Has your favorite television program been interrupted by “informative” prescription medication commercials?  In this new era of medicine, prescription drugs are being marketed directly to the consumer.  Sadly, this inspires us to self-diagnosis, which leads to more anxiety and confusion.  With this in mind, diabetics should have a baseline understanding of diabetic neuropathy in order to see the full picture and not just what is seen on TV.

It is widely accepted that having an increased amount of glucose (sugar) in your blood can cause nerve damage.  One theory is that excessive blood sugar can be converted to sorbitol (sugar-alcohol).  The sorbitol can easily enter the outer layer of our nerves and increase the pressure within the nerve.  The increased pressure can slow down nerve conduction and produce burning, tingling and numbness.
Diabetic neuropathy is distributed in a stocking and glove pattern, meaning that it will start in the fingers and toes.  As it progresses, it will expand up the extremity.  Those diabetics with chronically high blood sugars will experience neuropathy earlier with more pain and numbness.

The war against diabetic nerve pain has three fronts:  preventing nerve pain, cancelling nerve pain and restoration of damaged nerves.

Prevention of diabetic nerve pain consists of controlling the diabetes.  Adhering to a diabetic diet, exercise plan and compliance with medication will prevent the progression of diabetes and prolong the symptoms of diabetic nerve pain.  This is the most effective treatment.

Medications that cancel nerve pain have been available for over 25 years.  These non-narcotic medications aim to reduce your body’s ability perceive nerve pain.  They must be taken daily to control nerve pain. This is a long term, continuous treatment and does not reverse the damage to the nerves.  Although these medications can be effective in limiting the intensity and frequency of nerve pain, many users complain of drowsiness, forgetfulness and depression.

Nerve restoration is the latest effort to reverse diabetic neuropathy.  This method consists of vitamins and supplements that nourish and regenerate nerve fibers.  These supplements are available as prescriptions and over the counter medications.

The take home message is that anyone suffering from either diabetic nerve pain or neuropathy should be evaluated by a medical professional. When experiencing diabetic nerve pain in your feet, a podiatrist is your best option to remedy your situation. Podiatrists have superior medical training with diabetics, nerve complications and latest treatments of neuropathy. There are clinical and laboratory tests that can be done to confirm the presence of neuropathy and quantify the severity of the disease.  Once a comprehensive evaluation is complete, the treatment options can be discussed. Don’t let diabetic nerve pain interrupt your life like the prescription commercials on TV, your health is prime time. 

If you or a family member experience diabetic nerve pain, please call InStride Gaston Foot and Ankle Associates to make an appointment with one of our experienced podiatrists today.

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According to a recent survey by the American Podiatric Medical Association (APMA), 81 percent of obese Americans say they suffer from foot pain and at times experience multiple foot and ankle conditions. This finding, in conjunction with the soaring rates of US obesity, makes it critically important to visit Gaston Foot & Ankle Associates to address foot pain. Diabetes, arthritis, and nerve and circulatory disorders can all be detected with a comprehensive examination. Our Podiatrists have specialized medical training to treat foot and ankle problems.

About the APMA Survey

The study surveyed 1,275 US adults, ages 18 and older, to gain information about how many overweight and obese Americans experience foot pain. Results showed that not only do obese Americans have foot pain issues, but so do overweight Americans. In fact, 74 percent of overweight Americans say they experience foot problems. As foot pain contributes to a variety of negative health consequences, it is important that Americans seek the care of a podiatrist immediately if problems arise.

"Podiatrists are physicians, surgeons and specialists who treat diseases, injuries, and deformities of the foot and ankle," said APMA President Dennis R. Frisch, DPM. "This includes diagnosing the cause and treating foot pain, which can really restrict activity."

Click here to read the APMA release.

April is Foot Health Awareness Month. If you are overweight and experiencing foot pain, have diabetes, or recurring ankle or foot pain due to an old injury or lifestyle, schedule an appointment with the experienced podiatrists at Gaston Foot today. We are here to help you get back on your feet!

By: Gaston Foot  |  Source: APMA

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March is Fall Prevention Month and as our elderly population increases, we see an increased incidence of falling. More than likely, you have had a loved one fall and suffered from an injury. Did you know falls are the main cause of injuries leading to death? In fact, fall related hip fractures account for 25% of injuries that lead to death in those over the age of 65. Prevention is the key to keep your loved one from losing his or her independence and residing in a nursing home facility.

Risk factors for falls include old age, chronic pain, diabetes, muscle weakness, loss of balance, dehydration and low vitamin D. Some medications can lead to dizziness, lightheadedness and loss of balance. If you experience any of those symptoms, contact your doctor and find if there is another alternative to that medication. 

