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Achilles Tendonitis

Often caused by excessive use, or training without properly warming up, Achilles tendonitis affects the tendon that connects the calf muscles to the heel bone. It usually presents as swelling and pain in the back of the heel, pain will be worse when going up and down steps, climbing an incline or hill. Treatments begin with immobilization in a walking boot or heel lift, physical therapy, rest, and anti-inflammatories, , or even surgery in some cases which is unusual.

Athlete’s foot

Athlete’s foot is a fungal infection on the foot, usually between the toes. Itching and burning is often accompanied by a scaly rash, and is contagious. This is often treated with topical non-prescription and prescription antifungal creams, and sometimes oral antifungals.

Bone Spurs

A bone spurs (in the foot) form as a response to pressure, rubbing, or inflammation over a long period of time. The body is trying to repair itself. They can become a problem when there is pain, tenderness, or corns and calluses start to develop. Bone spurs can be identified with x-rays, ultrasounds, MRI and CT scans.

One of the most common bone spurs people hear about are heels spurs sometimes associated with plantar fasciitis. Plantar fasciitis is a condition that causes pain in the bottom of the heel usually hurts when you get out of bed or transition from a non-weight bearing position to a weight bearing position, ie, sitting then standing or sleeping and getting up. What is happening is the plantar fascia is pulling or tearing from its insertion into the heel bone. If the condition goes on for a long time a spur starts to develop. Usually the bigger the spur the longer the person has been suffering from the condition. There are a lot of treatments to get this pain to stop 90% of the time without surgery.

Another place you see spurs develop in the foot is in the big toe joint. If the joint doesn’t work properly the cartilage starts to wear out and you end up with bone rubbing bone. Bone rubbing bone leads to spurs whether it is in the big toe joint, hip, knee, shoulder. In the foot the spurs make the big toe very stiff and won’t go up which is necessary for a normal gait. The spurs cause the toe to jam up when you walk leading to pain. Stiff soled shoes is a good place to start. We even have thin steel shanks that fit in your shoes to stop the big toe from jamming. If it’s really bad there are other options, but the take home is the pain can be stopped.

Spurs commonly develop in the back of the foot at the insertion point of the achilles tendon into the heel bone. The spurs are a result of a long history of achilles tendonitis which causes calcium deposits to develop inside the achilles tendon. The easiest solution it high heels or an elevated heel. There are other treatments including things like physical therapy, immobilization and surgery is sometimes indicated, (not very often).

Bunions

A bunion, also called hallux valgus, is a bony prominence or bump that forms on the inside of the big toe joint. They usually develop slowly over time, and can be caused by wearing ill-fitting shoes, heredity, trauma, or other conditions, such as rheumatoid arthritis. Bunions are a problem when they are painful, red, inflamed, when they lead to difficulty walking or standing. Sometimes bunions can be relieved by changing footwear such as wider shoes, or wearing pads or spacers; sometimes surgery is recommended when conservative treatment fails to resolve symptoms.

Diabetic Neuropathy

Diabetic Neuropathy (neu·rop·a·thy): Nerve damage can happen when blood sugar levels stay high for too long, and most often affects the longest nerves in your body, the legs and feet, sometimes the hands. For diabetics, the best solution is prevention by properly managing blood sugar levels, exercising, avoiding smoking and excessive alcohol. If you are experiencing numbness, burning, pain and cramps in the legs and feet, weakness, increased sensitivity to touch, or an overall loss of sensation in your feet, you may be experiencing the most common type of diabetic neuropathy: peripheral neuropathy. There are several different types of medications that can help, topical creams, prescription oral medicines to treat peripheral neuropathy, as well as various therapies ie, a TENS unit, and alternative medicine. Often the same treatment does not work for every patient. It’s best to start with a topical and work your way up until the symptom resolve or you can handle them. My rule of thumb is if the symptoms don’t keep you awake at night don’t take oral medicine.

Diabetic Ulcer

Diabetic ulcers are the leading cause of amputations in diabetics and should be taken very seriously! A diabetic ulcer is an open sore or wound, usually on the bottom of the foot. Diabetic ulcers ~75 % or the tiime are caused by a callus which is just thick skin buildup just like if you swung an ax all day you would get calluses on your hands. What happens to people with diabetes is the skin gets too thick causing the little skin cells at the bottom of the callus to breakdown which allows bleeding into the area. This would show up as a black spot in the callus. It’s actually blood. Then if untreated the bleeding continues and eventually the callus separates from the sore and it starts to drain on you sock or in your bed. When the callus finally falls off you are stuck with the sore which is now called a diabetic ulcer. They can be caused by other reasons, and are often accompanied by poorly controlled blood sugar, poor circulation, or peripheral neuropathy, a loss of feeling in the feet. If they get infected symptoms may include redness, unusual swelling, a strong odor, or black tissue. Sometimes there are no symptoms other than a neglected, thickened callus. If any ulcer is suspected, seek podiatric medical attention promptly!

