Brief Answer:
Different specialists could deal with muscles...depends on the problems

Detailed Answer:
Good afternoon.

If for example, there is disease of the muscle as in wasting, deterioration from metabolic processes, or generalized weakness because of some sort of intrinsic functional or metabolic disorder such as Myasthenia Gravis then, a neurologist of the neuromuscular disorder type could be involved. If the muscle disease is due to inflammatory types of conditions then, again a neurologist or even a rheumatologist could be involved. And so forth. If on the other hand, we are talking about physical trauma to a muscle resulting in a tear, internal hemorrhage or bleed to the muscle, crush types of injuries or ruptures of the tendons from their attachments then, an orthopedic specialist would likely be the most appropriate individual.

As far as your 2nd STATEMENT (as opposed to question) goes....I am a neurologist and have for a long time included all my patients suffering from stroke, neuropathy, and other forms of imbalance, muscle disease, and lack of proper gait into programs to strengthen and improve balance and stability. We call that vestibulopathy. The vibrating insoles you are referring to are a mechanized version of a very old and time tested concept employed in any comprehensive physical therapy program.

And yes, I do recommend that my elderly patients (even if they are disease free) engage in these exercises....for the same reason the Chinese as a country get up every morning at the crack of XXXXXXX and do community coordinated exercises involving forms of martial arts independent of how old or young you are.....BECAUSE IT'S DARN GOOD FOR YOUR BODY and your BODY CONTROL AND SERVO MECHANISMS which clearly deteriorate as time and age take its toll.

We've used devices very similar to the Wyss Institute as well as self desgined mechanical apparatuses that could be worn in shoes as well as hand held devices used by physical therapists that are supposed to stimulate electrical circuits up and down the feet, legs, and spinal cord to the brain and back. All of the mechanical stuff is clearly very NOVEL, INNOVATIVE and exciting....but the honest truth....if that's what you're looking for.....(you never asked a question)....none of this time is ready for PRIME TIME and is geared toward appealing to those customers with a lot of finances and the desire to have cutting edge technology to make them believe that their health (or whatever else they're trying to improve using state of the art devices) is substantially improved and ahead of the curve.....

The best way to stimulate your sensory system in the soles of your feet is not by electrical stimulation which in isolation is really pretty useless as a accessory aid to the central nervous system but rather giving your feet REAL TERRAIN TO FEEL, PUSHING THE BALANCE SYSTEM OF THE BODY TO ITS LIMITS by forcing bare feet without eyes or other balancing mechanisms (arms, etc), and then, working on fine tuning DYNAMIC exercise routines to stimulate the sensory system with SUPRATHRESHOLD stimulation in order to first strength and enhance BEFORE going to minimally perceptible stimuli which in any regular or normal person is not only NOT FELT by the person....but frankly.....NOT EVEN ON THE RADAR of the peripheral or central nervous system of the person undergoing the treatment.

Bottom line...unless you have a more specific question is I would recommend a good old fashioned form of diligent work at balance and stabilization through a program of VESTIBULOTHERAPY done by trained and qualified SPECIALTY THERAPISTS and guided by NEUROLOGISTS, OTOLOGISTS, or NEURO-OTOLOGISTS who are knowledgeable and passionate about the concept that people don't have to fall just because they have problems that compromise their distal sensory systems.

You will get more mileage for the money you spend in that arena than any mechanized gizmos or devices...and it doesn't matter if it comes from Harvard or Mount Olympus....nothing beats a good pair of of bare feet, a hard working therapist and a motivated patient who wants to train their balance systems either to become more fine tuned...or start working again after a catastrophe of some type.

Good luck.

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Brief Answer:
No change to my thoughts regarding original question on use of device

Detailed Answer:
Given your symptoms and relationship to being in certain shoes or on your feet for a prolonged period of time I belief there is the possibility that problems with your arches or other support elements of the foot may be involved or contributory.

However, for that you would need to get a podiatric evaluation. As a neurologist, if you were my patient coming to me with such symptoms I would simply work you up with a number of laboratory tests (sans diabetes if you've been tested in the past 6-12 months) directed at metabolic causes of distal neuropathies such as serum Vitamin B12, folate, Vit. D, D2, D3, FT4, TSH, ESR or CRP looking for things to tune up. By the way, updated criteria for what are considered "adequate" levels of certain nutritional elements anymore such as B12 and Vit. D are at least 400-450 and 60-80 in serum as commonly tested in the U.S. More antiquated criteria can be found in the literature and some physicians may still subscribe to them, however, newer information tells us that we should be changing our thresholds of acceptance when it comes to symptoms of neuropathy, cognitive impairment cases, and other neurological symptoms that heretofore, have always been explained off as "that's the way it is...."

Now, after all of that testing as well as a good podiatric examination of your foot and I might even throw in an electrical study from the neurological side of an EMG/NCV making sure that you didn't have some milder form of Tarsal Tunnel Syndrome then, I would continue to recommend everything from above in terms of vestibulotherapy....which as I've said in the past is NEVER A BAD THING TO DO whether or not you have symptoms of anything in your feet, balance, etc.

As we age there is a natural tendency to neuronal sensor attrition in the pads of the feet which can also be hurt by toxic substances such as medications, alcohol, and other oxidative stresses beyond one's control. The rate is believed to be somewhere around 10% loss per year therefore, doing vestibulotherapy and other forms of ACTIVE and fairly robust STIMULATIONS of the feet (without unnecessarily being them up such as hard treadmill pounding of a traumatic nature) are fair game as interventions.

I would not send my patients for the device you mention...even if approved by the FDA....I see no value in it and especially since my guess is that as a medical device it will not be covered by insurance and likely be astronomical in its price tag. Stick to old fashioned medicine and you can't go wrong.

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This query has utilized a total of 75 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Physical examination is very much necessary to better answer your question

Detailed Answer:
Your question may be better posed to a podiatrist since it appears to involve interactions between the various arches in the foot and the bones of the foot. That level of information traverses the boundaries of my expertise as a neurologist. My best recommendation from a REHABILITATIVE perspective would be to use bare feet so that any stimulation be direct and not blunted in any way from what really should be perceived by the foot sensors.

Having said that, I don't know whether your maneuver in reducing "numbness" which you describe as stiffness and which I think of as a lack of or reduced sensation is something that is ultimately beneficial to regaining sensory capabilities or eliminating "stiffness" in your vernacular.

A physical examination is very necessary in my opinion (which I cannot perform) in order to know exactly what the terms "numbness" refers to and how it may relate to the maneuver you've performed.

I would not change MY approach to evaluating your "numbness" but the additional information you've provided certainly reinforces the notion that a physical examination would be indispensable to deciding on best next steps.

All the best.

If I've satisfactorily addressed your questions could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback on your opinion as to our transaction?

Many thanks for posing your question to our attention on this network and do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 143 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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