Hot Foot Bath – Good for Health

Hot foot bath gives relaxation to the entire body if you are tired and also helpful in eliminating toxins from the body. It is an effective means of reducing congestion of blood or water in the upper parts of the body.

When you have to take a foot bath, drink a glass of warm water, sit on a chair and lower you feet in a bucket full of hot water. The level of the water should, ideally, come up to the knees. The temperature of the water should not be too much above the body temperature. As the water gets cold, go on adding more hot water. Take care to see that the hot water added later does not scald the feet.

Cover yourself with a blanket. Wrap it around your body; even if the bucket is covered, it will be all right. The head should be covered with a towel wetted with cold water. As the coldness of the towel evaporated, dip it in cold water, wring it lightly and again cover your head with it.

In 15 to 20 minutes you will start perspiring. When a fair amount of perspiration has been formed, the bath can be terminated. Wash your feet with cold water afterwards and wipe them with a towel. Wipe your body with a wet towel and dress yourself. An ordinary bath can be taken after the hot foot bath.

The blood pressure decreases during the course of the bath. A feeling of giddiness therefore may ensue. This feeling will pass away on resting for a few minutes. But as a precautionary measure, very weak persons, pregnant women and patients with abnormally high or low blood pressure, should avoid taking hot foot baths.

Disclaimer: This article is not meant to provide health advice and is for general information only. Always seek the insights of a qualified health professional before embarking on any health program.

Author: Nick Mutt

Painful Diabetic Neuropathy

The toes burn and tingle and sharp pains shoot into the legs. The bed sheets feel uncomfortable on your feet and you toss and turn, hoping to drift away into a pleasant slumber. But, the "fire-like" sensation in your toes keeps you awake. You switch positions, wiggle the toes, prop a pillow under the legs, but nothing seems to help. You can only lie in bed and watch the hours on the clock pass by.

Background
Burning, numbness, tingling, hot and cold sensations, shooting and electrical pain are common sensations felt in the feet in individuals with painful diabetic peripheral neuropathy (PDN). Neuropathy is an abnormality of the nervous system. Diabetic neuropathy is nerve damage caused by diabetes and is described as a loss of sensation that starts in the tips of the toes and gradually works its way up the legs. Diabetic neuropathy is sometimes referred to as a stocking glove neuropathy because it progresses as if one was pulling on a stocking. Diabetic neuropathy can affect both the hands and the feet.

There are three types of nerves affected in diabetic peripheral neuropathy, sensory, motor and autonomic. Sensory nerves allow people to feel sensation, like pain, hot or cold or touch. Motor nerves control the muscles and allow movement. Autonomic nerves control bodily functions without our awareness or control. In the feet, an autonomic nervous response would be sweating. Neuropathy can affect all of these nerve group types, but sensory nerves are typically the first and most often affected.

Statistics
Almost twenty-one million Americans have diabetes. About sixty to seventy percent of diabetics have some type of nerve damage and about thirty percent of diabetics over forty years of age have diabetic peripheral neuropathy (CDC, 2005). Five percent of diabetics will experience painful diabetic neuropathy and the incidence increases with age. Over forty five percent of individuals who have had diabetes for over twenty five years will experience some symptoms of PDN.

The Cause
The exact cause of diabetic neuropathy is not clearly understood. Many theories exist, but the general school of thought is that high blood sugar causes chemical changes in the nerves and damages blood vessels carrying oxygen and nutrients to the nerves, impairing nerve function. A not so new theory, which is gaining in popularity is the idea that diabetics are susceptible to nerve compression. The susceptibility is thought to be due to the increased volume of the nerve from the abnormal glucose metabolism within the nerve. In layman's terms this is as if the nerve is swelling and the surrounding tissues and ligaments are pressing on the nerves, resulting in a loss of function.

Treatments
Currently, there are no treatments to reverse diabetic neuropathy and there are no treatments that will eliminate the numbness. There are, however, many treatments to decrease the symptoms associated with PDN.

Medications
There was hope of reversing or significantly improving neuropathy with medications like aldose reductase inhibitors, myoinositol, protein kinase C inhibitors, C-peptide, vasodilators and nerve growth factors. Unfortunately, the research did not show consistent or effective results.

The mainstay of medical treatment for diabetic peripheral neuropathy is to manage the symptoms with medications. For those individuals with painful diabetic neuropathy, prescription medications may be needed to manage the pain. Classic medications used for treatment include amitriptyline, desipramine and nortriptyline. These have been used to help decrease pain and to help with sleep. Fluoxetine, paroxetine, sertralene and citalopram tend to be better tolerated, but are also tend to be less effective at relieving pain.

