Optima Foot and Ankle

Foot Conditions

There are many foot ailments that can slow you down. We have listed a few below that are very common and can be corrected at Optima Foot & Ankle.

Arthritis in the Big Toe Joint (Hallux Limitus)

Arthritis in the big to joint can be degenerative arthritis or "wear and tear" arthritis, known as osteoarthritis. The clinical and x-ray findings include a limited joint range of motion and associated degeneration of joint cartilage. This is called hallux limitus or hallux rigidus. Signs include redness or swelling at the great toe joint and pain with bending motions, walking, or running.

 

The causes of hallux limitus include trauma to the joint, biomechanical abnormalities of the foot, infection, autoimmune disorders and shoe gear. Symptoms of hallux limitus include pain within the big toe joint, swelling, and stiffness which can increase with walking or activity. Treatment for this includes orthotics to limit motion, injections into the joint, and surgery. Surgery is aimed at decreasing the bony prominence or removing the joint motion. 

Bunions

Bunions are a common foot deformity. A bunion is an enlargement of the bone and tissue around the joint of the big toe. As the deformity gets worse, the big toe starts to move towards the second toe, resulting in malalignment of the joint. Bunions are often caused by faulty mechanics of the foot. People with flat feet or low arches are more prone to develop bunions. Bunions may also be associated with various forms of arthritis.  

 

The deformity may make it difficult to walk in shoes. High heeled or poorly fitting shoes can aggravate the problem. The lesser toes can be affected by the bunion. Painful calluses may develop around the big toe joint. If left untreated, bunions tend to get larger and usually more painful. Treatment includes padding, changing shoes, custom orthotics, anti-inflammatory medication, cortisone injections, and surgery.

Foot and Ankle Injuries

Injury to the foot and ankle is common. Early treatment should be sought including x-rays to look for fractures or dislocations. Until you can see your Podiatrist, you can start the following treatment: rest and restrict activity, ice wrapped in a towel for 20 minutes at a time, compression using an Ace bandage lightly wrapped around the area, and elevation to reduce swelling. For bleeding cuts, clean the area well and apply pressure with a towel and apply a clean dressing. Seek treatment immediately from the emergency room or your Podiatrist as soon as possible.

 

Prevent injury by using the correct shoe gear for the activity you are doing. Hiking boots should be worn in uneven terrain. Sturdy athletic shoes should be worn for walking, sporting events, and exercise.  Discontinue use of a shoe that is unevenly worn or worn out. Don't walk barefoot outside. Use hard top shoes for operating lawn equipment or machinery.

Bunionette (Tailor's Bunion)

A bony enlargement on the outside of the foot can be a Tailors bunion or Bunionette. Swelling, pain at this joint, and redness are findings associated with this condition. Numbness or tingling can occur and a small bursa, or inflammatory sac, can form. It may be difficult to wear narrow shoes. Pain can occur with walking or activity.

 

Treatment for tailors bunions varies and can include anti-inflammatory mediation, orthotics, steroid injections, wider shoes, and surgery. X-rays are taken to determine the extent of the deformity and used for surgical planning. Talk to your Podiatrist for treatment options for this problem. 

Callus and Corns

A corn or callus is a build up of dead skin cells due to friction or pressure. This can be due to an enlargement of bone or a bone spur, which presses the skin against the shoe. The outer layer of skin thickens to protect the foot from increased pressure. Corns and calluses may affect how your foot looks but but are not always harmful. Severe corns and calluses can become infected or affect the way your foot moves. 

 

The most common treatment is debridement or painless shaving of the skin lesion in the office. This is very effective and provides pain relief. This can be done every few months if the corn or callus develops again. Non-medicated pads are also very helpful to help prevent recurrence of the lesions and to decrease pain. Changing shoe, arch supports, and custom orthotics can relieve excessive pressure on the bottom of the foot. Surgery is an option to reduce the pressure due to the bone deformity. 

Diabetic Foot Infection

Diabetes and its complications, including infections and vascular disease, are the most common cause of amputations in the United States. The classic signs and symptoms of an infection include a red, hot, swollen toe including a foul odor and fluid drainage from the toe. Patients experiencing these symptoms should immediately contact your Physician and/or Podiatrist. Any delay in treatment of an infection can lead to serious complications such as the infection spreading to the bone. Treatment for bone infection includes long term antibiotics and/or resection of the infected bone. 

