Fixing a broken toe; remedies for opiate withdrawal

Q: Last week I got up in the middle of the night and slammed my foot into a chair. I’m pretty sure I broke my middle toe. It still hurts, but there’s nothing that can be done for it, right? —

A: Sorry Charlie, that’s a myth. It’s always best to have a broken toe evaluated, and the sooner you have it looked at, the better. The first and most obvious reasons are that a doctor can give you the right diagnosis (sprain, bruise, break?), help you correct the injury/problem, prevent further injury (if your gait is thrown out of whack) and help alleviate the pain.

Your toe might not be broken, and you treat a bad bruise differently than a broken toe. For example: Rest, Ice, Compression, Elevation (R.I.C.E.) work for a sprain or bruise, but may not for a break.

Untreated, your pain could go on for a long time and your injury could develop complications ranging from infection, if the skin were broken when you injured it, to arthritis, if the bones heal in a position that isn’t lined up properly.

Also, if your injury doesn’t heal correctly and you’re limping around for an extended time, you could develop muscle strain in your legs and back or even arthritis in your ankle, knee or hip joint.

So go see a doc and have it looked at. There’s a chance he’ll send you on your way, but he/she might tape it to the toe next to it (called buddy taping), surgically reset it or put a pin in the toe (really a screw) to make sure the bones heal properly. Then, down the road, you’ll be able to go down the road without pain or a limp.

Q: I saw an ad on the internet for an herbal supplement called kratom that claims it’s effective for alleviating the symptoms of opioid withdrawal. Is there any truth to this? —

A: We guess you or a loved one may be struggling with opioid addiction. That calls for immediate medical support and intervention. (Go to the National Institute for Drug Abuse at www.drugabuse.gov and look for “Effective Treatments for Opioid Addiction.”)

Be very careful with any herbal remedy that sounds too good to be true because, as the old adage says, it probably is. Kratom has come under fire recently because companies are marketing it unscrupulously. It was almost banned as a level 1 substance in 2016 by the Drug Enforcement Agency, but they backed off, which was a good thing because it can be researched further. However, on Nov 14, 2017, the Food and Drug Administration issued a public health advisory for kratom. Here’s the story.

The plant kratom (Mitragyna speciosa) grows in Thailand, Malaysia, Indonesia and Papua New Guinea and has been used for many years in Southeast Asia as an opium substitute. Yes, it’s addictive — and like too many things American, after its move across the Pacific (and under the radar of the medical community), it was immediately hyped, marketed and abused. (Curiously, there’s not a single doctor on the board of the herb-advocating American Kratom Association.)

The Center for Science in the Public Interest has asked the FDA and the Federal Trade Commission to take enforcement action to protect the American public from companies selling kratom, saying that they’re clearly exploiting the opioid epidemic. According to CSIP and the PEW Charitable Trust, there are currently only three FDAapproved medically assisted treatments for opioid withdrawal: methadone, buprenorphine and naltrexone.

For an opiate detox, find a medical supervisor and ask about using those meds. A good detox program will also include cognitive behavioral therapy and a support buddy or group to ensure long-term benefits. During withdrawal you also may get dehydrated and experience deficiencies of calcium, magnesium and potassium. That’s another important reason you should talk to a medical expert, Janine. Don’t go it alone.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.