What Is a Bunion?
A bunion is commonly referred to as a “bump” on the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place. The toe is forced to bend toward the others, causing an often painful lump of bone on the foot. Because this joint carries a lot of the body's weight while walking, bunions can cause extreme pain if left untreated. The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. A bunion—from the Latin "bunio," meaning enlargement—can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor's bunion."

Causes:
Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This disruption can lead to instability in the joint and cause the deformity. Bunions are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk and our inherited foot type or our shoes.

Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.

Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.

Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women.

Symptoms:
The symptoms of a bunion include the following:

• Development of a swelling, callus or firm bump on the outside edge of the foot, at the base of the big toe
• Redness, swelling, or pain at or near the MTP joint
• Development of hammertoes or calluses under the ball of the foot
• Corns or other irritations caused by the overlap of the first and second toes
• Restricted or painful motion of the big toe

Home Treatment:
What can you do for relief?

• Apply a commercial, non-medicated bunion pad around the bony prominence
• Apply a spacer between the big toe and second digit
• Wear shoes with a wide and deep toe box
• If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling
• Avoid high-heeled shoes over two inches tall

When to Visit a Podiatrist:
If pain persists, podiatric medical attention should be sought. Bunions tend to get larger and more painful if left untreated, making non-surgical treatment less of an option.

Diagnosis and Treatment:
Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity.

A podiatrist may recommend these treatments:
Padding and Taping: Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain.
Medication: Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation caused by joint deformities.
Physical Therapy: Often used to provide relief of the inflammation and bunion pain. Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement.
Orthotics: Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity.
Surgical Options: When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatrist. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.

A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatrist. Your podiatrist wants you to have a satisfactory and speedy recovery, and this can be achieved by carefully following the postoperative instructions that you have discussed prior to and immediately after surgery. 

Prevention:
​There are some steps that may help prevent, or at least slow, the progression of bunions:

• Avoid shoes with a narrow toe box
• If your foot flattens excessively, make sure you wear supportive shoes, and if necessary, get custom orthotics from your podiatrist
• See your podiatrist at the first signs or symptoms of a bunion deformity, as early treatment may stop or slow its progression

What are Warts?
Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus and can appear anywhere on the skin. Those that appear on the sole of the foot are called plantar warts. Children, especially teenagers, tend to be more susceptible to warts than adults. Some people seem to be immune to warts.

Causes:
The virus that causes warts generally invades the skin through small or invisible cuts and abrasions. The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.

If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts; these are often called mosaic warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed, creating another route for spreading. Occasionally, warts can spontaneously disappear after a short time, and, just as frequently, they can recur in the same location.

Symptoms/Identification:
Most warts are harmless, even though they may be painful. They are often mistaken for corns or calluses, which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.

Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown (but the color may vary), with a center that appears as one or more pinpoints of black. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.

When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel, for example), they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.

Home Care:
Self-treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue. Self-treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use these medications in the presence of an active infection.

When to Visit a PodiatristIt is wise to consult a podiatric physician when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis. It is possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart.

Diagnosis and Treatment:
It is possible that your podiatric physician will prescribe and supervise your use of a wart-removal preparation. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthetic, may be indicated.

Lasers have become a common and effective treatment. A procedure known as CO2 laser cautery is performed under local anesthesia in either your podiatrist's office surgical setting or an outpatient surgery facility. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions.

Prevention:

• Avoid walking barefoot
• Change shoes and socks daily
• Keep feet clean and dry
• Check children's feet periodically
• Avoid direct contact with warts from other persons or from other parts of the body
• Do not ignore growths on, or changes in, your skin
• Visit your podiatric physician as part of your annual health checkup

Article by APMA. (Used with permission.)

What is Peripheral Neuropathy?
Peripheral neuropathy is damage of the peripheral nerves. Your peripheral nerves are the nerves that travel to your arms and legs. When the nerves are damaged, they don't function properly. People with peripheral neuropathy have decreased or abnormal sensation in their toes and fingers. Sometimes, they develop problems moving these parts of the body as well.

Causes:
In the United States, the most common cause of peripheral neuropathy is diabetes. According to the American Diabetes Association, 60 to 70 percent of people with diabetes will develop neuropathy within their lifetime.

Other causes of peripheral neuropathy include:

• Certain medications, including some chemotherapy drugs.
• Heredity. Some people have a family history of peripheral neuropathy.
• Advanced age. Peripheral neuropathy is more common as people age.
• Arthritis. Certain type of arthritis, especially involving the back, can cause peripheral neuropathy.
• Alcoholism. According to the US National Library of Medicine, up to half of all long-term heavy alcohol users develop peripheral neuropathy.
• Neurological disorders. Certain neurological disorders, including spina bifida and fibromyalgia, are associated with peripheral neuropathy.
• Injury. Acute injury to the peripheral nerves may also cause peripheral neuropathy. 

Symptoms:
The most common symptoms of peripheral neuropathy include burning, numbness, tingling, or shooting or stabbing pain in the toes and/or fingertips. Any change in sensation in the fingers or toes may be a symptom of peripheral neuropathy. Be sure to report any abnormal sensations to your doctor. Those sensations may be the first sign of another problem, such as diabetes.

