Ingrown Toenail Care
An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders, or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail. In most cases, however, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
What is a Podiatrist?
The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.
To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.
When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.
Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise. Referrals will then be made to specialists that handle the greater health problems.
Some podiatrists have their own independent, private practices or clinics where they have a small staff and administrative personnel. Many podiatrists work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals, or visit patients in nursing homes. Podiatrists typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.
Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that results from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.
Foot and Ankle Trauma
The foot and ankle area works with 26 bones, 33 joints, and more than 100 different muscles, tendons, and ligaments. Problems with any parts of this network can result in some kind trauma within the foot and ankle area. Most foot and ankle trauma is a result of aging or intense activities such as sports. However, trauma in this area can also be the result of simple things such as wearing heels too much or even walking on an uneven pavement. There are several kinds of symptoms related to specific injuries, and there are also several different treatments that could be used as well.
Foot Injuries and Symptoms
Some common injuries in the feet include stress fractures and bunions. Stress fractures are small cracks in a bone or severely bruised parts of the bone. This type of injury is caused by intense and repetitive activity, which is found in actions involved with sports and exercise. Symptoms of this injury include pain, swelling, tenderness, and possible bruising. Another common injury with bones is also bunions, which are bony bumps typically formed on the big and little toes. This injury is typically a result from wearing high heels and unfit shoes. Some common symptoms are swelling around the big and little toe areas, as well as pain and restricted movement.
Ankle Injuries and Symptoms
The common injuries associated with ankle trauma consist of sprains, strains, and fractures. These injuries are defined by the type of tissue that has been damaged. Fractures are breaks within the bones caused by sudden impacts to the area. Sprains relate to any damage of the ligaments, commonly caused by being stretched beyond their normal range of motion. Strains are attributed to damage of the muscles and tendons from being pulled too far. Symptoms of these injuries include severe pain, limited range of motion, and swelling.
Diagnosis and Treatment
Since there are several types of injuries with a variety of symptoms, it is important to see a podiatrist about your condition. Podiatrists can run a variety of tests to diagnose an injury accurately. This includes physical examinations, X-rays, or MRIs. A podiatrist may even run a stress test, which is an X-ray taken while pressure is applied to the damaged area. Once your injury has been diagnosed, the doctor may have you wear a cast or a splint, or gradually develop your range of motion. Severe injuries may require physical therapy or even surgery if necessary. If you have any concerns from past foot and ankle trauma experiences, consult with Harvey Jacobs, DPM from Quality Foot Care Center. Our doctor can assess your condition and provide you with quality foot and ankle treatment.
If you have any questions, please feel free to contact our office located in Somerset, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Everything You Need to Know About Gout
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.
Flip Flops and Your Feet
When the weather heats up, you may want to start wearing flip-flops. However, it has been proven that these are not the ideal shoes in terms of preserving the health of your feet.
Flip flops are known to expose your feet to different types of bacteria and fungal infections. When you wear your flip flops in public, you are exposing them to staphylococcus which is a skin-irritating bacterium. Athlete’s foot is also highly contagious and can be spread when you walk around nearly-barefoot.
Another harmful effect of wearing flip-flops is that they develop blisters on the feet. This is because the thin strap rubs against the skin with each step taken. Unfortunately, when blisters pop, they cause you to be more vulnerable to pathogens you pick up by having your feet exposed.
These shoes may also cause “shooting pains”. If you have flat feet, you need arch support to keep your knees, hips, and back in alignment. If you wear flat shoes, your joints are forced to compensate which can cause injuries throughout the body.
If you constantly wear flip-flops, you should avoid doing so as they can lead to many problems for your feet. If you are experiencing any of these foot issues, you should seek help from a podiatrist right away.
