Foot and Ankle Questions (FAQ’s)

A bunion, also known as Hallux abducto valgus deformity (HAV) is a deviation or malalignment of the great toe joint. Often the cause is a genetic predisposition as well as poorly sized shoe gear, trauma and arthritis. Most bunion pain starts as a general nonspecific area of tenderness overlying the joint. It then progresses to a sharp radiating pain while wearing shoe gear. As the deformity increases, the great toe begins to crowd the second toe. Bunions often develop into Osteoarthritis and chronic pain. Treatment plans vary but surgical intervention is most effective.

A neuroma is a benign thickening of a nerve between the toes that usually results in radiating pain toward the ends of the toes or even up the foot and leg. Though neuromas can be found along any nerve, they tend to have a predilection for the area between the third and fourth toes. This is known as a Morton’s neuroma. The most common causes of neuromas are inappropriate or tight shoe gear and trauma. Treatment options consist of simply changing shoe gear, orthotic devices, anti-inflammatories, sclerosing therapy, and surgical excision.

Extracorporeal Pulse Activation Technology / EPAT is a relatively new treatment for plantar fasciitis. When other conservative therapies have failed to relieve the pain of plantar fasciitis (commonly referred to as “heel spur”) EPAT may be used. This procedure is routinely performed in an outpatient setting and is noninvasive. The entire procedure takes less than thirty minutes and relieves the pain of plantar fasciitis within a few weeks.

Plantar fasciitis (commonly referred to as “heel spur”) is a common cause of heel pain and affects millions of individuals in the U.S. each year. The plantar fascia is a broad ligament that spans the entire bottom (plantar) of the foot just beneath the skin. When this ligament is stressed, the small collagen fibers begin to fray which results in inflammation and pain. This is caused by a number of factors including sports injury, obesity, jobs that require lots of standing and walking, high arched feet and flat feet. Treatments consist of shoe gear changes, anti-inflammatories, orthotics, physical therapy, Extracorporeal Pulse Activation Technology (EPAT), and surgery.

Yes, there is and it’s a simple one. Most ingrown toenails result from an incurvatlon of the nail into the surrounding skin as it grows out from the root. As the nail digs into the skin it develops into a localized infection. These infections can become intense and must be promptly treated. Provided the patient’s general health is good, a simple in-office procedure can rid you of this chronic condition. Under local anesthetic, the nail border is removed and the matrix or nail root is destroyed. Most patients experience little discomfort with this procedure and the toe will go on to heal in a week or two.

Tarsal Tunnel Syndrome is a group of symptoms that results from the compression or entrapment of the posterior tibial nerve as it exits the leg and enters the foot. Three large tendons and an artery and vein also use this tunnel that is formed by ligaments. Repetitive motion or trauma can result in inflammation and compression of this nerve. Symptoms will include radiating pain to the toes or up the leg with motion of the foot, sweating abnormality to the affected foot and possible temperature changes. This syndrome is similar to Carpal Tunnel that is found in the wrist.

A plantar wart is a viral skin infection caused by the Humai Papilloma Virus (HPV). These are contagious and can be spread quite easily from person to person. These warts are benign in that they do not cause cancer, as some of the other warts from this group are known to do. Generally, they result from an area of trauma or site of pressure to the bottom (plantar surface) of the foot. A plantar wart may remain solitary or may spread to develop into a large aggregate. They are exquisitely painful. Treatment options consist of many topical preparations most of which are acids or chemotherapeutic agents. Laser surgery, cryosurgery, electro surgery, and excision are most effective.

A ganglion cyst is a fluid-filled cystic lesion that forms from the lining of a joint or a tendon sheath. These are commonly seen in the wrists, ankles, and feet. Ganglions are benign and generally grow slow. These cystic lesions can become painful when they begin to apply pressure to adjacent structures like tendons, vessels, and nerves. Ganglions are typically treated by initially draining (aspirating) the fluid. However the reoccurrence rate is high and will then require surgical excision.

