Archive for April, 2010
Ingrown Toenails in Nacogdoches and Carthage Texas
Posted by: | CommentsTo borrow a term coined by our youth of today, ingrown toenails are definitely the “pits”. In short, the problem is just what its name implies. The nail plate is too large for the under covering or bed and one or both sides are pressing into the skin. Ingrown nails can result from several possible causes such as improper cutting, abnormal nail structure, and localized injury to the plate. The appearance of the toe involved may range from a sensitive redness and slight inflammation to a full-blown infection of the toe with pus and bleeding usually evident. The object of course, is to prevent the infectious stage from taking place and to remedy the problem earlier in its development.
How do you treat them?
Adequate prevention of ingrown nails can be accomplished in most cases by proper trimming and judicious self-care. The nail plate should be carefully trimmed so as to follow the fleshy curve at the end of the toe. Under no circumstance, should a sharp instrument be used or inserted to cut diagonally back into the corners of the nail. Leaving a jagged nail edge, a loose piece, or inadvertently cutting the skin can predictably lead to problems. In those cases where injury has occurred with a subsequent ingrown nail, professional assistance by a foot specialist is suggested. The doctor is well trained and equipped to treat such a problem and with little to no discomfort to the patient.
Ingrown nails may seem simple enough but in actuality have sidelined many a person from his or her daily activities. These annoying and painful nail conditions are frequently encountered in various athletic activities. Soccer, jogging, racquet sports, football, basketball, and baseball all involve running and often lead to digital problems such as ingrown nails. Antibiotic medication, disinfectant soaks, and inactivity are like Kleenex for the cold. It is essential to reduce and/or remove the offending spicule or nail edge that is causing the problem. Then and only then, will the ingrown nail condition be resolved.
High Arched Feet at Sowell Podiatry in Nacogdoches and Carthage
Posted by: | CommentsA high arched foot is one where there is a marked elevation of the longitudinal arch both on and off weight bearing. This type of foot by itself is usually not a problem but tends to cause other difficulties, which frequently require treatment. For instance, the high arched foot creates excessive pressure on the ball of the foot and frequently produces thick and uncomfortable calluses. Hammertoes are also common with this foot type, which may cause problems with certain shoes. In addition, the high arched foot is notoriously known as a poor shock absorber, frequently resulting in discomfort in the heel and arch areas.
Causes
The three main causes of high arched feet include congenital development (at birth), trauma or injury (involving nerve damage), and certain neurological conditions. It is important to thoroughly evaluate a high arched foot in order to determine its probable cause. The type of therapy selected will then have a much better chance for success. It should be kept in mind that not all high arched feet require treatment. In the absence of symptoms or progressive soft tissue changes, clinical treatment may be unwarranted.
Treatment
The treatment of the high arched foot is directed at supporting the elevated mid section of the foot, providing shock absorptive benefits to those areas in need, and improving the functional mechanics of the foot and ankle. Orthotics prescribed by a foot specialist are the most effective means of accomplishing these objectives. The high arched foot usually responds well in a relatively short period of time to the use of orthotic supportive devices. In certain rare cases where the condition is excessive and defies therapeutic control, surgery might become a consideration.
Haglund’s Deformity – Now you know what it is!
Posted by: | CommentsA haglund’s bump is an enlargement or lump of bone, which forms on the back of the heel. This can become a very painful condition due to unavoidable shoe pressure and accessibility to injury. It is not uncommon that this condition also involves Achilles tendon discomfort since the tendon has fibrous attachments into that area of the heel. There may or may not be soft tissue swelling around the bump itself but regardless, pressure on the area itself produces significant discomfort. This condition is also referred to as a “pump bump” for it was originally found most frequently in women wearing dress pumps. Today however, we find these problems in both males and females and of various age groups.
What causes it?
There is some confusion as to the particular cause of a haglund’s bump. Some authorities believe that it is the result of an internal bone spur or calcium deposit on the heel, which then enlarges in response to pressure and friction. Another theory that is more widely accepted today is that certain rotational motions of the heel during walking cause the bump to form as a protective mechanism. In other words, the way one walks causes the heel bone to move with each step eventually causing a thickening of the bone to form. As the individual continues to walk and the rear counter of the shoe continues to irritate the heel, the bump gets bigger and the pain and disability worsens.
How do you treat it?
