February 19, 2015
Category: Uncategorized
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Tailor’s bunion, also called a bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. Metatarsals are the long bones in your foot that connect your ankle to your toes. Tailor’s bunions are not as common as bunions of the head of the first metatarsal bone, but they are similar in symptoms and etiology.

A tailor’s bunion can be due to an inherent defect in biomechanical structure of the foot. The fifth metatarsal bone projects outward, while the little toe projects inward. This transferal results in the growth of a bony enlargement that becomes irritated whenever compressed by shoes. In other cases, a tailor’s bunion may not be derived from a biomechanical deformity, but rather a naturally occurring outgrowth of bone on the side of the fifth metatarsal.

A major cause of tailor’s bunion can also be due to inappropriate and often tight-fitting shoe gear. Most shoes available to customers are not adequately wide for the average foot, especially in the toe box. This can result in painful irritation of the soft tissue underneath your skin at the prominence of the fifth metatarsal bone.

If prevention fails, there are conservative treatments your podiatrist can provide which include:

  1. Avoid wearing tight-fitting footwear. Choose shoes that have a wide toe box and little or no heel elevation. Getting a proper fit is crucial.
  2. Fit in a toe spacing product. Called a toe spacer, it restores proper alignment of your fifth toe to the fifth metatarsal, and away from the fourth toe. Be sure to only wear this in shoes with a wide toe box.
  3. Bunionette pads may help reduce the pain.
  4. Anti-inflammatories, taken as directed, can help alleviate the pain and swelling.
  5. Corticosteroid injections may also help reduce the inflammation.

If conservative treatments fail to rid the pain associated with your tailor’s bunion, surgical treatment could be your next option. If the irritation is due to soft tissue enlargements such as a bursa, neuroma or ganglion, your podiatrist can easily remove it in a simple surgery. If the cause is due to a bony prominence of the fifth metatarsal, your podiatrist can surgically remove or shave off the offending portion of the bone.

Post-operative instructions vary depending on the individual, but in most instances the patient is allowed to walk in a surgical shoe following surgery. 

For more information about treating tailor’s bunion, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Barry Mullen

By Kyle Alessi
December 24, 2014
Category: Injury Prevention

 

Neuromas, or abnormal growth of cells within a nerve, most commonly form between the third and fourth toe bones. Pain is often elicited as a result of these bones pressing together and irritating a segment of a nerve. This may be caused by wearing tight shoes, or by frequent stress on the foot. Women who wear high heels regularly are prone to neuroma formation.

Symptoms of a neuroma begin slowly, but often become progressive. You may feel a sharp, burning sensation in the ball of the foot, especially when bearing weight. Another common symptom is tingling or numbness between the toes and in the ball of the foot. There may also be pain on palpation at the neuroma site. Your podiatrist can perform a foot exam to determine if you have a neuroma. If needed, imaging studies such as X-rays and ultrasound can be done to confirm this condition and rule out other problems.

Fortunately, there are many treatment options available to reduce painful symptoms, and in most cases, without surgery. For example, your podiatrist may first suggest shoe changes. Shoes with good support, a wide toe box, and thick soles can help avert nerve irritation. Getting a proper fit is important. Avoid wearing high heels. If necessary, custom-made shoe inserts (orthotics) can provide support for your feet and prevent the neuroma from getting worse. Other conservative treatments include padding and taping. This can help take pressure away from the irritated nerve. Your podiatrist may also prescribe anti-inflammatory medications to reduce tissue swelling. Cortisone injections may also be used to relieve the nerve inflammation.

If conservative treatments still do not provide relief, your podiatrist may suggest treating the nerve directly in two different ways: surgery or injections. Surgery may be used to excise the neuroma. Upon removal of the neuroma at your podiatrist’s office or hospital, you can usually go home the same day. You can often return to normal activities within 3 to 6 weeks. Injections of an alcohol solution may be utilized to permanently numb the irritated nerve. Although the injections in your podiatrist’s office take just a few minutes, repeated treatments are usually required.

For more information about treating neuromas, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Kyle Alessi

By Fawaz Nesheiwat
September 24, 2014
Category: Nail Fungus

 

Naturally, fungi and bacteria are all around us. When a fungus begins to overgrow, however, an infection can occur. Fungal infections can affect any part of the body, from the skin to the eyes.

Onychomycosis, or tinea unguium, is a fungal infection that affects the nails. Fungal nail infections occur over a long period of time, so any abrupt change in nail integrity may be too subtle to notice at first.

There are various causes of onychomycosis. Although many of the causes are preventable, some risk factors expedite the possibility of developing it.  These risk factors include being diabetic, family history, advancing age, have a disease that affects blood vessels, living in a warm climate, swimming in a public swimming pool, compromised immune system, wearing closed-toe shoes thereby blocking airflow, having a nail injury, and poor podiatric hygiene.

A fungal infection of the nail may affect part of the nail, the entire nail, or several nails.

