Monday-Friday 9:00AM - 5:00pm

Closed Saturday & Sunday

847-885-9525

info@northwestsurgicalspecialists.com

3100 W.Higgins Rd., Suite 150

Hoffman Estates, IL 60619

On Site Accredited
Surgical Facility
Achilles Tendon Injuries
Ankle Arthritis
Ankle Injuries & Fractures
Ankle Sprains
Athlete's foot
Bunions
Custom Orthotics
Dermatology
Diabetic Footcare
Diabetic Neuropathy & Wounds
Diagnostic Ultrasound, X-Ray
Flat Feet (orthotics treatment)
Foot Bone Spurs
Foot Deformations
Foot Tendon Injury
Fungal Infections
Hammertoe
Heel injuries and Achilles Heel Injury
Heel pain (non-surgical options)
Heel Spur & Heel Bone Spur
High Arches
Ingrown Toenails
Nail Disorder
Neuroma
Pediatrics Foot Care
Plantar Fasciitis
Plantar Wart
Shoes for Diabetic Patients
Sport & Industrial Traumas
Toe Nail Fungus
ACHILLES TENDON INJURIES
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DESCRIPTION

Archilles Tendinopathy is a chronic, yet common condition in sports people and recreational athletes. In the past treatment options have been limited due to a poor understanding of its cause; however recent research has revealed valuable information that has provided further treatment options. Until recently Achilles Tendinopathy was referred to as Achilles Tendinitis. However, research has found that this type of injury does not involve inflammation and is most likely due to a series of microtears (tendinosis) that weaken the tendon.

SYMPTOMS

The most obvious one is pain above your heel, especially when you stretch your ankle or stand on your toes. It may be mild and might get better or worse over time. If the tendon ruptures, the pain is instant and severe. The area may also feel tender, swollen and stiff. If your Achilles tendon tears, you may hear a snapping or popping noise when it happens. You could have bruising and swelling too. You may have trouble pointing your toes if the tendon tears completely.

TREATMENT

Minor to moderate Achilles tendon injuries should heal on their own. You just need to give them time. To speed the healing you can.

  • Rest your leg. Avoid putting weight on your legs as best as you can. You may need crutches
  • Ice it. Ice your injury for 20 to 30 minutes every 3 to 4 hours to reduce pain and swelling. Continue this for 2 or 3 days, or until the pain is gone.
  • Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling.
  • Raise (elevate) your leg. Prop your leg up on pillow when you're sitting or lying down.
  • Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen will help the pain and swelling. Follow the instructions on the label to help prevent side effects, such as bleeding and ulcers. Take them with food. Check with your doctor first if you have any allergies, medical problems or take any other medication. If you need them longer than 7 to 10 days, call your doctor.
  • Use a heel lift. Your doctor may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching.
  • Practice Stretching and strengthening excercises. As recommended by your doctor,physical therapist, or other health care provider.

Source: http://sma.org.au/resources-advice/injury-fact-sheets/achilles-tendon-injuries/

ANKLE ARTHRITIS
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DESCRIPTION

The major types of arthritis that affect the foot and ankle are osteorathritis, rheumathoid arthritis, and posttraumatic arthritis.

Ostheoarthritis

Osteoarthritis, also known as degenerative or "wear-and-tear" arthritis, is a common problem for many people after they reach middle age, but it may occur in younger people, too. In osteoarthritis, the cartilage in the joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful osteophytes (bone spurs).

Rheumatoid Arthritis

(Top) Osteoarthritis that has progressed to bone rubbing on bone and bone spurs. (Bottom) Swollen, inflamed synovium and joint deformity are signs of rheumatoid arthritis. Reproduced from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003. Rheumatoid arthritis is a chronic disease that can affect multiple joints throughout the body, and often starts in the foot and ankle. It is symmetrical, meaning that it usually affects the same joint on both sides of the body.

Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In rheumatoid arthritis, immune cells attack the synovium covering the joint, causing it to swell. Over time, the synovium invades and damages the bone and cartilage, as well as ligaments and tendons, and may cause serious joint deformity and disability.

