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Complex Regional Pain Syndrome

Some common facts about Complex Regional Pain

Thanks to our modern science which helped us know a lot about CRPS (complex regional pain syndrome). CRPS is basically a pain condition that effects limbs like feet, hand, legs and arms especially after a trauma or injury. In some cases it is mild, some its moderate and in other cases it is severe too.

CRPS can occur due to malfunction or damage of central or peripheral nervous system. The central nervous system comprise of spinal cord and brain and peripheral nervous system consists of nerve signaling via spinal cord and brain to the entire body.

Some common facts about CRPS are

The pain is not directly associated to range of damage or injury

The pain that occurs in case of CRPS can be unbearable without affecting much to tissue health. Remember this pain part of protection of the body on its own and doesn’t indicate any tissue damage.

The limb that is affected can feel different from the way it actually looks

Here temperature and size are included. It also feels like detaches, not mine, doesn’t belong to me . The loss of sensation of owning the limb occurs as brain produces this sense, but brain can also regulate it.

The symptoms absolutely can change depending on how you feel and your mood

Stress can increase the pain. This is because of identified threat to the individual triggering  protection.

Looking at someone who can move their body part leads to depression or hurt you

The brain imitates the similar movement leading to actual pain.

Change in color of limb because of change in blood flow

The ANS (automatic nervous system) controls our blood flow. This system answers to identified threat – fright, flight, freeze.  In simple words this system responds to what and how we think. When it is a embarrassing situation for us we turn to red.  This is due to how we though of that situation. The ANS becomes sensitive, and is asoosciated with CRPS – sweaty palms, changed sense regarding size and color change.

The women are affected almost 3 times more than men. A series of CRPS  treatment is conducted normally to improve symptoms of CRPS. A MRI, x-ray, bone scan or a test of nervous system can help a person know if he/s she has CRPS.

A majority of CRPS patients within the age group of 30-55 years and CRPS can spread occasionally from one part to another anywhere in our body like opposite limb. Symptoms and signs exists from months and extend to years and treatment is only effective when started in initial stages of the disease.

The condition takes several to many years to improve. Approx 75% of patients get back to normal condition whereas some near normal. About 15 per cent have permanent diability(moderate) and 10% cases suffer from permanent diability(severe). Fifty percent of people who remain untreated end up facing extreme residual impairement.

It is better to get your CRPS condition treated in early stages of illness to avoid severe impairment.

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Complex Regional Pain Syndrome

Learning about causes of Complex Regional Pain Syndrome

Complex Regional Pain Syndrome is a disease and is a nerve disorder which is rare. Its symptoms start with intense pain that can arise in legs, hands, feet and hands. It happens when you come across a serious injury to the nerve or tissue of the area which is affected. The pain increases and often captures leg or arm. Some changes noticed in areas that get affected post the disorder is sudden changes in temperature and color of the skin. Other symptoms are burning pain which is very intense, skin sensitivity, sweating and swelling.

The theory written for the cause of this condition says it is because of triggering of our immune system, which causes inflammation in the area that is affected. Various symptoms of Complex Regional Pain Syndrome are

The affected area gets sensitive to touch

Change in texture of the skin

Painful and burning sensation in area which gets affected

Movement loss in affected area

Muscle weakness and pain

Change in color of the skin

Affected area gets sensitive o sometimes touch and sometimes to temperature.

Even if the disorder is not very common, the doctors are very much aware about this condition. The doctors diagnose based on the result of pain symptoms and physical examination. The above stated symptoms help doctor diagnose the problem correctly. The doctors also take other test like thermography, sweat test, tests for sympathetic nervous system. The disease can be diagnosed but there is not test that determines the disease Complex Regional Pain Syndrome.

Two types CRPS are

Type one CRPS (Complex Regional Pain Syndrome) – this type of disorder is caused because of injuries of ankles which get sprained or fractured. The nerve damage in this case is minimal.

Type two Complex Regional Pain Syndrome- this type of disorder is caused due to serious injuries where the nerve damage is quite serious like a broken bone or infection. Though it is rare there is a solution to this condition and doctors suggest sympathetic block, which involves anesthesia injection that helps in obstructing signals. Counseling and physiotherapy also helps many times. If the disorder is detected in its early stages the pain can be prevented from recurring through relevant treatments.

