Ingrown Toenails
By · CommentsAn ingrown toenail is a result of a nail growing into the skin that surrounds it. The big toe is the most common location but it may occur in any digit. At Sowell Podiatry, ingrown toes nails are very common. Too often these ingrown toenails are not cared for quickly enough and infection has typically set in when they arrive in our office. Ingrown toenails may cause pain at the tip of the toe or all the way down to the base of the toe and are usually more painful when walking and when wearing shoes.
A red, swollen, painful nail margin is very common with infection of the ingrown toenail and often times there will also be bleeding and pus. Parents should be aware that children are often times slow to discuss this problem and if they get any hint that there might be a problem such as altered gait, sock stains or a grimace they should inspect the child’s toes immediately. We perform many toenail procedures and take many steps to make this as comfortable and pain-free as possible.
Ingrown toenails have many potential causes. Some of the most common are:
- Improperly fitting shoes.
- Trauma to the toe.
- Thickened toenails due to fungus or repeated trauma.
- Improper trimming of toenails.
Treatment of an ingrown toenail typically involves addressing any bacterial infection in the skin first. Surface infection may often respond to proper foot soaks or antibiotic creams and oral antibiotics may also be used depending on the severity of the infection. A removal of the offending toenail is generally required and is often performed under local anesthesia. At this point, the toenail edge may be removed and allowed to re-grow or it may be removed permanently, this is called a matrixectomy. Please call Sowell Podiatry if you are suffering with an ingrown toenail and we will help you return to an active pain free lifestyle as quickly as possible.
Dr. Sowell loves his patients. He spends time getting to know each one and feels he is very fortunate to be in a profession that can provide so much pain relief! He calls them at home, checks on their care, visits at hospitals and seeks advice on cases that need outside help. Dr. Sowell also loves podiatry. He constantly reads medical literature, attends medical conferences and discusses interesting cases with fellow podiatrists. He particularly enjoys diabetic foot care, wound care, foot surgery, sports medicine and vascular assessment. In clinic, he trains his staff on common foot conditions and helps them prepare for various patients by discussing the disease and variations in its treatment. Our staff also performs various tasks around the office so they are cross-trained and have a better understanding of the wide variety of care we provide at Sowell Podiatry. We have two podiatry offices, provide care in over fifteen area nursing homes and perform surgery in three area hospitals and two surgery centers!
PAD – Peripheral Arterial Disease
By · CommentsPeripheral Arterial Disease (PAD) is a condition that affects approximately 12 million Americans. It occurs when blood vessels become narrowed and restrict blood flow. PAD can develop in many areas of the body but is very often first seen in the lower legs and feet. This can lead to Critical Limb Ischemia (CLI) which can end in amputation of toes, feet and legs.
At Sowell Podiatry, we treat PAD very seriously. Dr. Sowell has invested in a Sensilase non-invasive vascular study system to help detect patients with PAD as early as possible.
Symptoms of PAD:
- Claudication- Dull cramping pain in hips, thighs or calves during exercise and/or rest.
- Numbness or tingling in the leg, foot or toes.
- Changes in skin temperature, quality or color.
- Weakness in legs or arms.
There have been tremendous advances in the treatment of PAD. When I began practice at Sowell Podiatry many patients with PAD were doomed to amputation. Now with new advances in medications, testing and surgical techniques we are saving limbs that were once lost.
If you think there is any chance you are suffering with PAD, please call and get an appoint as soon as possible. We have many patients who are still walking on limbs that would have been lost without early action.
Morton’s Neuroma
By · CommentsMorton’s Neuroma is a benign thickening or enlargement of an intermetatarsal plantar nerve. The area of the foot known as “the ball of the foot” is made up of five large joints with very little room in the spaces between the joints. When these joints bump together, the nerve passing between them can become injured and over time will become more tuberous, or thickened. This is often described as a cord-like mass. Patients typically describe this condition as being painful, shooting, electrical and the most common description in my practice is that people say “it feels like there is a hot rock in my foot”.
Typically patients have more pain when weightbearing and wearing shoes and will often relay a history of taking off their shoes and rubbing their feet for relief. Morton’s neuroma can be diagnosed with advanced imaging techniques but is typically a diagnosis made clinically by a physician familiar with the condition.
Orthotics, pads, shoe modifications and corticosteroid injections are widely used to treat Morton’s neuroma. If such interventions fail, patients are commonly offered surgery known as neurectomy, which involves removing the affected piece of nerve tissue. Occassionally neurolytic injections are used to destroy the nerve without surgery.
Hammertoes
By · CommentsA hammertoe is a change in toe position due to contracture of tendons, laxity of ligaments or arthritic change in joints. These generally progress over time and have many causes and presentations. Hammertoes, one of the most painful foot ailments, can often be traced directly to the wearing of narrow, pointed-toe shoes. Women most often are the victims of hammertoes. Most of the time, female footwear is not much wider at the front than at the heel, and the outline of the normal foot is rounded. The combination of narrow shoe and wide foot, of pointed shoe and rounded foot, causes, predictably enough, painful foot problems such as hammertoes.
Additionally, there are certain foot shapes that are generally unstable while walking. Overtime this instability can cause the toes to flex to provide additional foot support. The toes contracture over an extended period of time can lead to contracture.
The tip of a hammertoe can strike the ground with a thud at every step and become flat and squat. A hard corn can form on top, and a distal corn can form at the hammering portion. The nail might split or grow inward. A corn or callused nail groove might develop where the flesh is caught between the nail and the toe bone or where the toe is angulated. A soft corn can prove especially annoying when it is between the hammertoe and the adjacent toe that is overlapped. Although any toe may be affected, the second toe suffers most often. It is longer than the other toes and therefore more likely to be deformed by small footgear. The effects of a hammertoe are not limited to the toe. The toe bones, forced back against the metatarsals, exert pressure against the center of the foot. The ball of the foot suffers, calluses form, and muscular cramps develop.
Wearing tight-fitting stockings, short footgear, tapered-toe shoes, pointed-toe shoes, tight leotards, or really snug pantyhose for long periods of time can produce a hammertoe. Because these articles of apparel are necessarily worn on each foot, there can be two hammertoes, one on each foot.
Surgery is sometimes required for this condition. There are many techniques that can be used to correct hammertoes and often times it is fairly simple. Patients almost always walk after surgery and minimal incision techniques greatly reduce discomfort and healing times.
Fractures
By · CommentsA podiatrist, like myself, is trained to handle almost all conditions concerning the foot. Not a week goes by in my office that someone does not come in with some sort of broken bone. If you feel you have broken a bone in your foot please seek medical attention immediately. Although it is true that some fractures do not require much care, it is also true that patients who put off the care of a fracture could have trouble getting the fracture to heal. The process is usually as simple as getting xrays (in office), diagnosis and treatment for the particular type of fracture present. Treatments range from splinting, protective shoe, walking cast and sometimes surgery. Yes, sometimes a fracture requires fixation using screw, pins and plates!
Signs of a possible broken bone in the foot are:
-Pain when walking.
-Bruising.
-Swelling.
-A change in foot or toe shape.
Occasionally, I have a patient come into my office with some of these signs but with no history of an injury or fall. Many times x-ray reveals that they have a fracture in their foot and they were not suffering with much pain. This particularly happens in patients with weak bones or osteoporosis. Please take these signs seriously and hopefully we can get you on the road to recovery as quickly as possible.
