens.us/aens/default.asp

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Does Chronic Pain Affect Your Personality?

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The term chronic pain syndrome is used quite a bit nowadays since so many people experience it. In many cases, people even end up with drug addictions because of it. Here, we will discuss what qualifies as chronic pain and the various ways it affects you physically and mentally.

chronic pain syndromeWhat is Chronic Pain?

The most common notion is that chronic pain is caused from nerve damage, possibly by trauma or from surgery. You may be in a car accident and suffer whiplash or a fractured ankle, and right after your surgery to repair the fracture chronic pain will ensue. The trauma of surgery or an injury can trigger chronic pain. This may be surprising, but something as simple as an ankle sprain may create a state of chronic pain.

The medical terms you may have heard for these conditions are Complex Regional Pain Syndrome, abbreviated as CRPS, and Reflex Sympathetic Dystrophy, abbreviated as RSD. RSD was the term used to describe the pain patients thought they were consigned to and had to learn to live with.  In 1993, the terminology was changed to CRPS, Complex Regional Pain Syndrome, but some still will use the original terminology. When you hear that someone is going to a pain clinic for treatment, this is most commonly what they have been diagnosed with.

Neuropathy and Restless Legs Syndrome

Problems such as neuropathy and restless legs syndrome can also be included in the chronic pain group. The symptoms of neuropathy can include burning, tingling, numbness, and pain, and is more common in the lower extremity than the upper. Neuropathy is often associated with diabetes, but can also be called idiopathic neuropathy, meaning it’s from an unknown cause. Restless legs syndrome can also be considered a chronic pain problem when it is severe. The symptoms associated with it are a nervous or restless type feeling in the legs that makes it difficult to sit still. Sufferers are often awoken by this feeling in the night and must get out of bed to relieve the symptoms. Other symptoms include a creepy crawly sensation, cramping and jerking in the legs. All these symptoms make it difficult to have uninterrupted sleep and ultimately affect your personality.

chronic-pain-personality-change-picChronic Pain and Your Personality

With chronic pain syndrome, the body goes into a fight or flight mode. This changes the chemistry within the brain; creating emotional issues where people want to isolate themselves – all resulting in depression. When a great part of your time is spent thinking about and focusing on your pain it can become very difficult to focus on other things or people. This feeling of isolation can lead to a depressive state.

Chronic pain can also cause significant anxiety – the feeling of hopelessness that a problem may never get resolved. Patients may also feel a loss of control, not knowing what to do and are desperate for help or improvement. In this case of restless leg syndrome, there can be severe sleep deprivation which also causes depression and anxiety in the inevitable terrible night of bad sleep.

A study reports that people with chronic pain may tend to worry more, which causes them to be less inclined to participate in novel activities. The desire of wanting to go out and explore the world goes away, ultimately minimizing the pleasures of life.

There’s also evidence that chronic pain can cause an alteration of how communication between brain cells takes place, thereby reducing your ability to effectively process your own human emotions. Without the ability to monitor your emotions, people experience a lack of control or misinterpretation of what is happening. The main way to treat this problem is to find the cause of the issue.

Weight Gain and Depression

Weight gain that comes with lack of activity and lack of sleep can also cause personality changes. When sleeping becomes difficult and your focus is on your chronic pain,  it reduces one’s self-esteem. The combination of lack of sleep, the emotional stress of the pain and potential side effects of the medication taken for these disorders make it difficult to get up each day,  let alone be active. 

This lack of activity can commonly lead to weight gain. Why is this so important? We know that lack of exercise has a negative effect on the biochemistry of your brain, and the potential for weight gain can also have an effect on one’s self esteem. The relationship between one’s physical and mental self is very important, and if you are not being greeted by the great looking self you once saw yourself as you can experience hardship.

At Anderson Podiatry we provide many options, including working with peripheral nerve disorders, that can get to the root of these problems rather than treating the symptoms with medications. We like to describe this method as “putting out the fire” rather than simply dealing with the smoke. So, if you’re questioning if you have mood or personality disorders from your chronic pain, please come visit us. Do not lose hope as we’ve been able to help many get back to feeling like themselves.

