Foot Problems

Common Foot Problems:

Bunions: Are an enlargement of the big toe joint which may become swollen and tender.  Oftentimes the big toe will drift toward the other toes.  Soreness is usually caused from shoe pressure on the side of the joint, whereas pain with bending the toe is related to joint limitation or early arthritic change.  This condition is usually hereditary, but is clearly aggravated by tight shoe gear.  Surgery is often indicated to correct this problem.

Hammertoes: are caused from muscle imbalance allowing the flexor tendon to pull the toe downward often causing irritation on either the top or tip of the toe due to the contraction.  Oftentimes a small hyperkeratosis or hard plug of skin forms in this area.  In the elderly, or diabetic patient, these areas are prone to ulceration as circulation diminishes.

Neuromas: is soreness and pain located underneath the ball of the foot caused from pressure or stretching on the nerve trunk.  The most common location in the foot is between the third and fourth toes.  Oftentimes a numbness or burning pain is worsened with tight or overly flexible shoes.  This is caused by foot structure that allows hypermobility and chronic stretch on the nerve causing inflammation.  This can oftentimes be alleviated with a steroid shot and change to more appropriate shoe gear.  In chronic cases surgery is indicated.

Plantar Fasciitis: Pain on the bottom of the heel, is one of the most common presenting foot complaints.  Typically patients have pain that is worse in the morning or after periods of inactivity.  This is also caused by a foot structure with hypermobility and excessive stretch on the plantar fascia causing chronic inflammation.  Walking in nonsupportive shoe gear or slippers aggravates the problem. Most patients will respond to stretching, properly adjusted orthotics, and cortisone injections.  Some heel pain is recalcitrant and requires surgical release of the fascia or entrapped nerve branches.

Ingrown Nails: soreness and inflammation caused from side of the nail pushing down into the skin.  These often become infected from improper cutting or by leaving a hook in the corner and redness and drainage is noted.  When this condition becomes chronic, a simple procedure under local anesthesia can eliminate this problem.

Tendonitis: often seen on the sides of the foot, this is caused from abnormal muscle pull causing inflammation at the insertion of the tendon into the bone.  This can cause a burning or aching sensation and prevents normal walking activities.  Wearing the right shoe with an appropriate orthotic and other anti-inflammatory measures usually eliminates this problem

Corns and Calluses: these are simply a buildup of skin layers caused from friction and pressure over a bony prominence.  Abnormal foot motion, or pressure related to malposition of toes or joints is the usual cause.  Choosing proper shoe gear, and using protective padding can minimize the soreness.  When they become thick enough, they require debridement in the office.

Warts: are caused by a skin virus and is spread by direct contact inside the shoe or from walking or stepping somewhere where someone else has shed skin scales containing the virus.  This is most common in gym, pool or locker room area.  They usually present as a small callused area with dark black spots, or occasionally clear white circular areas.  Home treatment rarely works, as effective debridement is critical.  Treatment options can vary from simple chemical applications at home, to removal in one visit under local anesthesia.

Treatments Offered:

• Heel Pain and Plantar Fasciitis
• Diabetic Wound Care
• Foot ulcers
• Treatment of Infection
• Ingrown Nails
• Debridement of deformed or thickened nails
• Hammertoe Surgery
• Bunion Surgery
• Removal of Bone Spurs
• Neuroma Surgery
• Endoscopic Release of Plantar Fascia
• Warts
• Biopsy of Skin Lesions
• Foot Care for the Elderly

Useful Links:

eMedicine  Clinical Knowledge Base
http://www.emedicine.com

DermAtlas: Dermatology Image Atlas
http://dermatlas.med.jhmi.edu/

American Podiatric Medical Association
http://www.apma.org/

American College of Foot and Ankle Surgeons
http://www.acfas.org/

National Institutes of Health
http://www.nih.gov/

American Diabetes Association
http://www.diabetes.org/