Blog - Foot Pain Doctors of Jax

Dr. Grobes Discusses Heel Pain

Sat, 28 May 2022 19:34:00 GMT

In this video, Dr. Grobes discusses heel pain and its causes and treatment options available at Foot Pain Doctors of Jacksonville.

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Acupuncture

Mon, 28 Mar 2022 20:13:00 GMT

Acupuncture is performed by inserting very thin and flexible needles into trigger points on the body that correspond to various ailments. Acupuncture has been practiced in China and other Eastern countries for thousands of years. Although acupuncture is often associated with pain management, it is also an effective method of treatment for a variety of illnesses and conditions. Acupuncture may also improve your overall well-being on an emotional and spiritual level.

Acupuncture is an effective treatment for many conditions, including:

Many of our patients at Foot Pain Doctors of Jacksonville inquire about acupuncture and ask us for recommendations. We highly recommend Constance Wulf, AP at Wulf Acupuncture for patients who would benefit from acupuncture services.

Constance Wulf (“Connie”) is an acupuncture physician with excellent training and experience that offers microdermal needling, holistic acupuncture & more for effective treatments to help stress, pain & more. She is located in Sawgrass Village, Ponte Vedra Beach, Florida. Service areas include Ponte Vedra, Jacksonville Beach, Jacksonville & surrounding areas. At Wulf Acupuncture, you will find a constant flow of positive energy (chi) to aid in overcoming a variety of problems, losing weight, quitting smoking, recovering from an accident or illness, improving sports performance, and more.

To learn more about acupuncture or make an appointment, please visit the Wulf Acupuncture website:

Or, call Constance directly at: (904) 994-3709

Address: 6000-A Sawgrass Village Circle, Ponte Vedra Beach, FL. 32082 Suite 15

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Embarrassing Nail Fungus

Mon, 28 Mar 2022 19:54:00 GMT

Nail Fungus (Onychomycosis) can cause pain, discomfort, and disfigurement and may produce serious physical and occupational limitations, as well as reducing quality of life.

Onychomycosis is a fungal infection of the nails that causes discoloration, thickening, and separation from the nail bed. Onychomycosis occurs in 10% of the general population, 20% of persons older than 60 years, and 50% of those older than 70 years.

Call our office today for an immediate appointment or a free initial consultation. (904) 329-1391

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Foot, Knee, Hip and Back Pain

Wed, 23 Feb 2022 16:32:00 GMT

If you experience knee pain at the inside(medial) aspect of your knee(s) while walking, standing, running, or coming down stairs, you may be experiencing an abnormal functioning of your foot named over pronation. Over pronating of the foot causes heel pain (plantar fascitis) and the possibility of developing many other conditions at the feet including bunions & hammertoe deformities, posterior tendonitis, achilles tendonitis, Morton’s neuroma, and much more.

The inside (medial) knee can be affected because when the foot pronates, the knee internally rotates causing abnormal stresses on the medial collateral ligament at the knee and possibly the medial aspect of the knee meniscus. If the pronation is not treated or treated correctly, surgical corrections at the foot, knee, or hip may be warranted over time. Also, lower back pain occurs very often due to abnormal functioning at the feet. Over pronation can be controlled by adding custom-made orthotics in your shoe gear.

Custom orthotics are made from a molding of your feet and they put and maintain your foot in its proper or “neutral” position, alleviating abnormal forces at the ligaments, joints, muscles, and tendons of your feet. Dr. Grobes molds & dispenses custom orthotics in one visit at Foot Pain Doctors of Jacksonville. Instant pain relief in most cases and a much better posture are instantly achieved. An immediate smile is what I enjoy seeing from my patients.. Gratification!

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Call our office today for an immediate appointment or a free initial consultation. (904) 329-1391

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PinPointe Laser Demonstration

Wed, 27 Oct 2021 19:56:00 GMT

PinPointe Laser

In this video, Dr. Grobes discusses the PinPointe Laser for treatment of toenail fungus.

