Bunion’s consist of a thickened callus, an inflamed bursa and excess bone forming at the side of the first metatarsal head (big toe).
Bunions are diagnosed by the following symptoms:
A bulging bump on the outside of the base of the big toe
Swelling, redness or soreness around the big toe joint
Corns or calluses — often where the first and second toes overlap
Persistent or intermittent pain in the area of the big toe
Restricted movement of the big toe if arthritis affects the toe
My treatments and recommendations
Avoid wearing tight shoes especially high heels with pointy toes. Buy footwear that is wide in the toe box area.
Shoe pads are an option especially if they offer relief.
I teach all of my hallux valgus patients awareness exercises: “Always try to straighten the big toe.” I have them press the big toe into the floor and slide the other four toes and foot laterally until the big toe is as straight as possible. This is how I want the patient to stand all the time.
Stretch the feet and calfs. I am yet to meet a patient with bunions that does not have tight calfs. I have my patients stand with the forefoot on a ½ foam roll (3” high) with the heels on the ground for 2 minutes at a time twice a day. After about two weeks they are able to stand up straighter while doing this stretch. Calf tightness can be a cause of low back pain in and of itself so it is important to take this tightness out of the patient’s body.
Strengthening the involved side glutes, getting the hamstrings length and strength proper, and the peroneus longus strength up to normal is important because it allows the first metatarsal to resist the medially directed component of forces associated with hallux plantarflexion.
Use toe spreaders or a bunion splint especially while sleeping.
Massage CBD (Phyto-Zol) serum into the bunion area two to three times a day.
Shock wave therapy aka pulse wave therapy. I do this directly over the bunion area. This is an effective way to reduce bunion discomfort and even reduce the deformity itself.
Other ways to prevent and ease the pressure and pain caused by bunions include:
Watch your weight – remember, the rest of you is pressing down on your feet when you stand, walk or run.
Taping with Kinesio-tape is very helpful. I bring the big toe into a straight position and tape the toe. I teach the patient how to do this at home on their own.
Cover the bunion with a soft, cushioning, protective moleskin or gel-filled pad.
I check for their footwear and offer off-the-shelf shoe inserts or recommend custom made orthotics.
For the acute flare up I try warm foot soaks, ice packs, whirlpool, more CBD serum, etc.
This protocol has helped many patients avoid surgery.
The goal for patients is to increase movement and pain reduction.
Since ‘no one size fits all’ I offer several forms of treatment that may be helpful. Having the ability to use and combine multiple modalities is providing very positive results in terms of increased movement and pain reduction versus single modalities alone.
An advanced modality that is getting a lot of attention is shockwave. This provides peak pressures that are 1000 times greater than a biphasic ultrasound wave. Shockwave increases local blood flow, increases cellular activity, has an analgesic effect on nerves, and can breakdown calcific deposits (primarily, but not exclusively in tendons).
Laser is another treatment device that can target tissues to impact mitochondrial activity. Laser can be used on nerves, tendons, muscles, ligaments, joint capsules, bone, and wounds.
Pulsed Electromagnetic Field Therapy (PEMF) (MagnaWave) has had FDA approval for muscle stimulation since 1998. PEMF is just gaining popularity as ‘nutritional therapy’ to the cells. It increases nitric oxide levels (same thing Viagra does) and has microcirculation enhancement.
Summary: Combining these 3 modalities along with my hands-on therapy is allowing my patients to feel more supple and experience less pain.
Lymphatic drainage at Dr. Jeffrey Tucker’s office uses the latest technology and takes a whole body approach. The Lymphatic System is one of the most overlooked yet significant systems in the body. The Lymphatic System travels throughout the body to remove waste from every cell while helping to regulate the immune system. It includes a complex network of vessels, ducts, lymph nodes, the spleen, the thymus gland, the adrenal glands, and the tonsils.
The lymphatic vessels act like a giant filter or drainage system for the body that needs to stay moving and clear for it to work properly. Stagnant or sluggish lymph flow leads to waste and toxic build up, weakening immunity and leading to a wide variety of health issues. When your lymph system becomes congested you may notice:
Stiffness, dry skin, water retention, brain fog, stubborn weight gain, chronic sinus congestion, cellulite build up, cold hands and feet.
Dr. Tucker uses the PhysioTouch machine for Lymphatic Drainage. Call 310-444-9393 for more information.