In September of 2004 the FDA approved duloxetine, known as Cymbalta. This was the first drug approved for specifically treating PDN. Gabapentin, also known as Neurontin, has been a successful treatment for painful diabetic neuropathy. Originally approved as an anti-seizure drug, it became a popular treatment in painful diabetic neuropathy. There was a controversy surrounding this medication when the manufacturer started marketing this medication to treat PDN, which is an off-label use. Many physicians still use this drug as a treatment. A newer medication has emerged called pregabalin, also known as Lyrica. Pregabalin was FDA approved to treat pain caused by nerve damage and many feel pregabalin is superior in effectiveness and has fewer side effects than neurontin. Tegretol and Dilantin, common seizure medications, can be used in more severe cases.

Therapy
Anodyne infrared therapy uses light energy to increase the circulation to the small vessels in the feet. Diodes are fit into flexible pads which can be applied directly to the skin on multiple areas of the foot. The theory is that light energy helps to increase blood flow which restores function to injured nerves. Initially released in 1994, Anodyne was met with mixed reviews, but has gained in popularity in more recent years. Some studies have shown great results with reduction in pain and relief of overall symptoms of neuropathy. Anodyne has also been used for treatment of diabetic ulcers, with some encouraging results.

Surgical
Nerve decompression has been increasing in popularity in recent years as a treatment for diabetic peripheral neuropathy. This surgical treatment was initially not met with much enthusiasm. Earlier studies showed poor surgical results and many surgeons were hesitant to perform elective surgery on diabetics. A new surgical approach has been introduced and surgical success rates have improved dramatically. The theory that diabetics are more susceptible to nerve compression, may warrant decompression of those nerves to give relief of the symptoms associated with diabetic neuropathy.

Natural Alternatives
There are numerous natural alternative treatment options for diabetic neuropathy. Many diabetics have had success with their use, but studies have not given consistent results showing their effectiveness. For painful diabetic neuropathy, red pepper powder can help decrease the pain experienced at night. Capsaicin is the active ingredient in chile peppers. When applied to the feet it acts as a counter-irritant and can help decrease neuropathic pain. Capsaicin can be purchased at your local drug store. Alpha lipoic acid is an effective anti-oxidant that has been shown in some studies to relieve pain associated with neuropathy. Gamma linolenic acid is an essential fatty acid, typically sold in the form of evening primrose oil. Most of the studies have shown modest results, but the possibilities are still encouraging. Side effects of long term use at higher doses may include inflammation, thrombosis (blood clots), or decreased immune system functioning. It is important to note that even if a product is labeled "natural" it does not necessarily mean that it is safe. Always talk with your physician before beginning any new supplements.

Prevention
As with all diabetic complications, prevention is the best treatment. Keeping the blood sugar levels within a normal range is the most important tool in treating and preventing peripheral neuropathy. Even with tight control, most diabetics will develop some level of neuropathy. Considering the severity of the complications associated with neuropathy (ulcers, infections and amputations), the associated pain in PDN, tight blood sugar control is of the utmost importance. Along with a healthy diet, exercising for 30 minutes each day will also help to increase circulation and stimulate the growth of new vessels, which may help slow the progression of neuropathy.

Treating painful diabetic peripheral neuropathy is very difficult and many of the above mentioned therapies should be tried and combined. Don't expect any "cures" and make sure you give each therapy a chance to work. It is recommended to talk with your physician or podiatrist to discuss these treatment options.

By Christine Dobrowolski, DPM

New Treatment for Peripheral Neuropathy

Millions of Americans suffer with Peripheral Neuropathy and until recently there was no specific treatment available. Peripheral Neuropathy is often associated with Diabetes, but can occur on its own. Typical treatments in the past included physical therapy, medication and in severe cases even surgery, all of these therapies offer little or no relief. Neurologist, Family Physicians and Podiatrists are now referring their patients for Anodyne Therapy with excellent results.

Anodyne Therapy is the only FDA approved treatment specifically for Peripheral Neuropathy. Anodyne Therapy utilizes the healing power of infrared light to stimulate increased nerve function and blood flow to decrease pain and improve feeling. Anodyne Therapy is completely painless, covered by Medicare and extremely effective. Medical research has shown that patients treated with Anodyne therapy experience the following results:

Significant pain relief : 88% , Increased sensory perception 96%, return to normal sensory perception 60% and an overall 72% increase in daily activity levels. There are no side effects and few contra indications for Anodyne Therapy and because it works on the underlying cause of the problem the results are long lasting.