Our Revolutionary Approach to Restless Leg Syndrome Treatment

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restless leg syndrome treatment

The name “restless legs syndrome” does not do the severe nature of the condition justice as it has been said that 10% of the population suffers from restless legs; and out of those, half have it severely. Restless leg syndrome is also known as Willis-Ekbom disease and is twice as common in female patients. Here at Anderson Podiatry, we have a revolutionary approach to the treatment of restless leg syndrome and are eager to share our findings with you.

Symptoms of Restless Legs Syndrome

The symptoms of restless leg syndrome almost always occur at night or at rest, making it difficult for those suffering to fly on a plane or sit in a movie theater. That’s the frustrating thing about restless legs; during the day you may be functioning just fine; but once it’s time to go to bed, it all starts up again. Day after day, the same symptoms occur. At first, it may be mild, but then it can become more severe until it’s consistently happening every night.

symptoms of restless leg syndromeSymptoms are experienced in the legs; particularly from the knee down rather than above. The symptoms can be a combination of cramping, a creepy crawly sensation- like bugs or ants are going on your skin, pain, or jerky legs. However, the most prevalent symptom is an anxious or nervous feeling that makes you want to get up and walk. In fact, most patients have said this is what they have to do during the night.Restless leg syndrome comes on quite slow, and because of this, patients do not realize the severity of the condition. In fact, many in healthcare do not even realize the severity, and their hands are tied because, in many cases, they’re not sure how to help.

Aside from all the physical symptoms, maybe the worst of them all is the psychological effect. This includes the anxiety people experience during the day- not wanting to think about what’s going to happen when they go to bed at night- to the anxiety of being up at night when everybody else in the world seems to be sleeping. Then comes the morning and you are absolutely exhausted.

The good news is, for many of you, you can come out of the bushes because at Anderson Podiatry, we understand how severe this is. In fact, we actually have a solution for many people suffering from restless leg syndrome. This is something we’ve been practicing for approximately seven years.

The Conventional Approach to Treatment of Restless Legs Syndrome

In conventional medicine there’s no known cause for restless leg syndrome, so people are often left helpless. In many cases, people also find that their doctors or loved ones do not understand the severity of the problem. This is incredibly unfortunate because restless leg syndrome is a very serious problem that can affect people’s general health. Recent studies have shown that there’s a higher incidence of early death with people experiencing severe restless legs due to lack of sleep. This lack of sleep can cause all sorts of secondary problems, such as increased incidence of diabetes, cancer, and heart disease. 

In the world of conventional medicine, the treatment options are very minimal. They usually involve pharmaceutical medications that deal with dopamine levels in your brain, or band-aiding the pain with medications that are used for treatment of neuropathy (namely Lyrica and gabapentin). Outside of this realm of drugs is the possibility that some of your restless legs could be caused by your back. Maybe you have a pinched nerve in your back that could be radiating symptoms in the leg.

So basically, the restless leg syndrome treatment options are relegated to two things; either it’s coming from the back, or in the vast majority of cases, it’s something the medical community does not know how to treat. However, many of these treatments, especially the drugs, can have detrimental side effects patients don’t like, including significant weight gain.

Our Concept

At Anderson Podiatry we prefer to call this disorder “restless legs compression syndrome” because we’ve been able to reverse the symptoms by opening up tight nerve pathways in the lower extremity. When the nerve tunnels become tight it can be damaging, which results in restless legs syndrome symptoms for many. For most, the success rate is incredibly high and there is minimal chance of worsening the condition. We also treat patients with restless leg syndrome non-surgically by utilizing laser and e-stim. Both of these treatments help to restore more normal nerve function and have proven very effective. However, for many patients with severe restless legs, the surgical option may be the best treatment of choice.

So you may be wondering, what do we do when we do surgery? We’re basically opening up nerve tunnels- usually three, but sometimes just two. Two of these nerve tunnels are in the lower leg just below the knee, and third is down in the front of the lower one-third of the leg. These tunnels can create a lot of pressure on the nerves in the legs. Instead of treating you with pharmaceuticals, or hoping that maybe treatment of the back will help, we have found that the fire is truly in the nerve tunnels of the lower extremity. While many treatment options simply blow away smoke from the fire, we believe that we’re able to get rid of the problem by directing our attention to the flames.