The disease affects women that fall under the age of forty to sixty. During advance stages a mere touch on the part that is affected or exposure to change in temperature increases the pain which is unbearable. Some people get frequent attacks while some are lucky and the pain disappears completely after a couple of months. There are also some symptoms which are extreme and visible such as growth of hair and nail. The growth is at either abnormal speed or is very slow.

Some people also experience clammy hands due to excessive sweating. If you notice symptoms being mentioned above it is better to consult your doctor immediately in order to get timely treatment which can help you reduce pain and stop pain from recurring.

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Fibromyalgia

Fibromyalgia and Back Pain

Fibromyalgia has only recently been used as a term to diagnose patients that suffer from a particular series of abnormalities revolving around chronic muscular irritation. This disorder has been found to be associated with a degenerating spine from neck to tailbone. Many sufferers experience severe back pain because muscle pain is one of the most common complaints of patients suffering with this disorder, which suggest there is a connection between fibromyalgia and back pain.

The treatment options for fibromyalgia and back pain range from holistic remedies to over the counter and prescription strength medications. Other forms of treatment include remedies applied to the area like electronic stimulation that can bring relief to sore muscles, ultrasound treatments and a combination of ice and hot packs. One of the most effective ways of reducing or even stopping your pain is an exercise regime consisting of low level exercise.

Pain

Pain is a description and not an entity, it is one of the ways our body tells us that something is wrong. Pain increases stress levels which in turn increases the level of cortisol released into the body. Prolonged levels of cortisol in the bloodstream has been shown to have negative effects.

This can include impaired cognitive performance, suppressed thyroid function, blood sugar imbalances such as hyperglycaemia, decreased bone density, decrease in muscle tissue, higher blood pressure, lowered immunity and inflammatory responses in the body, thus lowering the pain threshold. This pain can lead to sleep problems, which can also lead to more pain.

Fibromyalgia

Fibromyalgia is by far the most complicated and misunderstood condition associated with chronic pain. The symptoms and resulting back pain vary in severity. It is cross-cultural, race, sex and age indiscriminate, however this chronic condition appears to primarily affect middle-aged women, although men and children can be diagnosed with the disorder as well. Fibromyalgia involves the muscles and soft tissue of the body, causing pain and discomfort in many areas at one time. Its sufferers have also been known to not get into the deepest phase of sleep, known as the delta stage, and therefore their muscles do not shut down and rest properly.

Most sufferers of this condition have found that a combination of treatments is more effective in alleviating their symptoms. Health experts are now approving the idea that small amounts of unprotected sun exposure can be health-friendly, especially for patients of fibromyalgia. Massage and whirlpool therapy can also be effective methods for relieving the discomfort. Medications for fibromyalgia and back pain can be found in herbal supplements, over the counter medications and prescriptions, and it can be a matter of trial and error until you find the best choices that bring the most relief. Glucosamine and MSM have both shown promise in the treatment of this condition, and there are numerous other vitamin and mineral supplements that you can try as well. Prescription medicine often entails an antidepressant that can be effective on the chronic pain as well as the psychological effects of fibromyalgia and back pain.

One of the best things you can do if you have fibromyalgia is exercise. Begin with stretching exercises and gentle movements such as pilates and yoga. The type of exercise you choose is up to you. It’s important that you start exercising and keep doing it. Exercise relieves much of the pain fibromyalgia causes. Some people even find that exercise makes all their pain go away. You will also feel better if you take some control over your own care and well-being.

Categories
Complex Regional Pain Syndrome

Pain in the Butt – Understanding Piriformis Syndrome

Piriformis Syndrome is a condition where a small muscle known as the piriformis muscle  spasms or contracts in a way that irritates the sciatic nerve.  This results in pain in the hip or buttocks region, though it may also shoot into the lower back and thigh as well.

What is this piriformis muscle and why is it such a pain in the butt — literally?

The piriformis is a small muscle that is responsible for the rotation of your hip and legs.  It is located deep inside the hip joining the sacrum and the femur bone (basically the lower back and the thigh).

The hip is a very complex joint made up of many muscles and tendons.  The piriformis is the small muscle in the middle of it all running over the sciatic nerve.