Hyperhidrosis of the Feet
Each foot, on average, has about 250,000 eccrine sweat glands that produce half a pint of sweat each day. Sweating is a natural and important bodily function. It regulates the body’s temperature by cooling the skin so that it does not overheat. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than what is required. People with plantar hyperhidrosis experience an excess amount of sweat on their feet. It is estimated that 2% to 3% of all Americans suffer from some form of hyperhidrosis. This condition is often caused by neurologic, endocrine, infectious, and other systemic disease. Other factors that may trigger the condition are heat and emotions.
People with hyperhidrosis may notice an overabundance of sweat on their feet, along with a strong odor. The feet may also have a wet appearance coupled with infections such as athlete’s foot or toenail fungus. The sweat may even appear in low temperatures, such as during the winter months. People with plantar hyperhidrosis often need to change their socks several times throughout the day.
The specific cause of hyperhidrosis is unknown, and many believe it may be caused by over-activity. However, others believe the condition is genetic. Caffeine and nicotine are known to cause excitement and nervousness which are two emotions that may make the condition worse.
If you are looking to treat your hyperhidrosis the most important thing you should do is wash your feet every day. You may even need to wash your feet twice a day, if necessary. You should also make sure you are wearing the right socks. Wool and cotton socks are both known to be good for ventilation, meaning they allow the feet to breathe. You should avoid socks made from nylon which trap moisture and lead to sogginess. Other common treatment options are over-the-counter antiperspirants that contain a low dose of metal salt. In some cases, prescription strength antiperspirants that contain aluminum chloride hexahydrate may be necessary. In severe cases, surgery may be required.
Untreated hyperhidrosis can easily lead to complications. Some complications that may arise from the disorder include nail infections, warts, and bacterial infections. Consequently, it is important that you seek treatment from your podiatrist if you suspect that you may have plantar hyperhidrosis.
Flatfoot
Flatfoot is a foot disorder that is not as straightforward as many people believe. Various types of flatfoot exist, each with their own varying deformities and symptoms. The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot. Other signs of flatfoot include:
- “Toe drift,” or the pointing outward of the toes and the front part of the foot
- The tilting outward of the heel and the tilting inward of the ankle
- The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
- Hammertoes
- Bunions
One of the most common types of flatfoot is flexible flatfoot. This variation usually starts in childhood and progresses as one ages into adulthood. Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing. When not standing, the arch returns. Symptoms of flexible flatfoot include:
- Pain located in the heel, arch, ankle, or along the outside of the foot
- Overpronation, or an ankle that rolls in
- Shin splint, or pain along the shin bone
- General foot aches or fatigue
- Pain located in the lower back, hip, or knee
Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit. X-rays may be taken to define the severity and help determine the treatment option best for your condition. Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices. If nonsurgical methods prove ineffective, surgery may be considered. Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.
Solutions for Cracked Heels
Cracked heels can make life very frustrating and embarrassing when displaying the bare feet. Aside from being unpleasing to the eye, they can also tear stockings and socks and wear out shoes at a faster rate. When severe, cracked heels may cause pain or infection.
Cracked heels are a problem for those who are athletic, those who may walk a lot, and those who have especially dry skin. Those who use medication that dry the skin, those who swim often, wearing certain types of shoes, and those who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil may also have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.
Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter. Others are prescribed by a doctor, especially for those who have chronic dry feet and heels.
Some doctors recommend wearing socks at night for those with rough skin. This helps further healing, and helps creams stay on longer and better absorb into the skin.
One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to buff away dead skin before putting on moisturizer can also help. Cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.
Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it. Taking supplements of omega-3 fatty acids and zinc can also be very beneficial.
Nevertheless, not all products are guaranteed to help treat cracked feet. Seeing a professional is best if other treatments options were unsuccessful. A podiatrist should be able to give the best advice to help with this problem.
Foot Pain
The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.
Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.
Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.
Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.
If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.
Tarsal Tunnel Syndrome
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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All About Cuboid Syndrome
Though cuboid syndrome predominately affects athletes, non-athletes can suffer from it too. Cuboid syndrome is also called cuboid subluxation or cuboid fault syndrome, and occurs when a joint or ligament near the cuboid bone of the foot becomes damaged, or when the bone itself is dislodged from its natural position. Pain may be persistent, or come and go, and it is usually marked by the outside of the foot. Cuboid syndrome, unless severe, can be difficult to diagnose. A doctor will likely ask questions about how long the pain has been present, and will apply pressure on the cuboid bone to determine the origin of pain.