Many people are desperate for a solution, and our method of treatment is something you’re not going to hear conventional medicine speaking to. Why? Well, in many cases, it’s because big pharma has no interest in supporting what we’re doing, as it would be contrary to what they want you to think (that restless leg syndrome patients have to be on medication).

In conclusion, if you’re looking to target the direct cause of your problem, consider coming to our office for evaluation of restless leg syndrome treatment. For many, surgery may not be the option you desire, and this is a decision that we can mutually discuss. If you have any other further questions, please contact our office to get a better understanding of how our treatment options work. It’s time for you to get your life and sleep back.

Please visit our YouTube channel, where we have plenty of information about what we do, as well as testimonials from patients that have successfully gone through our surgical procedures and nonsurgical treatment options.

The End Of Heel Pain! Our 1-2…..-3 Punch Treatment!

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(Be sure to watch until the end of the video for an Ultrasound visual of before and after Ray’s fascia!)

Ray’s bump in the trail.

The plantar fascia has a BIG job. It stabilizes the arch of the foot and allows flexion of the first metatarsal, enabling the first metatarsal to carry the majority of the body weight. In other words, when the plantar fascia gets tired and aggravated, you’ll know very quickly! Your heel will hurt like crazy, especially if you’re an active person like our patient, Ray. “Before I came to see Dr. Anderson for treatment, I had heel pain for about a year. I would get this pain when I would run, or hike or snowshoe… so a lot of things that I enjoy doing!”

Running out of options…

“After about 9 months of this, I couldn’t run… I couldn’t do any of these things that I enjoyed.” Ray attempted physical therapy for relief, but with no avail. While we were impressed with Ray’s perseverance, we were very eager to ease him of his heel pain. After meeting with Ray, we found that he actually had Plantar Fasciosis, which means that his fascia was deteriorating rather than getting inflamed!  Knowing this offered Ray the ability to  get treatment specifically tailored to the ACTUAL cause.

Our 3 Step Approach!

“So I went to Dr. Anderson, who gave me custom orthotics, laser therapy, and regenerative medicine.” We ended up taking Ray through our 3 step approach for heel pain from start to finish! At Anderson Podiatry Center, our ultimate goal is to ensure we can get our patients back to the activities they enjoy as fast as possible. Ray was in a hurry to get back into action, and as exercise enthusiasts ourselves, we understood his urgency! We took him through these 3 steps so that he could get back out on the trail as quickly as possible.

It’s a RUNderful life!

“3 months after having the injection, orthotics and the laser therapy, I feel 100% better! I can run, I can hike, I can do anything that I want. Now I’m back to running 10-15 miles a week!”

Our doctors deeply care about our patients and their recovery, even well after we treat them. We always follow up with our patients, and after a recent follow up with Ray we were ecstatic to hear that he recently ran 9 miles without any heel pain! He was excited to announce that he is currently training for a half marathon. 

If you or a loved one have been putting the activities that make you happy on the backburner! We would love to get to know you, hear about what’s been holding you back, and work with you to plan an approach to rid you of heel pain!

Sports Or Other Injuries? Mls Laser Therapy Can Help Manage Pain, Reduce Inflammation, And Speed Recovery

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Have you ever been injured? If you have, you know that anyone who has had a physical condition, sports or any injury that affects mobility or quality of life has the same goal: A rapid return to everyday activities. From practicing cryotherapy to speed up muscle healing, to spending thousands of dollars on therapy… people will do just about anything to recover faster.

At Anderson Podiatry Center, our foot doctors and medical doctors have an innovative technology that promotes cellular reproduction and growth to allow your cells to repair themselves, faster! Anderson Center for Laser Therapy is proud to be on the medical technological forefront by offering MLS Laser Therapy. You will benefit from our investment in the very best technology as a key component of our continuing quest to offer you the finest in health care.

MLS Laser therapy has been cleared by the FDA and proven safe and effective as evidenced by extensive and credible studies conducted in our country’s finest institutions including Harvard University.

