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Advanced Foot & Ankle Center

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Danbury, CT
Advanced Foot & Ankle Center

At Advanced Foot & Ankle Center, we believe that healthy feet are happy feet and we offer the highest quality podiatric care in Danbury, CT.

At Advanced Foot & Ankle Center, we are dedicated to relieving pain and treating your foot and ankle conditions promptly so you can get back on your feet and living a healthy, active life. Our board certified podiatrist, Paul Betschart, D.P.M. has over a decade of experience treating common foot problems, such as warts, bunions, ingrown toenails, calluses, corns, fungal toenails, and athlete’s foot, as well as more serious ailments, like Achilles tendonitis, plantar fasciitis, arthritis, flatfeet, gout, cysts, and neuromas. Advanced Foot & Ankle Center also treats ankle sprains, strains, fractures, and other sports related injuries. We want our patients to be educated about good foot health so they can make informed choices about their care. We believe that the foot doctor is your partner in developing a healthy lifestyle and we promote proactive and preventive care for diabetic patients, children, and seniors. Advanced Foot & Ankle Center has two easily accessible locations, one in Danbury, and offer convenient appointments and digital x-rays in both offices. Healthy feet are the foundation of a healthy body and that’s why our friendly and compassionate staff is committed to meeting all your foot and ankle care needs with the best quality care currently available. If you have questions or concerns about your feet, we urge you to call us today to set up a consultation and take the first step to good foot health.

11/19/2025

Chemotherapy has revolutionized cancer treatment, significantly improving survival rates for many patients worldwide. However, its life-saving benefits often come at a cost, with nerve damage to the lower limbs emerging as one of the most debilitating side effects. Known as Chemotherapy-Induced Peripheral Neuropathy (CIPN), this condition affects nearly half of patients undergoing certain chemotherapy regimens, particularly those involving platinum-based agents such as Oxaliplatin. Despite the severity of the potential complications of neuropathy, a study from the University of South Australia reveals a distressing gap in supportive care: fewer than 20% of patients at risk utilize podiatry services that could dramatically alleviate their symptoms, improve their function and prevent complications. The results from the US population would be no doubt similar.

CIPN manifests as a constellation of sensory and motor impairments, including numbness, burning sensations, tingling, and muscle weakness that predominantly affect the feet. These symptoms often develop insidiously during or after chemotherapy, dramatically reducing patient quality of life. Podiatrists possess specialized skills in managing lower limb disorders and are uniquely positioned to address the multifaceted challenges posed by CIPN. Our expertise encompasses assessment, prevention, and treatment strategies aimed at preserving neuromuscular function, preventing falls, and minimizing foot trauma. Early podiatric intervention can contribute to fall prevention—a critical factor given that CIPN-related balance impairments significantly heighten fall risk. Moreover, effective podiatric care can reduce the incidence of ulcerations and infections, which, if left untreated, may escalate to amputations.

In our practice we have taken the additional step of addressing the nerve damage itself utilizing an innovative treatment, electric signal therapy with the Neurogenx Nerve Pro 2000 device. This sophisticated electrical therapy uses biosimilar electrical waveforms delivered through the skin to directly stimulate the damaged nerves promoting an increase in cellular metabolism and neurotransmitter release.

This can lead to improvement in nerve function and an increase in skin nerve fiber density. We have seen great clinical improvement in patients treated with this method over the last 7 years with over 85% of patients experiencing a positive effect.

If you or a loved one have been exposed to chemotherapy, we would be happy to help with any foot or leg issues including neuropathy.

11/12/2025

Losing the feeling in your toes and feet is a weird sensation.

There are many reasons why numbness of the feet can occur. Three common ones are diabetes, chemotherapy, and low back conditions. Alcohol, medications, and some autoimmune conditions can also cause neurological symptoms in the feet.

Regardless of the cause, the symptoms can be quite similar. Numbness, tingling, burning, and sharp stabbing sensations are what people describe the most.

The general term for these symptoms is NEUROPATHY.

A serious cause for concern is that these sensations can cause your balance to be compromised.

