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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.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do 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.
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:
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.
Hammertoe is a deformity of the second, third, or fourth 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 hammertoe include improperly fitting shoes and muscle imbalance.
Treatment for the condition typically involves wearing shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions, or nonmedicated corn pads may also relieve symptoms.
In severe cases, hammertoe surgery may be recommended to correct the deformity.
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.
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:
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.
Many heel pains are linked to heel spurs and plantar fasciitis. Detecting the actual cause of heel pain can be quite challenging without the help of an expert.
A heel spur is an outgrowth of calcium that causes a bony protrusion underneath the heel bone. This growth may be about a quarter to half an inch in length when examined by an X-ray.
Heel spurs are caused by repeated straining of the muscles and ligaments, which wears out the soft tissues at the heel. This condition also results from repeated walking, jumping or running on hard surfaces. If you wear shoes that don’t support your feet, it can also contribute to this problem.
Take the following steps as much as possible to avoid heel spurs:
The factors that increase the possibility of developing heel spurs include:
See a podiatrist when any of these symptoms occur:
Dr. Alan Robbins is a caring and well-trusted podiatrist who provides treatment for all kinds of foot conditions from his practice in Fort Worth, TX. Whether you have pain in your heel or suspect that you have heel spurs or plantar fasciitis, you’ll receive a thorough diagnosis and treatment from Dr. Williams. Give us a call at (817) 336-6600 to book an appointment, or contact Dr. Robbins through our website now.
The redness, discomfort and severe pain you feel from an ingrown toenail can affect your daily activities. Dr. Robbins is a specialist in ingrown toenail care, and he’d like to help you treat this condition.
An ingrown toenail is formed when the side or corner or your toenail starts growing into the flesh at the edges of the nail. Typical ingrown toenail symptoms include redness, swelling, pain and, in some cases, infection.
Normal causes of this condition include:
To prevent the occurrence of ingrowing toenails:
The following individuals are more likely to develop ingrown toenails:
When there’s no infection, you can treat an ingrown toenail in the following manner:
When there is an infection, you may need minor surgery to treat the ingrown toenail. Partial removal of the nail will take care of the part of it that’s piercing your skin. Total nail removal may be needed if the ingrown toenail is a result of thickening.
Schedule an appointment with your doctor if you:
From his office in Fort Worth, TX, Dr. Robbins has treated thousands of patients with various conditions in their legs and feet throughout his 33 years of practice.
If you’d like to schedule an appointment or discuss your foot condition, give Dr. Robbins a call at (817) 336-6600 or contact us through his website today.
A neuroma refers to a benign growth of nerve tissue and is most commonly found on the foot between the third and fourth toes. It is sometimes referred to as Morton’s neuroma or an intermetatarsal neuroma. Although the most common location for neuromas to occur is between the third and fourth toes, they can still be found elsewhere on the foot. Neuromas often compress or irritate the nerve and can be caused by wearing tight, tapered shoes, or high heels. Additionally, neuromas can be caused by sports that cause repetitive impact to the feet.
Individuals with bunions, hammertoes, flatfeet, or highly flexible feet are at a higher risk for neuromas.
You may have a neuroma if you are experiencing pain, tingling, burning, or numbness in the ball of your foot. Additionally, you may also feel that something is in the ball of your foot or have the sensation that you have something in your shoe.
Neuroma symptoms generally begin as occasional incidents and usually decrease with rest, removing the shoe, or massage. Eventually, however, the symptoms will progress in strength and duration, and can last for several days or even weeks.
Prior to making a diagnosis, Dr. Alan Robbins will ask you about your symptoms and medical history. Next, he will perform a physical exam of your foot by gently manipulating it into different positions. In some cases, additional testing or diagnostic imaging, such as a CT scan, MRI, or X-ray, may be required.
Your individual treatment plan will depend upon the extent of your neuroma and can vary. Mild to moderate cases of neuroma can usually be treated with non-surgical treatments, while more severe cases may require surgical intervention.
• Padding: to provide support and decrease the pressure and nerve compression
• Ice: to reduce swelling and discomfort
• Orthotics: custom-made to provide support and decrease pressure and nerve compression
• Modified Activity: reduce activities that can further irritate the neuroma
• Modified Footwear: selecting shoes with a wider toe-box and avoiding high heels
• Medications: Oral nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
• Injection Therapy: cortisone or other anesthetics can be injected to reduce pain and inflammation
• Alcohol Sclerosing Injections: if other injection therapies fail, alcohol sclerosing injections can be used. Also called chemical neurolysis, they contain a dilute ethyl alcohol solution (4%) and are given every 10-14 days until symptoms subside. Most cases require about 3-7 injections and there is an 89% success rate.
