If you need a more accessible version of this website, click this button on the right.Switch to Accessible Site

Douglas Pacaccio, DPM
Thomas Nordquist, DPM

Featured

Featured

Monday, 10 May 2021 00:00

Although rheumatoid arthritis attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA, such as a rheumatoid factor test. There is, however, no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Monday, 03 May 2021 00:00

Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.

Monday, 26 April 2021 00:00

Although walking shoes and running shoes look similar, they have characteristics that make them different from each other. Runners should avoid running in walking shoes and vice versa. It is very important that you wear the proper footwear for the activity you are going to partake in, for you to avoid injury.

If you are looking to buy a new pair of running shoes, there are certain things you should look out for. One of the main components that makes up a good running shoe is flexibility. You should be able to bend and flex the forefoot of the shoe that you are purchasing. If you can bend the entire shoe in half with ease, this is a sign that the shoe does not have enough structure for your feet. Another feature you should look for is a low heel. Certain running shoes have a low heel to support runners who land on the ball of their feet. Lastly, you should look for the fit of the running shoe. You should visit the best running shoe store in your area to have your feet properly sized for the shoes in the store. Usually, the staff will be able to help recommend the best type of running shoe for your needs.

When you are walking, the body’s weight is evenly distributed on the foot. This influences the design of shoes made for walking. If you are looking to buy a pair of walking shoes, there are different features you should look for to determine which pair of shoes is best for you. Walking shoes should be flexible through the ball of the foot to allow for a greater range of motion through the roll of the forefoot. These shoes also should have greater arch support for the foot. If you plan on walking long distances or on hard surfaces, it is best that you wear shoes that have cushioning.

When trying on a new pair of shoes, the heel should fit snugly without slip. You should shop for shoes after a long walk, since your feet tend to swell throughout the day. Many people have one foot that is a different size than the other, so it is best that you have both feet measured when looking for your true size. You should also beware that sizes vary depending on the shoe brand. A certain size in one brand may be a different size in a different brand. Lastly, you should always walk around in shoes that you plan on buying. This will help you determine whether the shoes are comfortable and if they fit well on your feet.

Always look for good shoe construction when shopping for new sneakers. The upper part of the shoe should allow for adjustment through laces or straps. If you need help with shoe sizing or if you need custom orthotics for your feet, you should make an appointment with your podiatrist for assistance. He or she will be more than happy to help you with your shoe sizing needs.  

Monday, 19 April 2021 00:00

Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection.  The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives.  Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth. 

Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering.  Sometimes, blisters can evolve into the cracks or breaks in the skin.  The exposed tissue can then create pain, swelling, and discharge.  The spread of infection can cause itching and burning as well.

While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet.  Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched.  Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.

Proper foot hygiene is essential in preventing athlete’s foot.  You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected.  Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.

While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks.  Any treatment used can be supplemented by frequently bathing the feet and drying the toes.  If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist.  He will determine if the underlying cause of your condition is truly a fungus.  If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.

Monday, 12 April 2021 00:00

Orthotics are shoe inserts that are meant to correct an irregular walking gait or provide cushioning to the feet.  Orthotics come in a variety of different models and sizes, including over-the-counter and customizable variants. Customizable orthotics can be shaped and contoured to fit inside a specific shoe and are typically prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

Orthotics are beneficial because they can help prevent injuries from occurring and provide cushioning to keep pain levels down to a minimum. They also allow for the correct positioning of the feet. Orthotics can act as shock absorbers to help remove pressure from the foot and ankle. Therefore, orthotics can make bodily movements, such as walking and running, become more comfortable as well as help prevent the development of certain foot conditions.

Orthotics alleviate pain and make the foot more comfortable by slightly altering the angle at which the foot strikes the ground surface, therefore controlling the movement of the foot and ankle. Orthotics come in different variants and can be made of various materials. To determine what type of orthotic is most suited to your feet and your needs, it is best to consult your podiatrist. He or she will be able to recommend a type of orthotic that can help improve your foot function or prescribe a custom orthotic to best fit your feet.  

Monday, 05 April 2021 00:00

Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough.  The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.

Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.

Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.

Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.

If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.

Monday, 29 March 2021 00:00

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.

Monday, 22 March 2021 00:00

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Monday, 15 March 2021 00:00

A corn is a lesion that forms in the skin of the foot, and it is typically circular in shape, small in size, and thick and rough in texture.  A corn generally occurs as a result of repeated pressure on the skin; one example of this is the rubbing of a shoe against the skin.  Corns differ from calluses in that their central cores are harder in texture.

A corn is a relatively common condition with a wide variety of treatment options.  If a corn becomes overly uncomfortable or painful, consult with your podiatrist; he can determine the best method of treatment that is appropriate for you.  Corns may return if the underlying cause of its development is not treated or removed.  Avoid removing corns at home, as improper removal may cause infection.

A callus, similar to a corn, is an area of skin that has become thickened due to repeated pressure and rubbing.  The rubbing causes the skin to create a layer of protective skin, which is the formed callus.  Calluses can differ in size between people, and they can also become painful.

Multiple treatments are available for calluses.  At-home treatment and removal should be avoided, as this can potentially lead to infection.  Your podiatrist can best determine the cause of your calluses and suggest the treatment most appropriate for you. 

Monday, 08 March 2021 00:00

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

 

Page 12 of 21
Connect with us