The symptoms of Peripheral Neuropathy usually effect the feet and calves but can also effect the hands and arms. Peripheral Neuropathy can present itself in a number of different ways including; numbness, pain, loss of feeling, weak muscles, difficulty walking and an odd feeling often described as " a wet sock squeezing the feet." These symptoms often effect older patients with diabetes and lead to secondary problems including difficulty with walking, balance and the basic activities of daily living.

"A typical patient receiving Anodyne Therapy will receive 24-30 sessions and start to notice results about half way through their treatment plan. A patient is seen three times a week until the therapy is concluded states Maricel Lazo, PT of Monmouth Advanced Medicine in Freehold. She also stated," Our patients receive Anodyne Therapy, ultrasound, joint mobilizations and strengthening exercises with our physical therapist to insure their long term success. I have seen patients who have been suffering for 20+ years and those requiring walkers return to near normal function in just a couple on months." Anodyne Therapy is available in only a hand full of clinics in New Jersey and proper diagnosis is a key to the therapy's success.

By Steven Zodkoy

Diabetes and Wound Care

Diabetes and wound care has grown to be a critical subject over the years. Approximately 5 million Americans suffer from some sort of chronic wound or open sore, 15% of these are diabetics. Chronic wounds can become infected, develop gangrene or require amputation.Diabetics are at a greater risk of developing chronic wounds because of poor circulation, slow healing times, vascular disease and neuropathy (numbness).Diabetic ulcers are the most common foot injuries leading to lower extremity amputation.

Because of this fact we will focus on diabetic foot ulcers, the most common of all diabetic chronic wounds. We'll discuss how ulcers form, what treatments are available to you and how to prevent ulcers. Patient education regarding foot hygiene, nail care and proper footwear is crucial. Let's get started.

What is a Foot Ulcer?

Foot ulcers are open wounds that develop on the sides, top or soles of the feet. Diabetics are prone to these wounds because of poor circulation and other problems that arise from having diabetes. Diabetes and wound care should be taken seriously. They are notoriously difficult to treat and the treatment can be lengthy and frustrating. Lower extremities, particularly foot wounds account for one quarter of all diabetic hospital admissions in the U.S. and Great Britain.

Who Gets a Diabetic Foot Ulcer?

Almost anyone who has diabetes can develop foot ulcers.

Who is more likely to develop foot ulcers? Statistically it's African Americans, Native Americans, Hispanics and older men.

Who is at risk? People who use insulin and those who suffer diabetes related ailments such as heart disease, kidney and eye problems are equally at risk. If you are overweight, smoke and use alcohol you are at a greater risk of developing foot ulcers.

How Do Diabetic Foot Ulcers Form?

There are 4 major causes of diabetic foot ulcers.

• Neuropathy (numbness). Neuropathy is a condition when you lose sensation in your limbs and lower extremities. Prolonged elevated glucose levels over time cause this to happen. This condition has a way of creeping up on you. Often you are not aware of the problem until it's too late.

Because of numbness patients can't feel small cuts on their feet, wounds can go untreated for days even weeks. Also neuropathy can cause a patient not to shift or move their feet when pressure points develop. This can lead to wounds developing.Your doctor can check your feet using a simple painless test with a tool called a monofilament.

• Foot deformities. Because of neuropathy patients can break bones in their feet and not be aware of it. Foot deformities can put unnatural pressure on certain areas of the foot and cause wounds to develop.
• Vascular Disease. This disease causes narrowing of blood vessels and can lead to wound development. Restricted blood flow and circulation make treating foot ulcers frustrating and lengthy. This condition reduces the body's ability to heal itself--which increases the risk of infection.
• Skin irritation and friction. Patients with neuropathy (numbness) cannot tell when they have skin irritation, problems with friction or pressure points. The only way to know for sure is to check your feet often for redness, peeling skin or blisters.

How Should a Diabetic Foot Ulcer be treated?

Prevention, prevention prevention. Diabetes and wound care is all about prevention. You know what they say about an ounce of prevention. Untreated wounds can lead to infection. The quicker you treat the wound the less likely you are to develop a problem.

There are 3 commonly used treatments for foot ulcers.