There are many causes of a discolored toenail or thickened nails. A frequent cause of a discolored toenail, thickening, and pain is fungus (onychomycosis). Nail fungus may initially begin beneath the edge of the nail, spread to the entire nail plate other toenails and to the skin as athlete’s foot. Oral antifungals are currently the treatment of choice for fungal nail infections. Other causes of painful, thickened, or discolored toenails could include nail dystrophy, psoriasis, glomus tumors, subungual hematomas and even melanoma.

Between the front and back part of the foot is the area known as the arch.  The arch of your foot bears a lot of weight and is subject to a lot of stress.  Painful arches can mean the bones, ligaments, and muscles are overworked and tired.  An overworked arch can also cause leg cramps and low back pain.  Flat feet, poor circulation, being overweight, having arthritis, or anemia are all conditions that can cause arch pain.

It is important to have a podiatrist do a proper diagnosis of the cause to ensure the correct treatment for your specific situation is chosen.

When you first begin to notice arch pain, you can try treating yourself with what’s commonly known as RICE… Rest, Ice, Compression, and Elevation.  Acetaminophen and an anti-inflammatory such as ibuprofen or naproxen help pain and reduce inflammation.  Arch supports or orthotics may also help relieve the pain.  It is important to note that if pain continues medical treatment by a podiatrist should be the next step.

Athlete’s foot is a superficial skin infection caused by a fungus called dermatophyte.  The moist, warm environment of shoes creates the environment for this fungus to grow.  Floors of locker rooms, public showers, swimming pools and whirlpools are all areas where this fungus can be found growing.

Common symptoms of athlete’s foot are itchy, cracking moist white scaly patches or sores between the toes and possibly the sole of the foot.  Another type causes dry, scaly, reddish area over the soles of the feet.

There are several over-the-counter antifungal creams available to self-treat athlete’s foot.  In most cases these creams will resolve the issue. For best results, it is important to apply these creams as directed.  Athlete’s foot will usually clear up within two weeks.

If these antifungal creams don’t clear up your problems, or if you have increasing pain, swelling of the foot, blisters or open sores, you may also have a bacterial infection as a result of the Athlete’s foot.  In these cases, you should seek medical attention to resolve the issue.  Oral antibiotics and or an oral antifungal medication may be prescribed.

Athlete’s foot can be prevented by taking a few simple steps to prevent contact with the fungus.  In public locker rooms and swimming areas be sure to wear sandals.  Don’t wear someone else’s shoes.  Make sure to thoroughly clean home showers and floors where walking barefoot frequently occurs.  Using a light talcum powder dusting the inside of your shoes and socks helps to decrease moisture level thus helping to prevent fungal growth. Keep the inside of your shoes as dry as possible.

Yes, the tendency to develop bunions can be inherited.  Bunions occur more frequently in women.  The suspect cause is the choice of footwear.  Repeated wearing of pointed-toe, high heeled shoes places additional pressure and stress on tissues at the base of the big toe.  This additional stress can cause the enlargement of the bone and tissue resulting in a bunion.

You can manage the pain of a bunion by resting the affected toe, application of cold and by taking an anti-inflammatory medication such as ibuprofen or naproxen.  Changing footwear to reduce the pressure on the affected area will also help to prevent pain and increased damaged to the area.

If self-treatment does not resolve the pain, seek the advice of a podiatrist.  Local cortisone injections, night splinting, and orthotics may be prescribed to alleviate bunion pain.  If pain continues after treatment, surgery can be performed to cure chronic pain.

An area of skin that is exposed to repetitive force may cause a callus.  A callus is a thickened area of skin that’s formed by the body to protect the skin.  When there is a mass of dead cells in the center of a callus, it becomes a corn.  Corns most often occur on the toes and the balls of the fee.  A callus can occur on any part of the skin exposed to repeated force.