Fallen Arch

Also known as pes planus, or flat feet, fallen arches can often be genetic or caused by nervous system diseases, rheumatoid arthritis, or several other conditions that usually make prevention impossible. Other factors include weak arches, trauma, aging, obesity, diabetes, and pregnancy. When there is no pain and no symptoms, no treatment is necessary. In the case of arch pain and swelling, or restricted foot movement, like standing on tip-toes, different treatment is available. Dr. Henson often treats fallen arches with a durable orthotic, cortisone injections, shoe modifications, and braces, depending on the severity. Surgery is usually a last resort.

Fractures or sprains

Fractures, or broken bones, may occur from trauma, or when some force against the bone is stronger than the bone itself. There are several types of fractures , but stress fractures may be caused by repetitive and bones in the feet are at higher risk for this due to absorbing so much force during walking, running, and jumping. Women are nearly twice as likely as men to develop a stress fracture, and adolescents going through a growth spurt are also at greater risk.

Adolescents frequently present with pain in the back of the heel after physical activity. Usually children 10-15, present complaining of pain in the back of the heel after football, soccer or some other athletic activity. The easiest fix is a heel lift if it’s not too bad. If it’s bad it has to be immobilized in a cast or cast boot. It usually resolves in 4-6 weeks.

Gout,

RED, HOT, SWOLLEN AND IT HURTS TO LOOK AT IT!

Gout is a condition characterized by RED, HOT, SWOLLEN AND IT HURTS TO LOOK AT IT. It frequently affects the big toe joint but can affect any joint in the foot. It is a form of arthritis that occurs when there are high levels of uric acid in the blood that accumulate sharp crystals in and around the joint, (it’s complicated, come in if you think you have it and I’ll explain it), . High uric acid levels can be affected by heredity, diet, certain medical conditions, and recent surgery or trauma. Gout is commonly diagnosed by a blood test, joint fluid test, or ultrasound. There are medications available to treat and prevent gout attacks, as well as diet recommendations.

Hammertoes and corns

A hammertoe is a deformity of the little toes, an abnormal bending, crunching, or curling, that slightly resembles a hammer? It can happen because of a weak muscle in the toe, injury, shoes that are too tight, aging, or a heredity. They may become sore from rubbing on shoes, or on other toes. Occasionally, a corn, or a patch of thickened skin, will form on the top of the toe joint, ouch. The treatments start with padding, deeper toebox shoes and periodically trimming the corn or thickened skin. If everything else fails there are surgery options from releasing a little tendon to slightly more invasive surgery to straighten the toes.

Heel pain

Heel pain can be caused by a number of factors, but the most common cause is Plantar Fasciitis. This is the inflammation of the plantar fascia, a band of tissue that connects the heel bone to the toes. It is often characterized by heel pain that is worse with the first few steps in the morning, or after resting, and can also present as swelling under the heel and pain in the arch. There are numerous non-surgical treatments such as wearing supportive shoes, icing, stretching, limiting activity, and taking anti-inflammatories. If pain continues or worsens, Dr. Henson has been known to strap with kinesiology tape, provide a rigid orthotic, provide a night splint, give cortisone injections and even discuss surgical options in some cases, unusual.

Ingrown toenails

An ingrown toenail is a common condition that occurs when part of the toenail grows into the skin. Most often in the big toe, ingrown toenails present with pain, redness, swelling, and sometimes infection. Some of the causes include sports injuries, ill-fitting shoes, cutting the toenails too short, or even dropping a heavy object on the toe. Some ingrown toenails can be managed at home, but when they persist, Dr. Henson can numb the area and remove the nail or the border of the nail. In some cases, he applies a chemical that destroys the cells that produce the nail, and the nail, or section of nail will not regrow. So no ingrown nail again in that border, yeh!

Plantar warts

A plantar wart is a small, rough growth on the bottom of the foot, often with a visible tiny black dot on the surface. They are caused by a virus that enters though a cut or weak spot in the foot. Walking barefoot in public places can put someone more at risk, or if a person already has a weakened immune system, or a history of getting plantar warts. There are home remedies and over-the-counter products that are sometimes effective, but if those do not work, a podiatrist, Dr Henson has tons of different ways to get rid of them.

My favorite in young children is a pill taken in divided doses throughout the day that dries up the wart by using the body to attack the wart. Takes about a month, but no pain for young people.

There are other good options for older people. No surgery is usually required.

Preulcerative callus

Calluses are layers of thickened skin that protect the body by keeping the bones from pushing through the skin. If however, a callus get too thick it begins to cause the skin underneath the callus to breakdown leading to bleeding under the callus. The bleeding will continue if unchecked and will eventually separate the callus which will fall off and the sore that has been developing. In a person with diabetes this is now called a diabetic ulcer. Patients that are more prone to develop calluses due to high pressure areas or a bony prominence. When a callus is noticed the person should seek routine callus trims with a podiatrist. Don’t let a callus threaten you feet.

Skin and nail care

Dr. Henson trims toenails routinely. The amount of time between trims can depend on the patient most people get there nails trimmed every 8-16 weeks depending on how fast they grow. Sometimes toenails can develop a fungus that causes the nails to become brittle, thick, and discolored. This condition appears to be only cosmetic and not painful. Dr. Henson is able to trim very thick nails, prescribe oral therapy, and dispense several different topical products in our office that are very affective.