Diseases and Conditions
Hallux Abducto Valgus (Bunion)
A bunion deformity is a structural condition caused by abnormal biomechanics. In this condition, the first metatarsal drifts apart from the second metatarsal. This causes the big toe to move towards the second toe. The result is a bump or prominence on the inside aspect of the foot. The big toe often “hits up against” the second toe. A hammertoe of the 2nd toe often develops as a secondary deformity.
With a course of conservative treatment consisting of anti-inflammatory medications, alterations in shoe gear, accommodative padding techniques, and orthotics, the pain associated with the bunion may be alleviated and surgery can be delayed. Surgical correction, if indicated, is aimed at realigning the first metatarsal with the second, restoring anatomical alignment, alleviating pain.
Ingrown nails are caused when the toenail “turns in” on the sides or end of the nail and punctures the skin. When this happens a patient is at risk for bacterial infection. Improper trimming of the nails, tight shoes, or injury to the nail can result in a painful ingrown toenail condition. Symptoms of an ingrown toenail includes redness, swelling, pain and drainage in the form of pus. Prompt treatment is essential and may include partial or total removal of the nail. If this condition becomes recurrent, then permanent nail removal of the corner might be suggested by our physicians.
Hammertoe deformity is a structural deformity in which abnormal biomechanics cause the toe(s) to contract at any of the joints in the toe. Hammertoes may be flexible (movable) or rigid (fixed in position). Hammertoes become painful when the joints in the toe become arthritic, the toe rubs on the top of the shoebox, or when corns form on the top or tip of the toe.
Temporary relief of painful symptoms can be achieved by having corns debrided and shoe gear modified. When the contracture becomes painful and increased swelling persists, then surgical correction might become necessary to alleviate symptoms.
Pain in the feet is not normal and it is usually the result of an abnormal musculoskeletal relationship or a misalignment of the bones in the foot. As a result of this bunions, hammertoes, heel pain, corns, calluses, or just tired aching feet can occur. Orthotics realign the bony abnormalities and restores normal function. As a result patient’s experience a reduction in pain and slowing of the progression of structural deformities. An orthotics is a custom-made biomechanical device fabricated from a plaster cast of your foot. Structural deficiencies and damaging compensatory habits can be modified with the use of properly fitted orthotics.
Corns and Calluses
Painful corns and calluses are the result of abnormal position of an underlying bone. They can occur anywhere in the foot but are most commonly seen on the bottom of the foot where pressure is applied. Corns and calluses are a response to pressure and if pressure is not alleviated, the corn or callus will return despite removal or debridement. Conservative treatment involves debriding the lesion and taking measures to decrease pressure. If that does not help with symptoms surgical intervention is sometimes necessary.
Plantar Fasciitis (Heel Spur)
Plantar fasciitis is the term commonly used to refer to heel and arch pain. It is also commonly referred to as heel spur syndrome. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia that inserts onto the bottom of the heel bone and extends to the toe region. Over pronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation on the bottom of the heel.
Plantar fasciitis can be treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Surgical intervention may be necessary when conservative treatment fails to relieve symptoms.
Plantar warts are typically harmless, but can be very painful. They are often mistaken for corns or calluses. A wart is caused by a virus which invades the skin through small or invisible cuts and abrasions. If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of warts. Unlike other types of warts on the body, plantar warts tend to be hard, raised, and callused, with a rough surface and well-defined boundaries. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. Plantar warts have a unique blood supply and may bleed easily. Because they often develop on the weight bearing surfaces, they often can cause a sharp, burning pain.
Ankle sprains are caused excessive stretching or tearing of one or more ligaments on the outside of the ankle. If not properly treated, ankle sprains may develop into long-term problems. Symptoms of ankle sprains are pain, swelling, and bruising and can occur on the inside or outside of the ankle.
Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages or ankle braces also may be used to immobilize and support the injury during healing. Complicated ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.
Pain in the area between the arch and toes, or ball of the foot, is generally called metatarsalgia. The pain usually centers on the bottom of the foot at the base of the toes in the area of the metatarsal-phalangeal joints. Metatarsalgia occurs when one of these joints become painful or inflamed. People often develop a callus under the affected joint. Metatarsalgia also can be caused by arthritic changes, injuries to the foot, walking on hard surfaces, and specific footwear (rigid-soled shoes).
A simple change of shoes may solve the problem. In more severe cases, custom orthotics or surgical intervention may be needed to alleviate the pain.
Fungal nails occur when the nail plate of the toenails is infected with fungus. Fungal infections of the toenail are typically more difficult to treat then fungal infections of the skin. Treatment for toenails fungus includes but is not limited to topical antifungal therapy, oral anti-fungal medication, and laser therapy. Fungal toenails are most successfully treated at the first sign of discoloration or thickening of the toenail.