Frequently Asked Questions
We like to educate our patients as much as possible so that we can create the most straightforward and effortless patient experience possible. Below are some of the most frequently asked questions that we get in our office.
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When is Bunion Surgery Necessary?
Generally speaking, bunion surgery is never “necessary” in a medical sense—as an elective procedure, you’re always able to make the call about whether or not it’s right for you.
However, surgery is often recommended if pain and discomfort are severe, you’re finding it increasingly difficult to find shoes that fit normally or accomplish daily tasks without pain, and especially if conservative treatment options fail to provide adequate relief. Once a bunion has formed, only surgery can fix the deformity itself, and while we never recommend surgery for cosmetic reasons—if there’s no pain, you shouldn’t have surgery—surgical correction or management is often the best choice when the bunion begins to infringe on your quality of life.
All that being said, this is merely a basic guideline—the decision about whether or not to have surgery must be made in consultation between you and your surgeon.
Can Children Get Bunions?
It is not uncommon to wonder if kids can get bunions—given the frequent association between bunions and women’s footwear—when you observe the distinctive bump at the base of a child’s big toe, but we can definitively say it is certainly possible for children to develop this particular issue.
Whereas many people think high-heeled shoes like pumps and stilettos are responsible for bunions, they actually are not caused by these kinds of footwear. This misconception makes sense, since these kinds of shoes often have narrow toe boxes which place the toes in an abnormal, uncomfortable position. Additionally, they place excessive pressure on the front of the foot (where bunions develop). That said, shoes can only really exacerbate an existing condition – not cause one in the first place.
The main factor behind bunions are structural and/or biomechanical in nature. (Basically, either natural variances in how a foot is structured or how it moves.) Children can have both structural and biomechanical irregularities, so it is entirely possible for them to develop bunions.
When it comes to pediatric bunions, early intervention is best. This is a progressive condition – one that will worsen over time if left unaddressed. We have options that may be able to halt progression and relieve symptoms for your child.
Bunions can affect individuals of all ages, but this doesn’t mean you or your child has to live with the pain and irritation that often accompanies them.
What Should I Look For in a Diabetic Foot, Self-Exam?
If you have diabetes, daily foot exams are a critical component of maintaining healthy feet and avoiding nasty complications such as wounds or ulcers, which (if untreated) may lead to serious infections or even necessary amputations.
You should be checking for anything out of the ordinary, even if it seems relatively minor. Cuts, bruises, cracks in the skin, redness, swelling, ingrown toenails, rashes or athlete’s foot, even temperature changes—any of these could be an early indicator of a potential problem.
Look at your feet carefully, including top, bottom, and between toes. Use a mirror or enlist a friend if you have to. Feel your feet with your hands for bumps and temperature. Gently squeeze toes to test for blood flow—normal color should return within 5 seconds. You should also track your progress over time, to make sure you note any changes.
If you find anything during your self-exam, or it’s time for your annual diabetic foot checkup, please call Associates in Podiatry today for a comprehensive examination and care.
How Can I Manage My Neuropathy at Home?
Symptoms of neuropathy, like pain, tingling, burning, and numbness, can interfere with daily life, but you don’t have to let them! There are steps you can take to minimize discomfort and manage neuropathy at home.
First off, keep your blood sugar under control and make sure your diet provides plenty of nerve-nourishing vitamins B and D. Also, don’t smoke, limit alcohol, and be sure to exercise every day to encourage good blood flow – a few lifestyle changes can go a long way! Other blood-pumping boosters include a warm foot soak or relaxing massage. Finally, there are various medications we can prescribe that will help to alleviate symptoms, as well.
Why Isn't My Wound Healing?
A wound on your foot that is not healing can indicate that your circulation is being compromised. This may be due to smoking, poor nutrition, or certain medications. It can also stem from conditions like diabetes and peripheral arterial disease which slow blood flow and decrease your body’s ability to deliver the nutrients wounds need for the healing process to occur.
A sore that doesn’t seem to be going away can also result from continued pressure being placed upon it. Such continued aggravation of the wound can cause tissues to break down, making it get worse instead of better.
The longer a wound stays open, the more likely it will become infected and lead to serious complications.
What Are The Benefits of Diabetic Socks and Shoes?
Socks made especially for diabetic feet have no irritating seams, compress without constricting to encourage blood flow and reduce swelling, and offer squared toes for plenty of wiggle room. They also provide padding that protects feet from excessive pressure. They are made of moisture-wicking materials to help your feet stay clear of fungal infections.
Diabetic shoes provide additional support and cushion in all the right places, with a durable yet flexible sole to keep obstructions out and your feet secure. They are also made of breathable materials.
How Are Diabetic Wounds Treated?
Diabetic wounds can have dangerous consequences, so it is vital that they are addressed as soon as possible. Call us immediately if you notice a problem! Treatment for diabetic wounds typically follows this sequence:
Cleaning the wound – this is done with warm water only
Debridement – the process of removing damaged tissues
Preventing infection – applying medication and dressing the wound
Off-loading – taking pressure off the wound while it heals. This can be done with a special boot, scooter, or crutches.
