With a course of conservative treatment consisting of anti-inflammatory medications, wider shoes, bunion shields and, occasionally, 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.
Many patients will be able to wear comfortably fitting shoes within six to eight weeks, but a return to full activity might take up to three to six months.
A bunion deformity is a structural deformity caused by abnormal biomechanics in which the first metatarsal drifts away from the second metatarsal. This causes the big toe (hallux) to drift towards the second toe. The result is a bump or prominence of the inside aspect of the foot and the big toe hitting up against the second toe.
Hammertoe deformity is a structural deformity in which abnormal biomechanics cause the toe(s) to contract at one, two or all three of the joints within that toe. When in its early stages, the deformity is flexible. Normally hammertoes by themselves are not painful, but with foot wear, the prominent knuckle of the toe rubs the shoe, producing an area of irritation which eventually forms a corn.
Temporary relief of painful symptoms can be achieved by having the lesion/corn, often present with this deformity, debrided (trimmed). When the contracture becomes rigid and nonflexible and increased swelling and pain persist, then surgical correction might become necessary to alleviate symptoms.
Corns and Calluses
Corns and calluses are NOT soft tissue problems and there is no “root” to be removed. No matter how much they are cut down or debrided, they will return. Painful corns and calluses are the result of abnormal position of the underlying bone. Often hammertoes become painful because a bursal sac will develop between the bone and corn or callus. The bursal sac can be treated with injections and anti-inflammatory medications. If this relieves the symptoms then surgery can be delayed. If these treatments fail, then structural correction of the hammertoe is recommended by your physician.
Ingrown nails are caused when the nail is incurvated (turned in) and penetrates the skin. The improper trimming of the nails, tight shoes, or injury to the nail can cause ingrown toenails to worsen. Early and mild ingrown nails are slightly painful and red. Later, more severe cases result in red, swollen nail boarders which might pus over. Partial removal of the corner of the nail usually gives prompt relief. If this condition becomes chronic, then permanent nail removal of the corner might be suggested.
Pain in the feet is not normal and it is usually the result of an abnormal relationship or misalignment of the bones in the foot at inappropriate times during the gait cycle (patho-mechanics). Patho-mechanics can result in bunions, hammertoes, heel pain, corns, calluses, or just tired aching feet. If your shoes wear out abnormally in the inside heel or outside heel, this is another good indication that patho-mechanics is occurring.
Orthotics realigns the bony abnormalities and restores normal function. An added benefit is reduction of pain and slowing the progression of structural deformities. 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.
Orthotics is molded right at our facilities and takes less than 30 minutes to have them fitted. There are many styles of orthotics, which may be customized for sports dress shoes or diabetic foot wear. The goal of an orthotic treatment regimen is to keep the patient active while balancing the foot in order to stabilize your gait cycle.
Warts are viruses that reside in the skin. They are spread by direct contact and can multiply and penetrate deeply in the bottom of the foot. Topical chemical agents and debridement (scraping) is a simple way to take care of warts in the early stages. As the wart grows and multiplies, it sometimes becomes necessary to excise them and cauterize the base to prevent reoccurrence.
New Laser Technology For Warts
The latest state-of-the-art treatment for warts is pulsed dye laser therapy (PDL).
- No Surgery
- No Injections
- No Post-Op Dressings
- Minimal/Mild Discomfort
PDL works by shining a beam of laser light on the wart. The pulse of laser energy affects the blood supply to the wart and it eventually disappears. Treatment usually takes less than 30 seconds. It’s safe for children and adults.
Heel pain, plantar fasciitis or heel spur syndrome is caused by an abnormal and excessive pull of the plantar fascia at its insertion. Morning pain and pain after periods of rest is characteristic and can progress to pain all the time. Treatment is aimed at shrinking the bursal sac via strapping, NSAID’s, injection and orthotics. If this fails, treatment can be rendered via surgical correction in order to release the fascia.
Having a spur does not make a difference in diagnosing or treating heel pain. It is simply a good indicator of the longevity of the problem and confirms the severity of the underlying biomechanical problem causing it.
New Treatment For Fungus Toenails Onychomycosis
After years of testing, there are new oral medications that have been found to be both effective and safe. They are well-tolerated and extremely effective on chronic skin and nail fungal infections. It takes about 6-12 months for the nail to clear up. About 71% of patients are cured.
Athlete’s Foot Tinea Pedis
These are caused by fungus that resides in the skin (tinea pedis) or nails (onychomycosis). This infection, if left untreated can blister and cause a break in the skin leaving you susceptible to a bacterial infection. In its early stages, the redness and itching can be treated with topical creams and liquids.
In more severe cases, oral medication is required.
Pediatric Foot Problems In-toe, Outtoe & Overlapping Toes
The most common foot problem seen in children is in-toe. Often times this is the result of lack of external rotation at the hip (femur). The result is in-toe gait and a flattening of the arch.
Although many of the deformities seen in the infant are a result of retained intrauterine position, the child will grow out of these if the intrauterine position retained is significant, or a structural deformity is present these problems will not be resolved. The earlier treatment is started, the more successful resolution can be.
Inversion sprains occur when the foot turns in and one of the three ligaments on the outside aspect of the ankle strain or rupture. The severity of the strain dictates the treatment.
A mild strain or sprain is treated by immobilization, non weight-bearing and anti-inflammatories and is followed by re-training and strengthening. Proper treatment is essential to prevent re-occurrence and chronic sprains.
Geriatric Foot Problems
The geriatric patient has many of the same foot problems as the younger patient but their condition is often complicated by poor circulation, arthritis, bursitis, neuritis or other inflammatory conditions.
Your feet should not hurt because you are older. Many of your conditions can be alleviated by modern foot care and proper shoegear.
Foot odor is caused by the bacterial decomposition of excessive perspiration on the soles of the feet and between the toes. The warm, moist environment inside your shoes promotes the bacterial growth on your feet.
Treatment of your feet is usually directed at controlling the sweating. Stubborn cases may be treated with prescription medicines.
Arthritic Foot Conditions
Rheumatoid arthritis and osteoarthritis are two common forms of arthritis that affect millions of Americans, especially those over age 45. Rheumatoid arthritis affects the entire body whereas osteoarthritis is isolated to the joints.
Surgery to reconstruct the joint may be needed if arthritis causes chronic problems that cannot be controlled by medication, orthotics or physical therapy.
Foot and Ankle Fractures
A fracture (break) of your ankle usually happens due to a fall, an accident or hard blow. There are different types of fractures that occur depending upon the severity of the injury. Spiral, hairline, open and crushed bones are names used to describe fractures.
Our doctors are experts in fracture care and will perform x-rays to determine the type fracture you have. We sometimes need to realign the bones, this is done through a process called reduction. Casting of the fracture, a walking boot, brace or splint are used to hold the bone in place during healing
Diabetic Foot Problems
Most of the problems diabetic patients have with their feet are as the result of either nerve damage (neuropathy), infection or poor circulation. Deformities of the foot and trauma to the foot also play a part in causing sores and infections.