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Ingrown Toenails

Sun, 04 Jul 2021 20:43:00 GMT

WHAT IS AN INGROWN TOENAIL
An ingrown toenail is a condition where the corner of a toenail grows into the soft flesh. This normally results into pain, redness, swelling, and oftentimes infection. Infection at the toe occurs when the toenail causes a break in the skin which is often marked only by redness increased warmth and/ or drainage. If the condition reaches this stage, it is absolutely urgent that you see a professional and have the condition treated. Dr. Grobes at Foot pain Doctors of Jacksonville has many years of experience diagnosing and treating painful Ingrown toenails effectively. Without treatment the condition will often worsen and possibly lead to increased complications such as sepsis (infection in the blood stream) or infection into the bone of the toe leading to amputation.

CAUSES OF INGROWN TOENAILS
• Heredity: For many people, the tendency for ingrown toenails is inherited such as curvature of the toenail bed.
• Trauma: Sometimes they result from trauma such as stubbing your toe, an object falling onto the toe or engaging in activities that involve repeated pressure on the toes such a kicking or running.
• Improper Trimming: I find this to be the most common cause of an ingrown toenail. Cutting the toenails on an angle at the corners or cutting them too closely frequently results in the skin folding over the toenail edge then forcing the edge of the toenail to grow into the skin.
Oftentimes, improper trimming will cause the toenail to repeatedly grow into the skin many times for weeks, months or sometimes years. If this occurs a more permanent procedure to treat the problem would be recommended which will be discussed further in this blog.
• Improperly Fitting Footwear: I have found shoe gear to be the second most common cause of ingrown toenails. There are three important aspects in regard to properly fitting shoes to prevent ingrown toenails.
1. Adequate length
2. Proper width
3. Good toe box height
Toe Box height is the measured area inside of the shoe, at the area of the toes, from the insole to the inside top of the shoe gear. Without an adequate toe box height, your toenail(s) will repeatedly press against the top of the toe. Note that different styles and brands of shoe gear will have different available toe box heights. I advise trying on newly purchased shoe gear later in the afternoon. Many times, the feet are slightly wider due to minimal swelling that occurs as a day progresses.
• Nail Conditions: Ingrown toenails can be caused by nail problems such as fungal nail infections, trauma or thickening of the toenail.

INGROWN TOENAIL TREATMENTS
If an ingrown toenail has not caused an infection at the toe, many times the toenail border can simply be removed by way of numbing the area with a topical substance to remove the toenail painlessly. This can be performed on most cases. However, if the condition is more severe, the toe would need to be anesthetized by way of injection after numbing the area with a freezing agent to reduce or eliminate any pain associated with the injection. Pain relief is usually immediate. A follow-up visit is often necessary to evaluate the condition to ensure of no developing infection or to evaluate if the current infection had resolved.

For those who experience an Ingrown toenail at the same location multiple times, there is a simple procedure that is performed here in our office that removes the painful Ingrown Nail border permanently to ensure of no additional recurrences. This procedure is completed within 15-20 minutes on average. It consists of applying a chemical directly to the area of the ingrowing nail to cease the growth of the matrix at the toe.

Call our office today for an immediate appointment or a free initial consultation. (904) 329-1391

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Neuropathy and Nerve Reverse

Fri, 18 Jun 2021 20:56:00 GMT

Why does diabetes cause nerve damage?

Prolonged exposure to high blood sugar can damage nerve fibers causing diabetic neuropathy. Also, high blood sugar can damage the capillaries that supply the nerves with oxygen and nutrients. Metformin, a drug commonly prescribed for diabetes, also inhibits B12 absorption which is a necessary nutrient for nerve health. Smoking and alcohol abuse can also worsen diabetic neuropathy

Why NerveReverse?