The exact cause of rheumatoid arthritis is not known. Although it is not an inherited disease, researchers believe that some people have genes that make them more susceptible. There is usually a "trigger," such as an infection or environmental factor, which activates the genes. When the body is exposed to this trigger, the immune system begins to produce substances that attack the joints.

Posttraumatic Arthritis

Posttraumatic arthritis can develop after an injury to the foot or ankle. Dislocations and fractures — particularly those that damage the joint surface — are the most common injuries that lead to posttraumatic arthritis. Like osteoarthritis, posttraumatic arthritis causes the cartilage between the joints to wear away. It can develop many years after the initial injury.

An injured joint is about seven times more likely than an uninjured joint to become arthritic, even if the injury is properly treated. In fact, following an injury, your body may actually secrete hormones that stimulate the death of your cartilage cells.

SYMPTOMS

The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:

  • Pain with motion
  • Joint swelling, warmth and redness
  • Pain that flares up with vigorous activity
  • Increased pain and swelling in the morning, or after sitting or resting
  • Tenderness when pressured is applied to the joint
  • Difficulty in walking due to any of the above symptoms
TREATMENT

Nonsurgical Treatment

Initial treatment of arthritis of the foot and ankle is usually nonsurgical. Your doctor may recommend a range of treatment options.

Lifestyle modifications. Some changes in your daily life can help relieve the pain of arthritis and slow the progression of the disease. These changes include:

  • Minimizing activities that aggravate the condition.
  • Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) to lessen the stress on your foot and ankle.
  • Losing weight to reduce stress on the joints, resulting in less pain and increased function.

Physical therapy

Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your foot and ankle. Your doctor or a physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.

Although physical therapy often helps relieve stress on the arthritic joints, in some cases it may intensify joint pain. This occurs when movement creates increasing friction between the arthritic joints. If your joint pain is aggravated by physical therapy, your doctor will stop this form of treatment.

A custom-molded leather brace can be effective in minimizing the pain and discomfort from ankle and hindfoot arthritis.

Assistive devices. Using a cane or wearing a brace — such as an ankle-foot orthosis (AFO) — may help improve mobility. In addition, wearing shoe inserts (orthotics) or custom-made shoes with stiff soles and rocker bottoms can help minimize pressure on the foot and decrease pain. In addition, if deformity is present, a shoe insert may tilt the foot of ankle back straight, creating less pain in the joint.

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00209

ANKLE INJURIES & FRACTURES
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DESCRIPTION

Ankle injuries are among the most common of the bone and joint injuries. Often, the degree of pain, the inability to walk, or concern that a bone may be broken is what might cause you to seek care in an emergency situation.

For the most part, your concern is the same as the doctor's: Is there a broken bone? It is often impossible to diagnose a fracture (broken bone) rather than a sprain, a dislocation, or tendon injury without X-rays of the ankle.

  • The ankle joint is made up of 3 bones coming together.
    • The tibia, which is the main bone of the lower leg, makes up the medial, or inside, anklebone.
    • The fibula is a smaller bone that parallels the tibia in the lower leg and makes up the lateral, or outside, anklebone.
    • The far ends of both the tibia and fibula are known as the malleoli (singular is malleolus).
  • Together they form an arch that sits on top of the talus, one of the bones in the foot.
  • These 3 bones (tibia, fibula, and talus) make up the bony elements of the ankle joint.
  • A fibrous membrane called the joint capsule, lined with a smoother layer called the synovium, encases the joint architecture. The joint capsule contains the synovial fluid produced by the synovium. The synovial fluid allows for smooth movement of the joint surfaces.
  • The ankle joint is stabilized by several ligaments, which are fibers that hold these bones in place.
SYMPTOMS

Signs and symptoms of ankle injuries and fractures tend to be obvious.

  • Pain is the most common complaint.
    • Often the pain will not come from the exact area of the fracture.
    • You may experience associated fractures of your foot (especially on the side of the small toe) or knee that also cause pain.
    • It is usually pain in the ankle that stops you from walking.
  • Swelling frequently occurs around the ankle too.
    • Swelling suggests either soft tissue damage with possible blood around the joint or fluid within the joint itself, most likely blood.
    • When blood is in the joint, it is called hemarthrosis.
  • You may see bruising ("black and blue") about the joint, although not immediately. This bruising can track down toward the sole of your foot or toward the toes.
  • In severe fractures you may see obvious deformities of bones around the ankle.
    • Your skin may be stretched over an underlying broken bone.
    • You may see actual exposed bone.
  • If you injure nerves or blood vessels that supply your foot, you may experience even more pain along with pale skin in the foot, numbness, or inability to move your foot or toes.
TREATMENT

Medical Treatment

The type of fracture and the stability of your joint will determine the type of splint or cast that will be used and how long it will need to be in place.

