One of the most common foot problems seen by podiatrists is a bunion. Typically recognized as an unsightly bump at the base of the big toe, a bunion is actually a deformity of the framework of the foot. It develops when the joint at the base of the big toe becomes unstable, causing both the bone and soft tissues to move out of place. The bunion’s characteristic bony knob appears on the foot just behind the big toe and angles outward as the big toe angles inward toward the smaller toes. Occasionally, a bunion may develop at the base of the little toe on the outside of the foot. This is known as a tailor’s bunion or bunionette.
Foot mechanics that put too much pressure on the big toe joint may be the reason behind the development of bunions. Factors such as gait, inherited foot type, wearing ill-fitting or poorly designed footwear, as well as having an occupation that puts a lot of stress on the feet can increase the risk that a bunion will form. Individuals affected by injuries to foot alignment, neuromuscular disorders, congenital deformities, or joint conditions are also more likely to develop bunions.
Without the appropriate podiatric care, a bunion can widen the foot, make wearing shoes more difficult and impair daily function. A shifting big toe can put so much pressure on the smaller toes, that they too develop abnormalities. Moreover, the toe joint damage associated with a bunion can cause stiffness, bursitis, or arthritis and give rise to additional complications.
Our podiatrist will evaluate your bunion and develop an appropriate treatment plan. If non-surgical, conservative methods of care fail to provide relief, and the bunion is interfering with your daily life, our podiatrist may recommend a surgical procedure.
One of the most common toe deformities seen by our office is a hammertoe. Most often attributed to wearing ill-fitting, tight footwear or high-heeled shoes that squish the toes into a bent position, a hammertoe can also be influenced by genetic factors, the result of a bunion, or caused by arthritis in the toe joint.
Just as the name implies, a hammertoe resembles a “hammer” with the toe bending at the middle joint into a claw-like deformity. Hammertoes can develop in any of the small toes of the foot, but most often affect the second and third toes. Hammertoes usually affect women, but men can develop them as well.
Hammertoes can cause you discomfort while walking or when you simply try to move or stretch your toes. You may also develop corns or calluses on the top of the toe and the ball of the foot and have difficulty fitting into your shoes.
While in the early stages of a hammertoe, the joint may still be flexible and conservative therapy will provide sufficient relief, left untreated your toe will become more rigid and less responsive to these methods of care.
Our podiatrist will develop an appropriate plan to treat your hammertoe, taking into consideration the severity of the toe deformity, existing medical conditions, your level of activity as well as any other factors that may influence your care. A non-surgical, conservative approach may include strategically placed foot padding, wearing shoes with a roomy toe box, custom orthotics, splinting and taking anti-inflammatory medication as needed to reduce pain and inflammation. In severe cases, surgery may be required to straighten the joint. A combination of procedures may be recommended when a hammertoe is accompanied by other foot deformities.
One of the most common complaints heard by podiatrists is that of heel pain. As the largest of the 26 bones in the foot, the heel is designed to perform many tasks. While the heel is equipped and able to handle heavy loads, too much stress can lead to problems.
Symptoms of heel pain may be felt in the front, back, or bottom of the heel. Pain that is felt under the heel is most frequently associated with a condition known as, plantar fasciitis. The plantar fascia is a band of connective tissue that runs along the bottom of the foot from the heel to the base of the toes. Overuse or prolonged wear and tear on the heel can strain this band causing damage, inflammation, and pain. Other sources of heel discomfort may include, stress fractures, tendonitis, arthritis, nerve irritation or cysts.
As plantar fasciitis can be a slow-healing and chronic condition, early diagnosis and intervention are important. Most individuals will experience improvements with conservative therapy alone. However, if symptoms are disabling and persistent even after an extended course of conservative treatment, then other approaches to care, including surgery, will be considered.
Since heel pain can occur for a variety of reasons, it is important when symptoms arise to contact our office for a thorough evaluation and care.
For those patients who do not respond to an individualized protocol or have had previous failed treatment for heel pain, we use minimally invasive Tenex as a surgical option. Developed in conjunction with the Mayo Clinic, Tenex is a groundbreaking minimally invasive technology used to remove chronically diseased tendon and fascia, giving quick pain relief and early return to function.