Are you taking pharmaceutical pain medications for your neuropathy? Did you know that these medications do nothing to fix the problem? Yes, these medications may help with your neuropathy symptoms, but they do not fix the underlying problem which is unhealthy nerves. You probably have some unpleasant side effects with taking these medications as well. Your nerves will continue to degenerate if you aren’t doing something to get them healthy again. NerveReverse was formulated to overcome these issues and solve neuropathy problems rather than just having a “temporary solution” on the problem. NerveReverse was formulated to give your nerves the nutrition they need in order to become healthy again.

NerveReverse Ingredients:

Vitamin D3 (Cholecalciferol)

Vitamin D deficiency has been linked to diabetes and neuropathy. High doses of Vitamin D have been shown to improve symptoms associated with neuropathy.

Vitamin B12 (Methylcobalamin)

It is widely accepted that a B12 deficiency damages the myelin sheath that surrounds and protects nerves. B12 supplementation is an essential part of preventing and treating nerve damage, especially diabetic neuropathy.

Folate as L-Methylfolate

Over half of the US population suffers from a gene mutation called MTHFR which inhibits the body’s ability to convert the folate from food into the metabolite our body can use. This can cause problems and can lead to an increased risk of disease due to unmetabolized folic acid in the body. NerveReverse uses a special form of Folic Acid called 5-MTHF or L-Methylfolate which bypasses this mutation effect to give the body what it needs without having to convert it to useable form

Benfotiamine

The most bioavailable form of B1 has roughly 5x superior absorption than Thiamine. Benfotiamine is fat soluble and can be absorbed directly through cell membranes, which increases efficiency of transportation to the cells where it’s needed. This keeps your B1 levels higher for longer.

Pyridoxal-5-Phosphate

The active form of vitamin B6 which is already converted to usable form. This can help remove harmful substances from the body that can damage nerves.

Alpha-Lipoic Acid

ALA is an antioxidant and protects against damage to the body’s cells. Several Studies have shown it to help with symptoms of peripheral neuropathy. NerveReverse comes with a guarantee to work in 90 days or less. If you have been on the product for at least 90 days and don’t notice any difference in your symptoms, we will refund your entire 90 days of orders.

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What is Peripheral Neuropathy?

Sun, 25 Apr 2021 21:03:00 GMT

Peripheral Neuropathy Symptoms

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.

• Muscle weakness
• Cramps
• Muscle twitching
• Loss of muscle and bone
• Changes in skin, hair, or nails
• Numbness
• Loss of sensation or feeling in body parts
• Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts
• Emotional disturbances
• Sleep disruptions
• Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain
• Inability to sweat properly, leading to heat intolerance

Our Modern Effective Treatments

Natural Supplements with a topical neuropathy cream provides nutrients and relief of neuropathy symptoms

