Focus on the Foot
Spend a day, or even half a day, in just about anybody’s pain clinic and you will be forced to deal with a problem below the knee. Our aging and infirm population puts a lot of wear and tear on the distal, lower extremities. As if the plain old trauma of ambulation isn’t damaging enough, a whole bunch of pesky and painful disorders, such as diabetes, arthritis, varicose veins, arteriosclerosis, and autoimmune disease, just love to attack below the knee.
Given the critical need to address and deal with painful leg and foot problems, Practical Pain Management is inviting the podiatry profession to join us. As a start, we’ve asked Stephen L. Barrett, DPM, MBA, FACFAS, to join our Editorial Board. In this issue, he gives us a most excellent essay on the role of podiatry in pain management. He touches on some of the innovative therapies that his profession is developing and implementing.
It might surprise some of our readers that podiatrists in most states can now prescribe controlled substances and order a full array of laboratory and x-ray tests, which we routinely require for upscale pain management. Lately, I’ve had the opportunity to meet and work with many fine podiatrists in several Veterans Affairs hospitals. I initially was quite surprised to find that many of their concerns and issues were the same as mine: centralized pain, high-dose opioids, unmotivated patients, medication abuse, and a need to objectively separate the real patient from the malingerer. My even greater surprise was some of the creative and helpful solutions to recalcitrant pain problems that podiatrists have pioneered.
Any experienced pain practitioner knows that pain management requires a multidisciplinary team. My recall is such, however, that the podiatrist is seldom mentioned or included as a team member. The high prevalence of painful diseases that occur below the knee clearly calls on all of us to invite the podiatrists in our communities to be members of our teams. Please suggest to any podiatrist you know who has a special interest in pain that they sign up for a subscription to Practical Pain Management. Podiatrists, welcome aboard! We need you!