Piriformis Syndrome is primarily caused by tightening of the piriformis muscle causing it to crush the sciatic nerve.  This tightening can be the result of either overworking the muscle (as in training errors) or mechanical imbalances (poor posture, etc.).

Overworking the muscle is often attributed to athletes and others that participate in a good degree of physical exercise.  However many cases occur in people that live relatively sedentary lives rarely exerting themselves the way an athlete would.  These other overworking causes may include:  exercising on hard surfaces or uneven ground, beginning a fitness program too aggressively after not exercising for quite some time, increasing intensity too fast, wearing shoes that don’t fit you properly, or sitting for long periods of time (say, in a cubicle?).

Mechanical Imbalances are related to the structure of the body and its mechanisms.  Poor posture, herniated discs, or simply the manner with which you hold yourself or move your body as you walk can be responsible for this.

The symptom of Piriformis Syndrome is most commonly a deep pain within the hip or buttocks, but as stated earlier, this pain can also run into the thigh or lower back as well.  However, weakness and stiffness is also a rather common symptom as well (remember that Piriformis Syndrome is caused by an overworked or tense muscle).  Tingling and numbness in the legs can be experienced from time to time.

Categories
Complex Regional Pain Syndrome

Causes Of Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a rare nerve disorder. It’s symptoms usually causes intense pain and the affected areas may be hands, arms, legs and feet. It usually happens after a serious injury to the tissue or nerve of the affected areas. The disorder is also called Causalgia. The cause responsible for the disorder is unknown. The pain often spreads to the entire arm or leg. Some of the changes observed in the affected areas post the disorder are dramatic changes in the color and temperature of the skin of the affected limb. Other symptoms also include skin sensitivity, intene burning pain, swelling and sweating. Although there are some theories behind the cause of this disorder, the authenticity of these theories are questionable. One theory is the cause behind the sustainance of the pain may be the sympathetic nervous system. The other speculation is the CPRS is caused by the triggering of the immune response which leads to the inflammation in the affected area.

The various symptoms of CRPS are listed as below:

A burning, painful pain in the affected region (usually an arm, leg, hand oe foot)
Change in skin color (may turn red, blue or white)
The affected area may be sensitive to touch, temperature
Change in skin texture (either too thin or shiny)
Loss of movement in affected areas
Muscle pain and weakness

Although it is a rare disorder, most doctors are familiar with it. The doctor will make a diagnose on the basis of a physical exam and the pain symptoms. The above symptoms will help the doctor make a correct diagnosis. Although, the disease is diagnosable, there is no one single test to determine CRPS. For instance, the doctor may take a test to check the skin temperature and the amount of blood circulation to a particular area. In case the diagnose is doubtful, a magnetic resonance imaging (MRI) can help determine CRPS.

There are two kinds of CRPS which have completely different causes. They are listed as follows:

1)Type one CRPS- This disorder is triggered by injuries such as ankles which are fractured or sprained. There is usually minimal nerve damage.
2)Type two CRPS- This type of disorder is caused by more serious injuries where there has been nerve damage such as an operation, a serious infection or a broken bone.

Although the disorder is rare, but it is not completely eradicated. Putting a number is hard, the estimate change from country to country. Some countries have 1 affected in 18, 000 whereas others have 1 in 4000. CRPS is more common amongst women and people between the ages of 50 to 70.

There is solution for the disorder. Doctors usually recommend sympathetic block. This usually involves an injection of anaesthesia which obstructs the pain signals. Physiotherapy and counselling may help at times.

If the disorder is diagnosed early regular treatments may help keeping the pain from recurring. But if it is diagnosed later or if the symptoms are severe, the patients may not respond to treatments.

Categories
Nociceptive pain

Joint Pain

You need ten thousand steps a day to meet the guidelines for physical activity to improve health. However , if you are like most people, who find walking painful or you fear your joints might buckle beneath you, each step might as well be a mile.

Your knees and hips are your largest joints. They support your body’s weight and they must work in close coordination to provide the mobility most people take for granted until injury, arthritis, or other problems interfere.

Depending on the cause of your pain, the solution might be a set of exercises designed to strengthen and stretch the muscles that support the joint, taking some of the stress off the joint itself. Minor surgery may also help.