Muscle weakness and atrophy are often caused by lack of exercise. An exercise program that is tailored to the person based on their abilities is imperative. “I can’t walk, I can’t exercise, I can’t do this, I can’t do that,” glass half empty mentality limits those from exercising. Instead, an exercise routine can be as simple as getting out of a chair without holding onto the arms of the chair. This will strengthen core muscles. Consult with your doctor for an exercise routine to benefit your balance. 

Environmental factors, both inside and outside of the home, can contribute to falling. Loose rugs, electrical cords, dark stairways, water on the floor can cause an individual to fall, but can be corrected easily.  Outside of the home, clear away debris from pathways around your home, car or garage. 
As foot and ankle specialists, we see many patients that are at risk of falling because of their shoe selection. We believe in the right shoe for the right activity.  Wearing bedroom slippers walking out to the mailbox? Not the right shoe. Going barefoot in the house to clean and cook? Put on shoes. Do you have a hard time putting on shoes and tying them up? Shoes need to be tied properly to ensure stability. Consult a podiatrist to help size, fit and recommend the best shoe for you. 

For severe cases, a customized balance brace may benefit a senior that is at risk of falling. Balance problems, history of falls or near falls, loss of feeling in the feet or weakness are signs that balance braces may benefit the individual. These are customized, covered by insurances and are accurately molded to the patient’s anatomy to provide maximum support. They are very lightweight and easy to apply and fit into most shoes easily. Ask your podiatrist for an assessment and evaluation to see if you’re eligible for this type of treatment. 

As the weather gets warmer and we come out of hibernation, we will see more of those we love getting hurt from falling. Please keep in mind these prevention tips and consult your physician or podiatrist if you have concerns about falling.

By: Ryan Meredith, DPM  |

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As a podiatrist, many of my patients have asked me , "Where can I get a safe pedicure ? " I guess the first question is, what is a safe pedicure?

A safe pedicure is one in which the patient has a cosmetic treatment of feet and toenails which is unlikely to produce an infection. Many of you have heard horror stories in which your friends and family have experienced a pedicure which may have produced a bacterial or fungal infection in either the skin or toenails.

Here are 10 Tips to a Safe Pedicure: 

  1. Inspect the facility for cleanliness.  You should expect an environment which is free of untidy, dirty instruments or foot basins that do not appear to be properly cleansed and sanitized. Watch out for the repeated use of anything that touches your skin or nails.
  2. Be sure to not use the recirculating jets in the foot bath. When water is recirculated through the pipes in a foot spa, the pipes cannot be guaranteed to be completely clean. They may harbor bacteria or fungus which can cause a potential infection. Use pipeless foot baths and preferably those with individual disposable liners to avoid cross-contamination.
  3. Be sure the metal instruments used are sterilized before each client pedicure. Sterilization can be done by a cold treatment such as soaking in disinfectant solution. Preferably, these tools should be steam sterilized in an autoclave like those used in operating room to kill 100% of the bacteria or fungus. If ultraviolet lights are used, they require six hours to sterilize instruments which is usually impractical for most salons. 
  4. If the instruments are nonmetal, they should be single use only! Nail files, pumices, nail buffers or orange wood sticks should be either brought by the client or only used once then discarded.
  5. Be sure your pedicurist is not rounding off the corners of the toenail like a fingernail. Nails should be trimmed fairly straight across-never into the corners. Trimming down in the corners is more likely to produce an ingrown toenail.
  6. Consider waiting two days after shaving your legs before getting a pedicure. When shaving, one produces micro tears in the skin which can allow bacteria to invade causing an infection. Of course, if one has any open sores on the foot or leg, pedicures are taboo. Wait until the wound is completely healed before considering a pedicure as infection is more likely to occur.
  7. Communicate with your pedicurist. Be sure he/she knows exactly what you want or what you don't want them to perform. It's your feet and only you can protect them from any unintentional harm.
  8. Individuals with diabetes, immune deficiencies such as HIV or AIDS or chemotherapy patients, poor circulation or vascular disease patients should consult a podiatrist or their physician before getting a pedicure to determine if it is safe.
  9. It is usually safe for pregnant individuals to have a pedicure. If you are pregnant, and you have any doubt  about  the safety of a pedicure , check with your  obstetrician. Swelling in the legs and feet can be improved with massage and caring for the nails properly can prevent infections especially ingrowing nails which are more common due to foot swelling in pregnancy. Chemicals such as toluene, acetone and formaldehyde used in many nail polishes can be harmful if inhaled in large doses so adequate ventilation is important. If pregnant, you should avoid polishes with toluene, formaldehyde and dibutyl phthalate.
  10. In order to provide safe pedicures for their patients, some podiatrists are incorporating medical nail spas into their practices. We, at InStride Gaston Foot and Ankle have opened just such a spa. These facilities employ  Medical Nail  Technicians who have additional  medical training  as well as intern with a podiatrist to ensure an exceptionally safe, sterile environment for their clients, while still providing that same special experience that helps to keep the feet healthy, relieve tension and stimulate circulation.

