FAQ's
Frequently Asked Questions
1. How will I know if a toenail has a fungal infection?
2. My toes are curling and and becoming painful and deformed. What is this condition called and what treatment is available?
3. How do I decide if a podiatrist or orthopedic surgeon should treat my foot problem?
4. I have pain under the balls of my feet. What is the cause?
5. Are warts contagious?
6. I am unsure whether to have my bunions fixed. How can I tell if they need to be removed?
7. How do I avoid ingrown toenails?
8. How do I treat a sprained ankle?
9. What can be done about the pain in my heel?
10. My child has flat feet. Does it need to be treated?
11. My heels are dry and cracked. What can I do?
12. How do I get rid of Athlete's Foot?
13. I exercise and run regularly. How often should I replace my shoes?
14. How often do I need to replace my orthotics?
How will I know if a toenail has a fungal infection?
Fungal infection in a toenail must be confirmed by your podiatrist with a fungal culture. Opaque discoloration, yellowish brown, black or superficial white powdery plaque on the nail plate surface are common manifestations of fungus, yeast or mold infections. The toenail is usually brittle, crumbly and may have an odor associated with it. Shoe pressure can cause painful and limited ambulation. Depending on the results of the toenail culture and your patient health status, your podiatrist will select the appropriate treatment program.
My toes are curling and and becoming painful and deformed. What is this condition called and what treatment is available?
Hammertoe deformities cause a curling of the toes and pain develops because they are becoming less flexible and are developing arthritis. Cause can be hereditary or a result of wearing improperly fitting shoes. Wearing a buttress or toe crest pad generally helps if the hammertoes are still flexible and reduce pain. When hammer toes are a fixed rigid deformity there is a surgical procedure which can straighten the toes if the pads do not provide enough pain relief.
How do I decide if a podiatrist or orthopedic surgeon should treat my foot problem?
A podiatrist is a foot and ankle specialist trained to treat foot problems in a conservative, surgical or bio-mechanical approach. Most orthopedic surgeons treat knees, hips, shoulders, arms and hands without exclusive devotion to the foot and ankle. Ask a friend, co-worker, family member or your primary care physician for a referral to a podiatrist or a foot and ankle orthopedic specialist.
I have pain under the balls of my feet. What is the cause?
The generalized term for pain in the ball of the foot is metatarsalgia. A podiatrist will examine your foot and x-rays will be taken to evaluate for stress fracture. Burning, tingling or numbness are signs and symptoms of a pinched nerve in the ball of the foot also called a Morton's neuroma. Clinical examination would reveal a plantar wart, or deeply embedded callous or a foreign body which are easily treated. Also, the pain may be a result of atrophy of the plantar fat pad which has a higher incidence as we grow older.
Are warts contagious?
Yes, warts are a viral infection in the skin which is contagious. You should wear flip flops when you shower to prevent the spread of this virus to anyone showing in the same facility be it at home, or a gym or swimming pool. Picking at the wart will cause it to spread on your foot and perhaps to your fingers or hand.
I am unsure whether to have my bunions fixed. How can I tell if they need to be removed?
If you are finding it difficult to find shoe gear which feels comfortable due to a bunion deformity or if the bunion interferes with activities you love to participate in, you should make an appointment with a podiatrist for clinical evaluation, x-rays and a discussion of treatment options.
Structural deformity in the great toe joint generally occurs when there is a hyper mobility of the foot and custom molded orthotics can be made. After a gait analysis and impressions of both feet are taken to order custom molded orthotics to stabilize and improve feet function and balance. You will require x-tra depth shoes to accommodate the custom molded orthotics to fit into oxfords and athletic shoes or by removing the original lining or insole from the shoes. Most men can wear athletic shoes, Rockport, Ecco or Clark shoes which accommodate a custom molded orthotic nicely. Ultra slim custom molded orthotics can be made to fit into dress shoes and your podiatrist can recommend brands of shoes which are orthotic friendly.
If the bunion is not painful it is generally recommend against major reconstructive foot surgery until after orthotics are worn at least 6 months.
How do I avoid ingrown toenails?
The toenail generally follows the shape of the bone below it and shoe pressure from improperly fitting shoes and trimming the nails too short or trying to dig them out from the corners of the toe nail will generally cause an ingrown toenail. Proper trimming of the nails should be to allow them to reach full length and trim them straight across and file the edges manually with an emory board. If your toe is red, swollen, warm skin temperature, painful, draining or numb because it has been swollen and infected for a long time it needs an immediate appointment with a podiatrist.