Whether due to repetitive strain (overuse injuries) or a sudden accident (acute injuries), sports injuries to the stress-bearing lower limbs are a frequent occurrence among athletes and casual exercisers alike. Common sports injuries to the foot, ankle and lower leg range from blisters, contusions, and toenail trauma to turf toe, heel pain, Achilles tendon problems, sprains or strains, as well as fractures from repeated stress or sudden impact.
It is recommended that individuals who have sustained an injury seek treatment in a timely manner and refrain from continued stress to the affected site, to prevent further trauma or the onset of other complications.
After taking a comprehensive patient history and performing a clinical exam of the injured site, including ordering diagnostic tests as needed, our podiatrist will determine the exact nature and extent of the problem, and design an individualized treatment plan based on the specific needs of the case. In addition to promoting healing and restoring mobility, our podiatrist will recommend treatment to prevent re-injury. While sports injuries to the foot, ankle and lower leg can be frustrating to those who enjoy regular physical activity, it is important for patients to prioritize treatment and recovery to ensure they can make a healthy return to their daily routine and recreational pursuits.
The purpose of arches in the feet is to add springiness and flexibility to the midfoot. Arches in the feet help to generate the strength to push off with movement, distribute body weight, absorb the shock of contacting the ground, and assist with balance. In addition to these functions, the arch of each foot acts as an energy store to support activities like walking, running, or jumping.
One of the most common and well-known deformities of the lower extremities is flat feet. They occur when the arches of the feet (the insteps) are either partially or completely collapsed. This deformity puts the soles of the feet, the plantar surface, in complete or near complete contact with the ground. When flat feet, which are also known as fallen arches, are present, the alignment of the legs may also be slightly altered. In some cases this can lead to pain and other problems in the feet, ankles, legs, knees, hips, and the lower back.
If you or your child has foot pain, it is a good idea to see our podiatrist for a thorough evaluation and treatment. This is the best way to prevent any additional and potentially debilitating complications from developing. Our podiatrist can provide the most suitable and therapeutic treatment options to stabilize the causes of flat feet, help restore and improve foot function, and alleviate any associated symptoms.
Since young feet are still growing, problems can develop quickly. It is important to catch any conditions before they continue into adulthood. Pay attention to the following as they might indicate possible foot problems your child is experiencing: a change in the wear on their shoes, discoloration of the skin or nails, bumps on the skin, a change in the general coordination and stamina of your child, falling and fatigue and/or if they become unwilling to participate in activities they normally enjoy.
Arthritis refers to joint disease affecting one or more joints. The word itself means joint inflammation, which can be a symptom of the disorder along with pain, stiffness, and a decreased range of motion.
Some types of arthritis that are associated with a degenerative process involving cartilage wear and tear are often confined to the joint. While other types of arthritis, such as those related to an inflammatory process and the immune system, may affect outside connective tissues and organs including the skin.
Risk factors for developing arthritis may include injury, aging, metabolic abnormalities, hereditary factors, infections, and immune system disorders. Symptoms of an arthritic condition can develop gradually over time or appear suddenly. There are several categories of arthritis including degenerative arthritis, inflammatory arthritis, infectious arthritis and metabolic arthritis. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis, with both of these disorders often affecting the joints in the ankles and feet.
- Osteoarthritis is the most common form of arthritis. It is a degenerative condition that is related to the aging process and joint wear and tear. Osteoarthritis develops when the cartilage covering the surfaces of the bone within the joint is worn away by repeated overuse or repeated impact. As bone on bone contact increases, symptoms of pain, swelling, and stiffness are produced. Furthermore, the flexibility of the joint is reduced, bony spurs develop and the joint swells. While osteoarthritis is most often seen in the big toe, it can frequently affect the midfoot and ankle as well.
- Rheumatoid arthritis is classified as an autoimmune disease. In an autoimmune disease, the body releases enzymes that mistakenly attack its own healthy tissue. In the case of rheumatoid arthritis, the tissue under attack is the synovial membrane. This membrane is important as it functions to line and seal the joint cavity as well as secrete a fluid, which helps to lubricate the joint. When rheumatoid arthritis is present, the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage and cause pain, stiffness, deformity, and reduce function. Foot problems caused by rheumatoid arthritis are commonly seen in the forefoot with sign and symptoms in the ball of the foot, near the toes. Symptoms and deformities associated with the condition can include nodules, dislocated toe joints, hammertoes, bunions, heel pain, Achilles tendon pain and flatfoot ankle pain.