It’s important to change the dressings and clean the wound daily, as well as manage your diabetes to keep glucose levels in check so they do not impede the healing process.
Make sure you check your feet daily for any signs of a diabetic wound to receive the prompt treatment needed to help you stay healthy and safe. Always wearing proper footwear to protect your feet will help to avoid problems from the start.
How Can I Treat My Yellow Toenails?
If your toenails have turned yellow, you likely have a fungal infection and we’re willing to bet your nails are also becoming thick, brittle, and misshapen. Fungal toenails can not only be unsightly, but may eventually be painful as well. It can also spread to your other nails, so prompt treatment is advised. There are topical ointments, polishes, and creams available in pharmacies, but these tend to not get the best results. We can prescribe a stronger, oral medication, or in severe cases, surgically remove the damaged nail. Perhaps the most attractive option, however, is laser treatment which uses concentrated light beams to penetrate the nail and zap the fungus beneath it without damaging surrounding tissue. This procedure is safe, painless, and quite effective.
What Are The Symptoms of Toenail Fungus?
We’re so glad you asked! Fungus is all around us, especially in warm, damp places, and all it needs is a tiny break in the skin to enter and take up camp under your toenails. So if you like to frequent the public pool, or tend to go barefoot in the gym locker room, beware — you are at risk for a fungal toenail infection! Knowing the symptoms of toenail fungus will indeed help you spot it early and stop it from getting worse or spreading. Keep an eye out for these signs:
- A white or yellow spot or streak
- Continued discoloration
- The nail becoming thick, brittle, crumbly, and even distorted and misshapen
- The nail lifting from its bed
- Debris collecting beneath the nail
- A foul odor
- Discomfort when wearing shoes
If you notice any of these symptoms, call and make an appointment so we can quickly get you on a treatment plan.
How Do I Know If I Have Athlete's Foot?
Unlike a skin rash from an allergic reaction, athlete’s foot is caused by a fungus that enters the skin on your feet through even the smallest scratch. The fungal infection typically shows up first between the toes, but can spread and cause not only redness and itchiness, but a burning sensation as well. The skin can also peel, crack, and even blister. It’s important to pay us a visit so we can confirm that you indeed have a case of athlete’s foot and we can get you started on an appropriate treatment plan. There are over the counter options including ointments, powders, and sprays, but for stubborn cases you may need prescription strength topical or oral medications. It’s smart to treat your shoes at the same time you treat your feet, too. Apply anti-fungal spray or powder inside your footwear, and while you’re at it, make sure you keep your feet, socks, and shoes clean and dry.
How Are Hammertoes Treated?
Hammertoes may be treated conservatively or surgically, depending on the severity of your condition, your lifestyle goals, and other factors.
Conservative strategies will not “fix” a hammertoe—that is, it won’t return it to its original alignment—but may offer adequate relief from pain and return to activity if the joints remain flexible. Such methods include footwear adjustments (especially switching to pairs with more room in the front for toes), custom orthotics, splinting or strapping, and other options.
If there’s significant pain or open sores, especially if the joints have become rigid and inflexible, we’ll likely recommend surgical correction. A number of different procedures can be conducted; one will be selected based on a thorough examination, as well as a discussion with you.
Why Does My Heel Hurt In The Morning?
Heels that hurt in the morning are the classic symptom of plantar fasciitis, an inflammatory condition caused by tiny tears in the band of tissue (the plantar fascia) that runs across the sole of your foot.
The reason the pain is often worse in the morning—or even after a nap or lengthy sit—is because of what happens to the plantar fascia when not bearing weight. During periods of rest, the tissues contract and tighten, and when you place weight on them again you may experience stabbing or shooting pain as the tight tissues react to the sudden change in pressure. After a few minutes of standing and walking, the plantar fascia stretches and loosens up a bit, leading to a decrease in pain.
Chronic heel pain can have a profoundly negative impact on your quality of life. If home care hasn’t helped, please contact Associates in Podiatry for a professional evaluation and treatment solutions.
Why Is My Child Complaining Of Heel Pain?
Heel pain in children, especially those who are active, can be the result of overuse injuries such as plantar fasciitis or Achilles tendinitis, but the most likely culprit is a condition known as Sever’s disease. While it may sound concerning, this condition is actually outgrown in time and has no lasting effects. It occurs when a child’s heel bone grows more quickly than does the Achilles, resulting in the tendon tightly pulling on the heel and causing pain. You can help to ease your child’s discomfort with anti-inflammatory medication, icing the area, and having your child take a temporary break from high-impact activities that involve running and jumping. Heel cups can be used in shoes as well, and make sure the shoes themselves offer plenty of cushion. There are also stretches your child can do to minimize symptoms.
Are There Stretches To Help With Heel Pain?
If heel pain is stopping you from doing the things you love, good news – there are stretches you can do to help ease your symptoms!