Onychomycosis can be identified by appearance. Visible fungal nail infection signs include scaling under the nail, white or yellow streak on the nail, crumbling corner or tip of the nail, flaking white areas on the nail’s surface, yellow spots at the bottom of the nail, or loss of the nail. Common signs of onychomycosis include a distorted nail, an odor coming from the infected nail, and/or a brittle or thickened nail. If you suspect you might have a fungal nail infection, see your podiatrist to have the infected nail tested. If the tests do come back positive, proper treatment will ensue. By following the basic FootCare guidelines, you more than likely can head off most common foot fungus problems.

Your podiatrist may prescribe an oral antifungal medication. Treatment may not rid your body of the fungal infection completely. In almost half of cases, the fungal nail infection will return. However, it is important to take your medicine as directed, as this is currently the best way to treat toenail fungus. Your podiatrist will also debride your thickened or brittle toenails on a regular basis to ensure your fungal infection is under control and your overall foot health is maintained.

Prevent the fungus from returning by practicing good podiatric hygiene. Wash your feet regularly with a mild soap, taking care to scrub between toes, and dry them completely once you have rinsed off all the soap.

For more information about treating fungal foot infections, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Fawaz Nesheiwat

By Barry Mullen
August 21, 2014
Category: Pain

 

Have you noticed your toes bending, particularly at the first joint? The bending takes on an upside-down V appearance when looked at from the side. This deformity commonly affects the second through fifth toes, or the lesser digits. There are two different types of hammertoes: flexible hammertoes and rigid hammertoes.

Flexible hammertoes can be diagnosed and treated while in the developmental stage, making this condition less severe. As the name implies, flexible hammertoes are moveable at the joint level. Rigid hammertoes, on the other hand, is a more severe condition since it can be seen in patients with aggressive arthritis or in patients who seek treatment after their condition has progressed. When the tendons in a rigid hammertoe stiffen, and the joint becomes deviated and fixed, surgery is indicated.

Typically, patients with hammertoes experience pain when pressure from footwear is applied at the top of the bent toe. This can result in the development of corns on the top of the joint.

Hammertoe is acquired due to disproportional balance of the muscles in the toes. This causes increased pressure on the tendons and joints of the toe, leading to its contracture. Genetic predisposition, trauma, wearing ill-fitting shoes for long periods of time, and/or arthritis can lead to hammertoe.

Conservative treatments include wearing a hammertoe pad or cushion around the bony prominence of the hammertoe, wearing shoes with a deep toe box, avoiding high heels, and avoiding wearing shoes that are too tight or narrow. If these treatment options do not relieve your pain, please visit a podiatrist.

Your podiatrist can identify the relative stage of your hammertoe. Identifying the deformity early in its progression is important to avoid surgery. Your podiatrist will evaluate and X-ray the affected area in order to create a treatment regimen particularly for your condition.

In case of acute pain and inflammation caused by joint deformity, anti-inflammatory drugs and cortisone injections can be prescribed by your podiatrist.

A non-surgical method commonly used in controlling foot function is custom shoe inserts. This may alleviate symptoms and prevent the exacerbation of the hammertoe deformity. 

If surgery is indicated, your podiatrist can determine which procedures would most be appropriate for your hammertoe deformity.

With that said, if you experience pain and discomfort with your hammertoes, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Barry Mullen

 

By Kyle Alessi
May 13, 2014
Category: Pain

 

Ever wake up abruptly at night by a hot, painful feeling in your big toe or ankle? Does the joint feel painful and appear red and inflamed? These can all be signs of a gout attack. Gout is a form of inflammatory arthritis. Be sure to seek treatment upon onset, otherwise it can lead to painful foot deformity and even kidney problems. Early treatment with medication and a proper diet can relieve the joint pain. In severe cases of foot deformity, surgery may be a required.

Gout is a disorder of uric acid metabolism, leading to increased uric acid (waste product) in the blood. The excess uric acid forms hard crystals in the joints, inducing a gout attack. Perpetual gout attacks lead to large deposits of chalky crystals called tophi.

Men are more predisposed to gout than women, but women are more likely to get affected after menopause. The chances of getting gout are increased if you are overweight and have high cholesterol, drink too much alcohol, and/or eat too much meat and fish that are high in chemicals called purines. Some medications, such as diuretics (“water pills”) can also induce gout.

Your podiatrist will ask you questions about your symptoms. He or she will ask about your diet, medications, and how much alcohol you consume. This will be followed by a physical examination of your feet for signs of gout, which include inflammation, heat, and redness.

He or she may then perform a joint fluid test by using a needle to draw fluid from your affected joint. This fluid will be analyzed for crystals. Your podiatrist may also take a blood sample to measure the uric acid level in your blood.

Treatment for gout usually requires medication. To relieve the pain and swelling associated with gout, your podiatrist may prescribe a non-steroidal anti-inflammatory (NSAID) to stop an acute attack, followed by a lower daily dose to prevent future attacks. Also, your podiatrist can give you a pill or injection form of corticosteroids to help with the gout symptoms. If complications occur, you can also be prescribed xanthine oxidase inhibitors (which limit the amount of uric acid your body produces) at the discretion of your podiatrist. Based on your past and current medical history, he or she will decide which medications would be best suited for you.

With that said, if you experience pain and discomfort with your gout, be sure to schedule an appointment to further seek professional care from one of our doctors at Foot Care Associates in Hackettstown, New Jersey.

 

By Kyle Alessi





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