 

Prevention is the key for diabetic patients. Daily foot inspections, proper shoes, control of blood sugars, regular visits to your health care provider, exercise, and diet are part of the process of prevention. While inspecting the foot, look for changes in the skin of the foot including cracks, red streaks, sores, drainage, or swelling. Any changes should be checked by your Podiatrist. 

Diabetic Foot Ulcers

A foot ulcer is a breakdown of tissue due to increased pressure. This can involve many layers of skin and to level of the bone in very serious cases. An ulcer can allow infection to reach the bloodstream or bone.  Ulcerations can on the anywhere on the foot. The increased pressure can develop from pressure from shoes on a bony prominence or spur.  Decreased circulation to an area can make ulcerations more prevalent. Impaired blood supply to the legs will increase the risk of ulcer formation. 

 

Diabetes can decrease the normal feeling in the feet and result in an ulceration without pain. It is extremely important for patients with diabetes to look at their feet daily and to look for open areas or drainage. Diabetic patients and other patients without normal feeling in their feet should have a yearly foot exam by a Podiatrist and may need to return for continued care. This will decrease the risk of severe complications such as infection, gangrene and amputation.  

Peripheral Neuropathy

Peripheral neuropathy is a disease that damages the nerves in the feet and hands which prevents them from working properly. It is associated with diabetes, trauma or nerve damage, nerve entrapment, vitamin deficiencies, medications, and other diseases. The pain is burning and radiating and the numbness can be compared to the feeling of wearing a thin stocking or glove. Extreme sensitivity, muscle weakness, and lack of coordination can occur. 

 

With peripheral neuropathy, it is important to inspect the feet daily. Diabetic patients and other patients without normal feeling in their feet should have a yearly foot exam by a Podiatrist and may need to return for continued care. This will decrease the risk of severe complications such as infection, gangrene and amputation. 

Ganglion Cyst

A ganglion cyst is a noncancerous fluid filled lump that occurs along a tendon or joint. The cyst is filled with a gelatinous type of fluid. Often, ganglion cysts do not cause pain and do not require treatment. The cyst can enlarge and press on nerves or tendons that are near it and begin to cause pain. Treatment includes draining the contents of the cyst, padding, steroid injection, or surgical excision to remove the cyst. X-rays and MRIs may be performed on the foot in order to rule out any bone involvement and the size of the soft tissue mass. 

 

Any mass or growth on the foot should be examined and carefully monitored by your Podiatrist or health care provider. Changes in the mass or growth should be checked. 

Hammer Toes

A hammer toe deformity refers to an abnormal position of the toe, where one or more small toes buckle or bend-under, out of their normal position. Contracture of the toe occurs causing the toe to bend out of normal position. Hammer toes are due to muscle imbalance, tight tendons, shoe gear, some forms of arthritis, or can be hereditary. 

 

Skin irritation or callus may form on top of these prominent, contracted joints where shoes can rub. Hammer toes can be flexible or rigid. X-rays are often taken to view the position of the bones, bone spurs, and the presence of arthritis. Treatment options include padding and strapping, debridement of corns or calluses, shoe gear changes, injections, orthotics, and surgical management to reduce the deformity and straighten the toe. 

Gout

Gout is a form of arthritis with pain, swelling, redness, warmth, and stiffness in the affected joints. The attacks are sudden. It can recur and cause joint damage. It is caused by uric acid crystals accumulating in the joint. Gout can flare up from food high in purines, such as meat and seafood, alcohol, certain medications, and being overweight.  It usually affects the big toe joint, foot, ankle, or knee. The attack can last a few days to several weeks.

 

Diagnosis includes history and physical as well as lab testing. Treatment includes prevention of future attacks using medication, reducing symptoms of the attack with anti-inflammatory medication, and changing diet and lowering alcohol consumption.

Neuroma

A neuroma is a nerve enlargement that occurs most commonly between the third and fourth toes. The nerve is irritated and enlarges causing sharp pain, cramping and burning. The symptoms may move towards the tips of the affected toes. Neuromas are caused by high heeled shoes, trauma, inflammatory conditions such as arthritis, and repetitive stress during activity. Tight shoes can make this worse. The condition is often related to the structure of the foot. 

