Same Day Appointments Available **






Posts for category: Laser Treatments

  Peripheral neuropathy, as we have spoken about before, is a gradual degenertaion or deterioration of the nerves, especially the small nerves of the feet.  It is most commonly seen in people with diabetes, but there are many other causes as well.  This can include idiopathic (where there is an unknown underlying cause, but many things have been ruled out), as a result of chemotherapy for cancer, vitamin deficiency (especially B12, although Thiamine and other vitamin deficiencies can also be to blame), heavy metal toxicity (mercury, lead, and even arsenic), and several others.  No matter what the cause of the neuropathy, the result is often the same.  There is usually numbness, tingling, pins and needles sensations, paresthesias (crawling sensations or other feelings of things that are not there), burning pain, sharp shooting electrical shocks, muscle abnormalities (causing hammertoes, change in muscle tone, muscle wasting, etc.), and autonomic changes (decrease in sweating, dry skin, discoloration, cold or hot feeling, etc.).  A person may have NONE or ALL of these findings.  Much of this will depend on how long the problem has been present (Diabetics, for example, may show no changes or have no symptoms at first, but the longer they are diabetic, the more of these problems may present themselves).  

   Once the diagnosis of peripheral neuropathy is confirmed, there are a number of treatment options.  Many drugs can be used to treat the symptoms of peripheral neuropathy.  The problem with drugs is that they just treat SYMPTOMS.  For the most part, these reduce the pain and burning, but really do little or nothing for the numbness or lask of sensation, which can be worse for the patient in the long run.  Narcotic medication is often the worst, because in addition to just masking the pain, the patient can suffer from sedation and constipation, and can, and often does, become addicted to the narcotic.  

     There are a number of vitamins that can help, and often help quite a bit, not only with the pain and burning of neuropathy, but also with the numbness and tingling that occurs.  These vitamins, in some cases, can actually result in the growth of new small nerve fibers within the skin.  One of these that has shown great promise is alpha lipoic acid.  Taking up to 600mg of this vitamin, up to three times per day, has often been shown to be beneficial in treating neuropathy in the diabetic patient, and the non-diabetic as well.  A lower dose is often advised to start with, and many pharmacies sell the vitamin in as low as 100mg.  B vitamins, such as B6, B9, and B12 have also shown beneficial effects in treating neuropathy.  A prescription medical food, known as Metanx, can also be prescribed if the over the counter vitamin therapies are not working.  One must understand, that none of these vitamin therapies will show results quickly.  A month is often the minimum amount of time needed to see any change at all, and in many cases it may take 2-3 months to see a significant improvement.  The advantage to using these vitamin therapies is that there are typically NO side effects, little or no drug interactions, and often the cost is significantly less.  In many cases, the beneficial effects of these can be measured OBJECTIVELY using an ENFD - or epidermal nerve fiber density test.  This is a skin biopsy, usually done just above the ankle, to measure how many nerve fibers are present within the epidermis (the outer layer of the skin) BEFORE the vitamins are prescribed, and can be repeated  AFTER (usually six months) treatment has been started.  This can often show a significant increase in the number or density of nerve fibers.

     In an upcoming blog, we will be talking about the use of LASER for peripheral neuropathy, another NON-INVASIVE treatment that is showing great results for a number of people with peripheral neuropathy.


Richard S. Eby, DPM

7348 East Brainerd Road

Chattanooga, TN.  37421

(423) 760-3115

March 01, 2015
Category: Laser Treatments
Tags: chattanooga   laser   therapy   ankle  

An ankle sprain is a very common injury seen in people of all ages.  The term "sprain" implies that the ankle was turned (usually with the bottom of the foot turned IN or toward the middle of the body) and is often called an INVERSION ANKLE INJURY.  There are other types of injuries to the ankle, but the vast majority of them are inversion injuries.  The fibula (the long thin bone running on the outside of the leg from the knee to the ankle) can be fractured, and this is easily identified on x-rays.  For purposes of this discussion, however, we are going to assume there is NO fracture, and the injury is a soft tissue only injury.  There are three degrees or GRADES of sprain - I, II, and III.  This refers to the severity of the sprain, and whether the ligaments are stretched (I), partially torn (II) or completely torn or ruptured (III).

Ankle sprains are treated in a number of ways.  Conservative treatment typically consists of R.I.C.E.  This stands for Rest, Ice, Compression, and Elevation.  We should also consider IMMOBILIZATION for the Grade II and Grade III sprains, meaning the foot and ankle are put into something to keep them from moving excessively.  Walking boots, aircasts, splins, and fiberglass or plaster casts are typical forms of immobilization.   A cast is used when complete immobilization is needed, and the foot must be held still and not allowed to move at all.  Other forms of immobilization are more partial forms of immobilization, in that the foot can move a little in the device, but the amount of motion is restricted.  In a Grade III stage, surgery has to be considered in some cases.  This is particularly true in the younger competitive athletic individual, where primary repair of the liagment(s) - basically sewing them back together or repairing them as soon as possible after the injury can prevent scar tissue, weakness, instability, and loss of function.