  • If your bones are not aligned properly, the doctor may realign them before placing the splint or cast.
    • If the bones cannot be realigned properly in the emergency department, then you may require an operation.
    • An operation will also be needed if any bone has broken through the skin. If the bone breaks through the skin, the fracture is then called a compound fracture. This is more serious than a simple fracture.
  • With any injured ankle, you should not bear weight until your doctor says it is OK to do so.
  • After the swelling decreases and you are reexamined, then an orthopedic doctor or your primary care doctor may place a better-fitting cast or splint on the ankle. Depending on the type of fracture, you may be placed in a walking cast, which can bear some weight, or you may still need a non-weight-bearing cast that will require the use of crutches to help you walk.
  • Depending on the degree of pain you are experiencing, your doctor may give you prescription-strength pain medication. These should be used only as needed. You should not drive or operate heavy machinery while using these medications.

Source: http://www.webmd.com/fitness-exercise/ankle-fracture#1

ANKLE SPRAINS
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DESCRIPTION

An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the lateral or outside part of the ankle. This is an extremely common injury which affects many people during a wide variety of activities. It can happen in the setting of an ankle fracture (i.e. when the bones of the ankle also break). Most commonly, however, it occurs in isolation.

SYMPTOMS

Patients report pain after having twisted an ankle. This usually occurs due to an inversion injury, which means the foot rolls underneath the ankle or leg. It commonly occurs during sports. Patients will complain of pain on the outside of their ankle and various degrees of swelling and bleeding under the skin (i.e. bruising). Technically, this bruising is referred to as ecchymosis. Depending on the severity of the sprain, a person may or may not be able to put weight on the foot.

TREATMENT

Surgery is not required in the vast majority of ankle sprains. Even in severe sprains, these ligaments will heal without surgery. The grade of the sprain will dictate treatment. Sprains are traditionally classified into several grades. Perhaps more important, however, is the patient's ability to bear weight. Those that can bear weight even after the injury are likely to return very quickly to play. Those who cannot walk may need to be immobilized.

In general, treatment in the first 48 to 72 hours consists of resting the ankle, icing 20 minutes every two to three hours, compressing with an ACE wrap, and elevating, which means positioning the leg and ankle so that the toes are above the level of patient's nose. Those patients who cannot bear weight are better treated in a removable walking boot until they can comfortably bear weight.

Physical therapy is a mainstay. Patients should learn to strengthen the muscles around the ankle, particularly the peroneals. An ankle brace can be used in an athlete until a therapist believes that the ankle is strong enough to return to play without it. Surgery is rarely indicated but may be needed in a patient who has cartilage damage or other related injuries. Ligaments are only repaired or strengthened in cases of chronic instability in which the ligaments have healed but not in a strong fashion.

Source: http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Ankle-Sprain-.aspx

ATHLETE'S FOOT
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DESCRIPTION

Athlete's foot - also called tinea pedis - is a contagious fungal infection that affects the skin on the feet and can spread to the toenails and sometimes the hands. The fungal infection is called athlete's foot because it's commonly seen in athletes.

Athlete's foot isn't serious, but sometimes it's hard to cure. However, if you have diabetes or a weakened immune system and suspect that you have athlete's foot, you should call your doctor immediately.

SYMPTOMS

There are many possible symptoms of athlete's foot. You may experience one or more of the following symptoms:

  • itching, stinging, and burning between the toes
  • itching, stinging, and burning on the soles of the feet
  • blisters on the feet that itch
  • cracking and peeling skin on the feet, most commonly between the toes and on the soles
  • dry skin on the soles or sides of the feet
  • raw skin on the feet
  • discolored, thick, and crumbly toenails
  • toenails that pull away from the nail bed
TREATMENT

Athlete's foot can often be treated with over-the-counter (OTC) topical antifungal medications. If OTC medications don't successfully treat the fungal infection, your doctor may prescribe topical or oral prescription-strength antifungal medications. Your doctor may also recommend home treatments to help clear up the infection.