Before you even get out of bed, pull your toes gently toward you, then try pulling your covers up with your toes. Once you’re up, face a wall with your hands on it, and extend one leg behind you pressing your heel to the floor. Next, take a seat and loop a towel around your foot, pulling the ends toward you as you point and flex your toes.
Heel pain stretches aren’t the only way to find relief, either. Try rolling your arch over a foam roller or frozen water bottle, and make sure you have shoes that fit well and offer plenty of cushion and support. Orthotics can help to take pressure away from your heel, as well. Remember, rest is essential to healing. Take some time off from activities and when you’re ready, gradually return to your normal activity level.
What Is This Bump On The Back Of My Heel?
If you notice a bump on the back of your heel, odds are you have a case of Haglund’s deformity. With this condition, a protrusion develops behind your heel mainly due to stiff-backed shoes pressing on the bone there, causing it to become irritated, and the surrounding tissues to become inflamed. It’s common for bursitis to also set in, making the problem even more painful.
You can reduce redness, swelling, and pain by wearing open-backed shoes or those made from softer, more flexible materials. Ice and anti-inflammatory medication can help as well. Once symptoms subside, try to keep those stiff-backed high heels, hiking boots, and skates in the back of the closet as much as possible. When you do wear them, place a protective pad across the back of your heel to avoid Haglund’s deformity from making a return visit!
How Can I Prevent Ingrown Toenails?
Ingrown toenails may not be 100% preventable through home care methods alone, particularly if you have a genetic predisposition to developing them (such as unusually curved nails). However, the following home strategies can reduce your risk:
- Don’t trim nails too short—they should stay about even with the tips of your toes.
- Trim nails straight across, rather than rounding at the corners.
- Wear comfortable, supportive shoes that provide adequate protection for your toes against stubs and jams.
To prevent ingrown toenails permanently, a minor surgical procedure can be performed in our office where we destroy a portion of the tissue responsible for growing new nail. This means that edge of the nail will never grow back. Generally, we only recommend this option for people who have chronic, recurring issues with ingrown nails.
How Should I Be Trimming My Toenails?
Are you trimming your toenails wrong? You might be tempted to think that there’s no wrong way to cut a nail, but actually, using proper trimming technique can help minimize the risk of injury, especially ingrown toenails.
The three big tips are:
- Use a heavier pair of trimmers with long levers and an uncurved blade. You don’t want to push too hard to clip, as this can cause injury.
- Cut nails straight across—do not curve in at the corners, as this can increase the likelihood that the edge of the nail will become ingrown as it grows out.
- Don’t cut nails too short. Keep them about even with your toe tips. This will also help decrease the odds of an ingrown nail.
Associates in Podiatry can help you with any foot or nail maintenance issues or treatment you may require, including ingrown nail removal, diabetic foot checks, and more.
What Is The Difference Between Custom Orthotics and Over-The-Counter?
Both over-the-counter insoles and custom orthotics are meant to help relieve foot pain and improve biomechanics, but there’s a big difference in both effectiveness and quality.
Store-bought insoles (sometimes referred to as over-the-counter orthotics) are mass produced, cushioned inserts. Depending on the quality and materials used, they can range from a few dollars to $30 or $40. While the best of these may provide some temporary pain relief, especially in more minor cases, they rarely provide lasting treatment for chronic foot issues.
Custom orthotics, by contrast, are uniquely designed to fit a specific pair of feet, according to measurements taken by professionals. Because they fit your feet exactly, they can provide much more effective pain relief than OTC insoles, and they can treat a much wider variety of conditions (including gait abnormalities). Although more expensive than insoles, they’re much sturdier, and can even last years with regular maintenance.
If your feet are hurting, custom orthotics may just be the solution you’re looking for.
How Should My Child's Shoes Fit?
It’s of the upmost importance that your child’s shoes fit correctly, as ill-fitting footwear can lead to a host of problems including juvenile bunions, ingrown toenails, and more.
To get the proper fit, measure your little one’s feet and be sure shoes are tried on for size. When your son or daughter is standing, check if you can fit a thumb’s width between the front of the shoe and your child’s longest toe. Also, make sure the heel is supportive and doesn’t slip. Let your child walk around a bit in the store – remember, shoes should feel comfy from the get go and should never have to be “broken in.”
Also keep in mind that children’s shoes can become too small very quickly! Perform the thumb check regularly and replace shoes as soon as the rule of thumb is broken.
How Can I Strengthen My Ankle After A Sprain?
Rehab is an essential component of treatment for an ankle sprain. Once the ligaments in your ankle heal, they’ll still need exercise to regain the strength, stability, flexibility, and range of motion that they lost due to both the injury and the downtime of recovery.
Initially you’ll probably be limited to range of motion exercises, but once your doctor clears you for weight-bearing activity and thinks you’re ready, you can begin strengthening exercises. Your program may consist of isometric exercises (which involves pushing against fixed objects, like walls or furniture) and isotonic exercises (which require the use of a resistance band).
It’s important to carefully follow the program set out by your doctor or physical therapist. Moving to a new phase of strengthening exercises before you’re ready for them can be counterproductive, even reversing some of the healing progress.