For many people, knee and hip problems become so intractable that the best solution is to replace a worn-out knee or hip with a mechanical joint. In 2003, there were about 902, 000 knee replacement and 728, 000 hip replacement procedures performed worldwide. The average age at which a person has such surgery is 65 to 70.

Physically, your knees and hips are closely interdependent, located as they are at either end of the thighbone. This proximity means the angle of your hip affects the pressure on your knee. A hip disorder may cause knee pain, and knee disorders can aggravate hip problems.

People live longer than they used to, so joints need to stay strong and healthy through those additional years. Nevertheless, both knees and hips are subject to wear and tear as you age, and you can traumatize them further if you increase your physical activity suddenly.

Medical care has changed in recent years. Doctors used to follow surgery by immobilizing the joint with a plaster cast. Weeks of immobility caused the muscles to weaken and shorten, resulting in long-lasting stiffness and poor function. Today, you can wake up from surgery with your knee already being gently bent and straightened by a machine. In addition , knee and hip replacements have freed thousands of patients from life in a wheelchair or on crutches.

Surgical techniques have also advanced. More surgery is performed through tiny incisions using an arthroscope, often on an outpatient basis. Pain relief has moved away from mind-clouding narcotics toward pain relievers that tackle the twin problems of pain and inflammation.

And finally, prevention has moved to center stage, alongside surgical repair and rehabilitation. More strength training added to your daily exercise routine helps support the joints and protect them from injury.

Water exercises support your weight, reducing stress on your joints. One in five people over age 60 has experienced significant knee pain, and one in seven people over age 60 reports significant hip pain.

Categories
Complex Regional Pain Syndrome

Causes Of Complex Regional Pain Syndrome

The disease Complex Regional Pain Syndrome (CRPS) is a rare nerve disorder. It’s symptoms usually causes intense pain and the affected areas may be hands, arms, legs and feet. It usually happens after a serious injury to the tissue or nerve of the affected areas. The disorder is also called Causalgia. The cause responsible for the disorder is unknown. The pain often spreads to the entire arm or leg. Some of the changes observed in the affected areas post the disorder are dramatic changes in the color and temperature of the skin of the affected limb. Other symptoms also include skin sensitivity, intene burning pain, swelling and sweating. Although there are some theories behind the cause of this disorder, the authenticity of these theories are questionable. One theory is the cause behind the sustainance of the pain may be the sympathetic nervous system. The other speculation is the CPRS is caused by the triggering of the immune response which leads to the inflammation in the affected area.

The various symptoms of Complex Regional Pain Syndrome are listed as below:

A burning, painful pain in the affected region (usually an arm, leg, hand oe foot)
Change in skin color (may turn red, blue or white)
The affected area may be sensitive to touch, temperature
Change in skin texture (either too thin or shiny)
Loss of movement in affected areas
Muscle pain and weakness

Although it is a rare disorder, most doctors are familiar with it. The doctor will make a diagnose on the basis of a physical exam and the pain symptoms. The above symptoms will help the doctor make a correct diagnosis. Although, the disease is diagnosable, there is no one single test to determine Complex Regional Pain Syndrome. For instance, the doctor may take a test to check the skin temperature and the amount of blood circulation to a particular area. In case the diagnose is doubtful, a magnetic resonance imaging (MRI) can help determine CRPS.

There are two kinds of CRPS which have completely different causes. They are listed as follows:

1)Type one CRPS- This disorder is triggered by injuries such as ankles which are fractured or sprained. There is usually minimal nerve damage.
2)Type two CRPS- This type of disorder is caused by more serious injuries where there has been nerve damage such as an operation, a serious infection or a broken bone.

Although the disorder is rare, but it is not completely eradicated. Putting a number is hard, the estimate change from country to country. Some countries have 1 affected in 18, 000 whereas others have 1 in 4000. Complex Regional Pain Syndrome is more common amongst women and people between the ages of 50 to 70.

There is solution for the disorder. Doctors usually recommend sympathetic block. This usually involves an injection of anaesthesia which obstructs the pain signals. Physiotherapy and counselling may help at times.

If the disorder is diagnosed early regular treatments may help keeping the pain from recurring. But if it is diagnosed later or if the symptoms are severe, the patients may not respond to treatments.