OTC Medications

There are many OTC topical antifungal medications, including:

  • miconazole (Desenex)
  • terbinafine (Lamisil A T)
  • clotrimazole (Lotrimin AF)
  • butenafine (Lotrimin Ultra)
  • tolnaftate (Tinactin)

Prescription Medications

Some of the prescription medications your doctor may prescribe for athlete's foot include:

  • topical, prescription-strength clotrimazole or miconazole
  • oral antifungal medications such as itraconazole (Sporanox), fluconazole (Diflucan), or prescription-strength terbinafine (Lamisil)
  • topical steroid medications to reduce painful inflammation
  • oral antibiotics if bacterial infections develop due to raw skin and blisters

Home Care

Your doctor may recommend that you soak your feet in salt water or diluted vinegar to help dry up blisters. Alternative Therapy

Tea tree oil (Melaleuca alternifolia) has been used as an alternative therapy for treating athlete's foot with some success. A scientific study published in the August 2002 issue of the Australian Journal of

Dermatology reported that a 50 percent solution of tea tree oil effectively treated athlete's foot in 64 percent of trial participants.

Ask your doctor if a tea tree oil solution can help your athlete's foot. Tea tree oil can cause skin dermatitis in some people.

Source: http://www.healthline.com/health/athletes-foot

BUNIONS
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DESCRIPTION

A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus.

Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.

Anyone can get a bunion, but they are more common in women. Many women wear tight, narrow shoes that squeeze the toes together-which makes it more likely for a bunion to develop, worsen and cause painful symptoms.

In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe.

SYMPTOMS

In addition to the visible bump on the inside of the foot, symptoms of a bunion may include:

  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • A callus or corn on the bump
  • Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
TREATMENT

In most cases, bunions are treated without surgery. Although nonsurgical treatment cannot actually "reverse" a bunion, it can help reduce pain and keep the bunion from worsening.

Changes in Footwear

In the vast majority of cases, bunion pain can be managed successfully by switching to shoes that fit properly and do not compress the toes. Some shoes can be modified by using a stretcher to stretch out the areas that put pressure on your toes. Your doctor can give you information about proper shoe fit and the type of shoes that would be best for you. (See below section on "Tips for Proper Shoe Fit")

Padding

Protective "bunion-shield" pads can help cushion the painful area over the bunion. Pads can be purchased at a drugstore or pharmacy. Be sure to test the pads for a short time period first; the size of the pad may increase the pressure on the bump. This could worsen your pain rather than reduce it.

Orthotics and Other Devices

To take pressure off your bunion, your doctor may recommend that you wear over-the-counter or custom-made shoe inserts (orthotics). Toe spacers can be placed between your toes. In some cases, a splint worn at night that places your big toe in a straighter position may help relieve pain.

Icing

Applying ice several times a day for 20 minutes at a time can help reduce swelling. Do not apply ice directly on your skin.

Medications

Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help relieve pain and reduce swelling. Other medications can be prescribed to help pain and swelling in patients whose bunions are caused by arthritis.

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00155

CUSTOM ORTHOTICS
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DESCRIPTION

Custom orthotics are specially-made devices designed to support and comfort your feet. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet, ankles, and legs, so the orthotic can accommodate your unique foot structure and pathology.

SYMPTOMS

If you have serious pain or discomfort, however, schedule an appointment with a podiatrist. He or she will assess your overall health and look for any other contributing factors. Today's podiatrists are specially trained to evaluate the biomechanics of the lower extremity.

Your podiatrist will examine your feet and how you walk. He or she will listen carefully to your complaints and concerns and assess the movement and function of your lower extremities. Some also use advanced technology to see how your feet function when walking or running.

The information gathered during the exam will help your podiatrist determine if shoe inserts might be helpful or if you need prescription orthotics. If orthotics are needed, your podiatrist will capture a three-dimensional image of each foot. Those images, as well as any measurements obtained by your podiatrist, are used to create a set of unique foot supports that will improve your foot movement and lead to more comfort and mobility. Your podiatrist might also suggest additional treatments to improve the comfort and function of your feet.

