Arthritis of the Foot and Ankle

Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle. There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.

 

Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.

 

Symptoms: 

The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:

 

* Pain with motion

* Pain that flares up with vigorous activity

* Tenderness when pressure is applied to the joint

* Joint swelling, warmth, and redness

* Increased pain and swelling in the morning, or after sitting or resting

* Difficulty in walking due to any of the above symptoms

 

Treatment:

 

Nonsurgical Treatment -

Initial treatment of arthritis of the foot and ankle is usually nonsurgical. Your doctor may recommend a range of treatment options.

 

* Physical therapy

* Assistive devices (such as wearing a brace or using a cane)

* Medications including non-steroidal anti-inflammatory medications

 

Surgical Treatment -

Your doctor may recommend surgery if your pain causes disability and is not relieved with nonsurgical treatment. The type of surgery will depend on the type and location of the arthritis and the impact of the disease on your joints. In some cases, your doctor may recommend more than one type of surgery.

 

* Arthroscopic debridement

* Arthrodesis (fusion)

* Total ankle replacement (arthroplasty)

 

In most cases, surgery relieves the pain of arthritis and makes it easier to perform daily activities. Full recovery can take from 4 to 9 months, depending on the severity of your condition before surgery and the complexity of your procedure.

 

If you you are experiencing arthritis of your foot or ankle, contact TOCA to schedule an appointment with one of our expert orthopedic physicians.

 

#Recovery. #Results. #Relief.

 

602-277-6211

www.tocamd.com

June 1-7: Hand Therapy Week!

Happy June 1st! This week is National Hand Therapy Week. 

What is a Hand Therapist?

A hand therapist is an occupational or physical therapist who, through advanced continuing education, clinical experience and integration of knowledge in anatomy, physiology and kinesiology, has become proficient in treatment of pathological upper extremity conditions resulting from trauma, disease, congenital or acquired deformity. A hand therapist may achieve advanced certification as a certified hand therapist (CHT). To obtain the CHT credential, a therapist must practice for a minimum of five years, accumulating at least 4,000 hours of treatment for hand and upper extremity disorders. Certified hand therapists must also pass a rigorous certification exam to demonstrate their competency in the practice of hand therapy.

What is Hand Therapy?
Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity (shoulder, arm, elbow, forearm, wrist and hand). Hand therapy uses a number of therapeutic interventions to help return a person to their highest level of function. It evolved from the need for a specialist with the knowledge and experience required to manage the challenging recovery of complex hand and upper extremity injuries 

What Can a Hand Therapist Do for Me?
Hand therapists bridge the gap from medical management of upper extremity conditions to successful recovery, allowing individuals to function normally in their daily lives. Hand therapists provide non-operative interventions, preventative care and post-surgical rehabilitation for a wide variety of upper extremity disorders, from simple fingertip injuries to complex replanted extremities. Patients with chronic conditions, such as arthritis, or neurologic conditions, such as a stroke, can benefit from hand therapy through education on joint protection and energy conservation, and with recommendations for adaptive equipment or devices to improve function. A hand therapist employs a variety of techniques and tools, including activity and exercise programs, custom orthotic fabrication, management of pain and swelling and wound and scar care. A hand therapist can also be a consultant in the industrial world, training employees in healthy work habits.


Hand Therapy at TOCA

The TOCA Upper Extremity and Hand Therapists (Certified Hand Therapists) provide services that improve function, increase motion, relieve pain, increase independence in activities of daily living, increase strength and dexterity for return to home, sports or work.

TOCA's Hand Therapists work with individuals of all ages with a variety of injuries or conditions. Their areas of expertise involve evaluation, treatment and custom splinting of the shoulder, elbow, forearm, wrist, hand and fingers.

Hand Therapy is a type of rehabilitation performed by an occupational or physical therapist on patients with conditions affecting the hands and upper extremities. Such therapy is performed by a provider with a high degree of specialization that requires continuing education, and often advanced certification. This enables the hand therapist to work with patients to hasten their return to a productive lifestyle.

To find a TOCA Hand Therapist near you call 602-277-6211 or visit: http://tocamd.com/HandTherapyatTOCA.html


#Results.Recovery.Relief.

