June 2020

Bunions are large bony bumps at the base of the big toe. Medically known as hallux valgus, a bunion is a misalignment of the metatarsophalangeal joint, or big toe joint. The misalignment will generally worsen with time if left untreated.

The exact cause of bunions is unknown, with genetics seen as a potential cause. High heels and poorly-fitted footwear, rheumatoid arthritis, and heredity all seem to be potential factors behind the exacerbation of bunions. Women have been found to be more likely to develop bunions in comparison to men.

Bunions do not always produce symptoms. The best way to tell is if the big toe is pushing up against the next toe and there is a large protrusion at the base of the big toe. You may or may not feel pain. Redness, swelling, and restricted movement of the big toe may be present as well.

Podiatrists use a variety of methods to diagnose bunions. If there are symptoms present, podiatrists will first consider that it is a bunion. If not, a physical examination will be conducted to check function of the big toe. Finally, an X-ray may be taken to view the extent of the bunion and confirm it is a bunion.

Typically, nonsurgical methods are used to treat bunions, unless the bunion has become too misaligned. Orthotics, icing and resting the foot, roomier and better fitted shoes, taping the foot, and pain medication are usually utilized first. If the bunion doesn’t go away or causes extreme pain, surgery may be required. Surgeons will either remove part of the swollen tissue or bone to straighten the toe out.

If you have a bunion, it is recommended to see a podiatrist. The longer it is left untreated, the worse it may get. Podiatrists can properly diagnose and treat a bunion before it gets worse.

People are constantly wearing improperly-fitting shoes. Though it isn’t hard, picking the right shoes does require keeping a few things in mind.

Shoe stores have rulers so you can get an exact measurement of your feet. Be sure to always measure your feet with your shoes on. Measuring just your foot will give you a shoe size that is 1-2 inches too small for picking the right size shoe.

To ensure that your toes won’t be cramped, make sure there is wiggle room. Approximately one inch should be between your toes and the tip of your shoe. It is easy to tell if your shoes are too tight, because you will start to experience pain, blisters, and swelling.

Additionally, do not always assume your shoe size will be the same at every store. Manufacturers sometimes run differently, and your size will vary from brand to brand. Make sure the stores you purchase from have return policies, in case there is a problem.

Rather than shoe shopping in the morning, it is advised to shop for shoes later in the day. Your feet will swell as the day passes. If shoes are purchased in the morning, they may not be as snug as they should be. Furthermore, not all two feet are the same size. Therefore, accommodations may be necessary.

An overall concern in buying shoes is making sure they are comfortable and supportive. There is no such thing as a shoe being ‘broken in’. If they are uncomfortable at the store, they likely will always be uncomfortable.

Since we do a lot of walking, it is important that we pick the right shoes. Our feet will benefit from this, and we will be happier and healthier because of it.

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

A neuroma is a thickening of nerve tissue and can develop throughout the body.  In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes.  The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.

Neuromas can be caused by anything that causes compression or irritation of the nerve.  A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes.  Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas.  Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.

Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up.  Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot.  An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.

Treatment for Morton’s neuroma can vary between patients and the severity of the condition.  For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed.  Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition.  The severity of your condition will determine the procedure performed and the length of recovery afterwards.

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.