TREATMENT

Prescription orthotics are divided into two categories:

  • Functional orthotics are designed to control abnormal motion. They may be used to treat foot pain caused by abnormal motion; they can also be used to treat injuries such as shin splints or tendinitis. Functional orthotics are usually crafted of a semi-rigid material such as plastic or graphite.
  • Accommodative orthotics are softer and meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, painful calluses on the bottom of the foot, and other uncomfortable conditions.

Podiatrists use orthotics to treat foot problems such as plantar fasciitis, bursitis, tendinitis, diabetic foot ulcers, and foot, ankle, and heel pain. Clinical research studies have shown that podiatrist-prescribed foot orthotics decrease foot pain and improve function.

Source: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=988

DERMATOLOGY
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DESCRIPTION

When we think of a podiatrist, we tend to think of a doctor that treats broken ankles, hang nails, neuroma and performs foot surgery. But did you know, podiatrists can also treat several dermatology issues related to your feet?

Common issues treated include: Dermatitis, Athlete's Foot, Melanomas, Warts and Venous Stasis Dermatitis.

Dermatitis

What is it? Dermatitis is a very common condition resulting in inflammation of the skin.

Causes/Symptoms: Dermatitis can occur when you have contact with a substance that causes an allergic reaction, such as, lotions, adhesives, nickel, poison ivy and even medications.

Treatment: Treatment includes a prescription for topical steroids or moisturizers. Your doctor will also want to determine the cause for your allergic reaction and eliminate exposure.

Athlete's Foot (tinea pedis)

What is it? Athlete's Foot is a fungal infection that usually occurs between the toes but can also affect other areas of the foot.

Causes/Symptoms: Fungus thrives in warm, damp environments, which are commonly found inside your shoe, around pools and showers. Symptoms include: dry skin, peeling skin, itching, burning, swelling and blisters.

Treatment: Treatment includes a prescription for an anti-fungal, as well as, encouragement to keep your feet dry, and to wear proper footwear around pools and in public places like showers.

Melanomas of the Foot

What is it? “Melanoma is a cancer that begins in the cells of the skin that produce pigmentation (coloration).” It can occur on your skin, but also be present in your finger nail or toe nail bed.

Causes/Symptoms: Most cases are caused by too much exposure to ultraviolet rays from the sun or tanning beds, but can also come from exposure to radiation.

Signs to look for on your skin- ABCDs of melanoma:

Asymmetry- one half of the spot is different in shape than the other half.

Border- border is irregular. The edge/ border is typically ragged, notched or blurred

Color- Mix of colors or hues are present. It is not uniform in color.

Diameter- Melanoma grows, whereas moles will remain small. A spot larger than a pencil eraser is cause for concern.

Signs to look for on your nail bed: A pigmented band, the length of your nail, that does not grow out with your nail. Overtime it can become wider, the color can change throughout the band, development of a nodule can occur, or may even cause the nail to crack.

Treatment: Treatment begins with examining area of concern and then taking a biopsy. If biopsy determines the area to be cancerous, your podiatrist will recommend the best course of treatment.

Warts

What is it? Warts are a viral infection caused by the humanpapiloma virus (HPV). They are often mistaken as corns or calluses. They occur when HPV enters the skin through a small cut or abrasion. Children and teenagers are more susceptible to getting warts, than adults.

Causes/Symptoms: Warts are spread by touching, scratching or contact with skin shed from another wart. If left untreated, wart clusters can form. Warts look like small rough growths on your skin.

Treatment: If self-care approaches have not helped, your podiatrist can provide you with a few options: prescription strength salicylic acid, Cryotherapy, minor surgery or laser treatment.

Venous Stasis Dermatitis

What is it? Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles and legs. “The pigmentation from the red blood cells stains the skin from the inside, and a reddish-brown discoloration develops on the skin, which is called Venous Stasis Dermatitis (VSD).”

Causes/Symptoms: Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles and legs. “The pigmentation from the red blood cells stains the skin from the inside, and a reddish- brown discoloration develops on the skin, which is called Venous Stasis Dermatitis (VSD).”