In many cases, problems with corns and calluses can be treated without any surgical procedure.  The key is to prevent the cause of the repeated force on the area and to soften and moisturize the area.  This can be accomplished by:

• Avoiding stress to area
• Applying lotions and other moisturizers to the area
• Soaking affected area in warm soapy water to soften.
• Using pumice stones or sandpaper to remove hardened areas.

If the area remains painful, becomes inflamed, or creates an open sore, medical treatment is necessary to resolve the issue.

Diabetes is a term used for several types of disease in which high blood glucose levels occur.  Over time these consistent high levels can damage nerves, kidneys, eyes, and blood vessels.  Someone with diabetes may have nerve damage causing the feeling in the feet and legs to be diminished.  Oil production and sweat secretion that lubricates the skin of the feet may also be impaired.  This can lead to abnormal pressure on the joints, bones, and skin of the foot, which can lead to breakdown of the skin.  Blood vessel damage can impair blood flow to the feet, making it difficult for the areas to receive the benefits of good blood flow.  This can cause damage, make it difficult for sores or injuries to heal for the diabetic.

For these reasons, it is important to have your feet regularly checked by your physician for signs of any damage or impairment.  Early detection and referral to a podiatrist can help to prevent further complications.

Achieving and maintaining good control of blood sugar levels is the best preventative measure diabetics can take to prevent foot complications due to diabetes.  Learning how to regularly examine your own feet and to recognize early signs and symptoms of potential foot problems is critical to prevention.

Once symptoms to become apparent it is important to seek medical advice as soon as possible.  The sooner treatment is started, the chance of complications becomes less likely.

While it is not mandatory that all diabetics see a podiatrist, it is important to understand that when problems do arise with your feet and ankles, a podiatrist can provide you with diagnosis and treatment protocol that can’t be otherwise provided.  Left untreated diabetic foot problems can lead to amputations and other serious complications.  Don’t hesitate if you have issues, see a podiatrist, and work with your physician to achieve optimum blood sugar control.

Flat feet is a condition in which the arch in the foot running lengthwise along the sole of the foot has not developed normally.  It is lowered or flattened out, thus the name flat feet.  One or both feet can have the issue of flat foot.

Flat feet can be inherited.  There are also other causes such as diabetes, rheumatoid arthritis, or stroke.  Job related flat feet can occur due to a lot fo walking and carrying heavy objects.

Many people with flat feet may show no signs of symptoms or problems.  However, over time problems may begin to occur. At times pain may occur because of changes in work habits, injury, weight gain, excessive walking, jumping or standing and poor fitting footwear.  Fatigue may occur at times.

Wearing properly fitting shoes and shoes with built in arch supports can help if you have issues because of flat feet.  A podiatrist can diagnose and prescribe proper orthotics to reduce discomfort or pain because of flat feet.

A very complex structure, the foot, has 26 bones, 33 joints, 19 muscles, and 107 ligaments.  The causes of foot pain are many with many variations.

Many foot ailments such as athlete’s foot, calluses, warts and other common issues may be self-treated.  However, if you have foot pain that lasts for more than a few days without relief it is highly recommended that you seek medical help to get a proper diagnosis and plan of treatment to alleviate your foot pain.

If you have tired achy feet, or occasional foot pain, there are a few things you can do to reduce the occurrence.  If these measures do not alleviate the pain and it becomes chronic, it is best to have your podiatrist do an evaluation.

One of the best preventative measures for foot pain is to make sure you have shoes that fit your feet properly.  Shoes should not fit tightly, be uncomfortable to wear, and they should have adequate support to provide your feet the best protection possible.  Poorly fitting shoes can often cause foot pain and issues.

A very common complaint physicians and podiatrists hear is heel pain.  Several issues can cause heel pain.  Some of the more frequent causes of heel pain are plantar fasciitis, heel spur, tarsal tunnel syndrome, stress fractures, and posterior heel pain.  Identifying the cause is the only way to treat heel pain properly, as treatment will vary depending upon the cause.