MLS Laser Therapy Treats

  • Back Pain
  • Shoulder & Elbow Pain
  • Arthritis/Degenerative Joint Conditions
  • Bursitis
  • Sports Injuries
  • Muscle Sprains, Strains, Tears and Soreness
  • Tendon and Ligament Injuries
  • Occupational Injuries
  • Repetitive Motion Injuries
  • Pre-Surgical Treatment and Post-Surgical Swelling
  • Wounds
  • Bruising
  • Neuropathy and other Neurological Conditions
  • Headaches
  • Neck Pain

MLS Laser Therapy uses specific wavelengths of light that have a strong anti-inflammatory, anti-edema effect on tissues that are exposed to the laser. Cellular reproduction and growth are accelerated, so the cells of tendons, ligaments and muscles repair themselves faster.

As inflammation is reduced, pain subsides very quickly. In simple terms, laser energy kick-starts the healing process, thereby speeding recovery. Unlike some pharmacological solutions, there are no known negative side effects.

MLS Laser Therapy is pain-less. Most patients report no sensation at all while receiving laser therapy. Treatments average 8 minutes. MLS Laser Therapy is fast-acting; many patients in high levels of acute pain experience relief after the first or second treatment. Over 90% of patients experience positive results after the 3rd treatment, with the average course of treatment being 7 to 10 sessions. In many cases, by the 3rd or 4th treatment, swelling is greatly reduced and there is a rapid relief of pain. The effects of MLS Laser Therapy are cumulative; therefore, expect to see improvement as you proceed through your treatment plan. Chronic conditions can be controlled with regular treatments. Acute conditions usually subside quickly, typically within one phase of treatments. It is critical that once you start, you complete the course of treatments recommended by your doctor or symptoms are likely to re-occur.

Benefits of MLS Laser Therapy

  • Rapid relief of pain
  • Strong anti-inflammatory effect

Timely healing of sprains and strains

  • Rapid recovery of the structural integrity of injured region
  • Rapid resolution of painful swollen areas
  • Immediate improvement of local blood circulation
  • Rapid repair of superficial injuries, such as wounds and ulcers
  • Affordable cost

Call us to see if MLS Laser Therapy is right for you!

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Elsie’s Story: Heel Pain & Knee Pain

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Walking On My Toes

Elsie didn’t have time for heel pain. She loved being active and going for runs, and suddenly heel pain had stopped her in her tracks.

“I was walking on my toes,” Elsie said. “The pain was so bad, I couldn’t put any pressure on my heels. So I had to stop running and I was looking for a solution.”

Heel Pain, Gone

Elsie came to see Dr. James Anderson, DPM, and tried conservative treatment first.

Dr. Anderson said, “Elsie had plantar fasciitis (heel pain). We tried orthotics first, but nothing was really helping her. Instead of doing surgery, we recommended stem cell treatment. Often, patients can avoid surgery, and experience pain relief with only one stem cell treatment.”

“I had the stem cell treatment,” Elsie said. “After only one week, the pain was totally gone!”

Two years later, she came to see Dr. Anderson for a follow up appointment, and she was back to running and her heel pain had not returned.

Then, Knee Pain

Elsie had started to have knee pain, and mentioned it to Dr. Anderson. “I wore my cartilage down on the top and bottom of my knee, and it was hurting when I ran.” she said.

Dr. Anderson had good news. “We have recently integrated our practice, and are now offering stem cell treatment for knee pain as well as shoulder and hip pain.”

Elsie was thrilled, “I’m a firm believer in stem cell,” she says. “Because I have not had any trouble with my foot since my injection.”

Dr. Anderson treated her with the newest regenerative product that contains umbilical cord stem cells. “Umbilical cord stem cell treatment has the highest concentration of stem cells, growth factors, and proteins, so it’s a highly-effective product and can help patients avoid surgery,” Dr. Anderson says.

The Power of Stem Cell Treatment

“Stem cell treatment is a really powerful tool,” Dr. Anderson explains. “Because it works by stimulating your body’s natural ability to heal.”

“As we age, our bodies begin to degenerate, and we start to have pain. But, stem cells have the ability to become any kind of cell. They can become bone, tissue, tendon, or cartilage. So, it’s an amazing treatment option for a variety of conditions.”