Early symptoms of VSD include:

  • heaviness or aching when you stand or walk for extended periods of time. -swelling at the ankle at the end of the day.
  • varicose veins
  • skin is itchy, dry, red or sore

Symptoms as VSD progresses include:

  • swelling beyond the ankle
  • dry cracked skin
  • red to violet colored open sores
  • shiny skin

Treatment: Types of treatment include:

  • compression socks
  • mechanical compression to help move fluid away from the leg -corticosteroid creams
  • vein surgery to repair damaged veins (such as placement of a stint)

Source: http://www.healthline.com/health/athletes-foot

DIABETIC FOOT CARE
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DESCRIPTION

While there is no cure for diabetes, there is hope. With proper diet, exercise, medical care, and careful management at home, a person with diabetes can avoid the most serious complications and enjoy a full and active life. Today's podiatrist plays a key role in helping patients manage diabetes successfully and avoid foot- related complications.

SYMPTOMS

Diabetes warning signs involving the feet and ankles include the following:

  • Skin color changes
  • Swelling of the foot or ankle
  • Numbness in the feet or toes
  • Pain in the legs
  • Open sores on the feet that are slow to heal
  • Ingrown and fungal toenails
  • Bleeding corns and calluses
  • Dry cracks in the skin, especially around the heel
TREATMENT

Because diabetes is a disease affecting many parts of the body, successful management requires a team approach. Today's podiatrist is an integral part of the treatment team and has documented success in preventing amputations:

  • More than 65,000 lower limbs are amputated annually due to complications from diabetes.
  • After an amputation, the chance of another amputation within three to five years is as high as 50 percent.
  • Including a podiatrist in your diabetes care can reduce the risk of lower limb amputation up to 85 percent and lowers the risk of hospitalization by 24 percent.

The keys to amputation prevention are early recognition and regular foot screenings performed by a podiatrist, the foot and ankle expert.

Source: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=980

DIABETIC NEUROPATHY & WOUNDS
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DESCRIPTION

According to the National Institutes of Health, this condition involves damage or disease that inhibits function of the nerves. It develops due to damage to the peripheral nervous system, the system of communication within the body that transmits information from every part of the body to the brain and spinal cord. It's what tells the central and, in nervous system that you're experiencing pain and other sensations. It can also inhibit muscle movement severe cases, cause debilitating pain. The symptoms of this condition generally include:

  • A numbness or tingling of the feet or hands that gradually worsens and may spread to the legs and arms Heightened sensitivity to touch
  • Sharp pain or a sensation of burning
  • Muscle weakness or paralysis
  • Lack of coordination that can lead to falls and potentially injury

In severe cases, neuropathy can cause damage of the autonomic nerves. This may lead to more intense symptoms, such as digestive issues, heat intolerance, excessive sweating and sudden changes in blood pressure that cause lightheadedness or dizziness.

SYMPTOMS

As the NIH reported, peripheral neuropathy affects an estimated 20 million Americans. It's particularly common among the elderly population. It also occurs in high rates in people with diabetes, and diabetic neuropathy is one of the most common forms of this disorder.

In those with this metabolic condition, nerve damage tends to lead to a loss of sensation in the feet, and the numbness rises to the legs and sometimes the hands and arms. The lack of sensation is a major problem that has led to a high rate of amputations - when a diabetic experiences a wound on the lower extremities, he or she may have trouble feeling it. This can lead to delayed wound careand untreated infection that, if it turns gangrenous, may need to be amputated to stop the spread.

TREATMENT

There is no cure for peripheral neuropathy, and the treatment options are nominal at best. Detecting the condition early is key to finding relief from the pain and increasing sensation in the limbs, which could potentially reduce the risk of amputation. In the past, clinicians have largely relied on patients' reports of numbness and pain to diagnose peripheral neuropathy; however, researchers have recently come across a new method for detecting his form of nerve damage.

A study published in the January 2015 issue of Diabetes Care revealed that a specific eye scan - corneal confocal microscopy - predicts peripheral neuropathy among people with Type 1 diabetes. The scan involves a high-magnification examination of the unmyelinated nerve fibers with a laser-scanning microscope. The microscope creates an image of the corneal subbasal nerve plexus, allowing a view of the corneal-nerve fiber. When this fiber shows reduced length coupled with reduced corneal sensitivity, it signifies that the patient may have peripheral neuropathy.