How do I treat a sprained ankle?
The rice technique is the principle to follow in treatment of a sprained ankle.
Rest Ice Compression Elevation
Ice should be applied intermittently 20 minutes at a time at least 4 to 6 times per day for the first 3 to 5 days. Elevating the foot above heart level will help reduce swelling. Compression elastic bandage needs to be applied gently but firmly. If pain and difficulty in ambulation persist for a few days contact your podiatrist for a visit which will include an exam, x-rays, sonogram, crutches or durable medical equipment to stabilize the ankle sprain and prescribe pain relievers, anti-inflammatories and physical therapy.
What can be done about the pain in my heel?
Schedule a visit with your podiatrist for a professional evaluation of this problem. If the pain is on the bottom of the heel you may have a heel spur syndrome. Inflammation and pain in the heel where the plantar fascia-ligament inserts into the bottom of the heel bone (plantar fascitis), acute bursitis with pinpoint pain on the bottom of the heel about the size of a postage stamp usually located central mid-line heel to the medial aspect or side of the heel toward the big toe. A heel spur is only diagnosed with an x-ray and looks like a hook of bone projecting from the normally round contour of the heel bone.
Pain in the back of the heel is generally Achilles tendonitis. Tendonosis which is a sever inflammation with degenerative changes in the Achilles tendon, Haglund's deformity or pump bump exostosis or enlargement of the heel bone or bursitis.
You should avoid cortisone injections in the back of the heel, but pain in the bottom of the heel generally responds to cortisone injections.
Silicone heel cushions, taping with padding and strapping, stretching exercises, intermittent ice, anti-inflammatories, custom molded orthotics and physical therapy are treatment options. A gait analysis should be performed to assess if there is a mechanical imbalance.
My child has flat feet. Does it need to be treated?
Many people function quite well with flat feet and have had no pain and did not require treatment with orthotics or foot surgery. If your family history indicates severity of the flat feet which required custom make orthotics or foot surgery, you child should be examined by a podiatrist. If gait analysis reveals significant rotational instability known as pronation it is wise to treat your child to prevent bunions, hammertoes and painful ambulation from developing by making custom molded orthotics. When feet are flat and propel the child forward without rotational instability it will probably not require treatment.
My heels are dry and cracked. What can I do?
Begin using a moisturizing cream, lotions are too thin. This should be applied twice daily for three weeks. After a shower when the skin is softest you may use a pumice stone to reduce the thickness of the dry cracked skin. If three weeks of care at home with the recommendations above do not improve the dry and cracked heels you should schedule a visit with your podiatrist. Use of a scalpel blade or tissue nipper may be required to remove the dead skin by your podiatrist to facilitate absorption of the medication. This condition might be caused by a fungal infection in the skin and may require skin culture or lab test. Many prescription remedies are available for your podiatrist to use.
How do I get rid of Athlete's Foot?
If your feet perspire heavily this creates a perfect breeding ground for fungus infections to develop and grow in the warm dark , moist environment of your shoes. Dry your feet carefully after bathing, apply anti funfal powder before wearing your socks and change socks and shoes frequently.
In an acute fungal infection or athletes foot blisters form which ooze and drain and they are very contagious. Wear flip flops or crocs when showerring and scrub the tub frequently with lysol solution or chlorox and rinse it out profusely. Wear white cotton socks or socks which wick moisture away from your feet. If using over the counter anti-fungal cream twice daily for 3 weeks does not cure the fungal infection schedule an appointment with your podiatrist.
If a bacteral infection develops simultaneously with fungal infection of the skin on the fet, this can become very serious and require immediate care by your podiatrist.
I exercise and run regularly. How often should I replace my shoes?
Runners who average 25 miles a week are considered serious runners. You should replace your shoes between 350 to 550 miles or about once every 3 to 4 months or when there is pain in the feet because the shock absorption is no longer adequate with the shoe.
How often do I need to replace my orthotics?
Most custom molded orthotics are replaced once every 12 to 18 months. This seems to coincide when the softer components of the orthotic break down and when the patient experiences foot pain due to reduced shock absorption and support.
Complete refurbishment of orthotics can generally be done for about 1/2 the cost of a new pair of orthotics. A wise thing to do is maintain a second pair of orthotics in excellent working condition, to alternate wearing them so they do not need to be removed requently from shoes. Refurbishment can generally be done once but it is rarely done a second time.
