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Question: Why does my heel hurt so much when I first get up in the morning?
Question: When I play golf my stroke is off because of foot pain from my bunion. Can I have my bunion or heel spur removed with the laser?
Question: I can’t wear shoes comfortably anymore because my feet are swelling and pain around my toes, which are looking strange. Is this what they call a hammertoe? Can the condition be fixed?
Question: My podiatrist has prescribed orthotics for my feet. Now I use them in my Golf Shoes. Just how effective are these?
Question: Doctor, I have these terrible bumps on the sides of my feet… What can be done about them?
Question: I broke my toe in the Golf Club locker-room. Is it true that nothing can be done for a broken toe?
Question: Why does my ingrown nail keep coming back?
Question: I have diabetes and my podiatrist suggest that I have foot surgery, is it safe?
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Answer: Heel and arch pain are among the most common complaints presented to the podiatrist. The heel bone is the largest bone in the foot and protrudes backwards beyond the leg bones. This allows the oalf muscles a useful lever with which to propel the body. The heel receives all of the body’s weight with each step. One can easily see that the stresses on it and its associated structures are tremendous. Most painful heels and so-called “Heel Spur Syndrome” conditions are de to the faulty mechanics within the foot and/or leg.
Some of these “Biomechanical Faults” include flexible flat feet, high arched foot types and a tight Achilles tendon. These can all cause excessive stress on the long band of tissues that extend from the bottom of the heel towards the beginnings of the toes. This band of fibers is called the “Plantar Fascia” and helps to create the arch of the foot. Other causes of stress on a rapid gain in weight, high impact athletics or even an increased time spent walking or standing.
Other potential causes of heel pain include fractures, Bursitis, low back problems or inflammatory conditions such as gout or rheumatoid arthritis.
Treatments for these conditions all depend on a thorough history and examination. Since most hell pain is blomechanical in origin, treatment is directed at improvement in function of the foot and leg, once initial pain is controlled by anti-inflammatory medications, physical therapy and rest. Ultimately, prescription inserts called “Orthotics” are used to relieve the stress on the plantar fascia and to redirect the forces in the foot and leg. The good news is: only those resistant cases to all forms of therapy require surgery.
If you suffer from painful heel condition, we at The Podiatry /center urge you to see your podiatrist, who specializes in treating this common foot problem.
DR. HOWARD M. IMANUEL & DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC FEET.
Answer: In recent years, the use of lasers has gained popularity among many medical specialties. The public envisions all laser surgery as simple and painless. While it is true that certain types of laser surgery have little to no pain involved, the burning of tissues with laser is not that simple.
The carbon dioxide laser has enjoyed widespread use and popularity within the podiatric profession since the early 1980s. This type of laser is effective only in water-abundant tissues, such as the skin and skin structures. The carbon dioxide laser quickly boils and vaporizes these types of tissues. Skin and skin structures are composed of roughly 70-75% water and therefore lend themselves as a better target for laser surgery. Bone, on the other hand, has 10% or less in water composition, and will char very easily. Necrosis (death of tissues) then sets in.
A recent experiment compared healing between bone cut with laser and bone cut using micro-surgical instruments. Microscopically, the bone operated in with laser showed persistent charred edges and fragments that caused a 35% delay in healing. In many instances, infection and complete necrosis of the bone occurred.
While laser surgery in podiatry offers an alternative choice of treatment for skin and skin strictures, and even to destroy certain tumors, it is highly recommended that tissue samples be sent for microscopic examination before complete destruction is performed. An unidentified lesion can sometimes be lethal. In many instances, podiatric laser surgery adds an unnecessary cost to an otherwise equally effective surgical procedure and therefore acts merely as “window dressing” for the public.
If you suffer from a foot problem, we at The Podiatry Center recommend that you seek advice from your podiatrist. DR. HOWARD M. IMANUEL & DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC FEET.
Answer: A deformed toe is one of the most common conditions affecting the human foot. The condition may be a hammertoe, mallet toe or clawtoe. The usual complaint of a patient may be that of swelling, pain or an inability to wear shoes. Other complaints may be the formation of corn on the tip of the toe, its top or in both areas. Often the attempts to remove this protective skin are followed by the corn reforming. Usually, the problem is progressive and can lead to the formation of an abscess, ulceration or deep space infection.
