Foot Problems
Please choose a foot problem to review:
Hammertoe
Hammertoe is a condition in which a person's toe is bent into a claw-like position, most commonly it is the second toe. Hammertoe is described as a deformity in which the toes bend downward with the toe joint typically enlarged. Over time, the person's joint will stiffen and enlarge as it rubs against their shoes. This happens when the bone of the toe becomes unbalanced. When the bone is off balance it makes the joint of the toe bend downward, with toes appearing raised near the foot.
A hammertoe can occur in one toe or in several toes, with the exception of the big toe. When more than one toe is affected the condition is referred to, naturally, as hammertoes. This can result in unsightly lesions or pain from pressure of the toes when wearing shoes. If you suspect you have a hammertoe consult New York Podiatrist to confirm a diagnosis since the condition can get progressively worse over time.
Some people may be prone to hammertoe, inheriting the genetics from their parents or grandparents. Well fitted shoes with enough toe room, shoe supports, and surgery may offer relief. Occasionally, hammertoe is caused by some kind of trauma, such as a previously broken toe. Hammertoe can develop when high heels or too-small shoes prevent your toes from lying flat. As a result, one of your toes, most likely the second, curls downward because of a bend in the middle toe joint. This contraction depresses the metatarsal heads. Hammertoe is one of the most common problems presented to podiatrists and foot doctors. Patients complain about pain and the inability to bear weight on the affected foot. It begins painlessly, but can become quite painful. It is fairly easy to relieve the pain in the early stage, while more aggressive tactics may be required if the condition progresses.
Hammertoe cushions and buttress pads can also be used for some relief. These pads are placed under the toes to help straighten the toes while walking. This will take pressure off the tops of the toes as well as limit pressure on the ball of the foot. Again, wearing roomy socks and shoes helps to alleviate some of the pressure. These measures only work on a flexible or semi-flexible hammertoe.
Rigid hammertoe is one which will not bend or straighten even when standing, will not respond well to buttress type padding. Surgery is a better option for relief at this stage. Hammertoe surgery is one of the most successful and gratifying procedures for surgeons and patients alike. Every year, over 300,000 hammertoe surgeries are performed. There are several surgical options and methods your podiatrist can discuss with you but as with any foot surgery, recovery can be slow and painful, especially with hammertoes or bunions. There are usually few complications and patients are able to resume their daily activities without significant interference after surgery. Once you have an inkling, the most important thing to do if you believe you have a hammertoe is to seek the treatment or advice from New York Podiatrist. Your feet are far too important to ignore when chronic pain becomes a part of daily life.
Treatment for Hammertoe
Treatment for a claw toe, hammer toe, or mallet toe is first to wear more comfortable footwear. Your shoes should have a deep, wide toe area. At first, a hammertoe is flexible, and any pain it causes can usually be relieved by putting a toe pad into the shoe to relieve the pressure. Just about any drug store will carry the toe pads. As the tendon becomes tighter and the toe stiffens, other treatments, including exercises, splints, and custom-made shoe inserts, called orthotics, may help redistribute weight and ease the position of the toe. Special pads and orthotics are made to protect the toes and even to correct the deformity of hammertoe. Usually problems arise from painful calluses and corns forming around the deformities. When someone has an abnormal toe, it tends to rub on footwear and cause problems. Protecting these problem areas with the pads will often control the symptoms.
The hammertoe pads don't usually solve the issue of identifying and addressing the cause of the problem. Oftentimes it is a combination of faulty foot mechanics, poor shoe choices, an increase in a training regimen or weight gain. The orthotics can be used to control abnormal foot movement and disperse pressure more evenly. Calf stretches or night splints can be used for those with tight calves to eliminate the heel lifting early during walking. There are a variety of metatarsal pads which can be used to distribute the pressure under the ball of the foot to help alleviate pain and accelerate healing.