The biggest challenge we face in the healthcare industry when it comes to neuropathy is finding an effective solution.

Medications such as Gabapentin, Lyrica and a few others have helped some people with neuropathy, especially when caused by diabetes. Some vitamins have been known to decrease symptoms, and topical pain relievers such as CBD products and capsaicin can help too.

Unfortunately, neuropathy from chemotherapy and lumbar conditions are much less responsive to any treatments. And a small percentage of people have what’s called idiopathic neuropathy, which means there’s no known cause.

In any case, neuropathy is a frustrating condition to have and equally frustrating to treat.

Depending on the particular circumstance, we have a method to help relieve the symptoms of neuropathy and potentially reverse the nerve damage of neuropathy. The technique is a one of a kind electric signal therapy using the Neurogenx Nerve Pro 2000 device. This therapy is the only one available that can improve the function of damaged nerves leading to the clinical benefits of decreased pain and numbness, improved balance and improved function. We have ad an over 85% success rate with this therapy over the last 7 years. If you or a loved one are experiencing the signs or symptoms of neuropathy, come in for an evaluation to see how this comfortable, private treatment can benefit you!

10/28/2025

If you stop to think about it, it is rather amazing what our feet do for us throughout our lifetime.

Anyone who can get through life unaffected by a foot problem is incredibly lucky.

When a foot problem does arise, we usually ask our feet to plow through in spite of the pain. But getting a foot condition to resolve while sticking with your normal routine isn’t always possible.

We certainly do our best to help foot and ankle problems without suggesting downtime. But here’s the thing… there are just some foot conditions that require us to give our feet a rest.

That rest could be in the form of avoiding the treadmill or power walking. For runners, it could mean not running for a while. For people who stand all day at work, it could even mean taking some time off.. Certain conditions might require the use of a boot or crutches to allow them to heal.

There is so much pressure on our feet, that hoping they will heal without giving them some rest is just plain asking too much.

If you’re not sure whether your foot pain needs a rest to heal, feel free to come and see us for an opinion.
We will get you back on your feet in no time!

10/08/2025

For most people that have surgery or an injury, healing of the area progresses normally with a gradual reduction of pain which eventually goes away. In some cases pain can persist and even worsen during the recovery process. When this type of pain persist and impacts function it is labeled as a chronic pain syndrome. Complex Regional Pain Syndrome is a type of chronic pain syndrome that affects a certain area of the body, for example an arm or leg. CRPS is further categorized into type 1 and type 2. There are similarities and differences to both types. The underlying pathological cause of the development of CRPS is not known. The prevailing theory is that of an abnormal response of the sympathetic nervous system to injury.

Definition:
CRPS Type 1: Also known as reflex sympathetic dystrophy (RSD), it occurs after an injury or trauma without direct nerve damage.
CRPS Type 2: Also known as causalgia, it develops after a specific nerve injury.

Symptoms:
Both types share similar symptoms, including:
Intense, burning, or throbbing pain
Allodynia (pain from normally non-painful stimuli)
Hyperalgesia (increased sensitivity to pain)
Swelling, redness, and warmth
Changes in skin color and temperature
Hair loss, nail growth abnormalities
Muscle weakness and spasms

Diagnosis:
Diagnosis is based on clinical criteria, including: History of trauma or nerve injury, Characteristic symptoms, Physical examination findings, and Ruling out other conditions.
Treatment:
Treatment aims to manage pain and improve function:
Medications (analgesics, antidepressants, anticonvulsants)
Physical therapy (range of motion exercises, nerve blocks)
Sympathetic nerve blocks
Spinal cord stimulation
Surgery (in rare cases)

Prognosis:
The prognosis varies depending on the severity and duration of symptoms. Early diagnosis and treatment can improve outcomes.
Key Differences:
Cause: Type 1 occurs without nerve damage, while type 2 results from a specific nerve injury.
Prevalence: Type 1 is more common than type 2.
Treatment: Treatment is similar, but type 2 may require additional interventions to address the underlying nerve damage.

