Foot Pain


 

FOOT PAIN


The feet support the body and are susceptible to daily wear and tear and to injuries that can cause discomfort and pain affecting your daily quality of life. At the Center for Integrated Pain Management, conditions are diagnosed and treatment plans are tailored for the patient’s optimal health and pain relief. Below is a list of hip, foot and ankle conditions treated at the Center.


  • Plantar Fasciitis
  • Muscle Spasms
  • Foot Osteoarthritis
  • Morton’s Neuroma
  • Nerve Entrapment/Radiculopathy


A diagnosis will be made once Dr. Kulick reviews your family history, completes a thorough physical examination and conducts an in-office ultrasound. If necessary,  Dr. Kulick may request that you obtain an MRI, a CT Scan or additional X-rays in order to determine the diagnosis and treatment plan.


To learn more about the treatment and relief of foot conditions please contact our office at  212-867-1777.


PLANTAR FASCIITIS


What is Plantar Fasciitis?

Plantar fasciitis commonly causes heel pain. A thick band of tissue that connects the heel bone to the toes, called the plantar fascia, becomes inflamed and may develops small tears. This shock absorbing tissue supports the arch of the foot and when stressed can trigger severe pain when walking, standing or running.  Age, weight, regular running or having a high arch or flat foot may be factors.


Seek Treatment for these Symptoms:

  • Stabbing heel pain
  • Pain worsens when walking, standing or running
  • Pain onset immediately after waking in the morning


Next Steps

Consult the Center for a diagnosis and for treatment choices.  Plantar fasciitis treatment options include strengthening exercises, ice application, and ultrasound-guided tenotomy injections to remove diseased tissue followed by ultrasound-guided prolotherapy injections or ultrasound-guided injections of platelet rich plasma therapy (PRP) to accelerate healthy replacement tissue growth.


To learn more about the treatment and relief of Plantar Fasciitis please call us at 212-867-1777.


Muscle Spasms

 

What Are Muscle Spasms?

Muscle spasms are very common and can happen without warning. Perhaps you stand on your toes to reach  for something or sleep in an awkward position. This suddenly triggers a muscle spasm in your foot and you cannot turn or move it without pain. Muscle spasms are the involuntary contraction or tensing of one or more muscles. They may occur in the knee, neck, wrist, forearm, hand, upper or lower back, and legs.  Muscle spasms may be caused by turning suddenly, heavy lifting, muscle overuse, weak muscles, nerve compression, spinal conditions such as degenerative disc disease or a herniated disc, and many sports injuries. Some sports including tennis, golf, football, weightlifting and basketball that require the constant twisting of the spine may lead to back spasms. Spasms may seem to appear out of thin air, however, typically small tears in the muscle may have developed over time. These tears may lead to swelling that compresses the nerves surrounding the muscle. This in turn sparks a muscle spasm that can cause pain, cramping or twitching.

Seek Treatment for these Symptoms:

  • Muscle pain that does not dissipate on its own
  • Constant muscle cramps in your foot
  • Muscle appears hard or distorted

Next Steps

If the muscle spasm does not resolve by itself after a few days of rest, icing the area for short periods of 10 to 20 minutes every two hours or using a heated pad, and taking non-steroidal anti-inflammatory medication, then seek treatment. Consult the Center for a diagnosis and for options.  The spasm may be the result of an underlying condition that can be treated. Once identified, treatment options may include ultrasound-guided corticosteroid injections, trigger point therapy, ultrasound guided prolotherapy injections or anti-inflammatory or muscle relaxant medication. Ultrasound guided injections of platelet rich plasma (PRP), or stem cell therapy may be advised. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections will be recommended.

To learn more about the treatment and relief of Muscle Spasms please call our office at 212-867-1777.

 

Foot Osteoarthritis


What is Osteoarthritis?


Osteoarthritis afflicts millions of people and can curtail physical activities and disrupt daily routines. Know as the wear and tear disease, it causes the gradual weakening of the cartilage. Cartilage is connective tissue that protects the ends of the bones and allows the bones to glide smoothly in the joint. When cartilage deteriorates, bones rub against one another creating inflammation, stiffness and pain. Bone spurs, an overgrowth of the bone, often develop and intensify the pain. Aging and daily attrition accelerates the degeneration of the joint.