If there is ever a doubt as to whether a pedicure would be safe for you, it is always advisable to seek the opinion of your medical doctor or local podiatrist.  Safety, should always be your first concern.

Naturally Nails MedSpa is a full service nail spa for feet and hands supervised by the podiatric physicians of InStride Gaston Foot and Ankle.

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So as I sit here in the Magic Kingdom, waiting for friends to get off the Barnstormer ride with their daughter, I’m watching the variety of shoes people are wearing here at Disney today. It seems we’ve got a lot of folks that are unprepared for a long day on their feet. I see everything from flip-flops, sandals, to walking shoes as well as running shoes. I think those folks with the flip-flops will be sorely disappointed as the day progresses. You know, long days on your feet always go better if you’re wearing good supportive shoes.

As most of the walking surfaces at Disney, or other theme parks, are made of concrete and asphalt, the feet tend to take quite a lot of shock as the surface does not give at all. If your shoes have good shock absorbing soles, the chances of a happy day will be much improved. Walking or running shoes will usually be your best bet! If it’s a hot day, wear those types that have a combination of leather and nylon mesh which will breathe keeping your feet cooler. On the colder days, all leather shoes will keep your feet warmer and better protected from the elements. If you want more information concerning how to pick a good supportive shoe, see my video and click here to schedule an appointment with your Instride Gaston Foot & Ankle podiatrists today.
By: Dr. Kirlin  |

Posted in  Videos



What is Plantar Fasciitis

Plantar fasciitis is the most common foot problem in the world.  Plantar fasciitis is an inflammation within the ligament on the bottom of the foot that connects the heel and the toes.  The inflammation is usually worse first thing in the morning when getting out of bed, or getting up from a seated position after 15 minutes of rest. The condition may appear to resolve after walking for a few minutes but may manifest as an aching and throbbing pain in the evening.  

What causes plantar fasciitis?

The root cause of plantar fasciitis is a result of excessive tightness of the calf muscles.  A normal foot will have 15° of dorsiflexion, or upward motion at the ankle while in a seated position with the knee straight. This motion is necessary to walk normally without tripping over our toes.
When the calf muscles are too tight, then too much tension within the plantar fascia. The plantar fascia is unable to withstand the tension and its fibers will tear. This tearing causes pain and inflammation most often at its attachment on the heel.  Less commonly, plantar fasciitis can manifest in the central arch area of the foot.

Another cause for plantar fasciitis is excessive collapsing of the arch while standing. Those with flat feet are at higher risk for plantar fasciitis.  As the arch collapses, tension on the plantar fascia will increase, leading to the tearing of fibers.

What are common treatments for plantar fasciitis?

The number one treatment for plantar fasciitis is stretching exercises. These exercises address the tightness of the calf muscles. If the calf muscles are no longer tight, then there is less tension on the plantar fascia and the tearing and inflammation will resolve.  Another technique to stretch the calf muscles is to use a dorsal night splint while sleeping. This will stretch the calf muscles during rest and helps with compliance to stretching exercise regimens.

Arch supports are useful to resolve plantar fasciitis. They help decrease the collapsing of the arch and therefore reduce tension on the plantar fascia. Custom arch supports made by your InStride Gaston Foot Specialist are most beneficial as they will match the contour of a person’s foot perfectly. Over-the-counter arch supports can also be helpful if they are firm and support the arch.

Other methods of treatment are aimed at resolving the inflammation of the plantar fascia. These include anti-inflammatory medications, steroid injections and deep heating techniques like ultrasound.

Most podiatrists will employ several treatment options to resolve plantar fasciitis.  If a patient fails conservative treatment for plantar fasciitis, a surgical option may be necessary. Surgical management of plantar fasciitis involves cutting two thirds of the plantar fascia to remove the excessive tension. When the tension is gone, the inflammation caused by plantar fasciitis quickly resolves.

The longer one suffers from plantar fasciitis, the longer it usually takes to resolve.  With multiple options for treatment and predictable results, there is no need to suffer. 

Contact InStride Gaston Foot & Ankle Associates at 704-861-0425 to schedule an appointment today!

By: Dr. Randall Contento  |



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InStride - Gaston Foot & Ankle Associates

251 Wilmot Drive
Gastonia, NC 28054