It's important to note that CRPS can be a complex and challenging condition. If you or someone you know experiences symptoms suggestive of CRPS, it's crucial to seek medical attention right away. Early treatment can prevent long term complications.

09/10/2025

The short foot exercise is a foot strengthening exercises from the Yoga tradition that aims to restore strength and stability to the arch of the foot.
How to Perform:
Stand with your feet shoulder-width apart.
Engage the muscles in the bottom of your foot, as if you are pushing your toes into the ground.
Spread your toes wide apart.
Lift the arch of your foot, bringing the ball of your foot closer to your heel.
Hold the contraction for 5-10 seconds.
Relax and repeat.

Benefits:
Reduces pronation (flattening of the arch).
May help prevent foot injuries, such as plantar fasciitis.
Strengthens the intrinsic muscles of the foot, which support the arch.
Improves foot posture and alignment.

Variations:
Sitting: Perform the exercise while seated.
One-legged: Perform the exercise on one leg at a time.
With weights: Hold a light weight in each hand while performing the exercise.

Precautions:
Avoid over-contracting the muscles, as this can cause pain.
If you have any foot injuries or conditions, consult with a healthcare professional before performing this exercise.

Frequency:
Start with 2-3 sets of 10-15 repetitions per day.
Gradually increase the number of sets and repetitions as you get stronger.
Video explanations of this technique are available on YouTube

The short foot exercise is a complementary exercise that can be used in conjunction with other foot strengthening exercises and stretches. It is important to have a comprehensive foot health routine to maintain overall foot health.

08/22/2025

Gastroparesis Awareness Month is a valuable opportunity, not just for public education, but also for healthcare providers to reexamine a condition that often goes undiagnosed, particularly in patients with chronic, complex illnesses.

Gastroparesis is defined as delayed stomach emptying without a physical blockage. It sits at the intersection of gastrointestinal dysfunction and neurological impairment. For physicians, recognizing this connection is critical, not only for symptom relief but also for maintaining quality of life and stabilizing blood sugar, especially in people with diabetes.

Not One-Size-Fits-All
Gastroparesis isn’t a uniform disease. It varies widely and often begins with vague symptoms like bloating, early fullness, or occasional nausea, complaints that are easy to dismiss. But in patients with autonomic nerve damage, these symptoms can be severe and ongoing, rooted in deeper neurological problems.

This isn’t just a case of slow digestion, it’s a breakdown in communication between the brain and the gut, particularly in the systems that regulate automatic body functions, the autonomic nervous system.. For patients with diabetes, that breakdown can further destabilize an already delicate balance.

The Nerve Connection: Autonomic Neuropathy
The most common known cause of gastroparesis is diabetic autonomic neuropathy (DAN), which leads to damage of the vagus nerve. This is the nerve responsible for signaling the movement of food through the stomach and intestines. When the vagus nerve is impaired, gastric contractions slow down, causing food to remain in the stomach for an abnormally long time.

This leads to symptoms including:

Nausea
Vomiting
Bloating
Abdominal pain
And it’s a vicious cycle: erratic stomach emptying disrupts insulin timing and blood glucose control. Even well-managed diabetes becomes unpredictable.

It’s Not Just Diabetes
While diabetes is the most familiar cause, many other conditions can lead to vagus nerve dysfunction and gastroparesis. These include:

Amyloidosis
Parkinson’s disease and other neurodegenerative disorders
Autoimmune diseases
Paraneoplastic syndromes
Post-viral autonomic dysfunction (including long COVID)
In some cases, gastroparesis may be one of the first signs of a broader neurological or systemic issue.

What to Look For
Patients with autonomic neuropathy–related gastroparesis tend to have:

More severe and persistent GI symptoms
Symptoms that worsen with blood sugar swings
Other signs of autonomic dysfunction (e.g., orthostatic hypotension which is a rapid blood pressure drop when standing up, resting fast heart rate, erectile dysfunction)
The degree of vagal nerve dysfunction often correlates with how delayed the gastric emptying is. In diabetes, parasympathetic nerve damage (especially involving the vagus nerve) can occur early, sometimes before other autonomic symptoms develop.

