Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening. The fungal infection itself occurs beneath the surface of the nail. Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail. If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk.
The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms. Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails.
Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes. Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential. Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.
Fungal nail treatment may vary between patients and the severity of the condition. Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections. Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications. Debridement, or the removal of diseased nail matter and debris, may also be performed. In more severe cases, surgical treatment may be needed. In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed. In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.
In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.
If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.
Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.
You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.
Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.
Although it may be tempting to wear flip-flops in warm weather, they are not the best choice of footwear for your feet. Flip-flops may be ideal for the beach, pool, spa, and shared showers, but you should avoid wearing them unless it is completely necessary.
Flip-flops only have a small strip of fabric holding your foot in place, but your toes need a better grip to keep your foot in place. The repetitive gripping can lead to an overuse of your muscles, which could result in tendinitis. This is only one of the many problems that stem from wearing flip-flops too often.
Flip flops aren’t good for extensive walking because they fail to offer arch support, heel cushioning, or shock absorption. As a result, people who wear flip flops are at a higher risk of experiencing an ankle sprain. Additionally, these shoes offer little protection for your feet, putting those who wear them at a greater risk for stubbed toes, glass cuts, and puncture wounds.
Although flip flops aren’t recommended for everyday use by anyone, it is especially important for diabetics to avoid them. A diabetic foot injury can easily become very serious, and it may even lead to amputation.
If you are experiencing pain from wearing flip-flops, you shouldn’t be hesitant to replace them with a more comfortable shoe that offers more support. If your flip-flop foot pain doesn’t go away, you should seek assistance from a podiatrist right away. It is possible that you may have a more serious foot problem such as a stress fracture or arthritis.
Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men.
Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.
People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.
Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.
Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.
To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks.
A neuroma is a thickening of nerve tissue and can develop throughout the body. In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes. The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.
Neuromas can be caused by anything that causes compression or irritation of the nerve. A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes. Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas. Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.
Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up. Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot. An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.
Treatment for Morton’s neuroma can vary between patients and the severity of the condition. For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed. Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition. The severity of your condition will determine the procedure performed and the length of recovery afterwards.
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
Flatfoot is a foot disorder that is not as straightforward as many people believe. Various types of flatfoot exist, each with their own varying deformities and symptoms. The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot. Other signs of flatfoot include:
One of the most common types of flatfoot is flexible flatfoot. This variation usually starts in childhood and progresses as one ages into adulthood. Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing. When not standing, the arch returns. Symptoms of flexible flatfoot include:
Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit. X-rays may be taken to define the severity and help determine the treatment option best for your condition. Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices. If nonsurgical methods prove ineffective, surgery may be considered. Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.
An ingrown toenail is a nail that has curved downward and grown into the skin. This typically occurs at either the nail borders or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. In most cases, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
Corns are hard and thick areas of skin that form as a result of constant rubbing, friction, or pressure on the skin. They are patches of dead skin with a small plug toward the center. They may appear on the tops and sides of toes and can make walking painful.
Soft corns are typically thinner with a white color and rubbery texture. Soft corns tend to appear between the toes. Seed corns are another type of corn that appear in clusters and can be tender if they are on a weight-bearing part of the foot. Seed corns usually appear on the bottom of the foot and are likely caused by a blockage in sweat ducts.
While corns and calluses are somewhat similar, calluses are a bit different. Calluses are a patch of dead skin that can occur anywhere on the body. In comparison to corns, calluses are usually a bit larger in size. However, both corns and calluses are caused by increased friction on the skin.
There are some risk factors that may increase your chances of developing corns and calluses. If you have bunions, hammertoe, or a bone spur, you are more likely to develop a corn or callus on your foot.
While Corns and Calluses tend to disappear when the friction to the affected area ceases, the help of a podiatrist may be useful in the removal process. It is important to remove the dead skin around the area and this may be done in a few different ways. Moisturizing creams may be helpful in softening and removing the dead skin around the callus. You should never use razors or other pedicure equipment to remove your corns. Doing this may worsen your corn or callus and cause infection.
In some cases, corns and calluses may be caused by abnormal foot structure or walking motion. In such a case, you should seek a podiatrist’s assistance in order to correct the issue.
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
The ankle is a hinged synovial joint made up of three bones: the tibia (shin bone), the fibula (outer ankle bone), and the talus (between the heel and leg). These three bones are bound, supported, and stabilized by strong, fibrous bands of tissue called ligaments.
A break in an ankle bone can be either traumatic or stress related. This injury may be referred to as a break or fracture. A traumatic fracture can result from tripping, twisting or rolling the ankle, falling, or by blunt impact to the ankle. These traumatic ankle breaks usually occur during sporting activities or accidents. Stress fractures, however, occur over time and are the result of repetitive stress to the ankle. These fractures sometimes occur when a new activity that engages the ankle is introduced, or when the level of activity is abruptly increased or intensified.
There are various symptoms that accompany an ankle break. The most significant symptoms are pain and swelling that occurs in the ankle and sometimes spreads up from the foot to below the knee. Bruising or discoloration may develop eventually. It will be difficult or even impossible to put weight on the affected foot, and in severe cases there may be a visible deformity or even exposed bone.
It is very important to seek immediate treatment when an ankle break occurs or is suspected to have occurred, in order to allow the bone to properly heal and to avoid future complications such as stiff joints, limited range of motion, and osteoarthritis.
To diagnose a broken ankle, your podiatrist will first ask you to explain how the injury occurred and what your symptoms are. They will perform a thorough examination, checking for damage to nerves, blood vessels, and other structures around the injury site. They will also test your range of motion. An X-ray will need to be reviewed and, in some cases, an MRI or CT scan may be necessary.
Proper treatment of a broken ankle will depend on where and how severe the break is, how stable the ankle is, and whether the bone is displaced (misaligned or separated) or non-displaced (broken yet still aligned properly).
Mild fractures (where the bone is non-displaced) may be treated by resting, icing, and elevating the ankle at first, followed by immobilization with a cast or walking boot. Pain and inflammation may be treated with acetaminophen. More severe or complicated fractures where bones or joints are displaced may require surgery.
Recovery time will also vary, and it may take 4-6 weeks or longer for a broken ankle to heal. Your podiatrist will most likely order progressive X-rays or stress tests to be taken in order to monitor the healing process.
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