Hammertoe conditions usually form from an inherited muscle-tendon imbalance that forces the buckling of the joint. The ligaments may shorten or lengthen around the joint causing a fixed or rigid position of the bond ends that form that joint. Gradually, the joint adapts to the abnormal position, and degenerative arthritis sets in. Pain may then be present even without shoe pressure. Other causes of deformed toe positions may be inflammatory arthritis or Injury.
Many different treatments are available today for the variety of toe deformities seen in the foot specialist’s office. These include digital padding and trimming of the corn, medication to reduce inflammation and orthotic inserts to redirect some of the abnormal forces that bend the toes during weight bearing. Surgery is often recommended and has become one of the common means used to relieve path and allow the patient to wear shoes comfortably and function more normally. The surgical correction of you toe deformity may be performed painlessly in the doctor’s office or the outpatient department of the hospital.
If you suffer from a painful toe deformity or one, which makes it uncomfortable to wear shoes, we at The Podiatry Center urge you to see your podiatrist. His or her skills in evaluating your problem will certainly be a step in the right direction for solving your foot problems.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET.
Answer: Your podiatrist has years of medical training dealing with the foot and ankle. He is an expert in treating a multitude of problems using orthotic devices. No other specialty has the training or experience that deals exclusively with the intricate mechanical problems of the foot and ankle in relationship to the rest of the body. Similar to the way contact lenses help vision problems, orthotics are designed to improved foot movement. These custom-made inserts are placed within the shoes and control the way the joints in the feet move. They can also help the foot to compensate for a hip or knee motion that mat otherwise cause a pathologic foot motion.
Orthotics are made of a vast array of materials, ranging from super-soft for diabetic and circulation-poor patients who have recurrent pressure ulcers on the soles of feet to the average patient who suffers from heel and arch pain requiring a more firm type of material to relieve the tearing effects of tissues around the heel and arch area.
Most podiatrists use a certified laboratory for custom-made orthotics. Precision techniques are used in the fabrication of each patient’s orthotics and it is rare indeed for any pair to be the same.
Some foot problems indeed are best treated by surgical means, but orthotics can often delay the need for surgery and certainly help to maintain proper alignment after surgical correction.
We at The Podiatry Center highly recommend that you see your podiatrist and ask if your problem can be controlled with the use of foot orthotics.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET.
Answer: Bunions are bumps on the side or top of the foot on the bone just behind the great toe joint. Strictly speaking some bunions do not cause pain. On the other hand, many bunions limit the motion of the large toe joint or limit the types of shoes one can wear. Bunions are most often due to a hereditary fault in the structures of the foot.
Many bunions are seen in youngsters, especially children with overly flexible feet (pronated), which can cause misdirection of the great toe in an outward position. The resultant position of the great toe can often lead to inward displacement of the bone behind it. This tends to broaden the forefoot which can cause improper shoe fitting and resultant inflammation in the joint.
Many bunion deformities can be deterred or halted in their progression by custom-made orthotic devices which can be put into shoes and which redirect the abnormal forces placed on the inside of the foot.
For may people, bunion surgery has proven extremely effective in realigning the great toe, allowing normal shoe fit and restoring a more normal function of the great toe and the first metatarsal. Additionally, people whose bunion deformities are associated with advanced arthritic changes can now be given dramatic pain relief. Modern technology allows bunion surgery to be performed in an outpatient or office setting.
If you or someone you know suffers from a painful bunion deformity, whether mild or severe, or are unable to wear normal shoes without comfort, we at The Podiatry Center urge you to see your podiatrist for a thorough evaluation. Let your foot specialist make the suggestions necessary for your particular foot problem.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET.
Answer: Fractures of the toes can be one of the most painful conditions one can experience. These fractures often result in extreme pain, deformity and the inability to walk normally or wear closed-in shoes. Untreated, angular deformities may unnecessarily lead to future surgery to realign the toes.