Takeaways
Gastroparesis isn’t just a GI disorder, it’s often a warning sign of deeper neurological issues.

In diabetic patients, persistent GI complaints should trigger evaluation for autonomic neuropathy and adjustments in insulin regimens.

In non-diabetic patients, new gastroparesis symptoms may warrant a broader neurological or autoimmune workup.

Treatment should go beyond medications that promote motility. A well-rounded approach includes:

Dietary changes
Optimizing blood glucose
Considering neuromodulatory therapies when appropriate, especially where peripheral neuropathy also exists.
Ultimately, recognizing the gut–nerve connection can lead to better care, fewer unnecessary tests, and more precise treatment.

What’s more, peripheral neuropathy, which causes numbness, tingling, or weakness in the hands and feet, can sometimes predict problems with the autonomic nervous system. This is especially common in people with diabetes, where long-term high blood sugar can damage many types of nerves over time. When the same nerve damage that affects the feet and hands starts to impact the nerves that control automatic body functions, it can lead to more serious issues. It’s a red flag that the nerve damage is no longer staying in one place and it’s time to take action before more systems are affected.

06/26/2025

Gout is a specific type of arthritis that causes inflammation and pain in one or multiple joints.

It often begins suddenly without a warning. The pain can bring you to your knees.

It’s common for a gout attack to occur within the foot and ankle. In fact, the big toe joint is the most common place where gout shows up.

Gout happens when crystals of uric acid, a naturally occurring substance in the body, collect in the joint. The joint often becomes red, warm, and swollen.

The average age of onset for gout is between the ages of 30 and 50. Causes of gout include genetics, obesity, certain medications (diuretics), and diets rich in purines (red meat, shellfish, and beer).

We can often diagnose gout simply by the symptoms. X-rays and bloodwork can also aid in the diagnosis.

The good news is that gout is easily treatable with diet modifications and medications that prevent the production and collection of uric acid crystals within the body.

If you have a sudden onset of pain, redness, and swelling — especially if it’s at the big toe joint — don’t wait to have us evaluate it. We can often make the intense pain of gout disappear in a few hours.

06/11/2025

One of best decisions you can make for your feet is to wear shoes or quality slippers or sandals in the house.

Going without shoes on a hard surface over the course of time can cause problems.

It’s especially important to wear shoes at home if you are experiencing a foot or ankle issue. For a common condition like plantar fasciitis, just making this one change can help relieve some of the pain.

As we get older, we gradually lose the fat pad in our feet. It just makes sense to cushion our feet when on a hard surface.

If you like your feet to breathe at home, Birkenstock or Vionic sandals are two of the more supportive options.

Since we plan to live to a ripe old age, we must do whatever we can to preserve these two precious assets: our feet.
If you need specific recommendations for footwear, we are here to help!

05/28/2025

There are many conditions that can show up in the feet as a result of diabetes. Although we can’t diagnose diabetes just by looking at the feet, there are signs and symptoms that indicate the possibility.

Diabetes can affect circulation, skin, bones, muscles, tendons, and nerves. Blocked arteries can lead to pain as well as very extreme circumstances such as amputations. The skin can become darker, thinner and dry. People with diabetes can develop curled toes from the muscles and tendons not working properly.

A more severe consequence of diabetes can be that the bones in the mid-foot cause a collapse of the arch.

Numbness, tingling, burning and sharp pain - especially in the toes - can stem from a condition called diabetic neuropathy.

Those are just a few examples of how diabetes can affect the feet in many unfortunate ways.

One of the main reasons we encourage our patients not to wait on a foot concern is because sometimes the root cause is something bigger.

Waiting to treat a condition that might stem from diabetes could have dire consequences.

We specialize in treating diabetic foot conditions and preventing severe complications.

Please let us know how we can serve you.

