Multiple Sclerosis
Multiple Sclerosis (MS) is a chronic, potentially debilitating disease that affects your brain and spinal cord (central nervous system). The illness is probably an autoimmune disease, which means your immune system responds as if part of your body is a foreign substance.

In the case of MS, your body directs antibodies and white blood cells against proteins in the myelin sheath surrounding nerves in the brain and spinaal cord. This causes inflammation and injury to the sheath ultimately to the nerves. The result may be multiple areas of scarring (sclerosis). The damage slows or blocks muscle coordination, visual sensation and other nerve signals.

MS generally first occures in people between ages of 20 and 40. An estimated 330,000 Americans have MS. The disease is twice as common in women as in men.

Multiple Sclerosis Types

• Benign
• Relapsing-Remitting
• Primary Progressive
• Secondary Progressive
• Progressive Relapsing

Signs and Symptoms

• Numbness, weakness or paralysis in one or more limbs
• Brief pain, tingling or electric shock sensations
• Tremor, lack of coordination or unsteady gait
• Impaired vision with pain during movement in one eye
• Disordered eye movements, causing double vision or moving field of vision
• Fatigue
• Dizziness

As the disease gradually worsens, muscles spasms, slurred speech, vision loss, problem with bladder, bowel or sexual function and paralysis may develop. Occasionally, mental changes such as forgetfulness or confusion occur.

Common Foot Problems

Bunions
If you have a bunion, you know it can be painful enlargement at the joint of the big toe. The skin over the joint becomes swollen and is often quite tender. Bunions can be inherited as a family trait, can develop wiht no recognizable cause or can be caused by shoes that fit poorly.

Morton's Neuroma
Morton's Neuroma is caused by a nerve being pinched. This pinching usually results in pain between the third and fourth toes. Tight shoes can squeeze foot bones together. The nerve responds by forming a neuroma, a build up of tissue in the nerve. The neuroma results in pain, that may radiate into the toes.

Treatment usually involves wearing wider shoes and taking oral medications to decrease the swelling around the nerve. A pad on the sole of the foot to spread the bones is often helpful. Your doctor may also inject cortisone around the nerve. If your difficulty continues, surgery to remove the neuroma may be suggested.

Hammertoes
Hammertoes are one of several types of toe deformities. Hammertoes have a permanent sideways bend in your middle toes joint. The resulting deformity can be aggravated by tight shoes and usually results in pain over the prominent bony areas on the top of the toe and at the end of the toe. A hard corn may develop over this prominence.

Treatment usually involves a shoe to better accommodate your deformed toe. Shoe inserts or pads may also help. If, after trying these treatments, you are still having marked difficulty, surgical treatment to straighten the toe or remove other or remove the prominent area of bone may be necessary.

Corns and Calluses
Corns and calluses are caused by pressure on the skin of your foot. They may occur when bones of the foot press against the shoe or when two foot bones press together.

Common sites for corns and calluses are on the big toe and the fifth toe. Calluses underneath the ends of the foot bones are common. Soft corns can occur between the toes.

Treatment involves relieving the pressure on the skin, usually by modifying the shoe. Pads to relieve the bony pressure are helpful, but they must be positioned carefully. On occasion, surgey is necessary to remove a bony prominence that causes the corn or callus.

Diabietes and Foot Problems
Diabetes is a serious condition that can develope from the lack of insulin production in the body or due to the inability of the body's insulin to perform its normal everday functions.

Neuopathy
Of the sixteen million Americans with diabetes, 25% will develop foot problems related to the disease. Diabetic foot conditions develop from a combination of causes including poor circulation and neuropathy. Diabetics suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity. If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can cause deformities such as bunions, hammer toes, and charcot feet.

Poor Circulation
Diabetes often leads to peripheral vascular disease which inhibits a person's blood circulation. Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrition supplied to the skin and other tissues, therefore causing injures to heal poorly. Poor circulation can also lead to swelling and dryness of the foot. Preventing foot complications is more critical for the diabetic patient since poor circulation impairs the healing process, and can lead to ulcers, infection, and other serious foot conditions.

Ulcers of the Foot
An ulceration of ulcer is usually a painless sore at the bottom of the foot or top of the toes, resulting form excessive pressure at that site. Ulcers frequently underlie a pre-existing corn or callus that was allowed to build up too thickly. Trauma from heat, cold, shoe pressure, or penetration by a sharp object are also potential causes. Neuropathy allows the lesions to develop because the normal warning sense of pain has been lost and they go unrecognized. Continued pressure or walking on the injured skin creates even further damage and the ulcer will worsen. The open sore will frequently become infected and may even penetrate to bone.

Infection
Persons with diabetes are generally more prone to infections than non-diabetic people. Due to deficiencies in the ability of white blood cells to defend against invading bacteria, diabetics have more difficulty in dealing with and mounting an immune response to the infection.

Prescription Foot Orthotics
Prescription foot orthotics are custom made inserts for your shoes designed to address various foot and lower body conditions. The manufacturing and materials used vary based on patients needs, activities and health factors. Orthotics are often prescribed to accommodate various foot conditions such as plantar fascititis, metatarsalgia and soft tissue degeneration. Foot orthotics can also assist in the care of lower body conditions like back pain, diabetic ulcers and knee problems.

How Does an Orthotic Help?
An orthotic is a custom made device that controls the amount of excessive pronation and supination that a foot goes through when walking, running, or cycling. All people naturally pronate and supinate but excessive movement either way can be problematic. Pronation control shoes or shoes with stabilizing features help to control wearing of the shoe while orthotics help to control the stabilizing of mechanics of the body.