The treatment of a haglund’s bump is directed at relieving the shoe pressure, stabilizing the heel or reducing its motion in the shoe and relieving any soft tissue swelling or skin irritation if present. Protective padding, shoe modifications, occasional injection therapy, physical therapy, and orthotics are effective in the management of this annoying problem. In some cases, immobilization or casting is beneficial while in certain instances where the condition seems resistant to care, surgery can be an effective approach.
Ganglionic Cysts at Sowell Podiatry
Posted by: | CommentsA ganglionic cyst is a fluid filled sac or soft tissue growth that lies over a tendon or underlying joint defect. The joint problem is most often a bone spur or roughened projection that causes friction with the soft tissue above it and in time results in the formation of a cyst. Ganglionic cysts can vary in size from that of a small grape to a walnut and can become quite firm to touch. The discomfort caused by a ganglionic cyst is because of shoe pressure against the growth and subsequent irritation to the surrounding nerves in the area. A frequent site for these annoying soft tissue cysts is on the top area of the foot and on the front of the ankle.
What causes it?
Trauma or injury is the prime cause of ganglionic cysts with bone growth abnormalities taking up the number two slot. The sequence or order in which these factors may occur is less clear but we do know the following:
- There is frequently some sort of injury to the involved site which sparks the formation of the cyst.
- There is frequently an underlying bone projection or roughened area of a joint that irritates an overlying tendon, which in turn results in a cystic growth.
- The time between the injury and the onset of a noticeable cyst can vary from days to several months.
How do you treat it?
The treatment of a ganglionic cyst, like that of many other clinical conditions, includes both conservative and surgical approaches. A good initial treatment option is to drain the cyst and inject an anti-inflammatory medication followed by compression a dressing to prevent refilling of the growth. Two or three injections might be necessary over a several week period to accomplish the desired effect. Proper shoe selection and modifications are also carefully monitored during this initial period in order to reduce the soft tissue irritation. Physical therapy on a scheduled basis, in some instances, can also be beneficial. Surgical removal of the cyst is usually suggested when the conservative therapies have failed in resolving the problem.
Gout Attacks – Sowell Podiatry in Nacogdoches and Carthage Texas
Posted by: | CommentsOften times, podiatrists are the first to diagnose gout. I thought it might be helpful to get a basic knowledge of what to look for and how to handle it.
An acute gout attack is an inflammatory process that occurs in a joint secondary to a high concentration of uric acid in the blood. It is most commonly seen in the middle age, the elderly, and is much more common in men. Theoretically, it can occur in any joint in the body but is most common in the big toe joint followed by the knee and the ankle. It is extremely painful and is characterized by a red, hot, swollen joint. Patients who are undergoing acute gout attacks are usually in extreme pain and find it most difficult to even bear weight during normal walking.
What causes it?
An acute gout attack results when elevated levels of uric acid in the blood cause crystals to settle into certain joints. The body’s defense mechanism tries to fight the foreign material and an inflammatory process is initiated. Uric acid is a metabolic end product that is normally found in certain foods. People that experience “gouty attacks” have increased levels of uric acid for a variety of reasons. Often, very rich foods like alcohol, chocolate, seafood, and meats can precipitate attacks. The uric acid crystals settle in joints in one’s arms and legs because of the decreased temperature seen in the extremities. The crystals are recognized as foreign material and the body fights it like an infection. The area becomes swollen, red, hot and extremely painful. Often times, a person in an acute gout attack cannot even tolerate the bed sheets touching the affected area.
How do you treat it?
Acute gout attacks are usually treated with a combination of therapies. Oral medications such as anti-inflammatories, analgesics, and colchicine are most commonly used to treat this disorder. Often times, local injections into the affected joint will help relieve symptoms. Various other treatments include warm compresses, elevation of the involved area, physical therapy, and the use of pain relievers such as narcotics. The goal of treatment in acute gout attacks is to end the “flare up” and convert the patient’s condition to the chronic state. Certain oral medications are available on a long-term basis to help prevent recurrent attacks and possible systemic damage.
Bunions in Nacogdoches and Carthage Texas at Sowell Podiatry
Posted by: | CommentsIt is not uncommon for patients to call alomost anything on their foot a bunion! I thought it might be helpful to explain in more detail what a bunion is and how a podiatrist, such as myself, can address them.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
Surgical Treatment
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.