05/21/2025

Sport-specific shoes are important because they can help prevent injuries, while enhancing performance and comfort. Material technologies used can provide cushioning, flexibility, fit/snugness/room, and traction to address the distinct biomechanical patterns inherent in the particular sport. Sport-specific shoes have uppers with midfoot support and most importantly, specially designed outsoles created for a given playing surface. In addition, some companies are offering additional widths in court and field shoes.
Midsoles, outsoles, upper materials, and heel and midfoot lockdown differ for each sport due to different containment, cushioning, and traction needs.
Using the wrong type of footwear for a particular activity can predispose you to injury.
An example of this that I have been seeing lately is the use of running shoes while playing the fast growing sport of pickleball, Pickleball is a court sport similar to tennis which demands lateral stability for side to side motion, Many people start playing pickleball in whatever athletic shoes they already have. Running shoes are designed for forward motion having less lateral stability and a thicker heel to cushion heel strike. These features can predispose court sport players to ankle sprains and tendon injuries. Pickleball specific shoes are currently rare but the choices are growing along with the sport. Tennis specific shoes are a great option as they provide the stability and mobility needed. Basketball shoes can be ok but are heavier on the feet.
Whatever the sport shoe needed, getting the correct fit is important. Start with a foot measurement using the Brannock device or similar measuring instrument . This should give a starting point for length and width.
Keep in mind that shoe sizing is not a uniform standard and can vary significantly even within brands. My rule of "thumb" for length is to be able to press the tip of your thumb between the end of the shoe and the longest toe.

05/07/2025

You may have a custom of not wearing shoes at home for cleanliness, comfort, or cultural reasons.

If you are working outside the home or tracking in the rain, slush, or dirt, you probably shed your shoes the moment you walk in the door. And of course, a change of shoes makes sense for these reasons.

But here’s the thing…

Consistently being barefoot, or just wearing socks or slippers at home, can cause or exacerbate foot conditions.

This is especially true if you have flat feet or high arches. Flat feet that don’t have support are prone to strains like plantar fasciitis and achilles tendinitis. High-arched feet need cushion, especially on hardwood floors.

If you are experiencing foot pain of almost any kind, wearing shoes at home can help prevent the condition from worsening.

If you can’t stand having shoes on at home, the next best thing is a quality pair of sandals. Some of the better brands for foot health are Birckenstock, Vionic, Keen, Chaco and Propet.

We have helped hundreds of plantar fasciitis sufferers get relief simply by recommending quality shoes or sandals for home use.

If you are doing a fair amount of standing at home, wear proper footwear. Your feet will thank you for giving them the support they need.

Com in and check out our new summer collection of quality foot wear from Propet. Your feet will be happy!

04/30/2025

Imagine a pain that just won't quit. It might start after an injury, even a minor one, but instead of fading away, it intensifies, spreads, and becomes a relentless, burning torment. This is a glimpse into the world of Complex Regional Pain Syndrome (CRPS), a chronic pain condition that can be both debilitating and perplexing.

CRPS, also known as Reflex Sympathetic Dystrophy (RSD), is a neurological condition characterized by persistent, often severe pain that is out of proportion to the initial injury. It typically affects one limb (arm, leg, hand, or foot) but can sometimes spread to other parts of the body.

What are the hallmarks of CRPS?

The symptoms of CRPS are varied and can change over time, making diagnosis challenging. However, some common signs and symptoms include:

Intense Pain: This is the defining feature, often described as burning, throbbing, shooting, or stabbing. The pain is usually far more severe than what would be expected from the initial injury.
Sensitivity to Touch (Allodynia): Even a light touch, like clothing brushing against the skin, can trigger excruciating pain.
Increased Pain Sensitivity (Hyperalgesia): Painful stimuli, like a pinprick, elicit an exaggerated and prolonged painful response.
Swelling: The affected limb may swell, sometimes significantly.
Skin Changes: These can include changes in temperature (feeling hot or cold), color (red, blue, pale, or mottled), texture (shiny, thin), and sweating patterns (increased or decreased).
Joint Stiffness and Movement Problems: Difficulty moving the affected limb, stiffness, and decreased range of motion are common.
Hair and Nail Changes: Hair growth may become faster or slower, and nails can become brittle or grooved.
Muscle Weakness and Tremors: Weakness in the affected limb and involuntary muscle twitching or tremors can occur.
What causes this intricate pain puzzle?

