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If you have any of the symptoms below, you may require a foot examination.
* Foot Pain
* Pain, redness or swelling surrounding the toenails
* Irritations on the top or sides of your toes
* Bumps or swelling in the back of the heel
* Pain beneath the heel bone
* Red, cracked skin or white irritation between the toes
* Burning pain on the top or bottom of the foot
* Numbness and tingling of the toes
* Ankle, calf, or shin pain
* Painful corns, callouses, or bunions |
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FOOT FACTS |
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Bunions: A bunion is an enlargement and deformation of the great toe joint. It is often associated with pain during ambulation or in shoe gear. The angular deformation of the great toe joint most associated with a bunion has a strong hereditary influence. Patients often believe a bunion deformity is caused by wearing improper fitting shoes. Although a tight fitting or narrow toe-box shoe may irritate the bunion, it is not the cause of the structural changes around the great toe joint.
Bunion pain can be a result of bursa formation, nerve impingement, or arthritic changes in and around the great toe joint. Treatment is initially directed at symptomatic relief by using wider shoes, anti-inflammatory medication and arch supports if appropriate. Surgical correction of a bunion is used to realign the great toe joint and narrow the forefoot. |
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Hammer toe: A hammertoe is a contracture of a digit usually resulting in a painful corn or callous formation on top of the toe or under the ball of the foot. Any of the toes can be affected, individually, or as multiple hammertoes. In most cases a hammertoe forms slowly over time due to an imbalance in the pull of the tendons on the top and bottom of the toe. Occasionally a hammertoe is caused by trauma to the digit such as a broken toe. Treatment consists of trimming and padding of the corn/callous, deeper or wider shoes, and surgical straightening of the toe or toes. |
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Neuroma: A neuroma is an enlarged, inflamed nerve mass occurring most commonly at the ball of the foot near the 3rd and 4 th toes. Symptoms usually consist of a sharp, stabbing or burning pain under the ball of the foot with radiating pain into the toes. In severe cases, a "clicking" sensation can be felt while walking. This is the nerve mass moving between the adjacent metatarsals. Although the exact cause of a neuroma is not known, it may be due to mechanical irritation of the nerve by narrow, thin-soled shoes, or poor foot mechanics causing metatarsal irritation of the nerve. Initial treatment consists of cortisone injections, arch supports/orthotics, and a change in shoe gear. If this fails to give relief, surgical excision of the mass is done. |
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Warts: Warts are viral induced growths occurring on any part of the body. When occurring on the bottom of the foot they are known as plantar warts. They can vary greatly in size and number. When located beneath a weight bearing area of the foot the lesion can be quite painful. These growths are unpredictable and can multiply rapidly or remain the same size for many years. Although the transmission of warts is not completely understood, they are generally believed to be contracted through direct inoculation through the skin. Many treatment options exist. Chemical cauterization, liquid nitrogen, surgical excision, and laser ablation are the most commonly used treatments. |
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Nail fungus: Nail fungus lives under the nail plate causing a thickening and discoloration of the nail. Topical medication is generally ineffective because the medication does not reach the fungus beneath the nail plate. Oral anti-fungal medication is often very successful at resolving the fungus and returning the nail plate to its normal color and thickness. |
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Ingrown toe nail: An ingrown toenail occurs when the nail border penetrates the skin causing pain. If left untreated infection may result. An ingrown toe nail has many causes: Improper nail cutting, aggressive cuticle care, tight fitting shoes, or direct nail trauma are the most common. A fungal infection of the nails can cause the nail to change shape and grow inward. Even infants can have ingrown nails, which are usually hereditary. Initial treatment consists of removal of the offending portion of nail and drainage of infection if present. If the ingrown nail is recurrent, then permanent removal of the ingrown portion of nail is performed. |
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Heel pain Heel pain is an extremely common foot malady affecting young and old, active and sedentary people alike. The most common type of heel pain is called plantar fasciitis. This occurs when the main supporting ligament of the arch is strained at its attachment to the heel. Many factors can cause excessive strain of the plantar fascia: Weight gain, non-supportive shoes and flat feet are the most common causes. Other types of heel pain are due to bursitis and Achilles tendonitis. Treatments for heel pain include anti-inflammatory medications, physical therapy, motion controlling orthotics , passive stretching night splints, and in resistant cases, surgery. |
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Bursitis
Bursa are small fluid containing sacs, that are situated between areas of high friction such as bone (heel bone, metatarsal bone) against the ground/shoe and against other structures like tendons, skin and or muscle.
The bursa's job is to act as a shock absorber, and to allow stress free movement between the above noted structures. Bursitis is a swelling/inflammation of the bursa sac, due to constant micro-trauma or overuse. It is most commonly found on the foot, at the bottom of the heel, the back of the heel or beneath the metatarsal heads. A bunion is also a favorite spot to find bursitis in the foot.
When there is increased pressure or friction in these areas, the bursa fills up with excessive fluid causing pain, this is called bursitis.
We believe there needs to be both a medical and a mechanical approach to treating bursitis.
- The medical approach is with anti-inflammatory medications, cortisone injections and physical therapy.
- The mechanical approach utilizes paddings, arch supports, orthotics (both over the counter and custom made), rest, and shoe changes/modifications.
There are times when the above conservative therapy fails to eliminate the symptoms and surgery may be necessary to completely eliminate the symptoms. |
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Orthotics
a. Functional orthotics
A functional foot orthotic is a device used to control or alter foot and leg motions during gait. Human locomotion is a complex series of events that occur as the heel strikes the ground, carries through mid-stance and ends at toe-off. Most of us have some form of biomechanical fault that can result in foot, leg or even back pain. With proper analysis, a functional orthotic can be fabricated to change a persons biomechanics resulting in pain relief.
b. Accommodative orthotics
An accommodative orthotic is a device used to disperse weight off a particular area of the foot. As an example, a diabetic patient who forms ulcerations under a bony prominence on the bottom of the foot would benefit from this type of orthotic. |
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Pediatric foot disorders
Many adult foot ailments have their origins in childhood. If structural and functional deformities are detected early, treatment can be initiated to minimize these ailments in later life.
Some of the more common childhood foot problems are: In-toe and out-toe gait, flat feet, overlapping toes, juvenile bunion deformity, ingrown nails and warts. |
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The diabetic foot
Diabetes is a chronic disease which afflicts 16 million people in the U.S. Chronic elevation of blood sugar is associated with damage to the eyes, heart, kidneys, nerves and blood vessels. Diabetics are at particular risk for foot infections due to loss of sensation and decreased blood flow. Prevention through regular professional foot care is essential. |
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