Medical Massage

Anodyne Therapy

Qutenza Medical Patch

Gabapentin

Class 4 Laser Treatments

Vitamin B-12

Topical Compound Prescription Creams

Call our office today for an appointment. (904) 329-1391

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Chronic Wounds

Tue, 06 Apr 2021 21:12:00 GMT

WHAT IS A WOUND
A wound is an injury that causes a break in the skin. Chronic wounds are wounds that do not heal completely within 6 weeks. There are three (3) types of wounds, Infectious Wounds, Surgical Wounds, and Ulcers. Ulcers are the most common type of chronic wound and there are several kinds of chronic ulcers.
1). ARTERIAL TYPE ULCERS are often caused by hypertension, clotting or hard plaques of substances such as cholesterol or calcium that deposits within the arteries causing narrowing or blockages of the blood vessels which limits or disrupts blood flow to affected areas.
This causes open sores or ulcers due to the lack of blood and nutrients being supplied to a particular area of the skin. They often develop on the legs and feet. Long term uncontrolled elevated blood Glucose from Diabetes, Smoking, Heart Disease, Kidney Disease, Hypertension and Lung Disease are just a few common conditions.
2). VENOUS ULCERS are foot and leg ulcers caused by problems with blood flow in your veins. They most commonly develop on the inside of the leg, just above the ankle, however, they are not limited to this location.
Venous Ulcers are commonly associated with long term or Chronic Edema (swelling) of the feet and/ or legs. The Edema is commonly caused by weakness or “malfunctioning” of tiny vessels within the veins. For example, imagine a garden hose that has doors throughout the length of the hose that opens and closes at the same beat of the heart. As blood is forced up through the hose toward the heart, they open then immediately close to not allow the blood to seep backdown the hose. When the tiny valves with our vessels (the garden hose) become weakened, they do not totally close allowing the fluid to seep down causing Edema (swelling). This constant high pressure can gradually damage the tiny blood vessels in your skin and make it fragile. As a result, your skin can easily break and form an ulcer after a knock or scratch.
If you have a Venous Ulcer, you may also have:
• Swollen Ankles
• Discoloration and darkening of the skin around the Ulcer
• Hardened skin around the Ulcer
• A heavy feeling in your legs
• Aching or swelling in your legs
• Red flaky, scaly and itchy skin at your legs
• Swollen Veins
3). PRESSURE ULCERS develop when constant weight and friction on a specific area for a long duration of time causes the skin to tear. This type of Chronic Ulcer is especially common on the back, ankles, and feet. The pressure ulcer is commonly associated with the same predetermined factors as the Arterial Ulcer which is a limited blood supply or available oxygen to the affected area which does not enable the skin to heal timely or at all.
*There are two additional factors worth mentioning that lead to Chronic Wounds by slowing the healing process.
1). An infected wound will surely slow or stop the healing of a wound. In addition, it could cause more advanced conditions such as Sepsis, which is when infection enters your blood and tissues and could then cause a fever and eventually death.
Long term infections at the feet, legs and other areas of the body also are responsible for required amputation of the infected area(s). An infection occurs when bacteria enters into a wound. Diseases such as diabetes can also increase your risk of infection.
2). A weak immune system may also lead to a chronic wound. Radiation treatments, Poor nutrition, and certain medications such as Steroids, weaken the immune system. Diseases such as Cancer and Diabetes, can weaken your immune system and make it hard to fight an infection.
*Those who are Diabetic are often prone to any of the Ulcers noted below:
1.) Arterial
2.) Venous
3.) Pressure
4.) Neuropathic –NEUROPATHY is the cause which is a condition where the nerves in your skin is unable to feel the normally associated pain with blisters, break down and tearing of the skin, cuts, punctures, abrasions and more. A wound (Ulcer) then develops at the area many times without an individual with neuropathy knowing the wound exists.

Chronic Wounds and Diabetic or Idiopathic Neuropathy are effectively treated at Foot Pain Doctors of Jacksonville with great Success. We have over 30 years of experience and knowledge at treating these conditions with modern and up to date treatments. Call our office today for an immediate appointment. (904) 329-1391

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Heel Pain

Fri, 15 Jan 2021 21:26:00 GMT

Plantar fasciitis is a very common foot ailment. It is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. The fascia becomes irritated and then inflamed, resulting in heel pain.

The primary symptom of plantar fasciitis is gradually increasing pain on the bottom of the heel, sometimes progressing to the mid arch and up the sides of the heel. It can affect one foot or both and the pain can be sharp or dull, burning or aching.

Symptoms
• Pain on the bottom of the heel, sometimes extending into the arch and up the sides of the heel.
• Pain that is usually worse upon arising, or after being off your feet for a while, due to the contraction of the fascia when non-weight-bearing.
• Pain that increases over a period of months.

Causes
The most common cause of plantar fasciitis is a faulty structure of the foot. People with overly flat feet or high-arched feet are more prone to developing plantar fasciitis.

Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis.

You’re at a greater risk of developing plantar fasciitis if you’re overweight, especially if you have sudden weight gain. Women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy. It’s most common between the ages of 40 and 70 and women are affected more often than men. Long-distance runners are at risk, as well as people with tight ligaments and structural deformities of the foot, like high arches, or flat feet. Wearing shoes with soft soles and poor arch support are aggravating factors.

