Thursday, 30 June 2011

Support for the Feet

Anyone who has neuropathy problems in their feet knows exactly what this post is talking about. You do end up walking differently,either because you can't feel parts of your feet anymore, or they're so painful you invent a sort of 'self-protection' walk for yourself. Quite often it's not until somebody asks, "Why are you walking like that?" or starts making Monty Python, 'Ministry of Funny Walks' jokes, that you realise what you are subconsciously doing. Of course, it's absolutely no joke and it's very important that we take any measures necessary not to fall, or damage things further.
The problem is that by adjusting our walks, we aren't doing our feet any favours and there are plenty of bones, muscles and nerves in the feet to make your life miserable if you damage them. For that reason alone, investing in the right shoes or in-soles, to give as much support as possible, has to be a wise move. Dr. Scholl won't be available in every country but there will probably be an equivalent, or at least an orthopaedic practitioner/retailer who can make shoes to measure. Buying from the Internet is probably not a good idea because of the personal attention needed - everybody's neuropathic needs are different. This is another helpful post by Canadian, Bob Leahy, writing for

Good news (I think) for relieving that hurting feeling from peripheral neuropathy- affected feet
Bob Leahy checks out Dr Scholl’s Foot Mapping Technology and Custom Fit Orthotic Inserts

So regular readers will know my feet are a mess, the product of peripheral neuropathy caused perhaps by the prescribed drugs I take or have taken, perhaps by HIV itself. I’ve recounted here more than once how this side-effect induced pain in the feet has advanced so that it's hard to get it under control. Firstly my healthcare team has withdrawn Truvada from my five-drug combo and secondly they have added Gabapentin to the mix.

For my part, I have invested in New Balance brand shoes which I wear most of the time – they have a lot of cushioning, come in wide fittings, and are probably the most comfortable shoes I’ve ever owned. But they just can’t stave off the affects of neuropathy. In my case, I walk differently when my feet are hurting, which in turn eventually makes your lower-back hurt and turns you in to one miserable SOB.

So I was definitely in the market for alternative solutions.

Dr Scholls “Orthotic Centre” first caught my eye in our local Wal-Mart. I saw one again at Costco last week and decided to give it a try. It’s a fearsome looking shoulder-high kiosk with a platform you stand on, having removed your shoes. There are two handles to hold on to. A computer screen tells you what to do. Lean forward. Raise one leg and lean forward. Raise the other leg and lean forward. The machine meanwhile is mapping the pressure points on the underside of your feet. The result is a customized recommendation for one particular smodel of Dr Scholl’s orthotic inserts, of which there are many.

The technology behind the kiosk as well as what goes in to the three-layered inserts is described here.

The kiosk contains a supply of the inserts in all the various fits that the computer might recommend. My test resulted in a recommendation for the CF340 model which provides extra-good support for the arches. I know mine had suffered badly though having to walk flat-footed because of the neuropathy, in effect taking pressure off my toes. The inserts aren’t cheap – at Costco they are $70, for which you get two pairs, which realistically you probably need. But that $70 price compares with the hundreds of dollars you would pay for custom-fitted inserts elsewhere. It seemed well worth a try. Besides, the Wal-Mart reviews (an authoritative source if ever there was one, LOL) are pretty glowing.

Now to the important question: do they work? The answer is that based on just two days experience I would say yes. They certainly seem to make your feet feel more comfortable when standing or walking, providing support where you need it (arches) and cushioning elsewhere (heel and toes.) It’s true they do occupy space inside your shoes, so the shoes appear tighter, and that may not work well for some people. Also your first outing in them will almost certainly feel a bit strange: it feels as if there is something balled up under your arches which shouldn’t be there – a sock or something. Also returning to more correct walking form tests neglected leg and back muscles, so you might feel sore at first until your body adjusts.

To be fair, I haven’t tested these inserts long enough to fully evaluate them as an antidote to the debilitating impact of peripheral neuropathy. And the benefits I’m feeling now may in fact be at least partly responsible to the changes in my drug regime I referred to earlier. So it’s hard to judge. But let’s say right now I’m most favourably impressed by this product.

I think what it boils down to is that I’m seeing that the pain from peripheral neuropathy benefits from being attacked on several fronts. Prescription drugs might work, over the counter pain killers might work, dropping troublesome drugs from your regime might work, even acupuncture might work. But you also have to take measures which are kind to your feet. My take is that Dr Scholl’s Custom Fit orthotic inserts might do just that. So yes, I’m a believer.

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