A Description of Some Common Foot Ailments

BUNIONS
If you have a bunion, you know it can be a painful enlargement of the joint at the big toe. The skin over the joint becomes swollen and is often quite tender. Bunions can be inherited as a family trait, can develop with no recognizable cause or can be caused by shoes that fit poorly.

An important part of treatment is wearing shoes that conform to the shape of the foot and do not cause pressure areas. This often alleviates the pain. In severe cases, bunions can be disabling. Several types of surgery are available that may relieve pain and improve the appearance of the foot. Surgery is usually done to relieve pain and is not meant for cosmetic purposes.

HEEL PAIN
Heel pain is extremely common. It often begins without injury and is felt under the heel, usually while standing or walking. It is usually worse when arising out of bed.

Inflammation of the connective tissue on the sole of the foot (plantar fascia) where it attaches to the heel bone is the most common cause of pain. It is often associated with a bony protrustion (heel spur) seen on x-ray studies.

Most cases will improve spontaneously. Heel and stretching, medication to reduce swelling of the soft tissues in your foot and shoe inserts (orthotics) are quire helpful. If pain continues, steroid injections or walking casts are used. Only in the most troubling and prolonged case is surgery recommended.

DIABETIC FOOT CARE
Because diabetes can cause damage to the nervous system, a person with diabetes may begin to experience breakdown of the skin of the foot, and infections or foot ulcers may develop. Diabetic foot care is an important part of the practice at Podiatric Care of Northern Virginia, ranging from annual foot checks to Charcot reconstructions.

Dr. Knudson instructs patients about how to prevent foot problems before they occur, to recognize problems early, and the importance of seeking treatment when problems do occur. Maintaining control of blood sugar levels is essential to preventing diabetic complications.

MORTON’S NEUROMA
Morton’s neuroma is caused by a nerve being pinched. This pinching usually results in pain between the third and fourth toes. Tight shoes can squeeze foot bones together. The nerve responds by forming a neuroma, a buildup of extra tissue in the nerve. The neuroma results in pain that may radiate into the toes.

Treatment usually involves wearing wider shoes and taking oral medications to decrease the swelling around the nerve. A pad on the sole of the foot to spread the bones is often helpful. Your doctor may also inject cortisone around the nerve. If your difficulty continues, surgery to remove the neuroma may be suggested.

CORNS & CALLUSES
Corns and calluses are caused by pressure on the skin of your foot. They may occur when bones of the foot press against the shoe or when two foot bones press together.

Common sites for corns and calluses are on the big toe and the fifth toe. Calluses underneath the ends of the foot bones (metatarsals) are common. Soft corns can occur between the toes.

Treatment involves relieving the pressure of the skin, usually by modifying the shoe. Pads to relieve the bony pressure are helpful, but they must be positioned carefully. On occasion, surgery is necessary to remove a bony prominence that causes the corn or callus.

HAMMERTOES
Hammertoes are one of several types of toe deformities. Hammertoes have a permanent sideways bend in your middle toe joint. The resulting deformity can be aggravated by tight shoes and usually results in pain over the prominent bony areas on the top of the toe and at the end of the toe. A hard corn may develop over this prominence.

Treatment usually involves a shoe to better accommodate your deformed toe. Shoe inserts or pads also may help. If, after trying these treatments, you are still having marked difficulty, surgical treatment to straighten the toe or remove the prominent area of bone may be necessary.

PLANTAR WARTS
Plantar warts occur on the sole of the foot and look like calluses. They results from an infection by a specific virus. They are like warts elsewhere, but they grow inward. The wart cannot grow outward because of weight placed on it when you stand. You may experience severe pain when walking, and can have just one or many plantar warts. Plantar warts are extremely difficult to treat, but success has been achieved with repeated applications of salicylic acid (available over the counter) to soften the overlying callus and expose the virus. Other treatments include injection of the warts with mediation, freezing the warts with liquid nitrogen and, very rarely, surgery.

INGROWN TOENAILS
Ingrown toenails can be caused by cutting a toenail too short or wearing shoes that do not fit well. The toenail may be pressed into the toe when a shoe is too tight, causing it to grow into the skin. If an ingrown toenail is left untreated it can become infected or abscessed and require surgical treatment. While any toe can become ingrown, the condition is most often see in the big toe.

Early signs that the toe is ingrown include reddening at the end of the toe that is painful and possibly accompanied by minor swelling. There is usually no pus or drainage but it may feel warm to the touch. Later on, as an infection develops, the swelling will worsen and there may be drainage (pus) from the area. If this happens, a patient should see a doctor as soon as possible. Diabetic patients who are at an increased risk of infection should be especially aware of developing ingrown toenail conditions and seek treatment immediately.

GENERAL FOOT CARE INSTRUCTIONS

1. Inspect your feet for blisters, cuts, and scratches daily. Use a mirror to examine the bottom of your feet.
2. If vision is impaired, have a family member inspect your feet daily.
3. Wash and lubricate your feet daily.
4. Avoid extremes of temperature. Test water before bathing.
5. If the feet feel cold at night, wear socks.
6. Do not use chemical agents for removing corns and calluses.