A newer way to treat these types of injuries, especially in the Grade II or MODERATE injury, is with laser treatment.  We are not talking here of laser surgery, but of laser therapy.  The injured person has anywhere from 3 to 5 treatments in an office setting, space 1-3 days apart, and is given a treatment with a CLASS IV laser.  This is also known as HDLT or High Dosage Laser Therapy.  In my office, we use the Diowave 30 watt laser.   This is done without anesthesia, and the patient feels only a profound sense of warmth during each treatment, which ranges from 10 to 20 minutes in length.  This is a deep pentrating light energy delivered into the body to reach damaged cells and tissues.  This not only makes the patient feel better, but results in healing of damaged tissues at a much faster rate.   Healing of ankle sprains is often 20 to 30% faster than by conventional means of treatment alone (ice, rest, immobilization, etc.).    The patient can still ambulate, although it is still beneficial to restrict movement with a walking boot or pneumatic walker.  The patient also experiences a lot less pain and swelling during the recovery.  If this is an athletic individual, it is often possible for him or her to return to sports acitivites much quicker.  As with any other conservative treatment, the sooner treatment is started, the better the outcome.  Unlike some forms of treatment, however, this type of laser can be used for CHRONIC, as well as ACUTE pain and swelling.

If you, or someone you know, has a foot or ankle sprain and needs a little extra help in healing it, call our office.  We are here to help.


Dr. Richard S. Eby


October 13, 2014
Category: Laser Treatments

Ugly Toenail Syndrome

I want normal toenails, can you help me?

Have you been suffering from the discomfort and embarrassment of toenail fungus? If you visit your local pharmacy, you will find many over-the-counter options for treatment of this condition.  However, these often do not address the issue, especially if the fungus has already spread into the nail.  Prescription medicines are also available, but they also have limited effectiveness, and the side effects can cause permanent liver damage.

Dr. Eby is happy to offer a safe and pain-free option for the treatment of fungal nails:

Laser treatmentAt our office we effectively treat fungal toenails by utilizing the Q- Clear laser. Visit our office three times over the course of three months, and you’ll be on your way to fungus free toenails.  Each affected nail is treated for 1 painless minute, and the results will knock your socks off!

Call (423)622-2663 today to schedule an appointment at our Chattanooga office.  You can also visit our website and request an appointment online.

What is causing your toenails to become discolored, thick and brittle?

Have you inspected your toenails lately?  Many people rarely look at their feet and can later suffer from foot conditions that, if caught early, could have been easily treated.  Toenail fungus or onychomycosis is one of these common foot issues.

All fungi are not created equally.  While some actually aid the body, others can create infections.  One particular group called dermatophytes is the cause of most nail infections.  Other organisms like molds and yeasts can also cause this type of condition.

Along with environmental circumstances, there are other risk factors that increase a person’s chances of fungal nails.  The biggest contributor to your risk is age.  Certain natural changes that occur with age affect the ability of the feet to fight off fungal infections.  Over time the growth of nails slows which also puts the toenails at greater risk of infection.   As we get older, the circulation in the feet is diminished.  This means that it is more difficult for the body’s defense system to take action when it is being attacked.  This is also a concern for people with diabetes and those that have illnesses that impact their immune systems.  Other high risk scenarios include:  working in a humid place, sweaty feet, going barefoot in public places, skin conditions that cause cracking (such as psoriasis), injured nails, and unsanitary pedicures.

Want to prevent toenail fungus?

Preventing infection can be difficult, because these tiny, living things cannot be seen by the naked eye, and they do not need light to grow.  Their size or lack thereof, allows them to use entry points (cuts or cracks) that may not even be visible to the human eye.  The right conditions promote the growth of fungi:  warmth and moisture are the key ingredients for their breeding.

There are different types of nail fungus, but the early signs are typically yellow or white specks beneath the edge of the nail.  Stopping the spread of nail fungus is easier at the onset.  If left untouched, the infection goes farther into the nail, and will cause more discoloration, thickening and crumbling.  The affected nail may actually separate from the toe, and you may notice a foul smell as well.

Because of these factors, it is important to maintain healthy cleaning practices. This can be done by:

Clean your feet daily – By cleaning your toes daily you can keep your toenails clean. It is important that you do not scrub too hard and scratch the nail. Scratching the nail will make the nail vulnerable to infection.
Wear effective socks – Socks can help reduce moisture around your feet. The best kind of sock for this is a synthetic sock. By doing this you will eliminate the environment needed for the fungi to live.
Allow your shoes to dry out – Since the fungi thrive in moist environments, a dry environment inside the shoe can stop the fungal infection from multiplying and surviving.
Do not share shoes – Toenail fungus is contagious and can be spread through contact. If you wear a shoe infected with toenail fungus, you could infect yourself.

Prevention is one of the best treatments. By eliminating the cause you can help resolve the problem. If you are beginning to develop toenail fungus, do not worry! Dr. Eby and his staff can help you stop the condition from progressing.


March 03, 2014
Category: Laser Treatments
Tags: laser  
Coming soon.
February 07, 2014
Category: Laser Treatments
Tags: laser   fungus nails  

We are so pleased to be able to tell you that we are able to extend our offer for the laser treatment of fungus nails!  So, let us ZAP that fungus off your toenails and get them ready for the summer.  You must do it soon, the offer ends on February 27, 2014.