Categories
Neuropathic pain

Dealing with the Pain in the Nervous System

Any damage or disorder in the nervous systems normally leads to neuropathic pain. Neuropathic pain is a very intricate and never-ending pain acquired as a result of injured or dysfunction of tissue in the nervous system. This is often the case when the nerve fibers are injured, damaged or are not performing as it should.

Neuropathy can result from dysfunctions of the peripheral nervous system or the central nervous system. With damage to the peripheral nervous system, all the nerves branching from the spinal cord to all parts of the body might be affected. Patients with peripheral neuropathic pains can suffer from muscle pains, tingling and numbness, shooting and burning pains, muscle wasting, paralysis, and gland or organ dysfunction.

Certain pains, like central neuropathic pains are often seen as a result of multiple sclerosis, spinal cord injury and other types of injury to the brain like partial paralysis and stroke.

Individuals with diabetes, fibromyalgia, herpes-zoster infection, multiple sclerosis, cancer, and HIV-related disease can suffer from neuropathic pains.

Neuropathy pain relief and treatments:

Antidepressants: These are used to limit the pain signals from the nerve endings to the brain resulting in the relief of neuropathic pain. However , use of antidepressant is not recommended for depressed patients because it may trigger the wrong signals in the brain and alleviate depression instead of the pain.

Anticonvulsants chemical properties: Anticonvulsant plants like hypericum perforatum and coriandrum sativum can block specific neurons on the brain, thus lessening or relieving pain caused by peripheral and central neuropathy.

Opioids: This is becoming more renowned as part of treatment for neuropathic pains. Although not first in line in neuropathic pain treatment, opioids are still considered the most consistently effective relief for this condition. It must be noted that opioids are only appropriate for use in some individuals and close supervision is always recommended.

Anti-inflammatory painkillers: These are commonly used to relieve neuropathic pain. Severe cases may require stronger dosage or painkillers like morphine.

Topical ointments: These can serve as agents mainly used to desensitize the skin nerves and reduce skin sensibility. However , benefits and effects appear to be modest.

Dietary supplements: Dietary supplements that can give relief are benfotiamine and alpha lipoic acid, not only for neuropathic pain but for diabetics also. However , non-diabetic individuals may not reap the same benefits from these dietary supplements.

Spinal cord stimulators: By placing electrodes next to the spine, this will help to treat spinal cord injury from the outside.

Neuropathic pain relief does not only come from pharmacological treatments, but from lifestyle changes like avoiding alcohol; getting cognitive remedial exercise like yoga, massages, chiropractic care, meditation and other types of exercises. Acupuncture is also sought by some neuropathic pain sufferers, which can produce variable results. Long-term solutions without significant complications are still being improved and undergoing clinical trials.

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Neuropathic pain

Aarkstore Enterprise – Neuropathic Pain – Pipeline Assessment and Market Forecasts to 2016

Aarkstore announce a new report “Neuropathic Pain – Pipeline Assessment and Market Forecasts to 2016” through its vast collection of market research report.

Summary

The industry analysis specialist’s new report, “Neuropathic Pain – Pipeline Assessment and Market Forecasts to 2016”, is an essential source of information and analysis on the global neuropathic pain market. The report identifies the key trends shaping and driving the global neuropathic pain market. The report also provides insight into the prevalent competitive landscape and the emerging players expected to bring significant shifts in the positioning of the existing market leaders. Most importantly, the report provides valuable insights into the pipeline products within the global neuropathic pain sector.

This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData’s team of industry experts.

GlobalData estimated the global neuropathic pain market to be valued at $ 4. 8 billion in 2008. It is expected to grow at a Compound Annual Growth Rate (CAGR) of approximately 4. 3% from $ 4. 8 billion in 2008 to $ 6. 5 billion in 2015. This growth will be supported by the increase in the aging population, increased treatment seeking behavior and increased uptake of the current products. The diagnosis rate remains as one of the barriers for the growth of the market. The available treatment options are moderately successful in meeting the market demand. There is still a need for better therapy and there exists unmet needs. There exists a market potential for any new entrant that will cater for these unmet needs. There is enormous opportunity for any drug that could match or better the efficacy provided by the current players with increased safety.

