FAQ

BUNION DEFORMITY

What is it? What to expect? What to do about it?
Bunions are one of the most common deformities of the forefoot. There is a displacement of the first metatarsal bone toward the midline of the body, while simultaneous displacement of the great toe away from the midline. This causes a prominence of bone on the inside of the forefoot, this is termed a bunion. The great toe will continue to drift toward the smaller toes and may come to rest either over or under the second toe. The incidence of bunions is higher in women than in men. This may be attributed to shoe fashion. There are also genetic factors as well as certain foot types that predispose people to develop bunions.

Symptoms– patients may experience redness, swelling, or pain along the inside margin of the foot just behind the great toe. A painful callus may develop over the bunion region. There may be stiffness and discomfort in the joint of the big toe. The patient may also develop an ulcer, resulting from skin breakdown at the pressure point of the bunion.

Causes– Pronated foot

• Family/ genetic
• Narrowed toed dress shoes and high heels
• Limb length inequality
• Ligamentous laxity
• Trauma to the big toe region
• Arthritis( rheumatoid, psoriatic, gouty)

Treatments– conservative treatment includes modification of shoe gear, prescription orthotics, steroid injections, or callous trimming. Surgical treatment, if necessary, involves an outpatient procedure where a bone is broken and slid over and fixated with a screw to reduce the bunion deformity.

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HAMMERTOES

What is it? What to expect? What to do about it?
Your little toes help stabilize and propel your body when you walk. As your foot flattens the little toes bend to grip the ground. Then they straighten acting like levers to push your foot so you can walk, run or dance. Hammertoes develop due to instability in the joints. There are basically three toe joints that can unstable or contracted. The toe itself then begins to curl (develop a hammertoe) because of the instability of the joints and the muscle imbalances or tight tendons that result.

Symptoms– irritation and pressure over affected joints

• Corns and calluses may develop at pressure points
• An ulcer can develop if pressure is severe
• Inability to wear most styles of shoes

Causes– extremely tight Achilles tendon

• A very high arched foot
• Neuromuscular imbalance
• Loss of muscle tendon strength
• Trauma

Treatments– Conservative treatment- wear wider /deeper shoes, accommodative padding, and orthotics with modifications.

Surgical treatment when required is an outpatient procedure involving a small incision, removal of the offending prominence, and then a wire to hold the toe straight.

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HEEL PAIN/ PLANTAR FASCIITIS

What is it? What to expect? What to do about it?
Heel pain is one of the most common problems to affect the feet. It is usually caused by straining or tearing of the band like ligament which maintains the arch, called the plantar fascia. you may also develop a bony heel spur where the plantar fascia attaches to the heel bone or compression of a nerve which travels under the heel bone.

Symptoms– the most common complaint is a sharp pain in the bottom of the heel especially in the morning with the first few steps out of bed, or after sitting for any long stretch of time. The pain may decrease after a few minutes of walking. Some patients experience pain the entire day when walking or standing. Professional athletes have been sidelined due to this injury.

Causes– Injury to the plantar fascia may be caused by overactivity, improper shoes, poor walking mechanics, flattening arches, increased weight on the feet, or injury.
Treatments– conservative care involves modification of shoe gear, prescription orthotics, stretching, icing, anti-inflammatory medication, and possibly a cortisone injection.

If conservative therapy fails a small surgical procedure to loosen up the plantar fascia can be performed utilizing a 2 small incision and a camera.

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NEUROMA

What is it? What to expect? What can I do about it?
A neuroma is an inflammatory condition of one of the nerves of the foot. A neuroma can occur at any site in the ball of your foot, but the most common place is between the third and fourth toes. Neuromas are more prevalent in women, with narrow toe boxes and high heeled shoes as part of the culprit. What happens is the communicating branch of the two largest nerves in the bottom of the forefoot become trapped between the heads of the 3rd and 4th metatarsal bones- causing numbness and shooting stabbing pain.