Sometimes you may have heel pain that can be alleviated by temporarily discontinuing the activity causing the pain.  For example, taking a few days off from walking, jogging, or prolonged standing can often relieve a flare up of pain.  Temporarily discontinuing such activity will allow inflammation to decrease, thus eliminating the pain.  For heel pain that lasts more than a few days you should seek medical help to diagnosis and treat the cause.

Since there are many possible causes of heel pain there is not one specific treatment.  If you have heel pain that persists for more than a few days, be sure to visit your podiatrist for diagnosis and treatment options.

Depending upon the cause of the pain, treatment may involve a variety of options such as anti-inflammatory medication, shoe inserts, stretches and exercises and other treatments.  One common cause of heel pain is plantar fasciitis.  Plantar fasciitis is and irritation and inflammation of tissue forming the arch of the foot.  Heel spurs can result from lengthy plantar fasciitis.

The ligament connecting your heel bone to your toes is the plantar fascia. This ligament supports the arch of your foot.  When strained the planar fascia becomes weak, swollen and inflamed thus causing pain known as plantar fasciitis.

The straining of this ligament is the cause of plantar fasciitis.  Continued strain causes tiny tears in the ligament, which leads to inflammation, pain, and swelling.  There are various treatment methods.  Seeking the advice of a podiatrist is advisable to obtain the best relief from this painful foot issue.

An ingrown toenail occurs when the corner of the toenail digs into the skin.  This usually occurs at the end or side of the big toe.  Ingrown toenails are painful and can cause more serious issues if left untreated.  Over time infection or even an abscess requiring surgical treatment can result.  If you have an ingrown toenail that becomes very painful and is not getting better seek treatment to prevent serious issues.

Thick or discolored toenails are not something you should ignore.  There are many causes which can be the result of another medical condition or something such as fungus, injury, or improperly fitting shoes.  Left untreated the toenail can even fall off.  Also, if there is an underlying medical condition, you should see a doctor for proper diagnosis to prevent further problems.

A black toenail usually is due to bruising beneath the nail bed.  Just like any other bruise, the toe can be very painful and sensitive.  Obvious types of injury, such as dropping something on your toe are often the cause of a black toenail.  It can also occur when the toe has been fractured.  In many cases this type of bruise can be self-treated, but if problems persists, see a doctor to determine the cause and best treatment method.

The most common skin problems on the feet are athlete’s foot, warts, and corns and calluses.  All these conditions can usually be prevented by by a few simple precautions.  For athlete’s foot and warts, it is important to always wear sandals at any public location such as showers, pools or whirlpools.  Don’t wear other peoples shoes.

For corns and calluses, make sure you have properly fitting shoes that don’t place repeated pressure on areas of your foot.  Calluses can cause corns, so it is important to try to keep feet soft and moist, and to use a pumice stone or sandpaper to remove tough callused areas.

When too much stress is placed on joints or tissues, injuries such as bursitis, Achilles tendinitis, stress fracture, and plantar fasciitis can result.  These are common sports injuries occurring from repetitive use and stress.  Often supportive braces, orthotics, and other avenues can be used to strengthen and protect the affected area.

Whenever there is an acute injury to the ankle, foot, or toe during sports, it is a good idea to receive medical attention.  Even if the injury is minor it is better to take precautions than to self-treat and have more problems as a result.  Things like minor sprains and strains can be self-treated, but if the issue doesn’t resolve within a few days, or pain or discomfort worsens, seek medical attention.

If you think you have broken a toe, get prompt attention.  With x-rays the extent and location of the fracture can be identified and method of treatment prescribed for quick relief.  Left untreated a post-fracture deformity can result causing other painful issues such as corns or other pain due to the misalignment.

If you think you have broken a toe, get prompt attention.  With x-rays the extent and location of the fracture can be identified and method of treatment prescribed for quick relief.  Left untreated a post-fracture deformity can result causing other painful issues such as corns or other pain due to the misalignment.