Osteoarthritis can occur in any joint – neck, shoulder, elbow, wrist, fingers, hips, spine, knees, ankles, feet or toes.


Seek Treatment for these Symptoms:


  • Pain and tenderness in the foot or toes
  • Loss of range of motion
  • Stiffness in the joint after a period of inactivity
  • Inability to participate in former activities
  • Swollen joints in the toes or feet
  • Difficulty walking especially up or down the stairs


Next Steps


Seek a diagnosis and treatment choices. Dr. Kulick will design a customized treatment plan designed to alleviate the symptoms suffered.  Options include anti-inflammatory medication, ultrasound-guided corticosteroid injections, ultrasound-guided injections of a hyaluronic injection acid such as Synvisc and Supartz to help cushion the joint, ultrasound-guided prolotherapy injections and physical therapy.  Cutting edge therapy such as ultrasound-guided stem cell injections that may stimulate the growth of new cartilage.


To learn more about the treatment of Foot Osteoarthritis please contact our office at 212-867-1777.

 

Morton’s Neuroma


What is Morton’s Neuroma?


Morton’s Neuroma is a painful condition resulting from nerve compression between the third and fourth toes of the foot.  Pain is typically felt at the ball of the foot and it may feel like you are standing on a pebble. The plantar digital nerve provides sensation to the areas between the toes. This nerve runs alongside a major forefoot ligament called the inter-metatarsal ligament. If the nerve is trapped and squeezed by this ligament, the nerve thickens causing further compression, inflammation and pain.  Wearing high heeled shoes or footwear with a tight fit, such as ski boots, have been linked to Morton’s Neuroma. High impact sports like running may also place pressure on the nerve. Women tend to be at higher risk than men for developing this condition.


Seek Treatment for these Symptoms:


  • Burning sensation on one side of the forefoot
  • Tingling or numbness in the toes
  • Pain at the bottom left of the forefoot particularly when walking or wearing shoes
  • Pain may be intermittent


Next Steps

Consult the Center for a diagnosis and treatment options. These may include ultrasound-guided corticosteroid injections, ultrasound guided prolotherapy injections, physical therapy and anti-inflammatory medication. For nerve entrapment, steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections will be recommended.


To learn more about the treatment of Morton’s Neuroma please contact our office at 212-867-1777.



Nerve Entrapment/Radculopathy


What Is Radiculopathy?

Radiculopathy is a group of conditions affecting one or more nerves in the spine. These nerves may become pinched or compressed, causing pain, numbness or tingling in the arms or legs. The sciatic nerve, the large nerve that runs down the lower back, hip, buttocks, and back of leg to the foot may be compressed in the lower back as a result of a herniated disc or other spinal damage.

Radiculopathy commonly occurs in the cervical spine (neck), the thoracic spine (mid back)or the lumbar spine (lower back).

Cervical, thoracic, and lumbar radiculopathy are often caused by herniated discs in the vertebrae (bones of the spine) and spinal stenosis, a narrowing of the hole in the vertebrae through which spinal nerves exit.  This places pressure on the nerves as they branch out from the spine. The compression may also be caused by an injury, overuse of muscles and tendons, poor posture, bone spurs, and arthritis.

Seek Treatment for these Symptoms:

  • Pain that radiates outward from the injured nerve
  • Numbness, tingling, burning sensation
  • Muscle weakness
  • Cervical radiculopathy affects the neck, upper back, shoulder, chest, arm,or hand.
  • Thoracic radiculopathy affects the chest, ribs, shoulders, mid back or stomach area
  • Lumbar radiculopathy causes sciatica which is an irritation of the large sciatic nerve located in the lower back.  This causes pain to radiate down the back of the leg to the calf or foot called sciatica
  • Pain may be aggravated by activities such as walking, climbing stairs or sitting

Next Steps

Consult the Center for a diagnosis and for treatment choices.  Depending on the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, ultrasound -guided injections of platelet rich plasma (PRP), ultrasound-guided prolotherapy injections, physical therapy and anti-inflammatory medication. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve and ultrasound-guided nerve block injections will be recommended.


To learn more about cervical radiculopathy and its treatment please call our office at 212-867-1777.

Location
Alexander Kulick, MD
112 East 61st Street
Upper East Side

New York, NY 10065
Phone: 917-810-4139
Fax: (646) 585-0042
Office Hours

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917-810-4139