Home Care:
If you have peripheral neuropathy, it is important to inspect your feet regularly. Because decreased sensation may develop eventually, you might not notice an injury or infection. Someone who has diabetes and peripheral neuropathy with loss of protective sensation, for instance, could step on a tack without noticing it. Regularly inspect your feet so you can note any injuries or infections and seek appropriate medical attention as needed. 

If you're unable to properly inspect your own feet, enlist a family member or friend to help you, or use a mirror. It's absolutely essential that any injuries are caught and treated promptly. Otherwise, an infection can develop and progress.
People with peripheral neuropathy should wear properly fitted shoes and avoid walking barefoot to prevent injury. If you have diabetes, it's important to control your blood sugar as well, because out-of-control blood sugar leads to increased nerve damage. Take your insulin or medication as prescribed and follow the recommended diet.

When to Visit a Podiatrist:
Everyone with symptoms of peripheral neuropathy of the feet should see a podiatrist. Podiatrists are doctors who are specially trained to preserve the health of the feet.

Diagnosis and Treatment:
A podiatrist, family physician, internist, or physician who specializes in diabetes can diagnose peripheral neuropathy. The diagnosis is made on the basis of a physical exam, health history, and your reporting of symptoms. The doctor may order a blood test to check your blood sugar level because high blood sugar levels and diabetes are an important cause of peripheral neuropathy.

There is no known cure for peripheral neuropathy. The goal of treatments are to slow the progression of the disease, to maintain foot health, and to decrease pain (if present) and improve the quality of life.

The podiatrist may prescribe oral medication to help with symptoms. He or she will also perform a thorough foot check to look for any injuries or infections and will teach you how to do the same. Your podiatrist will also show you how to take care of your feet at home. People who have peripheral neuropathy should have their feet examined by a podiatrist at least once per year. 

If you also have diabetes, the podiatrist will work closely with you and other health-care professionals. Controlling the patient's blood sugar levels with diet, exercise, and medication (if needed) can slow the progression of peripheral neuropathy and maintain foot health. 

Prevention:
​The best thing you can do to prevent peripheral neuropathy is to keep your blood sugar levels under control. Peripheral neuropathy is common in people with diabetes, but the degree of neuropathy generally corresponds to the degree of blood sugar control. Someone whose blood sugar is kept under tight control will usually have much better sensation in their fingers and toes than someone with poorly controlled diabetes.

*Article by apma.org (used with permission)

What Are Ingrown Toenails? Ingrown nails, the most common nail impairment, are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is the most common location for this condition, but other toes can also become affected.
Causes:
Ingrown toenails may be caused by the following:

• Improperly trimmed nails
• Heredity
• Shoe pressure; crowding of toes
• Repeated trauma to the feet from normal activities

Symptoms:
The following symptoms may be present with ingrown toenails:

• Pain
• Redness and swelling
• Drainage
• Odor
• Prominent skin tissue (proud flesh)

Home Treatment:
If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.
People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self-treatment and seek podiatric medical care as soon as possible.
Other “do-it-yourself” treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided. Nail problems should be evaluated and treated by your podiatrist, who can diagnose the ailment, and then prescribe medication or another appropriate treatment.

When to Visit a Podiatrist:
​You should see a podiatrist immediately if any drainage or excessive redness is present around the toenail. Also, if a short trial of home treatment has not resulted in improvement of the condition, see your podiatrist. If you have diabetes or poor circulation, you should seek immediate treatment at the first signs of an ingrown toenail, as it can lead to more severe complications.

Diagnosis and Treatment:
A podiatrist will remove the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of that piece of nail, are removed by use of a chemical, a laser, or other methods.

Prevention:

• Trim toenails properly: cut them straight across, not longer than the tip of the toes. Do not dig into corners and only gently round off corners with a nail file. Use toenail clippers.
• Avoid shoes with pointy or narrow toe boxes.
• Never rip or tear edges of nails.

​
​*Article used, by permission, from APMA.

Whether you're slogging through deep snow and sub-zero temperatures in the north, or contending with dampness, chill, and muddy conditions in the south, it's important to take care of your feet all winter long. You'll want them to be healthy and ready for action when spring finally arrives.
Most Americans will have walked 75,000 miles by the time they turn 50. Is it little wonder, then, that APMA's 2010 foot health survey found that foot pain affects the daily activities—walking, exercising, or standing for long periods of time—of a majority of Americans?
"Each season presents unique challenges to foot health," said Matthew Garoufalis, DPM, a podiatrist and APMA past-president. "Surveys and research tell us that foot health is intrinsic to overall health, so protecting feet all year long is vital to our overall well-being."
APMA offers some advice for keeping feet healthy in common winter scenarios:

• Winter is skiing and snowboarding season, activities enjoyed by nearly 10 million Americans, according to the National Ski Areas Association. Never ski or snowboard in footwear other than ski boots specifically designed for that purpose. Make sure your boots fit properly; you should be able to wiggle your toes, but the boots should immobilize the heel, instep, and ball of your foot. You can use orthotics (support devices that go inside shoes) to help control the foot's movement inside ski boots or ice skates.
• Committed runners don't need to let the cold stop them. A variety of warm, light-weight, moisture-wicking active wear available at most running or sporting goods stores helps ensure runners stay warm and dry in bitter temperatures. However, some runners may compensate for icy conditions by altering how their foot strikes the ground. Instead of changing your footstrike pattern, shorten your stride to help maintain stability. And remember, it's more important than ever to stretch before you begin your run. Cold weather can make you less flexible in winter than you are in summer, so it's important to warm muscles up before running.
• Boots are must-have footwear in winter climates, especially when dealing with winter precipitation. Between the waterproof material of the boots themselves and the warm socks you wear to keep toes toasty, you may find your feet sweat a lot. Damp, sweaty feet can chill more easily and are more prone to bacterial infections. To keep feet clean and dry, consider using foot powder inside socks and incorporating extra foot baths into your foot care regimen this winter.
• Be size smart. It may be tempting to buy pricey specialty footwear (like winter boots or ski boots) for kids in a slightly larger size, thinking they'll be able to get two seasons of wear out of them. But unlike coats that kids can grow into, footwear needs to fit properly right away. Properly fitted skates and boots can help prevent blisters, chafing, and ankle or foot injuries. Likewise, if socks are too small, they can force toes to bunch together, and that friction can cause painful blisters or corns.

Finally—and although this one seems like it should go without saying, it bears spelling out—don't try to tip-toe through winter snow, ice, and temperatures in summer-appropriate footwear. "More than one news show across the country aired images of people in sneakers, sandals, and even flip-flops during the severe cold snap that hit the country in early January," Dr. Garoufalis said. "Exposing feet to extreme temperatures means risking frostbite and injury. Choose winter footwear that will keep your feet warm, dry, and well-supported."
Article by APMA (used with permission)

Article by: APMA
(used with permission)

​One perk of a beach-bound vacation is knowing that instead of snow soaking through your Choos or having your feet feeling toasty in sweaty Uggs, you can lounge happily with your toes dangling in the warm weather, shoe-free with the sand at your feet. But alas, the dream does come with its own set of tootsie troubles. "Even if you are just lying still on your back soaking up the rays, your feet are still vulnerable," says American Podiatric Medical Association member Jane Andersen, DPM. "You can seriously sunburn your feet and no matter how upscale your hotel, athlete's foot can lurk in all public pool areas."
Wouldn't you rather spend time collecting sea shells than doctor's bills? No worries. There are ways to prevent these future foot predicaments so you can go back to your sun-kissed dreams and enjoy a liberated foot experience.

1. Limit walking barefoot as it exposes feet to sunburn, as well as plantar warts, athlete's foot, ringworm, and other infections and also increases risk of injury to your feet.
2. Wear shoes or flip-flops around the pool, to the beach, in the locker room and even on the carpeting or in the bathroom of your hotel room to prevent injuries and limit the likelihood of contracting any bacterial infections.
3. Remember to apply sunscreen all over your feet, especially the tops and fronts of ankles, and don't forget to reapply after you've been in the water.
4. Stay hydrated by drinking plenty of water throughout the day. Drinking water will not only help with overall health, but will also minimize any foot swelling caused by the heat.
5. Keep blood flowing with periodic ankle flexes, toe wiggles, and calf stretches.
6. Some activities at the beach, lake, or river may require different types of footwear to be worn, so be sure to ask the contact at each activity if specific shoes are needed. To be safe, always pack an extra pair of sneakers or protective water shoes. If your shoes will be getting wet, they should be dried out completely before your next wearing to prevent bacteria or fungus from growing.
7. If you injure your foot or ankle while on vacation, seek professional medical attention from a podiatric physician. Many often only contact a doctor when something is broken or sprained, but a podiatrist can begin treating your ailment immediately while you're away from home. Use our Find a Podiatrist tool to get treatment wherever your travels take you!
8. In case of minor foot problems, be prepared with the following on-the-go foot gear:
   • Flip flops—for the pool, spa, hotel room, and airport security check points
   • Sterile bandages—for covering minor cuts and scrapes
   • Antibiotic cream—to treat any skin injury
   • Emollient-enriched cream—to hydrate feet
   • Blister pads or moleskin—to protect against blisters
   • Motrin or Advil (anti-inflammatory)—to ease tired, swollen feet
   • Toenail clippers—to keep toenails trimmed
   • Emery board—to smooth rough edges or broken nails
   • Pumice stone—to soften callused skin
   • Sunscreen—to protect against the scorching sun
   • Aloe vera or Silvadene cream—to relieve sunburns

Say goodbye to plaster fittings for orthotics!  With our new scanner technology, we can scan your foot with an iPad that directly sends the image to the orthotics company!  You can sit back and relax while the Doctor scans your foot and then be on your way.  Orthotics are shipped back to us within 2-3 weeks.