There are a number of causes that can lead to the syndrome. Due to athletic activities, repeated stress placed on the foot can cause cuboid subluxation. Ballet dancers, runners, and other athletes often develop this condition. Basketball or tennis players may also develop this condition, as they place stress on their feet while moving side to side. Cuboid syndrome can often develop over time; however it can come out of a sudden injury as well. Over pronation, or other problems with feet, can exacerbate the condition if not corrected.
Among podiatrists, there is some disagreement about the treatment, as well as the definition of cuboid syndrome. Some see the injury as an injury to the ligaments located nearby the cuboid bone, while others believe it refers to the dislocation of the calcaneal-cuboid joint only. Treatment opinions differ as well. Although it can be treated by manipulation in order to reposition the bone, this must be done with extreme care in order to avoid injury. Some doctors, however, prefer treatment through the use of orthotic pads, designed to keep the bone in its place. Effectiveness of these treatments may vary, according to the severity of the injury.
When you experience side foot pain, it is important that you seek medical assistance. If a subluxed cuboid is caught and treated early, treatment is usually successful, and individuals may begin activities such as sports when the pain subsides. If left untreated, the pain will worsen, and the condition could cause permanent damage.
Corns and Calluses
A corn is a lesion that forms in the skin of the foot, and it is typically circular in shape, small in size, and thick and rough in texture. A corn generally occurs as a result of repeated pressure on the skin; one example of this is the rubbing of a shoe against the skin. Corns differ from calluses in that their central cores are harder in texture.
A corn is a relatively common condition with a wide variety of treatment options. If a corn becomes overly uncomfortable or painful, consult with your podiatrist; he can determine the best method of treatment that is appropriate for you. Corns may return if the underlying cause of its development is not treated or removed. Avoid removing corns at home, as improper removal may cause infection.
A callus, similar to a corn, is an area of skin that has become thickened due to repeated pressure and rubbing. The rubbing causes the skin to create a layer of protective skin, which is the formed callus. Calluses can differ in size between people, and they can also become painful.
Multiple treatments are available for calluses. At-home treatment and removal should be avoided, as this can potentially lead to infection. Your podiatrist can best determine the cause of your calluses and suggest the treatment most appropriate for you.
Peripheral Artery Disease
Peripheral artery disease (PAD), or peripheral arterial disease, is a circulatory problem in which there is a reduction of blood flow to the limbs due to narrowed arteries. When peripheral artery disease develops, the extremities do not receive enough blood flow; this may cause symptoms to develop such as claudication, or leg pain when walking. The legs are the most common site of peripheral artery disease.
Claudication, or leg pain when walking, is one of several symptoms that can develop due to peripheral artery disease. Other symptoms caused by the disease include painful cramping in the hips, thighs, or calves after certain activities; leg numbness or weakness; coldness in the lower leg or foot; sores on the lower extremities that do not heal; hair loss on the lower extremities; and a missing or weak pulse in the lower extremities. In more severe cases, pain may even occur when the body is at rest or when lying down.
Peripheral artery disease is typically caused by atherosclerosis, a condition in which fatty deposits build up in the arterial walls and reduce blood flow. Smoking, diabetes, obesity, high blood pressure, and high cholesterol are some of the risk factors for peripheral artery disease.
If you are experiencing pain, numbness, or other symptoms in the lower extremities, see your healthcare professional immediately. Diagnosed peripheral artery disease can be treated with various medications, angioplasty and surgery, exercise programs, or alternative medicine. It is important to consult a healthcare professional to determine the best treatment for you.
Heel Pain
Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.
One condition is plantar fasciitis. Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.
There are various options your podiatrist may suggest for heel pain. Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.
Preventing heel pain is possible. If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.
