Common Foot Conditions
Triangle Foot & Ankle Specialist, PC specializes in both conservative and surgical treatments for disorders of the foot and ankle. Many conditions that we see on a regular basis respond very well to conservative treatments, including lower extremity-specialized physical therapy, stretching, orthotics, and injection therapy. If your condition requires surgical intervention, Dr. Thomas is board-certified and dedicated to providing the latest techniques to achieve a rapid recovery and an optimal long-term result.
We provide comprehensive treatment, both non-surgical and surgical for the vast array of foot and ankle conditions, which include:
- Achilles tendonitis
- Ankle Sprains
- Athletes foot
- Diabetic foot care
- Flat feet
- Fungal toenails
- Heel pain
- In-grown toenails
Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. It causes pain along the back of the leg, normally near the heel. There are two areas of the Achilles tendon that often are symptomatic for patients. One is the bursae on the back of the heel bone and the second is along an area of the Achilles tendon that gets less blood supply.
Achilles Tendinitis/Bursitis commonly occurs in runners, middle aged people who play sports, such as tennis, soccer or basketball. The repetitive stress to the tendon can be the problem. Achilles tendinitis can weaken the tendon, making it vulnerable to a tear which is a painful injury that usually requires surgical repair.
It is extremely importance to have our doctor examine the condition prior to treatment to avoid potential further injury to the Achilles tendon. An in office examine will help determine the extent of the tendonitis and the best conservative treatment measures to pursue.
Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.
Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising. Treatment includes resting and elevating the ankle and applying ice to reduce swelling.
Compressive bandages also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments. To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercising, stretching, and wearing well-fitted shoes.
Arthritis can encompass many different types of changes within and around a joint, including inflammation of the joint and surrounding soft tissues, bone spurs, loose bone fragments, and erosion of the cartilage inside of the joint. Pain can be present with movement of an arthritic joint and a limitation in the amount of movement is likely as the condition progresses.
There are numerous types of arthritis. The reason that your feet seem to be more susceptible to arthritis than other parts of your body is that your feet have so many joints that can be affected. The odds are just stacked against your feet. In addition, your feet and ankles bear the full weight of your entire body every single day.
A chronic infection caused by various types of fungus, Athlete’s foot is often spread in places where people go barefoot such as public showers or swimming pools. The condition ranges from mild scaling and itching to painful inflammation and blisters. It usually starts between the toes or on the arch and may spread to the bottom and sides of the foot.
Depending on the type of infection you have, various kinds of medication may be used in treating your fungal problem. Successful treatment usually involves a combination of medication and self-care.
If your condition is not serious, over-the-counter and prescription powders, lotions, or ointments can often help treat scaling, itching, and inflammation. Consult us before taking any medication. Foot soaks may help dry excessive perspiration, but you should contact our office first. If your Athlete’s foot does not improve, we may prescribe stronger medication.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Bunions are hereditary and tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Custom-made orthotic devices to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
- Cortisone injections are used to help alleviate the pain of bunions.
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.
Corns develop on parts of your feet that don’t bear weight. They often surface on the sides of your toes, on the top of your feet or in between your toes. They can be very painful and have a hard center with inflamed skin around the hard center.
Calluses, on the other hand, develop on the more weight bearing part of your feet. Calluses often develop on the balls of your feet or on your soles. They vary in shape and size, but are often bigger than corns. The skin thickens and hardens all over the surface of the callus. Calluses can be as painful as corns.
Never cut corns or calluses with any instrument, and never apply home remedies, except under Dr. Thomas instructions.
Diabetes is a lifelong chronic disease that is caused by high levels of sugar in the blood. It can also decrease your body’s ability to fight off infections, which is especially harmful in your feet. When diabetes is not properly controlled, damage can occur to the organs and impairment of the immune system is also likely to occur.
With damage to your nervous system, you may not be able to feel your feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired, which can lead to an abnormal pressure on the skin, bones, and joints of the foot during walking and other activities. This can even lead to the breakdown of the skin of the foot, which often causes sores to develop. If you have diabetes, it is important to prevent foot problems before they occur, recognize problems early, and seek the right treatment when a problem does happen.
Diabetic Complications and Your Feet
When it comes to your feet, there are several risk factors that can increase your chances of developing foot problems and diabetic infections in the legs and feet. First of all, poorly fitting shoes are one of the biggest culprits of diabetic foot complications. If you have red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes, new proper fitted shoes must be obtained immediately. Additionally, if you have common foot abnormalities such as flat feet, bunions, or hammertoes, prescription shoes or orthotics from your podiatrist may be necessary to further protect your feet from other damage.
People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy. If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet.
Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much. With diabetes, you may not be able to properly sense minor injuries, such as cuts, scrapes and blisters-all signs of abnormal wear, tear, and foot strain. The following can also compromise the health of your feet:
- Poor circulation
- Trauma to the foot
Diabetes can be extremely dangerous to your feet, so take precautions now. You can avoid serious problems such as losing a toe, foot, or leg by following proper prevention techniques offered by your podiatrist. Remember, prevention is the key to saving your feet and eliminating pain.
Flat feet are generally associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of adults and children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Many people with flat feet do not experience pain or other problems. When pain in the foot, ankle, or lower leg does occur, especially in children, the feet should be evaluated.
Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.
