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Monday, 09 December 2019 00:00

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Sunday, 01 December 2019 00:00

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area.  It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.

Monday, 25 November 2019 00:00

Debilitating foot pain is a problem for many people. But just as stretching the torso can help alleviate back pain, stretching the feet can also help mend existing foot problems and prevent future ones.

The feet, as the body’s foundation, carry the body’s entire weight and can get easily strained from overexertion. Persistent sharp pain and cramping in the feet are often common concerns. Foot pain and foot problems can be due to any number of causes, and in many cases pain may be eased without medication or doctor visits. It is always a good idea, however, to first rule out any serious medical issues with a physician.

Stretching can help relax the feet and alleviate pain, but is especially important before heavy aerobic exercise. Stretching before such activities can help you avoid experiencing painful cramps or strained foot muscles. Stretches should be performed slowly and deliberately without forceful pulling. The stretch should be held for several seconds before relaxing.

A great way to stretch out and loosen up the foot muscles while sitting is to cross one leg over the other and pull the toes carefully back without overextending. Start by resting the left ankle on the right knee. With the left hand, gently flex the left foot by pulling back on the toes. Do not pull too hard; just hard enough to feel the stretch in the arch of the foot. Then point the toes of the left foot as far as you can. Rotate the motion of pointing with pulling back on the toes. This should relax and stretch the muscles on the bottom and the top of the foot. Doing this stretch ten to twenty times should bring relief. Repeat the whole process for the other foot by resting the right ankle on the left knee.

A stretch that focuses on the often injured Achilles tendon involves standing and facing a wall with your arms out and hands flat against the wall. Step back with one foot, keeping it flat against the floor. Move the other leg forward and lean toward the wall. You should feel a stretch through the back of your leg and your Achilles tendon, but do not push yourself too much. Stop when you feel a stretching sensation, and hold for 30 seconds. Ten repetitions may be done for each foot.

Stretching the feet is important for athletes or those performing aerobic exercise, but it can also help anyone with foot pain caused by poor footwear, plantar fasciitis, or long hours standing and walking. Individuals who tend to their feet by regularly stretching every day should be able to minimize foot pain and prevent new problems from arising.

Monday, 18 November 2019 00:00

Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome.  This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.

Causes of Cuboid Syndrome

  • Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
  • Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
  • Over-pronation can exacerbate the condition if not corrected.

Disagreements Amongst Podiatrists Regarding Cuboid Syndrome

  • Some refer to it as the dislocation of the calcaneal-cuboid joint only.
  • Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.

It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.

Monday, 11 November 2019 00:00

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

Monday, 04 November 2019 00:00

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Monday, 04 November 2019 00:00

Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place.  However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.

Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.

Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.

If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.

Monday, 28 October 2019 00:00

In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.

The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.

While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.

Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries. 

Monday, 28 October 2019 00:00

Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.

Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.

Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should instead consult their doctor immediately.

According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn white after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can lead to infection. If your corn gets infected, and is not treated immediately, a visit to the doctor will be necessary.

Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes. This fixes the way you walk. This will lower your chances of getting corns, and eliminate current corns by reducing rubbing from friction.

Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.

To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.

Tuesday, 22 October 2019 00:00

Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.

To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.

Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.

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