Can you stop the pain of diabetic peripheral neuropathy? It is worth doing a trial of laser and vitamin B12. Both are safe and effective treatments.
B12 supplements are known as one of the easiest and safest ways to help relieve this problem – could utilizing laser coupled with supplements increase the results?
Julie Waldfogel, a Johns Hopkins doctor of pharmacy, authored a paper specifically referring to those diabetics who suffer from the excruciating shooting and burning pain of peripheral neuropathy – here’s what we know: The common drugs prescribed for neuropathy come with some serious side effects.
Duloxetene (better known as Cymbalta) also used to treat fibromyalgia, can cause difficulty breathing, swelling of your face, lips, tongue, or throat, anxiety and panic attacks, depression and suicidal thoughts.
Pregabalin, which goes under the brand name Lyrica and is already prescribed for nerve pain from shingles and diabetes, can cause things such as agitation, aggression, and “dangerous impulses.” As if that wasn’t enough, some of the more common side effects are dizziness, blurry vision, weight gain, and swelling of your hands and feet. It has also been linked to the development of blood vessel tumors.
Duloxetene and venlafaxine are said to potentially increase serotonin levels in the blood — something that can be life-threatening.
On the good side, Vitamin B12 is non-toxic, and has been proven to be effective in helping diabetics with this kind of nerve pain. Doctors learn in medical school that a classic symptom of a B12 deficiency is peripheral neuropathy! And guess what has been found to be “unequivocally demonstrated as the prime factor” linked to a B12 deficiency? None other than the popular diabetes medication called metformin.
A study done at Bethesda Diabetes Research Center in the Netherlands, found using metformin could increase the risk of a B12 deficiency by 19 percent. On top of that, around 25 percent of people in the U.S. are deficient in B12, whether they’re diabetic or not.
Another group of drugs draining your B12 are the acid-suppressing meds called proton pump inhibitors (PPI) like Nexium and Prilosec. So, if you have neuropathy please get your B12 levels checked and make sure you don’t have B12 deficiency. If you’ve been on metformin for any length of time, or have been taking one of those PPI drugs, it makes perfect sense to have your B12 levels checked.
And since we know there is plenty of research that laser helps peripheral neuropathy, do a trial of the TheraLase class 3B laser on the feet, legs and lower lumbar spine. It makes sense to take a B12 supplement and try the TheraLase laser!
Chronic low back pain is the most common and important clinical, social, economic, and public health problem of all chronic disorders. There is a need for improvement to help reduce chronic pain and learn how to manage it. Contemporary pain neuroscience that I use to help persistent chronic low back pain includes
- Identification of central nervous system pain (brain memories of pain) vs actual lower back region pain
- Decreasing chronic inflammation in the body and in the brain itself (Glia cell activation or gliopathy) using laser therapy, extracorporal shockwave therapy and nutrition;
- Improving sleep (poor sleep can increase pain and anxiety);
- Optimize gentle movement therapy to your capacity
My main goals for you include decreasing pain, improvements in coping with pain symptoms, decrease the threatening nature of pain, anxiety, and cognitive speed. I am a specialist in teaching patients how to move again without that “dangerous’ or fear-memory taking over.
If you suffer from chronic low back pain feel free to call for an appointment at 310-444-9393
Does shockwave therapy such as EnPuls and PiezoWave stimulate stem cells in inhibiting disc degeneration and disc herniation? The research and my clinical experience suggest the answer is ‘Yes’. Stem cells can be injected into the area of local damage but this is invasive and costly. We are using EnPuls and PiezoWave pulse therapy and laser (all non-invasive) to stimulate stem cells to interact with the local stem cells and immune system cells to achieve successful disc pain relief and tissue regeneration.
The current theory is that the combination of these non-invasive deep tissue treatments stimulates stem cells that are able to bring more oxygen to the damaged disc and accelerate healing by reversing the low-oxygen (degenerative or dying) environment in the spine. Also inflammation comes in many forms. To keep it simple one type is healing and another type is non-healing inflammation. Research supports stem cells are able to reduce or prevent herniation by suppressing the non-healing inflammation.
Here’s what we think is happening when a shock wave and laser treatment is applied to a damaged joint causing you (in your joints):
- Stem cell stimulation occurs which sends signals to the local stem cells and other growth factors to regroup and begin repairing damaged joints.