Hammertoe Surgery
Surgical evaluation may include x-rays to assess the level and severity of the hammertoe. Surgical correction of the deformity is needed to bring the toe into a corrected position and to increase its function.
Correction of the hammertoes is a simple outpatient surgery with limited downtime. One surgical option is to fuse the deformed and contracted digit in a straight position. This limits the need for future surgery and prevents the deformity returning. CAT scans and MRI may also assist in the preoperative planning for hammertoe surgery.
Surgical treatments for hammertoe are suggested to numerous hammertoe patients depending upon the severity of the condition. One of the most frequent hammertoe surgeries is arthroplasty. A tiny portion of the bone from the afflicted joint is detached and the hammertoe is cured in most cases. 　Another kind of surgery is arthrodesis which is for patients with extremely severe hammertoe issues. With arthrodesis, the toes are straightened by fitting a small joint with a device like a pin till it gets cured. There are other surgical procedures that may help in fixing the hammertoe condition.
Several surgical procedures for hammertoe, and other foot ailments, are available through New York Podiatrist. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain. Severe hammertoe, which are not fully reducible, may require more complex surgical procedures. Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatrist after your hammertoe surgery.
When you need Orthotics
Our group of podiatric physicians is adept at accessing and prescribing these important devices which help control abnormal and unwanted motion in the rearfoot (pronation.) Orthotics are also prescribed to help redistribute weight. They are of particular use in patients with rearfoot pain secondary to fasciitis and heel spurs. After an orthopedic evaluation and analysis of your gait, if it is determined that custom orthotic devices will help with the particular problem the doctor will create a cast of your foot. We have employed the same orthotic lab for over twenty years, assuring continuity and continued excellent quality control.
Plantar Warts
These annoying growths (technical name "verruca") on the sole of the foot are frequently misdiagnosed. Podiatric specialists can spot them right away due to their characteristic appearance. Treatment is usually via paring and application of a painless freezing solution (cryotherapy.) Conservative treatment is usually enough to destroy the wart, though laser surgery can be used for more recalcitrant lesions.
Plantar Fasciitis
Plantar Fasciitis is a very painful inflammatory foot condition that leads to heel pain or heel spurs. This is recognized by irritation and swelling of the thick tissue at the bottom area of the foot, known as the plantar fascia. In this article, we will take a look at the causes, symptoms, treatments and other related issues that will help you to address plantar fasciitis.
Causes
The bottom region of your foot has thick tissues which cover the bones and these are referred to in medical terms as plantar fascia. Whenever this tissue becomes swollen this causes pain which makes walking difficult, particularly when you are taking your first couple of steps after getting out of bed each morning and this is what is known as plantar fasciitis. The most widespread cause of this condition is irregular pronation of the foot, which causes biomechanical imbalance. Some of the factors that could lead to this condition are obesity, excessive standing or walking on hard surfaces, inactivity and badly worn footwear with lack of arch support and protection.
Symptoms of Plantar Fasciitis
In most cases, plantar fasciitis is linked to foot discomfort at the bottom of the heel. During the morning hours, this could be severe, but it will often improve slowly throughout the day. A dull ache will replace the pain towards the evening hours, which might subside with enough rest. Typically, the physical symptoms could include a slight swelling in the impacted area, redness and tenderness at the bottom section of the heel.
Treatments for Plantar Fasciitis
The traditional treatment options for plantar fasciitis are often effective. The average time period to effectively treat this foot problem is about nine months. Some of the common options include medication for the inflammation, orthotic shoe inserts and stretching exercises to target the heel area. Of course, at New York Podiatrist, we stress that proper foot care will be crucial in treating plantar fasciitis. For simple cases, the arch support supplied by the orthotic insoles might provide the necessary relief. For severe cases, it's a good idea to consult us so we can help to identify the right type of foot arch supports or insoles. Sometimes a short cast that would extend to the knee might be recommended.