• Offloading - That's offloading off-roading. It means quite literarily putting your feet up. Reducing pressure on a wound is probably the single most important and most neglected factor in chronic wound treatment.

It could mean anything from using crutches or a wheelchair to complete bed rest. Taking a load off sounds like a nice idea but it could take anywhere from 6-12 weeks for your wound to properly heal. That's a lot of downtime.

This is where doctors have a problem. Their patients rarely ever follow the proper protocol. So, listen to your doctor!

It's a little technical, written for doctors by doctors but it's very informative.

• Debridement - The removal of dead skin and tissue. Dead tissue can slow or impede the healing process. The dead skin can appear yellow, tan or black in color. A doctor usually includes debridement as part of complete diabetes wound care protocol.

There are 4 ways to debride a wound, autolytic, mechanical, enzymatic, and surgical.

• Applying medication or dressings - This is usually used in conjunction with other treatments. Your doctor will advise you what medication or dressings to apply. In most cases you will be responsible for changing the dressing and keeping an eye on the wound. The medication could be a course of antibiotics or simply an antibiotic ointment. With diabetes, wound care can be a big responsibility for the patient.

How to Keep a Foot Ulcer from Becoming Infected If you want to keep a foot ulcer from becoming infected, there are a few things you need to do.

• Control your blood sugar levels - It is vitally important that you control your blood sugar level. It's especially important during the time you are receiving treatment for diabetic foot ulcers.

Try to avoid and reduce the risk of infection while undergoing treatment--consult your doctor about the steps you should take to control your blood sugar. Eat right, exercise and check your levels daily.

• Keep the wound clean and bandaged - The old way of thinking about wounds, "let it breathe", is not correct it can impede the healing process. Keep a wound clean, covered and moist is the way to go.

Clean the wound daily. Cover it with a medical bandage. Keep the wound or ulcer moist--with creams or antibiotic ointments.

Not moist as in; whirlpools, peroxide, soaking or full strength Betadine. These things are not recommended for healing a wound or ulcer. They can in fact make things worse.

• Do not walk barefoot - Diabetics often suffer from neuropathy (numbness). As a result, they won't feel it if they accidentally step on a tack or a piece of glass.

The subsequent wound could be difficult to heal, or worse, become infected and lead to serious consequences. So, keep your feet covered.

• Never reuse a syringe - As a rule our skin acts as a good barrier to most infections. But if you are on insulin, you routinely have to breach the surface of the skin and puncture the underlying tissue.

From the minute you uncap the syringe it is exposed to the atmosphere of the room.

After drawing in the insulin, the needle is moist. So you are administering a shot with a moist needle exposed to the room temperature and atmosphere.

It would be unwise to recap a moist syringe after puncturing the skin.

Make sure you always have a healthy supply of syringes on hand and that you never run out.

How Can a Foot Ulcer be prevented? The best and by far the easiest way to prevent a foot ulcer is.... never getting a foot ulcer! Other than the obvious, you can follow the steps recommended above.

Wear shoes; keep your feet covered with heavy or thick socks. They should fit snuggly but not too tight, you should avoid constriction.

Every time you buy shoes you should have your foot measured and sized correctly. Clean and inspect your feet daily. Try to correct any foot deformities such as bunions, corns or hammertoes.

Take care to reduce all risk factors such as; drinking alcohol, smoking tobacco and uncontrolled blood sugar levels.

Self-Care Products and Diabetic Wounds

There are many products available on the market today, so called "beauty aids" for the feet. It can be a treat on occasion to have a home pedicure. However, if you are a diabetic these products can lead to open wounds.

For example, there is the "pumice stone", a hard abrasive stone used to scrape away "dead" skin from the foot. If you're a diabetic this can leave cuts and abrasions on your feet that won't heal.

There is something called a "corn plane", this device operates exactly like a wood plane. Instead of shaving away wood pieces, you are shaving away skin.

In the category of corn and callus removal, there is salicylic acid. The way this acid works is to slowly erode skin that makes up warts, corn and calluses.

All of these products come with a strict warning for diabetics to refrain from use, as their sole (get it "sole", foot "sole") purpose is to abrade the skin.

The most common of these self-care products is the nail clipper. Most people cut their nails too close to the cuticle. If you are diabetic you should cut your nails straight across. The object is to avoid getting a hangnail.

See a podiatrist regularly and let your doctor advise you on the best way to care for your feet.

By Jennifer L Williams