Symptoms– sharp pain in the ball of the foot with tingling and numbness traveling to the toes with weight bearing. The condition can feel like walking on a pebble. The symptoms can increase with shoe gear.

Causes– high heeled shoes or narrow fitting shoes can cause a neuroma, trauma, foot structure.
Treatments– conservative care consists of orthotics, and possibly a cortisone injection.

Surgical treatment– involves excising the nerve that is causing the pain-usually as a last resort because the surgery can be unpredictable.

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INGROWN TOENAILS

What is it? What to expect? What can I do about it?
Ingrown Toenails are a very common foot problem. They can be very painful, with people limiting their activity to keep off of their sore feet. Ingrown toenails are caused by impingement of the skin along the margins of the nail by the nail plate. Some ingrown toenails are chronic, with repeated episodes of pain and infection. The usual signs of infection include; redness, swelling, increased warmth, and pain.

Symptoms– pain along the margin of the toenail, aggravation by wearing shoes, signs of infection may be present, evidence of pus or watery discharge.
Causes– improper trimming of nails, tight-fitting shoes, abnormally shaped nail plate (genetic or traumatic).

Treatments– your doctor can first try to just trim the corner that is affected. More likely you will need a small procedure which removed the offending nail border all the way back to the base- the nail can also be removed permanently if the patient so desires.

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WARTS

What is it? What to expect? What can I do about it?
Warts are caused by a virus which generally invades the skin through small or invisible cuts and abrasions. They can appear anywhere on the skin, but technically only those found on the sole are called plantar warts.

Warts can be painful and can be mistaken for corns or calluses. Plantar warts tend to be hard and flat with a rough surface and a well-defined border. Plantar warts are either grey or brown with pinpoint black dots.

How is a wart contracted? The plantar wart is often contracted by walking barefoot on dirty surfaces or ground where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.

If left untreated warts can continue to grow and spread. Like any other infectious lesions, warts are spread by touching, scratching, or even contact with skin shed from another wart.

Tips for prevention– avoid walking barefoot, except on sandy beaches, change socks and shoes daily, keep feet dry and clean, avoid direct contact with warts, do not ignore growths or changes in your skin, visit The Advanced Footcare Center for your annual check-up.

Treatments– professional treatment consists of shaving the callous of, freezing the wart and then giving you some strong acid compound to apply daily until the wart has resolved.

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FUNGAL TOENAILS

What is it? What causes it? What can I do about it?
Toenails are excellent breeding ground for fungus. The nails spend their entire day in dark moist environments. a fungus can start in the nail or sometimes it can start as athletes foot. Toenail fungus is thought to be transmitted through public bathrooms, locker rooms, and pools.
Signs– the appearance of the nail is often thickening of the nail, discoloration of the nail, and separation of the nail from the nail bed, and in some cases, the nail becomes very brittle.

Treatments– varies from having your nails trimmed every 3-4 months, trying topical medicated nail lacquer, oral medications, or removing the nail and treating the underlying nail bed.

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GOUT

What it is? What causes it? What can I do about it?
Acute gouty arthritis is the attack of a metabolic disease marked by uric acid deposits in the joints. This disorder causes painful arthritis, especially in the joints of the feet and legs.

Causes– Gout is caused by a defect in metabolism that results in an overproduction of uric acid, or reduced ability of the kidney to eliminate uric acid. The condition may also develop in people with, diabetes, obesity, sickle cell anemia, and kidney disease.

Risk factors– the risk is increased in males, postmenopausal women, and people with risks factors stated above.

Symptoms– joint pain, joint swelling, fever, skin lumps, redness, increased heat at the site.

Treatments– first early diagnosis is very important. You will be advised to drink more water, avoid certain foods and drinks, maintain a healthy weight, and avoid alcohol consumption. Also, it is very important to immobilize the joint that is affected. Blood tests and oral medications may be necessary for control of gouty arthritis.