602-277-6211
www.TOCAMD.com

Meet Gretchen Bachman - Hand Therapy Manager at TOCA

Gretchen Bachman is the Hand Therapy Manager at TOCA.  Hand Therapists, through advanced study and experience, specialize in treating disorders of the entire upper extremity. All hand therapists at TOCA are Certified Hand Therapists, certified by the Hand Therapy Certification Commission.  Hand Therapists help bridge the gap between medical management with a physician and facilitate patients return to their daily work, leisure and life activities.

Gretchen graduated with her Bachelor’s Degree from Saginaw Valley State University in her home state of Michigan. She became a practicing occupational therapist in 1998, then in 2001 went on to earn her Master’s in Business Administration in Health Care Management. In 2007 she completed her Doctorate in Occupational Therapy in a Hand Therapy cohort. She has been working with TOCA since 2010.

Gretchen has peer reviewed publications in the Journal of Hand Therapy and wrote a chapter on fracture management and dislocations of the upper extremity in the book, Advanced Concepts of Hand Pathology and Surgery: Application to Hand Therapy Practice. She has presented nationally and internationally on the topics of fracture management, digital replantation, rheumatoid arthritis, custom splinting/orthosis fabrication, and various topics related to evidenced based practice.

Nationally, Gretchen has served on the Board of Directors for both the American Society of Hand Therapists (ASHT) and American Association for Hand Surgery (AAHS). She has been intimately involved on various committees, task forces, and special projects within these associations. Gretchen has also served on the Editorial Board for HAND, the official peer-reviewed journal for the AAHS.

Internationally, Gretchen has served on the Education Committee for the International Federation of Societies for Hand Therapy (IFSHT) since 2008. She has also served as the IFSHT Special Events Chair for the 2010 International Meeting when hosted in Orlando, FL.

Gretchen was granted an award through the IFSHT in 2009 and organized a multi-discipline educational conference related to disorders of the upper extremity in Lima, Peru. The Peruvian therapist who hosted this conference won a subsequent award and grant from the IFSHT to travel to the USA, contributing to further educational outreach brought back to her home therapy community in Lima.

Gretchen is passionate about a non-profit organization called the Guatemala Healing Hands Foundation. She has been supporting and traveling on medical mission trips with this organization since 2005.  The GHHF is a nonprofit organization dedicated to improving the quality and availability of health care in Guatemala through education, surgery, and therapy.

There is a Venn diagram of 3 primary areas of service:  Direct patient care, education, and community outreach. Direct service care primarily specializes in the treatment of congenital and pediatric hand injuries.

Direct patient Care:  Following a mandatory screening day, where upwards of 200 children are evaluated to determine their best treatment plan:  surgery, therapy, or other intervention.  Due to GHHF’s unique infrastructure GHHF is able to monitor children year after year to insure they receive the best possible consistent care. Depending on the severity and length of each case, surgical patients are provided with both in and outpatient care with costs covered 100% by GHHF.

Education: Each mission, a two day educational conference is organized annually, and integrates the Guatemalan provider community. GHHF has a unique relationship with the Guatemala Hand Associations, and they are a trusted teaching source and a vital American group providing cutting- edge hand education to both the surgical and therapy communities to over 2,200 doctors, therapists, and students to date.

Community Outreach: The heartbreaking reality and reasons why we meet so many children with serious hand conditions and injuries of the people in this nation cannot be ignored and disregarded. GHHF is committed to addressing the sources behind the problems seen. GHHF has teamed up with the village of Chichoy Alto, in the region of Patzun, Chimaltenango, to improve sanitation, health, education, and the overall quality of life for these 120 families. Community members of Chichoy Alto are required to collaborate and provide a portion of the labor necessary to implement these improvements. Within this community, GHHF has sponsored and constructed 55+ latrines, sponsored and constructed 21 efficient ONIL stoves, distributing crucial fertilizer needed to replenish Chichoy Alto’s barely existent crops, distributed emergency maize to families struggling with malnutrition, helped dig hillside trenches to lay piping to supply fresh water throughout the village, purchased school supplies to the 100+ elementary aged children, and have sponsored many children to attend high school and education beyond. 