This advancement may lead to patient awareness of the condition, leading him or her to take special care of the feet to look out for cuts and abrasions as well as signs of wound infection.

Source: https://www.advancedtissue.com/peripheral-neuropathy-effects-diabetics-wound-healing/

DIAGNOSTIC ULTRASOUND, X-RAY
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DESCRIPTION

Musculoskeletal ultrasonography is a very powerful diagnostic tool for the diagnosis of wide array of foot and ankle problems. Your physician may order an ultrasound or perform the ultrasound in their office to help diagnose your foot problem. Ultrasound is used typically for soft tissue problem, not bone conditions. Some of the foot disorders that ultrasound is used for are the following:

  • Foreign bodies
  • Morton's neuroma
  • Soft tissue masses
  • Bursitis or capsulitis of the joints
  • Ligament injuries
  • Tendonitis or tendon tears
  • Heel spurs or plantar fasciitis
  • Tarsal tunnel syndrome
  • Ultrasound guided injection or aspirations

What is Ultrasound? Most people know about ultrasound to image a baby or a gallbladder, but it has growing application in musculoskeletal disorders. Ultrasound is based on sound waves. Sound waves are emitted from a transducer probe that is applied to the body and these sound waves will past into the body and then are reflected back to the transducer probe to be recorded. The recorded image is based on the density of the object that the sound waves encounter. An object with a high density appears white or brighter on the recorded image, while objects of low density will appear black or dark on the image. Intermediate densities will appear gray. The sound waves are recorded back to the machine, which will produce the image. This image will appear on the computer screen and is recorded permanently either by a hard copy film or video tape (if available) or both. A radiologist or your doctor will read these images and write a report on their findings.

Ultrasound is completely safe and painless. It also has no contraindications. There is no problem in having the examination if you are pregnant, have a pacemaker, or other medical conditions that may prevent you from having a MRI or CT scan. Ultrasound also does not produce any radiation as with a CT scan or x-rays.

In preparing for the examination, you can eat and take your normal medications. The examination will take from 45 minutes to an hour based on the area being scanned. It is advised that you bath the day of the examination but avoid the use of any skin lotions or emollients. Also you should where loose fitting clothing or shorts to make it easier to perform the examination. Your physician will discuss the results with you. If you have any further questions regarding why this test was ordered for you, please ask your physician.

Source: http://www.podiatrynetwork.com/document_disorders.cfm?id=221

FLAT FEET (ORTHOTICS TREATMENT)
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DESCRIPTION

You have flatfeet when the arches on the inside of your feet are flattened, allowing the entire soles of your feet to touch the floor when you stand up.

A common and usually painless condition, flatfeet can occur when the arches don't develop during childhood. In other cases, flatfeet develop after an injury or from the simple wear-and-tear stresses of age.

Flatfeet can sometimes contribute to problems in your ankles and knees because the condition can alter the alignment of your legs. If you aren't having pain, no treatment is usually necessary for flatfeet.

SYMPTOMS

Most people have no signs or symptoms associated with flatfeet. But some people with flatfeet experience foot pain, particularly in the heel or arch area. Pain may worsen with activity. Swelling along the inside of the ankle can also occur.

When to see a doctor

Talk to your doctor if you or your child has foot pain.

TREATMENT

No treatment is necessary for flatfeet if they don't cause pain.

Therapy

If your flatfeet are painful, your doctor might suggest:

  • Arch supports (orthotic devices). Over-the-counter arch supports may help relieve the pain caused by flatfeet. Or your doctor might suggest custom-designed arch supports, which are molded to the contours of your feet. Arch supports won't cure flatfeet, but they often reduce symptoms.
  • Stretching exercises. Some people with flatfeet also have a shortened Achilles tendon. Exercises to stretch this tendon may help.
  • Supportive shoes. A structurally supportive shoe might be more comfortable than sandals or shoes with minimal support.
  • Physical therapy. Flatfeet may contribute to overuse injuries in some runners. A physical therapist can do a video analysis of how you run to help you improve your form and technique.