- Mesenchymal stem cell (MSCs – connective tissue stem cells) suppress inflammatory T–cell proliferation and provide anti-inflammatory effects. Applying these (Piezo Wave, EnPuls, TheraLase, Light Force) treatment modalities inhibits damaging chronic inflammation.
- Mesenchymal stem cells express various growth factors – these are active molecules that stimulate local tissue repair. These growth factors, and the direct cell to cell contact between MSCs and chondrocytes (the present remaining cartilage cells in the joint), have been observed to influence chondrogenic differentiation and cartilage matrix formation – in simple terms – stem cells regenerated cartilage.
Can shock wave repair disc lesions and other degenerated joints? We are seeing clinical outcomes that suggest it does. Do I think you should try this before more expensive and risky injections of stem cells? The answer is Yes!
Is Shock Wave Therapy Right For You?
My treatment goal is to help you relieve pain as fast as possible. My bigger goal is to help you slow the aging process of muscles, tendons and joints and change the internal environment of the joints from a degenerative condition to a healing condition.
When EnPuls (radial shockwave) therapy or PiezoWave (acoustic waves) is applied to the spine or joints it interacts with the skin, the fascia, the muscles, the blood vessels, nerves, and lymph to cause a mild controlled trauma that will restart the inflammatory and healing cycle. Part of that cycle is stem cell stimulation – the immune cells become ‘re-stimulated’ or ‘re-awakened’ to the site of damage. This will begin or restart the repair process needed.
These newer technologies called ‘shock wave’ are helping the body to re-start the healing cycle, especially if you have had a poor quality of healing take place. Poor quality of healing is probably felt as pain or stiffness in the area of a trauma or where there has been repetitive trauma even after a sufficient amount of time has passed by.
Cartilage is the soft padding that keeps your bones from grinding against each other.
When you’re young, the cartilage between your bones is moist and thick…but as you get older, that soft padding can start to get dry, wear thin or tear. Knee cartilage is meant to be smooth so you can walk, run, and even jump. If you have muscle imbalances this can cause excessive and uneven wear and tear in the joint cartilage.
Over time, friction may develop in the joint and you feel inflammation, burning, discomfort, and pain.
Cartilage pain relief – Patients ask me “Can I regrow and rebuild my joints?” The answer is yes!
I see this happen in patients who get laser and shock wave or pulse wave therapy. You can also make your joints fluid and flexible by decreasing inflammation by losing extra fat if you are overweight. I also recommend water-based “lubrication” supplements that help keep your joints soft and moist. If you need certain exercises I will teach you those.
These new technologies (laser and shock wave) are non-invasive without the pain and risk of costly surgeries or addictive drugs.
Some patients start to feel relief within the first 12-24 hours.
I used this very same procedure of laser and shockwave to help rebuild my knee when I had a meniscus tear years ago. I remember when the radiologist said “You need to go see an orthopedic surgeon”. After seeing the ortho surgeon I decided to use my own machines and it helped me avoid surgery and years of endless pain… and I think it could help you, too.
Laser and Shockwave is the Missing Technology that
Lets Your Body Build MORE Cartilage and Repair Tendons
Call 410-444-9393 for an appointment
We are the only office in West Los Angeles with two types of laser and two types of shock wave devices
I use two different types of shock wave devices for pain relief in my practice. One is a radial pulse wave (EnPuls) and the other is an acoustic wave (PiezoWave). Both carry energy that can be targeted and focused noninvasively to affect a selected region like the shoulder, hip or foot. When these devices are applied to the soft tissues, the impulses or shock waves interact with the targeted tissues and induce a cascade of biological reactions. This results in the release of growth factors, which in turn triggers new blood vessel formation (neovascularization) of the tissue with subsequent improvement of the blood supply and oxygen to the tissues. This helps healing.
Another effect of shock wave therapy is related to the stimulation of cell proliferation, tissue regeneration, and a process through which new blood vessels form from pre-existing vessels called angiogenesis.
The therapeutic effects of shock wave therapy can be used on patients who need pain relief and reduction of inflammation even in cases with diabetes, nerve pain, soft tissue injury, arthritic joint irritation, and healing of bone (2013, Qiu et al; 2013 Liu; 2013 Siegfried).
My practice is located in Brentwood, CA. I can be reached at 310-444-9393.