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Diabetic Foot Care

Diabetes is a systemic condition that can also affect your feet. It may cause nerve damage, reduce blood flow to the feet and can cause injuries longer to heal. Often blisters or small sores can lead to an infection or a non-healing wound that could put you at risk for an amputation.
To avoid serious foot problems that could result in losing a toe, foot, or leg, follow these guidelines.
Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet.
Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily.
Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes – that could encourage a fungal infection.
Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toe nails. I
Never treat corns or calluses yourself. Visit your doctor for appropriate treatment.
Wear clean, dry socks. Change them daily.
Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).
Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.
Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.
Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.
Take care of your diabetes. Keep your blood sugar levels under control.
Don’t smoke. Smoking restricts blood flow in your feet.
Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.

Ingrown Toenails

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected, or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot, or poor circulation. Call our office to schedule an appointment to quickly treat an ingrown toenail so you cane get back to a healthy and active lifestyle.

Fungus

A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.
Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail.
Many people have difficulty with their toenails and need assistance in caring for them. A foot and ankle surgeon can diagnose the cause of toenail problems and recommend treatments.

Plantar Fascitis

Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fascitis.
Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fascitis. This can often occur when one’s job requires long hours on the feet. Obesity may also contribute to plantar fascitis.

Symptoms
- the symptoms of plantar fasciitis are:

• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that is usually worse upon arising
• Pain that increases over a period of months

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Diagnosis
 – To determine a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome. For the best treatment plan, the doctor will review a variety of options for each patient’s individual needs.

Ligament Issues and Sprains

For the many people experience ligament issues and sprains from sports injuries, falls or accidents. Many times these are minor and can be treated with routine home care such as cool compresses, heat and over the counter pain relief medicine. However, sometimes the injuries are more serious and require further diagnosis and treatment. If you suffer from a leg, ankle or foot sprain that doesn’t seem to be healing on it’s own, be sure to call our office and schedule an appointment. Proper diagnosis and treatment can help healing improve and get you back into a healthy, active lifestyle.

Arthritis

Arthritis is a general term for a group of more than 100 diseases. “Arthritis” means “joint inflammation.” When it affects the ankle joint it can produce swelling and pain, and may eventually result in deformity, loss of joint function, and decreased ability to walk.

There a different arthritis conditions but a common one that affects the foot and ankle is Osteoarthritis. It appears at various joints throughout the body, including the hands, feet, spine, hips, and knees. In the foot, the disease most frequently occurs in the big toe, although it is also often found in the midfoot and ankle. People with osteoarthritis in the foot or ankle experience pain and stiffness in the joint, swelling in or near the joint, difficulty walking or bending the joint. Your doctor will thoroughly examine you and order necessary imaging such as X-rays to determine the best course of treatment. To relieve symptoms, your doctor may prescribe medications, injections, orthotic devices, physical therapy or in some cases surgery.

Warts

A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. Plantar warts most commonly occur in children, adolescents, and the elderly.
Plantar warts are caused by direct contact with the human papilloma virus (HPV). This is the same virus that causes warts on other areas of the body.

Symptoms
 – The symptoms of a plantar wart may include:

• Thickened skin. Often a plantar wart resembles a callus because of its tough, thick tissue.
• Pain. Walking and standing may be painful. Squeezing the sides of the wart may also cause pain.
• Tiny black dots. These often appear on the surface of the wart. The dots are actually dried blood contained in the capillaries (tiny blood vessels).

Plantar warts grow deep into the skin. Usually this growth occurs slowly, with the wart starting small and becoming larger over time.

Diagnosis and Treatment
 – To diagnose a plantar wart, the foot and ankle surgeon will examine the patient’s foot and look for signs and symptoms of a wart. Although plantar warts may eventually clear up on their own, most patients desire faster relief. The goal of treatment is to completely remove the wart.

Bunions

A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

Causes
 – Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.

Symptoms
 – symptoms which occur at the site of the bunion, may include:

• Pain or soreness
• Inflammation and redness
• A burning sensation
• Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Diagnosis – Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Heel Pain

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and determine the underlying source of your heel pain.

Bone Spurs

Bone spurs are bony projections that develop along the edges of bones. Also called osteophytes, bone spurs often form where bones meet each other — in your joints.
Most bone spurs cause no signs or symptoms. Often you don’t even realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints. If your bone spurs are causing pain, your doctor may recommend over-the-counter pain relievers. Bone spurs that limit your range of motion or press on nerves may require surgical removal.