Scope

The scope of the report includes:
– Annualized global neuropathic pain market revenues data from 2001 to 2009, forecast forward for eight years to 2016.
– Pipeline analysis data providing a split across different phases, mechanism of action being developed and emerging trends. Key classes of mechanism of action include opioid receptor agonists, cannabinoid receptor modulators, NMDA antagonists, protein kinase inhibitors, ion channel targetters, serotonin norepinephrine reuptake inhibitors, adenosine agonists, cytokine modulators, AMPA antagonists, nicotinic receptor agonists, TRPV1 receptor agonists, selective subtype sodium channel antagonists and iNOS/nNOS dual inhibitors.
– Analysis of the current and future market competition in the global neuropathic pain market. Key future market players covered are NeurogesX, Cephalon Inc., UCB S. A., Newron Pharmaceuticals, EpiCept Corporation, GW Pharmaceuticals, Johnson & Johnson, Avanir pharmaceuticals, GlaxoSmithKline plc and AstraZeneca.
– Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide a qualitative analysis of its implications.
– Key topics covered include strategic competitor assessment, market characterization, unmet needs and the implications for future market associated with neuropathic pain.

Reasons to buy

The report will enhance your decision making capability in a more rapid and time sensitive manner. It will allow you to:
– Develop and design your in-licensing and out-licensing strategies through a review of the pipeline products and technologies and by identifying companies with the most robust pipeline.
– Develop business strategies by understanding the trends shaping and driving the global neuropathic pain market.
– Drive revenues by understanding key trends, innovative products and technologies, market segments and companies likely to impact the global neuropathic pain market in future.
– Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
– Identify emerging players with potentially strong product portfolio and create effective counter-strategies to gain the competitive advantage.
– Organize your sales and marketing efforts by identifying the market categories and segments that present the maximum opportunity for consolidations, investments and strategic partnerships.
– What’s the next big thing in the global neuropathic pain market landscape? Identify, understand and capitalize.

For more information, please visit:
http://www.aarkstore.com/reports/Neuropathic-Pain-Pipeline-Assessment-and-Market-Forecasts-to-2016-65412.html
Or email us at press@aarkstore. com or call +919272852585

Categories
Headache and Treatment

What Causes Foot Pain?

Pain is an indicator that something is going wrong in person’s body and needs to be taken care of. Foot pain is one of the most common diseases. A research showed that 75% of people have suffered from at least one form of foot pain during their lives.

Our bodies are like machines. They have joints and links. In time, these joints wear and tear, so they need to be taken care of regularly. Foot pain is not just a pain that is going to go away after some time, but it can get serious if ignored. The foot has to be positioned properly in order to function correctly. Any kind of twisting or over-Pronation will cause severe damage to the foot and will also change the way the body’s bio-mechanics function.

Foot pain can be divided into three main categories. The most common one is the Biomechanical Pain which is caused by functionality disorder in the foot. In this type of pain, all increased activities may cause the foot condition to worsen over time. It may take other symptoms such as knee pain or body misalignment. There are many reasons why biomechanical pain happens such as foot misalignment. Foot misalignment is caused by excessive weights, which can put a lot of pressure on the foot; especially the heels. Wearing tight shoes or high heels is not recommended for those who suffer from foot pain. Any kind of injury may affect the foot such as fractures, bruises or trauma. Any of those conditions can have very serious consequences on the foot proper mechanics.

Infections can have serious impact on human bones, especially the legs. One can be infected by bacteria or microbes. Bacterial infections have the ability to cause death to the patient. But we need to have bigger scope on these diseases. Not only does foot pain come from foot-related diseases, but it may also be caused by other diseases such as diabetes and arthritis. Those are examples of systemic diseases and each one of them has its own way affecting the foot.

Diabetes reduces the amount of blood supply that is going down to the foot. As a result, it causes severe damage to the nerves down the legs. This is why systemic diseases are very dangerous to the foot.

Arthritis is a condition in which the body’s joints are affected and cause a significant pain to the patient. When combined with mechanical abnormality, severe consequences may occur.

There are many treatment methods to foot pain, but we need to consider all of the above symptoms and causes so that a perfect solution can be chosen amongst all available solutions. DocPods help heal the biomechanical foot pain. DocPod Orthotic helps support the natural arches and limit the pain caused by the disease. There are three different types of the DocPod Orthotic: The Ultra Soft Orthotics, 3 Quarter Orthotics, designed for people work use, and Slimline Orthotics, designed for fashionable shoes.