“We’ve treated plantar fasciitis, Achilles tendonitis, and arthritis in the joints with stem cell therapies for years, and now we can treat knee pain, shoulder pain and hip bursitis as well.”

Back On Track

Elsie had the stem cell injection in her knee two weeks ago. “This week I was hurrying to do something, and I didn’t even mean to, but I started to run, and it didn’t hurt at all!”

“My knee just keeps feeling better and better every day,” Elsie says. “In another week or so, I’ll be back out there, running again.”

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Summer Special!

Now offering a FREE new patient exam and consultation! Expires 6/30/18. *X-Rays, testing and treatment not included.  

Call us today! Just mention this blog to receive the offer.

Learn more about regenerative medicine here.

Grace’s Story: Arthritis in Big Toe Joint

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On My Feet All Day

As a kindergarten teacher for many years, Grace was used to being on her feet all day. “I was busy,” Grace says, “And I just didn’t have time to address all my aches and pains.”

Grace had pain in her big toes, but she ignored it and kept up with her active life, and her daily one-mile walks. “I just sucked it up,” Grace says, “I think a lot of people do that when they are busy.”

Then The Pain Kicked In

When Grace retired from teaching, suddenly the pain kicked in. “I was having trouble walking because of the pain. Finally, I got tired of dealing with it and decided to find treatment.”

Grace went online, began researching, and soon found Dr. James Anderson, DPM. “I didn’t realize I had arthritis in my big toe joints,” she said. “You just know you have pain, but you don’t really know what’s going on until you go in and make an appointment.”

Regenerative Medicine + Surgery

Dr. Anderson says, “Because of the arthritis, there was a bone spur on her joint. I recommended surgery to remove it and clean up the bone. Then, we could follow up with a regenerative medicine injection.”

Grace decided to have the surgery, and then followed up with the regenerative injection, and laser therapy to help reduce inflammation and prevent scar tissue from forming.

“Regenerative medicine works by stimulating the body’s natural ability to heal, and the stem cell components help to regenerate the damaged cartilage,” says Dr. Anderson. “If we see the patient early enough, we can often use regenerative therapies to avoid surgery completely.”

“For Grace, this treatment approach helped us to save her joint and improve function! Many times, patients will have to have a joint fusion or replacement, and we were able to prevent that.”

Hitting the Trails Again

It wasn’t long before Grace was living the retired life she had hoped for. “I’m back to doing anything that I want,” Grace says.

“I can go hiking, and I can travel! I walk two miles every day, and I can wear any shoes I want to!”

Her advice for others is this. “Don’t wait any longer to address your pain. The longer you put it off, the more damage can occur. And then, that’s more time and money you will have to spend to resolve it.”

“Take the time to take care of yourself. It’s important.”

Call today to make an appointment, and we can discuss treatment options with you.

To learn more about regenerative medicine, click here. 

CJ’s Story: Chronic Tendon Pain (The Power of Regenerative Medicine)

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CJs testimonials chronic tendon pain

The new year is here, and for many of us that means it’s time to focus on our health, and address some of those lingering issues we’ve been putting off.

Today, I will share a success story of a patient who was dealing with chronic joint and tendon pain for several years. My goal is to help instill hope in many of you who have been experiencing similar pain, and have perhaps given up on finding a solution. So, here we go.

52, Healthy and Active

This patient is a 52 year-old female, who was healthy and active. We will call her CJ. She came into my office with a variety of foot complaints. The primary issue was chronic joint and tendon pain in her right foot and ankle, and this had been going on for several years.

Seven years prior, a horse stepped on her foot and she was diagnosed with a “hairline fracture” and wore a cast for three months. Once she was out of the cast, she could get back to activity with little pain. However, over the next five to six years, she started having more and more pain in the area that began to significantly limit her activity. This gradually led to weight gain, which only made the problem worse.

Plantar Fasciitis, Arthritis and Tendon Pain

When I first saw CJ, she was planning on having gastric bypass surgery, but was concerned that she would not be able to exercise properly after the surgery because of her foot and ankle pain. She had previously been treated for plantar fasciitis by another doctor.  She had steroid injections and wore a night splint, but neither treatment seemed to give her any relief.