The exact cause of CRPS isn't fully understood, but it's believed to involve a malfunction in the peripheral and central nervous systems. Often, it's triggered by an injury, surgery, stroke, or heart attack. However, in some cases, there is no identifiable trigger.

Researchers are exploring several potential contributing factors, including:

Nerve Damage: Injury to nerves may lead to abnormal pain signals.
Inflammatory Response: An exaggerated inflammatory response to the initial injury might play a role.
Autonomic Nervous System Dysfunction: This system controls involuntary functions like heart rate, blood pressure, and sweating. In CRPS, it may become overactive, contributing to pain and other symptoms.
Genetics: There might be a genetic predisposition in some individuals.
Navigating the complexities: Diagnosis and Treatment

Diagnosing CRPS can be a journey, as there isn't one definitive test. Doctors rely on a thorough medical history, physical examination, and evaluation of the patient's symptoms. Imaging studies like X-rays, bone scans, and nerve conduction studies may be used to rule out other conditions.

Treatment for CRPS is typically multidisciplinary, aiming to manage pain and improve function. It often involves a combination of therapies, including:

Pain Medications: Over-the-counter and prescription pain relievers, nerve pain medications, and sometimes opioids may be used.
Physical and Occupational Therapy: Exercises to improve strength, flexibility, and range of motion are crucial.
Nerve Blocks: Injections of local anesthetics near affected nerves can provide temporary pain relief.
Spinal Cord Stimulation: Implanting a device that sends mild electrical impulses to the spinal cord can help block pain signals.
Psychological Support: Coping with chronic pain can be emotionally challenging. Therapy and support groups can provide valuable tools and understanding.
Other Therapies: Depending on the individual's needs, treatments like transcutaneous electrical nerve stimulation (TENS), biofeedback, and acupuncture may be considered.
Living with CRPS:

Living with CRPS can be incredibly challenging, impacting not only physical well-being but also mental and emotional health. It's essential for individuals with CRPS to have a strong support system, including family, friends, and healthcare professionals. Patient advocacy groups can also provide valuable resources and connections.

While there's currently no cure for CRPS, early diagnosis and a comprehensive treatment plan can significantly improve outcomes and quality of life. By understanding the complexities of this condition, we can foster greater awareness, encourage timely intervention, and ultimately help those affected navigate their journey with more hope and support.

If you or someone you know is experiencing persistent and unexplained pain, it's crucial to seek medical attention to explore the possibilities and receive appropriate care.

Address

57 North Street, Ste 108
Danbury, CT
06810

Opening Hours

Monday	9am - 7pm
Tuesday	8am - 5pm
Wednesday	8am - 5pm
Thursday	8am - 5pm
Friday	8am - 5pm
Saturday	8am - 12pm

Telephone

+12037910466

Website

http://www.danburypodiatrist.com/

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Our Story

At Advanced Foot & Ankle Center, we are dedicated to relieving pain and treating your foot and ankle conditions promptly so you can get back on your feet and living a healthy, active life. Our board certified podiatrist, Paul Betschart, D.P.M. has over two decades of experience treating common foot problems, such as warts, bunions, ingrown toenails, calluses, corns, fungal toenails, and athlete’s foot, as well as more serious ailments, like Achilles tendonitis, plantar fasciitis, arthritis, flatfeet, gout, cysts, and neuromas. Advanced Foot & Ankle Center also treats foot and ankle sprains, strains, fractures, and other sports related injuries. We want our patients to be educated about good foot health so they can make informed choices about their care. We believe that the foot doctor is your partner in developing a healthy lifestyle and we promote proactive and preventive care for diabetic patients, children, and seniors. Advanced Foot & Ankle Center has two easily accessible locations, one in Danbury and one in Middlebury, and offer convenient appointments and digital x-rays in both offices. Healthy feet are the foundation of a healthy body and that’s why our friendly and compassionate staff is committed to meeting all your foot and ankle care needs with the best quality care currently available. If you have questions or concerns about your feet, we urge you to call us today to set up a consultation and take the first step to good foot health.