In her free time, Gretchen enjoys traveling; camping, reading, and watching her son grow. She enjoys volunteering at his elementary school, and she and her family all recently started volunteering with the Special Olympics, another organization Gretchen has supported for a long time. 

TOCA

602-277-6211

www.tocamd.com

ARTHRITIS AT BASE OF THUMB: Dr. JOSH VELLA

WHAT IS ARTHRITIS?

Any condition that irritates or destroys a joint is referred to as arthritis.  The most common form is osteoarthritis, or as it is sometimes known, degenerative joint disease.   In a normal joint, cartilage covers the ends of the bones and permits their smooth, painless movement against one another.  In osteoarthritis, the cartilage layer wears out, allowing bone to make contact against bone.  As the process worsens, the signs and symptoms of arthritis develop.

The basilar joint, or the first carpometacarpal joint of the thumb, is formed by a small wrist bone called the trapezium and the thumb metacarpal bone.   The unique shapes of these bones permit the thumb to move in and out of the plane of the palm, as well as bend across the palm to oppose the other fingers.  Arthritis involving the base of the thumb is far more common in women than in men, and typically occurs after the age of 40.  A prior history of fracture or other injury to the joint may increase the likelihood of developing arthritis.

WHAT ARE THE SIGNS AND SYMPTOMS?

The earliest symptom of basilar joint arthritis is pain with activities that involve pinching.  These include opening jars, doorknobs, car door and turning keys.  Prolonged or heavy use of the thumb may produce an aching discomfort at the base of the thumb.  Changes in the weather may produce similar symptoms.  As the disease progresses, less stress is required to produce pain.  Pinch strength diminishes.  Activity-related swelling may develop.  Later, any motion of the thumb, even without stress, may become painful.  Eventually the joint begins to appear larger and out of place.  This is usually accompanied by decreased thumb motion.  Often the most difficult maneuver is grasping objects.

HOW IS THE DIAGNOSIS MADE?

A careful history by the physician will give a high index of suspicion of basilar arthritis.  Inspection of the thumb will sometimes reveal a tender prominence at the base of the thumb.  As a diagnostic test your physician may press the thumb metacarpal against the trapezium and move the joint.  This grind test will usually reproduce the symptoms of pain, and may produce a gritty sensation called crepitation.  This represents bone on bone contact, which also may show up on x-ray.

HOW IS TREATED?

Initially, the symptoms of basilar joint arthritis will respond to limited activities and rest.  If this fails, use of an anti-inflammatory medications and a protective splint may be of benefit.  Additional relief of symptoms can sometimes be achieved by a cortisone injection into the joint.  When conservative methods of treatment no longer provide benefit, surgery may be warranted.

The goal of surgery is to decrease pain and preserve motion in the thumb. This is accomplished by removing the destroyed joint and creating a substitute joint called an arthroplasty.  Unrestricted use of the thumb is usually allowed at 12 weeks from surgery.

TOCA

Dr. Feng speaking on Women's Health at Banner Baywoond June 26th

On June 26th from 6pm to 8pm Dr. Feng will be speaking at Banner Baywood Medical Center (6644 E. Baywood Ave., Mesa) on Women’s Health as part of their Spirit of Women seminar series.

“Do you move through life with energy and enthusiasm...or aches and pains?

Problems affecting the major joints of the body like the spine, shoulders, hips and knees can cause persistent pain, interfere with daily living and restful sleep, and develop into more serious problems which can become difficult and complicated to treat.

The seminars will emphasize awareness of risk factors, how to tell if the pain is related to a manageable muscular issue or a serious problem, when to seek medical help and what participants themselves can do, including what they can eat, to fortify their bones. Rest, heat and cold, physical therapy exercises, and simple to sophisticated pain relief methods will be presented, as will traditional and minimally invasive techniques for the minority who may require surgical intervention. All those in attendance will also receive some real recipes that they can cook up at home with ingredients that fortify their bones as they enjoy indulging in them.

Join our medical experts as they help you to “Fortify Your Bones” at our upcoming Spirit of Women seminars.”

Register by calling, (602) 230-CARE (2273). Seminars are free. Seating is limited.
www.BannerHealth.com/SpiritofWomen

TOCA

602-277-6211

www.tocamd.com