Many patients present to a Podiatrist with a variety of foot
and ankle complaints. As a Podiatrist I like to take a whole body approach to
treating patients. I tend to utilize other medical specialist to help with
diagnosis, treatment and ultimately to heal patients. I think all physicians should
use all the tools that are available to them to help treat patients.
While performing a foot exam I tend to break down the exam
into four components. The four components of the foot exam are the
dermatological, vascular, orthopedic and neurologic aspects. I think that
during an exam it is important to listen, examine and ask appropriate questions
in order to get a complete picture of what the problem is. The foot and ankle
are connected to the body and even though someone may think their symptoms are
in the feet many times it is related to something else going on in the body.
For example, during the winter months many patients come
into the office complaining about cold, purple toes. They state that as the
weather gets colder they toes change colors, from red to white to blue to purple.
It is important to perform a vascular lower extremity exam, but it is also
important to ask if they get similar symptoms in their fingers. This disorder
can be a variety of things, include Raynaud’s, Chilblains, but what is
important is to ask general questions. Once I diagnosis the problem I
frequently get other specialties involved in the patient’s care. I will refer
the patient to a vascular surgeon, since this is not only a lower extremity
problem, but a vascular problem as well.
Another example that I see very frequently is a patient who
presents with numbness, tingling and burning to the feet. When a patient
presents with neurological problems in the feet the first question I ask is do
they have a history of pain back, spinal stenosis or disk disease. Nine out of
ten times the patients have low back complaints and nine out of ten times the
foot problems are coming from the back. At this time I complete my exam and
make my treatment plan. Most times a neurologist consult is recommended. Many
people say “well I came to see you because of my feet but you are sending me to
a neurologist”. What I explain is that the foot is connected to all other
systems of the body.
So whether the foot problem is related to the circulation
(vascular), the skin (dermatology), the nerves or the biomechanics I utilize
other medical specialists to give my patients a complete and thorough treatment plan.
With medicine emerging and physicians becoming
sub-specialized it is importation for doctors to rely and ask for assistance
from their counter parts to help treat their patients.
For more information, please visit our website at www.footnj.com
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