Toenail fungus is a condition resulting from a bacterial infection in your toenail or a naturally occurring fungus that has manifested itself underneath the nail. Common symptoms include pain and/or a distortion in the shape of the nail, a thick and/or brittle structure, or an abnormal change in color. Often times we will perform an in office non-painful nail biopsy to further evaluate the nail and give you a definitive diagnosis. If you are experiencing any of these changes to your nail please call our office for an in office examine.
It is often difficult to determine the precise cause of toenail fungus, although the common cause is any form of trauma occurring to your toenail. Injury may include a one-time event, such as the dog stepping on the toe nail, or progressive damage from wearing shoes that are too tight. When the nail or nail bed experiences damage, it will thicken and discolor to help protect itself from future damage.
As your expert podiatrist, we offer a variety of treatment options based on the distinct form of fungal nails you are experiencing, the severity of the condition, and many other factors. Treatment options include topical medications, foot wash or possible surgical removal of the toenail.
A topical medication is essentially a medicinal nail polish, which you apply onto the affected nail twice a day. Dr. Thomas will also discuss proper nail health and trimming to help avoid future complications.
Surgically removing the affected toenail is the most aggressive option, as it eliminates the fungus all at once. However, it may take up to a year for your nail to fully grow back, and we cannot guarantee that the bacteria will not return if your new nail is exposed to the same conditions as what originally caused the problem. However, a lot of patients once the nail has been removed will begin a topical medication for the nail as it re-grows to help promote a new healthy toe nail.
At Triangle Foot and Ankle Specialist, Dr. Thomas specializes in the diagnosis and treatment of nail disease and creating a treatment plan based on your individual needs. It is very important to seek treatment as severe cases may permanently damage your toenail.
Hammertoe is a deformity of the second, third, fourth, and fifth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Causes of hammertoes include muscle/tendon imbalance, genetics, foot injuries and many other foot conditions.
Conservative treatment for the hammertoe include orthotics, steroid injections, corn pads and wearing shoes that do not aggravate the condition can help to alleviate associated pain. In-office surgical toe straightening procedures are used in more severe cases.
In severe cases, hammertoe surgery may be recommended to correct the deformity.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as steroid injections, night splints, shoe modification and orthotics. When conservative measures do not resolve the issue surgery can help, but it is rare that is necessary.
Plantar Fasciitis is a condition that will rarely resolve on its own so it is important that you be evaluated and treatment is started early in the progression of the condition. Call the office for an evaluation by Dr. Thomas if you experience any of the symptoms of Plantar Fasciitis or general ongoing heel pain.
In-grown toe nails can affect individuals of all ages, including young children, and are most often experienced in the big toe. They occur when a sharp corner of the toenail digs into the skin at the end of or side of the toe. Pain and inflammation at the spot where the nail curls into the skin occurs first. Later, the inflamed area can begin to grow extra tissue or drain yellowish fluid. This can be caused by cutting nails too short, wearing tight shoes or socks that press the nail into the skin at the outside of the toe, rounding the corners of the toe nails, stubbing or injuring the toe and repeated activities such as kicking a soccer ball with the toe. If left untreated, in-grown toe nails can progress to infection and even abscess. It is important to see Dr. Thomas at the first sign of an in-grown toenail to have it properly treated to avoid further pain or infection.
At Triangle Foot and Ankle Specialist, we diagnose and treat many types of common foot and ankle injuries including tendonitis, ankle sprains, stress fractures and traumatic injuries. Sports injuries are being seen with increased frequency as the Triangle continues to make regular exercise part of their overall fitness plan. Sports injuries to the foot and ankle can be caused by trauma, improper warm-up, overuse, improper foot wear, and playing on hard surfaces. At our office, we treat sports injuries with a working knowledge of individual sports and their commonly associated injuries.
A neuroma is an enlarged, benign growth of nerves, most commonly between the third and fourth toes. Neuromas are caused by the local bones pushing against the nerve and irritating the tissue. Pressure from poorly fitting shoes or an abnormal bone structure can also lead to this condition. Symptoms may include sensations of thickness, burning, numbness, tingling, or pain in the ball of the foot. Treatments generally include padding, shoe gear modifications or orthotics and/or receiving steroid injections. In severe cases, surgical removal of the growth may be necessary.
Morton’s neuroma is a thickening of tissues around the nerve that leads to the toes. Morton’s neuroma usually develops between the third and fourth toes in response to irritation, such as that caused by wearing narrow shoes, or from trauma. Symptoms may include a burning pain that radiates from the ball of the foot to the toes or numbness in the toes. Conservative treatments usually resolve the pain or progressions of the condition, and we also discuss treatments that will help prevent the condition from recurring in the future.
Plantar warts are growths resembling a callus that typically occur on the bottom of your feet. These are caused through direct contact with a virus that commonly occurs in the environment, which enters your foot and results in this unpleasant and contagious condition. The most important thing a patient can do is seek treatment as soon as possible before the condition spreads or becomes more resistant.
Plantar warts appear as single lesions or multiple lesions in varying colors, sizes and overall texture, depending on the severity of the case. They can cause pain while walking and will generally increase in size as time goes by. These warts are also highly contagious and can easily spread through skin contact between individuals, including family members, as well as walking barefoot in your own home’s bathroom and/or shower, public pools, and other similar areas.
Dr. Thomas has been extremely successful in treating warts for both children and adults. Our in office treatment for warts still hold true as the most successful form of treatment since the start of the practice in 2009. Please call our office to help rid yourself of warts today.