Peripheral neuropathy is a condition in which the peripheral nerves become damaged, resulting in tingling, numbness, pain or loss of feeling in the feet and hands. Unfortunately, the condition can cause severe complications. A lack of feeling in the feet, for example, may prevent a person from feeling pain or temperature changes. This, in turn, can lead to serious wounds, injuries and infections. Anyone with peripheral neuropathy should be diligent about getting regular foot checkups.
that approximately 20 million people in the U.S. live with some degree of peripheral neuropathy? There are many causes of peripheral nerve damage, including alcoholism and traumatic injury from repetitive stress. However, the most common cause of peripheral neuropathy is diabetes mellitus, in which chronically high blood glucose levels damage the peripheral nerves.
A person with peripheral neuropathy will have various symptoms depending on which nerves are affected. For some, this may mean inability to perceive foot pain or temperature changes. For others, it may include progressively worsening tingling or numbness that spreads from the feet into the legs. Some experience a sharp pain, while others report muscle weakness and problems with coordination.
Yes. Your podiatrist may recommend one of several different treatments and therapies aimed at reducing symptoms and treating the condition responsible for causing your peripheral neuropathy. This may include the use of medications to minimize pain and tingling, as well as nerve stimulation therapies. Limiting alcohol consumption and managing healthy blood glucose levels can also improve peripheral neuropathy in some patients.
If you begin experiencing symptoms of peripheral neuropathy, do not hesitate to get medical care right away. Early diagnosis and treatment can help manage symptoms and prevent additional damage to the peripheral nerves. Contact our office today for more information about the treatment of peripheral neuropathy.
Flat feet are a common condition of the foot structure. In infants and toddlers, prior to walking, the longitudinal arch is not developed, and flat feet are normal. Most feet are flexible and an arch appears when children begin standing on their toes. The arch continues to develop throughout childhood, and by adulthood most people have developed normal arches.
Flat feet are generally associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of 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.
Nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, and orthotics are common treatments for painful progressive flatfoot. Note: Please consult your physician before taking any medications. In some cases, a surgery may need to be performed to repair a torn or damaged tendon and restore normal function. In the most severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.
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.
The Achilles tendon runs down the back of your ankle and connects your calf muscle to your heel bone. This powerful tendon is responsible for raising your heel off the ground when you walk or run. Achilles pain is usually the result of overuse and is referred to as either Achilles tendonitis or Achilles tendonosis. Achilles tendonitis is classified by the short-term inflammation of the Achilles tendon. Achilles tendonosis is classified as the degeneration of the Achilles tendon that can result in tendon rupture, and can occur if Achilles tendonitis is not treated.
Individuals with flat arches are more prone to experience Achilles pain because their Achilles tendon is under greater stress than the average person’s. To reduce the chances of developing Achilles tendonitis or tendonosis, people with flat arches are encouraged to wear shoes with proper support and stretch their calf muscles daily.
You may have Achilles tendonitis or Achilles tendonosis if you are experiencing aching, stiffness, soreness, or tenderness within your Achilles tendon. This pain can be located anywhere from above the heel to the bottom of your calf and is worse after periods of rest, but gradually improves with limited activity. The Achilles tendon will also be more tender to the touch along the sides of the tendon. If the condition has begun to progress to Achilles tendonososis, the tendon may enlarge and develop bumps where the tissue has begun to degenerate.
Prior to making a diagnosis, Dr. Alan Robbins will ask you about your symptoms and medical history. Next, he will perform a physical exam of your foot by gently testing your range of motion to determine the condition of the tendon. In some cases, additional testing or diagnostic imaging, such as a CT scan, MRI, or X-ray, may be required.
Your individual treatment plan will depend upon how long the injury has been present and how much damage has been done. Early stages of Achilles tendonitis can usually be treated with non-surgical treatments, while more severe cases and Achilles tendonosis may require surgical intervention.
• Immobilization: uses a cast or removable walking boot to rest the tendon and allow it to begin the healing process
• Ice: reduces swelling and inflammation
• Medications: Oral non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
• Orthotics: custom-made for those with overpronation or gait abnormalities
• Night Splints: keep the Achilles tendon stretched when sleeping, decreasing pain in the morning
• Physical Therapy: uses strengthening exercises, soft tissue massage, mobilization, gait training, stretches, and ultrasound therapy to improve symptoms