Non-Surgical Treatment
Most people with plantar fasciitis respond well with conservative treatments, including resting, icing the painful area, stretching exercises, wearing gel heel pads, supportive shoes and orthotics
• Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
• Avoid going barefoot on hard surfaces. When you walk without shoes, you put undue strain and stress on your plantar fascia.
• Ice. Good for reducing inflammation. Ice the heel for 20 minutes several times a day as needed. Do not apply ice directly to the skin.
• Rest. Limit physical activities to give your heel rest and allow healing to occur.
• Shoe modifications. Wear supportive shoes with good arch support and a slightly raised heel.
• Medications. Oral anti-inflammatory medication like ibuprofen can ease the pain and inflammation associated with plantar fasciitis. Topical pain creams are also effective. Foot Care Source USA offers a complete line of effective products for treating heel pain, including CBD Topical Skin Cream.

If pain persists beyond a couple of weeks, see a podiatrist. Dr. Rodney Grobes, DPM at Foot Pain Doctors of Jacksonville has extensive training and experience successfully treating plantar fasciitis. Treatments may include:
• Padding and strapping. Pads in the shoes soften the impact of walking. Strapping helps support the foot and reduce strain on the fascia.
• Orthotics. Custom orthotic devices help correct the underlying structural deformity that causes plantar fasciitis.
• Injection therapy. Anti-inflammatory injections reduce inflammation and relieve pain.
• Night splint. Night splints are effective in stretching the plantar fascia and often resolve the problem for good.
• Walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.
• Physical therapy. Exercises and physical therapy modalities are often successful in relieving plantar fascia pain.

Surgery
Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If your symptoms persist after a few months of conservative care, Dr. Grobes will discuss surgical options.

Don’t live with heel pain. Make an appointment with Foot Pain Doctors of Jacksonville today!

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Diabetes and your Feet

Wed, 19 Aug 2020 21:20:00 GMT

4 Different Types of Diabetes

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes generally results in few symptoms; however, it does increase the risk of pre-eclampsia, depression, and requiring a Cesarean section. Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice. lf untreated, it can also result in a stillbirth. Long term, children are at higher risk of being overweight and developing type 2 diabetes.

Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst. The amount of urine produced can be nearly 20 liters per day. Reduction of fluid has little effect on the concentration of the urine. Complications may include dehydration or seizures.

Type 1 Diabetes (T1 D), previously known as Juvenile Diabetes, is a form of diabetes in which very little or no insulin is produced by the pancreas. lnsulin is a hormone required for the body to use blood sugar. Before treatment this results in high blood sugar levels in the body. The classic symptoms are frequent urination, increased thirst, increased hunger, and weight loss. Additional symptoms may include blurry vision, tiredness, and poor wound healing. Symptoms typically develop over a short period of time.

Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.

People with diabetes are at increased risk of foot infections. You can protect your feet with these simple foot care guidelines:

• lnspect and wash your feet daily. Look for redness, swelling, cuts, blisters and nail problems. When washing your feet, use lukewarm water and dry gently, especially between the toes.

• Wear clean, dry socks and properly fitting shoes.

• Don’t go barefoot.

• Trim your toenails carefully. Cut the nails straight across. You might want to have this task done professionally, especially if you have thickened nails, vision impairment or numbness in your feet.

If you have any concerns, seek medical care to prevent more-serious conditions from developing.

• Foot care helps protect your feet and prevent foot ulcers ar sores. Long-term high blood sugar levels can damage the blood vessels and nerves in your legs and feet. This damage makes it hard to feel pressure, pain, temperature, and touch. You may not be able to feel a cut or sore, or shoes that are too tight. Foot care is needed to prevent serious problems, such as an infection or amputation.

• Diabetes may cause your toes to become crooked or curved under. These changes may affect the way you walk and can lead to increased pressure on your foot. The pressure can decrease blood flow to your feet. Lack of blood flow increases your risk far a foot ulcer. Do not ignore small problems, such as dry skin or small wounds. These can become life-threatening over time without proper care.

How do I care for my feet?

Make an appointment with Foot Pain Doctors of Jacksonville today!

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