During her initial exam, her X-rays showed that the old injury had been more than just a hairline fracture. She had evidence of post-fracture arthritis in two joints in the middle of her foot. The fracture had healed, but left joint damage behind. Her other main issue of ankle pain was diagnosed as a partial tendon tear. This had likely been aggravated by compensating for the joint pain.

Regenerative Medicine + Surgery

Many times, when patients present with arthritis, tendon pain, or plantar fasciitis, we use regenerative medicine therapy to help stimulate healing and avoid surgery altogether. But, in CJ’s case, we needed to use several different treatments to help address all the issues that had been accumulating for all these years.

We performed surgery to repair the tendon tear and used regenerative injections to help heal the joint damage. To better support the damaged joints, we fitted her for custom orthotics. She then began physical therapy to improve her strength, balance, and flexibility.

Ten Weeks Later

CJ was on crutches for four weeks after the tendon repair. But, once we cleared her to start walking, she progressed quickly. She was highly motivated and committed to her therapy and post-operative rehab. Ten weeks after surgery and regenerative therapy, she was already back to walking and elliptical workouts daily. She still has the occasional sore muscles, but no longer has anywhere near the pain she did before. CJ is still considering gastric bypass surgery. But, she now feels she will be able to lose the weight without it since she can exercise without pain.

So, if you or someone you love is struggling with daily foot or ankle pain, please don’t wait any longer to address it. Call today to make an appointment, and we can discuss treatment options with you.

2018 can be your last year to deal with chronic pain. It’s time to get on the path to healing, together.

Raymond’s Story: Decades of Chronic Foot Pain

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24 Years in the Military

Raymond Evans was accustomed to toughing out pain. But after serving for 24 years in the military, he was experiencing chronic foot pain that had become debilitating. Now working in the mail business, Raymond’s job required him to be on his feet all day every day, and it was becoming harder and harder for him to get through the day.

Many Diagnoses, No Relief

Raymond went to doctor after doctor to try to find a solution. “I was diagnosed with a bone spur, and plantar fasciitis, and I was seeking treatment but I wasn’t getting any relief,” Raymond says. “It was getting to the point that sometimes I would have to crawl to get from point A to point B, and I was worried I was going to lose my job.”

Finally, A Referral That Brings Hope

Raymond was being treated at the VA Center nearby where he lives in Spearfish, South Dakota. He had tried many treatments, and even more holistic options like acupuncture and yoga, but nothing was working.

One day his doctor referred him to Dr. James Anderson, and the seed of hope was planted.

A Specialist Six Hours Away

“I didn’t know much about Dr. Anderson at the time,” Raymond said, “But I knew he was a specialist in his field, and that’s what I needed.” Although Fort Collins, CO is  6-hour drive from where Raymond lives in South Dakota, he was more than ready to make the trip. “I would have gone across the country to get help at this point,” Raymond said. “I was having trouble just walking, and I needed answers.”

A Treatment Plan That Worked 

“Raymond had seen multiple doctors for this chronic pain in his left foot. After a thorough physical exam and testing, I diagnosed him with arthritis,” Dr. Anderson says. Dr. Anderson recommended a nerve resection in Raymond’s foot to help with the pain.

“We performed surgery on one nerve above the ankle, and he got relief from that, so we did a second surgery to resect the other nerve,” Dr. Anderson explains. He also used a regenerative injection during surgery to stimulate the cells heal faster. “Sometimes we use regenerative treatment to help patients avoid surgery altogether, but in Raymond’s case, this was a great option to save him from needing a much more painful and intense surgery to fuse the joints together.”

Chronic Foot Pain, Gone

Today, Raymond is back on his feet. “I give Dr. Anderson 10 out of 10 stars,” Raymond says. “He takes the time to really figure out what’s going on. He has the passion, and he knows what he’s doing.”

Raymond is back to work on his feet every day, and he has resumed his normal activity level without pain. He also has custom orthotics made just for his feet, and he wears them every day to help provide continued support.

Raymond’s advice to other is this. “If you are in pain, don’t let it go on and on without addressing it. Eventually it can get to the point that you are struggling just to get through each day. I feel like this treatment saved my job, and in a lot of ways, really, it saved my life. I am truly grateful.”