Our podiatrist offers the most effective and advanced approaches to care to help patients who are suffering foot problems due to arthritic conditions. Offering a comprehensive range of treatments including medications, orthotic devices, temporary immobilization, bracing, steroid injections, and physical therapy, our goal is to alleviate symptoms as well as maintain or improve function as possible. If pain and deformity do not respond to conservative methods of care, a surgical procedure may be recommended. Surgery options can range from shaving bone spurs (osteophytes) that have formed on the joint, fusing the joint, or performing a synthetic cartilage implant procedure. This implant, known as Cartiva, is composed of the same material as contact lenses, allows the patient to maintain motion of the joint, and is a leading edge innovation in joint replacement surgery. This type of surgery is done under a local anesthetic with twilight sedation, and most patients return to sneakers just two weeks after the surgery.
For people with diabetes even the smallest blister, sore, or cut on the foot can pose tremendous risks. Something as minor as an irritation from a small pebble in a shoe can quickly progress from a wound that doesn’t heal to a dangerous infection that can lead to an amputation and even a life-threatening situation. The statistics are alarming. Foot infections and their complications are the leading cause of hospitalization for diabetics. More than 60% of non-traumatic lower limb amputations occur in people with diabetes.
The keys to avoiding the foot related complications of the disease are the prevention and early detection of problems. If someone has diabetes it is extremely important that in addition to maintaining a healthy blood sugar level and healthy lifestyle, they practice a daily foot care regimen at home, and see a podiatrist for a thorough examination on a regular basis.
Our podiatrist will screen for the presence of diabetic neuropathy and vascular damage as well as check the foot and nearby structures for redness, swelling and non-healing wounds. Furthermore, our podiatrist will provide guidance and care to prevent foot ulcerations or injury. In cases of an existing cut or ulceration, our podiatrist will perform the most appropriate wound care as well as prescribe strategies to protect the foot from infection and accelerate the healing process.
Fungal nail infections are very common in adults and account for nearly half of all nail disorders. Technically known as onychomycosis, fungal nail infections can affect both your fingernails and toenails, but are most frequently seen in the toes. While the infection is a slow-growing one, a nail fungus can eventually cause the overlying nail to discolor, thicken, change texture, become increasingly brittle, break and even detach from the nail bed.
Left untreated an increasingly disfigured toenail can cause discomfort and irritation, especially while wearing shoes or walking. Not only that, fungal nail infections can spread to the other nails. If a diseased toenail breaks, it can also pierce the skin thereby allowing bacteria to enter, which can lead to a more serious type of infection. This is especially dangerous for individuals who have diabetes or a compromised immune system.
For all of these reasons, it is a good idea to give our office a call at the first sign of any discoloration, thickening or deformity of your toenails. Although a fungal nail infection can often be identified by its appearance, other conditions can produce a similar look, and an accurate diagnosis is essential for proper care. One thing is for certain; you can rest assured that our office will consider every aspect of your case in determining the best approach to care. Furthermore, we offer the most effective methods of care including the latest generations of topically applied medications, oral antifungal drugs, laser and surgical procedures.
An ingrown toenail occurs when the edge of the toenail grows into and penetrates the underlying skin at the end of or side of the toe. While an ingrown toenail may not initially cause symptoms as it continues digging into the skin, it can produce increasing irritation, inflammation, redness and pain. An ingrown toenail can become so uncomfortable that wearing any shoes, other than ones with a wide, open toe may be impossible. With an ingrown toenail, extra skin, as well as other tissue, can begin to grow around the impinging portion of the nail. Furthermore, once the ingrown toenail penetrates the skin, an infection may develop with pus and worsening symptoms.
Common causes of ingrown toenails may include:
- Over-trimming the Toenails
- Improper Footwear
- Nail Disorders
- Faulty Foot Mechanics
If you are suffering from an ingrown toenail, the safest approach is to see your podiatrist for professional guidance, diagnosis, and care. This advice holds true for everyone and is especially important if an infection is present, if you suffer from diabetes, have nerve damage in your feet, suffer from poor circulation, or have a compromised immune system.
The good news is that fixing most ingrown toenails and relieving the associated symptoms can be accomplished with a minor in-office procedure. The extent of the procedure depends upon the severity of the case, whether or not your ingrown toenail is a chronic problem, and if there are other contributing medical factors.