Treatments

Heel Pain

Heel pain can be the result of several different causes. Below I list a few of the most common.
  • Trauma to the heel can cause a fracture or bone bruise. Treatment depends on the severity of the problem.
  • Infection can be a serious problem, leading to surgical care. This can be caused by upper respiratory virus.
  • Inflammation of the plantar fascia, a ligament on the bottom of the foot. This condition is treated by supporting the ligament with a custom made pad and wearing the proper shoes. Physical therapy, injections and bracing are some additional therapies that can be used if conservative care is not 100% effective.

Ingrown Toenails

Ingrown toenails are caused by heredity, shoes that are too constricting, and trauma. The nail edge becomes painful and may even start to drain fluid. The treatment for this problem is to anesthetize the toe by giving two injections and removing the offending nail edge. A chemical is applied to the nail "root" or matrix to prevent the nail edge from growing back. Healing takes 3 - 4 weeks. For more information, see our Ads page.

Warts

Warts are caused by Human Papilloma Virus or HPV. There are many different strains of the virus, but one thing remains constant: once you have it you can't get rid of it. Treatment of warts varies from topical treatments to freezing to cutting them out. These lesions are hard to treat and can recur spontaneously once they are gone! Unfortunately we have no "cure-all" for warts, but research will continue until there is a cure. If you have a wart or think you do, early treatment is less costly than waiting, so make an appointment today!

Fungus

As a podiatrist I see a lot of fungus. Usually the fungus affects either the skin or the toenails but can affect both. Treatment for skin infections is treatable with oral antifungals (Lamisil) or topical creams. Treatment for nails is not a 100% cure and is limited to oral antifungal therapy. Generally I see full resolution in patients under the age of 55 - 60. Past that age the treatment becomes less effective, although no studies show clear distinctions of age related efficacy.

Ganglion Cyst

Ganglion cysts are kind of like a blister under the skin. They are filled with a very thick substance that resembles hair gel and are associated with joints or tendons. The ganglion cyst can occur anywhere there is a joint or tendon sheath. The cause is either trauma or overuse or heredity. Usually I drain the cyst and see what happens. If it doesn't come back or takes a long time (6 mos. - 1yr.) to come back, I just treat conservatively. If it is very recurrent and painful, I will surgically excise it. The recurrence rate AFTER surgery is about 50%.

Diabetes

Diabetic patients should have an initial foot exam to determine any future problem areas. If I see potential problems I can recommend solutions, usually a change or accommodation to footwear, to prevent acute infection or ulcerations. Diabetic patients, even under good "control", are at risk for a condition known as peripheral neuropathy. If you have numbness, tingling, burning, cold or other unusual sensations you probably have this condition. Treatment for this is only if it becomes painful and is oral medication. If a diabetic has neuropathy, he/she is at risk for ulcerations since there isn't enough feeling in the feet to recognize injury. If a diabetic patient has no current problems, depending on age, I will see the patient once a year for a follow up evaluation/consultation.

Wounds

Wounds are openings in the skin. They develop as a result of trauma, poor circulation or sometimes surgery/infection. Treatment of wounds is fairly straightforward. Keep it clean and dressed, decrease pressure on the site and it needs professional debridement (removal of dead tissue) weekly.

Sprains/Fractures

Sprains and fractures are the result of trauma most of the time. Fractures can also be the result of thin bones (osteoporosis), or secondary to infection. Treatment varies by patient, but rest assured you will at the least be wearing a brace or splint.

Bunions

Bunions are a bony deformity occurring at the great toe joint. These are usually hereditary but can also be brought on by trauma. Treatment is conservative, with shoe gear changes (lace up, wide forefoot) and orthotic devices. If conservative treatment fails and the patient is having pain on a daily basis, I will consider surgical correction.

Hammertoes

Hammertoes are toes that have become contracted and have a prominent knuckle on top. Usually these can be accommodated with a deeper toe shoe (I like SAS Freetime). When toe surgery is necessary, part of the knuckle is removed and the toe straightens out again. I like this surgery if the patient is ulcerating at the tip of the toe due to friction and pressure or has recurrent pressure on the top of the toe.

Neuroma

Neuroma is a term for an irritated nerve at the ball of the foot close to the sulcus area (the pocket behind the toes). This is usually associated with a hammertoe, and the toe contracture is pulling on the nerve all the time while the patient walks. In addition to the pulling, the nerve is being rubbed against a ligament that runs across the ball of the foot. This condition can also be caused by a traumatic flexing of the toes. Usually the treatment consists of a simple metatarsal pad. Patients usually get 80 - 100% relief unless their neuroma has been around longer than 6 months. Injections usually don't help unless the pad helped some. I can also surgically remove the section of nerve that is affected, and this will leave the toes numb but without pain. This surgery is not frequently required but it is effective. Recurrence is common, especially if the patient doesn't use orthotics after the surgery or continues to use inappropriate shoes.

Tumors

The most common tumors are benign (fat or fibrous), but malignant tumors occur in the foot and can be overlooked. If you have a spot on your foot that is unusual or is growing, it should be biopsied right away.

Arthritis

Arthritis literally means inflammation of a joint. This can be caused by "wear and tear", trauma, infection, gout, etc. The treatment varies by patient and diagnosis but is usually treatable in the foot. Custom made orthotics are often a big help with "wear and tear" arthritis pain.