 

Treatment for neuromas includes injection therapy, padding and strapping, orthotics, physical therapy, and surgery to remove the neuroma. If conservative methods fail to relieve the pain, surgical intervention may be indicated. The procedure is an out-patient procedure and you can walk on the foot immediately after the surgery. 

Plantar Fasciitis

The plantar fascia is a thick tissue band connecting the heel bone to the forefoot. The plantar fascia is a shock absorber and forms the longitudinal arch of the foot. This band can become inflamed, irritated, and painful which can make walking painful. This is one of the most common complaints relating to the foot. Risk factors include high and low arches, weight gain, standing for long periods of time, change in activity, and tight Achilles tendon.

 

The pain is localized to the heel and arch. Treatment includes stretching, physical therapy, decreased weight bearing activity, anti-inflammatory medication, steroid injections, night splints, orthotics and arch supports, and surgery if the pain continues. 

Shoes

Shoe selection should take into consideration activity, foot structure, comfort, and style. When looking for a pair of shoes, consider the fit, the shape of the shoe, the materials, and the tread and cushion. For certain activities, the weight of the shoe is a factor. For structural deformities, custom fit shoes may be required. 

 

Purchase shoes at the end of the day or after your activity. Measure both feet and buy shoes for the larger foot. Make sure the shoes are comfortable to walk in around the store. The shoe should fit and feel comfortable at the time of purchase.

Toenail Fungus (Onychomycosis)

Discoloration and thickening of the nails is most commonly caused by a fungus. Nail fungus can be caused by athlete's foot, micro-trauma to the nail plate, damage to the cuticle, and immune system impairment, including diabetes. It can cause ingrown toenails and infections. If you are suffering from toenail fungus and interested in treatment for this problem, schedule an appointment. Existing treatment options include oral and topical medication, as well as debridement of the nails. Toe nail fungus can now be treated with a painless, touchless, cool laser technology called Lunula Laser®. This NEW treatment has been very effective in generating healthy, clear nails. Optima Foot and Ankle is the only podiatry practice in all of Oregon to offer this safe toenail fungus laser treatment, which stimulates new nail growth with no downtime or risk.

 

Nail fungus can originate from any affected surface. Use caution in common areas such as the gym, pool, or a nail salon. Wear sandals in shared shower or pool areas. Wash your feet daily. Consider a medically sterile foot spa for your pedicures to prevent contracting a nail fungus from a nail salon.

Warts (Verruca Plantaris)

Warts are growths on the surface of the skin caused by the human papilloma virus. Warts are contagious and can be spread from one person to another and to other parts on the affected person. The wart can be painful and irritating. If not properly or completely removed, warts can recur. Treatment options include debridement, topical acids and chemicals, cryotherapy to freeze the wart, laser excision, and surgically excising the wart. 

 

Warts can be difficult to treat. Use caution with over the counter treatments. These can cause open sores and pain and should only be used for limited amounts of time. Wear sandals or shoes in common areas such as the gym, pool, or shared showers. 

Ankle Pain

Ankle pain can come from many sources. Fractures, ligament sprains and tears, tendinitis, arthritis, gout, infection, and nerve entrapment can all occur in the ankle region. X-rays are taken of the ankle to rule out fractures or bone lesions. 

 

Ankle sprains are the most common ankle injury. A twisting or turning motion can cause an ankle sprain.  Swelling and bruising are common with this injury. Once the ankle is sprained, it can take weeks to months to heal. Often, the injured ankle remains weaker. Treatment for ankle sprains includes ice, elevation, bracing, crutches, and physical therapy. At times, the ligaments need to be surgically repaired. 

Ankle Arthroscopy

Ankle arthroscopy involves the use of a fiber-optic camera and small surgical instruments though two or three small incisions to completely evaluate the inside of the ankle joint. Any debris in the ankle joint can be removed through this technique.

 

Ankle arthroscopy is used for ankle pain caused by conditions such as sprains and arthritis. It is a relatively safe procedure with low complication rates. Tissue bands, cartilage damage, arthritis, ligament tears, bone spurs, and tendinitis can all be resolved with this minimally invasive procedure. The recovery from surgery is quicker, less painful, and allows faster return to activity than surgery done through a larger incision.

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