An alternative solution to this approach would be cast boots, like a ski boot, to be worn during the day and even at night, except for showering or swimming. Although some doctors may recommend steroid injections, you should know that these are extremely painful and might not be ideal for everyone. For some people, we may consider surgical procedures for extreme cases of plantar fasciitis.
Managing Plantar Fasciitis
You can manage this condition with a combination of the right foot exercises and the wearing of suitable arch support insoles. There are various kinds of orthotic arch supports and insoles on the market today. Some are the regular off-the-shelf products, whilst others can be custom-made under the supervision of a podiatrist. You should come see us here at New York Podiatrist if you are experiencing pain from plantar fasciitis.
Neuroma
This very painful condition is characterized by pain, numbness, or tingling that originates underneath and behind the toes. Diagnosis is aided by MRI studies (our group uses an extremity MRI machine, only your leg goes in.) Conservative treatment consists of padding, orthotics, and concentrated alcohol injections. Surgery is usually not required unless all conservative efforts fail.
Toenail Fungus
What is Toenail Fungus? Onychomycosis is the medical term for toenail fungus. It is a difficult infection to treat, and there are a number of species of fungi which invade the toenail. The hard nail is a protein (keratin) that the fungi feed upon and destroy. It is possible to have several types of fungus infecting the nail at the same time. As we age, the incidence of this fungus rises. It is seen less frequently in younger persons.
Causes of Toenail Fungus
This type of fungus prefers a dark, moist climate in which to grow. The fact that toes often have diminished circulation due to tight shoes or diabetes adds to a climate ripe for infection. A diminished immune system, wearing socks that don't wick perspiration, heavy layers of nail polish and having the skin condition psoriasis are all factors that can increase your chance of developing a toenail fungus infection. It is also spread in public areas such as bath houses, locker rooms and shower rooms person-to-person.
Symptoms of Toenail Fungus?
When infected, the nail will begin to discolor, thicken and turn brown or yellow. It can split or peel in ragged layers and grow misshapen. There may be a foul smelling substance under the nail which becomes thick and crumbles. The nail sometimes detaches from the nail bed and eventually falls off. These symptoms can lead to discomfort or pain when wearing shoes or walking.
Toenail Fungus Treatment
As with many conditions, treatment of toenail fungus is dependent upon the severity of the condition. The nail should be trimmed and filed down to prevent damage to surrounding tissue, and to minimize the area the fungus can feed upon. When nails become very thick, a podiatrist has the proper tools to trim the nails with no discomfort.
If the area of infection is very localized and mild, it is possible that the podiatrist can prescribe a medicated nail coating containing Lorprox (ciclopirox) or Loceryl (amorolfine).
Systemic anti-fungal medication may be required for persistent toenail fungus infection or one that continues to spread. Sporanox (itraconazole) or Lamisil (terbinafine) may be prescribed for a course of treatment consisting of about 12 to 16 weeks of oral medication. Since there are serious side effects associated with these drugs, an open dialogue with your podiatrist is important. In severe cases, surgery may be indicated. The permanent removal of the nail may be the only way to successfully remove the toenail fungus.
Prevention of Toenail Fungus
On a daily basis one should change stockings or hosiery. Properly wash and dry the feet and apply foot powder each day. By alternating shoes regularly, you give the inside of the shoes time to dry completely between wearing.
Limit the amount of nail polish applied to the toes, and keep the nails trimmed. Always wear sandals or swim shoes when walking in public places such as shower rooms, public swimming pools and locker rooms. Avoid wearing tight fitting shoes for prolonged periods. Contact New York Podiatrist for a consultation if you feel you may be developing toenail fungus.
Bunions
Definition
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly. Another type of bunion which some individuals experience is called a Tailor’s Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.
Cause
Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function, or arthritis, but is made worse by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion. Women who have bunions normally wear dress shoes that are too small for their feet. Their toes are squeezed together in their shoes causing the first metatarsal bone to protrude on the side of the foot.