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Learn about more treatment options for arthritis and chronic foot pain. 

To make an appointment, click here.

Chronic Foot Pain: Why Am I Still in Pain?

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It’s never fun to suffer an injury of any kind. There is always the initial pain and limitations. But, what happens when the pain doesn’t go away even when the injury is “healed?”

Does it just need more time? Are you doing something wrong? In many cases, the injuries look completely healed on X-rays or MRI, but the pain continues. So what do you do next?

I’d like to tell you a story about a patient who had just this problem. We will call her Alice.

The Ankle Fracture that “Healed”

Alice is a 32 year-old female patient. She came to see me for severe daily pain in her foot and ankle, which initially started after she fractured her ankle. Alice fell on her ankle and heard/felt a pop. She was evaluated in the ER and properly diagnosed, and subsequently had surgery to repair the fracture. The repair went as planned and after six weeks her X-rays showed a completely healed fracture.

She was then allowed to start walking on it again. That was when her pain really started. After surgery, she had experienced the normal post-op pain, but it wasn’t until she was out of a cast that she began having constant ankle and foot pain that was not relieved by much of anything. It hurt when she walked and it hurt when she didn’t walk. The pain woke her up and kept her awake.

Time to Put on My Detective Hat

Alice was at the end of her rope, and was even considering possible amputation if the pain could not be relieved. With any patient in this much pain, my first impulse was to throw the kitchen sink at her problem to try to find some way of getting her relief. However, in order to help these patients, I know I have to put on my detective hat, do a thorough review of their injury, treatment, and health history, and then put together a step-by-step plan to hone in on the primary cause of the pain.

A Painful Scar

Alice had pain throughout her foot and ankle, but the majority of the constant pain was along the inside of the ankle and down into the foot. This area was so sensitive that any light touch would send pain up and down her leg. She was especially sensitive along a surgical scar from her ankle fracture repair.

She had mentioned this to the surgeon who fixed her ankle and he assumed it was simply a painful scar and would improve with time but instead the pain grew steadily worse. An X-ray showed the screws and plates in the bones did not appear to be causing any problem and the scar itself did not appear thickened or contracted. However, the location of the incision was right over one of the main nerves in the leg, and I considered the possibility that the nerve had been damaged or cut during the fracture repair.

Testing the Theory

A simple way to test this theory was to perform a diagnostic nerve block of the nerve higher up the leg with a long-acting local anesthetic and a small amount of steroid. This will decrease inflammation and reduce sensitivity of the nerve for 2-3 days after the injection.

If the patient’s symptoms significantly improve for a few days after the injection, then it is a good bet that the nerve itself is the source of the pain and not just the messenger. If it only feels better while it is numb, then it’s time to head back to the drawing board. Alice had significant improvement for 3-4 days after the block before the pain returned. This is normal and expected because you can only use this injection for diagnosis, not treatment.

The Source of the Pain

Once we knew the nerve was the source of her pain, it was time for treatment. In this case, I recommended a procedure called a neurectomy of the nerve. This involves making a small incision over the nerve, farther up the leg than the damaged portion. I then locate the nerve, and cut it to shut off the pain signals. It’s kind of like throwing a breaker on an electrical outlet.

Although this might sound drastic, it is a much safer and effective option than other chronic pain management options (opiates or a spinal stimulator for example). For Alice, it worked very well. Once the nerve pain was eliminated, she was finally able to participate in physical therapy to address the other tendon pain and weakness that had developed from how she was compensating for the pain.

Finally, Pain Free

At Alice’s last follow up, she was pain free. She still had a bit of residual limp that will continue to improve with therapy. I present Alice’s story as an example of the complex diagnostic work-up often involved with post-traumatic chronic pain.

No two patients are the same and no two injuries are the same. What worked on one may not work on the other. As a doctor, when I see patients with chronic pain, I have two goals in mind.

1. Identify the primary problem.

2. Do not aggravate the pain any further with unnecessary treatments.

Once we identify the root of the issue, we can then proceed with the appropriate treatment to relieve the patient’s pain.

If you are experiencing chronic injuries or unresolved pain, please come see us! We can help. Come visit your podiatrist in Fort Collins or Broomfield for further consultation.

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