The most common cause of a broken (fractured) toe is usually sustained while walking barefooted around the home. Banging the toe(s) against a piece of furniture most often is the reported complaint. Not all fractured toes will stop the patient from being able to walk or bear weight. In fact, usually people can go right on with most activities. However, if there is an undetected displacement of the bony fragments, there is a higher likelihood of future deformity and pain. Often these “ureduced” fractures result in long delays in healing and even lack of keeling called “Non Union” Healing without reducing or splinting the fracture can lead to many weeks or even months of slow, painful healing. During the first few hours after injury to a toe, the “RICE” regimen should be followed. Rest, Ice, Compression, and Elevation become the immediate treatment plan Certainly, x-rays are necessary to determine the actual extent of the fracture and therefore the appropriate course of treatment. Relief of pain, swelling and disability is dramatically enhanced by the podiatrist’s evaluation and treatment. If you suffer from injury to your toe, consult with your podiatrist immediately, for optimum care.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET.
Answer: One of the most common foot ailments seen in the podiatrist’s office today is the painful, ingrown toenail. Past remedies for this ageless problem have included a range of the simple “Learn to Live With It” philosophy to self treatment that can lead to more serious problems.
Today, there is absolutely no rational reason why 70%-80% of the population continues to suffer from such a painful foot ailment, when they can be corrected quickly with virtually no pain and with no loss of time during the healing period.
The problem is caused by a number of conditions including an hereditary curvature of the nail plate, fungal infections, injury to the nail root, bone spurs beneath the nail plate, and even improper trimming of the nail. Regardless of the type or types of problems, if attention is not directed at “The Root Area”, the problem is assured of recurring. This is the mayor reason people who treat themselves have the problem occur repeatedly. All of these conditions can be alleviated painlessly in the doctor’s office and with immediate ambulation.
People should be aware of an impending toenail problem with frequent observation for any fluid discharge, redness, changes in the thickness and color of the nail itself. Many people, such as diabetic and the circulation-poor individual should not rely on sensation alone, since their may be impaired.
A visit to the podiatrist’s office today can most often dine immediate and lasting relief for an ingrown toenail problem. Several alternative methods are available, ranging from the use of certain chemicals that eliminate the section or sections or unwanted nail root, to the use of radio wave and laser technologies. Each method offers the patient the road to a more comfortable foot.
We at The Podiatry Center, strongly suggest those who needlessly suffer from a painful toenail condition to see their Podiatrist for evaluation and treatment of this universal problem.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET.
Answer: Diabetes is a disease that can significantly affect the foot and leg. Diabetes not only affects the blood sugar, but also decreases the circulation and alters the ability to feel pain. The alterations in the nervous system can result in deformities of many of the small joints and bones in the foot. These changes can lead to areas of repeated infections and open wounds.
There are several reasons why a diabetic patient may choose elective foot surgery. One of these may be a painful area of the foot such as a bursitis associated with increased pressure to a specific area. While many diabetic patients have impaired pain perception, others may have normal sensation. For these people, a hammertoe, bunion or a bone spur can cause significant discomfort,. Surgical repair may be the patient’s best option in not only decreasing the discomfort. But also in decreasing the possibility of future complications associated with the deformity. Diabetes is often progressive with age. Therefore, surgery performed at a younger age, when the blood supply to the foot is best, can often prevent future problems that may require surgery when the older patient has even more decreased circulation..
Another reason the patient may choose to have foot surgery could be due to an area that has developed repeated ulcerations and/or infections. Here, surgery can be used to repair an area of increased pressure on the foot to help prevent further infection that may progress to include bone (osteomyelitis). Surgery can also be used to help prevent infection from spreading to other areas of the foot. This helps to decrease the potential of partial or total amputation of the foot at a later date.
The podiatrist is trained to recognize potentially serious foot problems that may threaten the total foot condition. He will consult with the family doctor to help coordinate the best care for the foot problem, as well as handling the diabetic condition.
If you are a diabetic with a potential foot problem, we at The Podiatry Center urge you to consult with your podiatrist for evaluation and a treatment work up.
DR. HOWARD M. IMANUEL AND DR. JOSEPH GRILLO
This information is provided by The Podiatry Center. For further information, call 768-2323 or toll free 1-800-SIC-FEET. |