Source: http://www.mayoclinic.org/diseases-conditions/flatfeet/basics/definition/CON-20023429?p=1

FOOT BONE SPURS
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DESCRIPTION

A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as "heel spur syndrome."

Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot.

SYMPTOMS

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain -- especially while walking, jogging, or running -- if inflammationdevelops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.

Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning -- a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

TREATMENT

Non-Surgical Treatments for Heel Spurs

The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night's sleep, the pain may feel worse as the plantar fascia suddenly elongates, which stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking.

If you have heel pain that persists for more than one month, consult a health care provider. He or she may recommend conservative treatments such as:

  • Stretching exercises
  • Shoe recommendations
  • Taping or strapping to rest stressed muscles and tendons
  • Shoe inserts or orthotic devices
  • Physical therapy

Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid may be done to relieve inflammation in the area.

Source: http://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments#1

FOOT DEFORMATIONS
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DESCRIPTION

Pediatric foot deformity is a term that includes a range of conditions that may affect the bones, tendons, and muscles of the foot. Among those most frequently treated at HSS are cavus foot, tarsal coalition, clubfoot, accessory navicular, and juvenile bunion.

TREATMENT

Treatment of foot deformities in children can vary significantly from that needed in adults. Fortunately, pediatric orthopedists who specialize in this field can bring to bear a range of non-operative and operative techniques specifically developed to address the distinctive needs of children, which include special attention to preserving the integrity of the growth plate, allowing continued growth and development of the foot.

FOOT TENDON INJURY
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DESCRIPTION

Tendons are the tough fibers that connect muscle to bone. For example, the Achilles tendon camera.gif connects the calf muscle to the heel bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Doctors may use different terms to describe a tendon injury. You may hear:

  • Tendinitis. This means "inflammation of the tendon."
  • Tendinosis. This refers to tiny tears in the tissue in and around the tendon caused by overuse.
SYMPTOMS

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

  • The pain may get worse when you use the tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be a lot like those caused by bursitis.

TREATMENT

Initial treatment for a tendon injury (tendinopathy) typically includes rest and pain relievers. Acetaminophen can reduce pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce both the pain and inflammation you might have from a tendon injury. The goals of this early treatment are to:

  • Reduce pain and inflammation of the tendon.
  • Restore normal motion and strength.

If you are still having pain, stiffness, and weakness after initial treatment, your doctor may recommend some type of physical therapy. Also, you may need to make long-term changes in the type of activities you do or how you do them to prevent your tendinopathy from returning. The goals of ongoing treatment are to:

  • Reduce pain.
  • Avoid further degeneration or tearing of the tendon.
  • Encourage regeneration of the damaged tendon.

Source: https://www.hss.edu/conditions_pediatric-foot-deformities-overview.asp

FUNGAL INFECTIONS
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DESCRIPTION

Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair your ability to work or even walk. The resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

SYMPTOMS

Toenail fungus is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

TREATMENT

Treatments may vary, depending on the nature and severity of the infection. Your podiatrist can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Your podiatrist may also prescribe a topical treatment, which can be an effective treatment modality for fungal nails.

In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.

Trying to solve the infection without the qualified help of a podiatrist can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

Source: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1523

HAMMERTOE
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DESCRIPTION

A hammer toe is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot. It most often affects the second or third toe. Although a hammer toe may be present at birth, it usually develops over time due to wearing ill-fitting shoes, such as tight, pointed heels, or arthritis. In most cases, a hammer toe condition is treatable.

SYMPTOMS

A hammer toe causes you discomfort when you walk. It can also cause you pain when you try to stretch or move the affected toe or those around it. Hammer toe symptoms may be mild or severe.

Mild Symptoms

  • a toe that bends downward
  • corns or calluses
  • difficulty walking
  • inability to flex your foot or wiggle your toes
  • claw-like toes

Severe Symptoms

See your doctor or podiatrist right away if you develop any of these symptoms.

TREATMENT

You can correct a hammer toe caused by inappropriate footwear by wearing properly fitting shoes. If a high arch caused the condition, wearing toe pads or insoles in your shoes can help. These pads work by shifting your toe's position, which relieves pain and corrects the appearance of your toe.

You can usually use over-the-counter (OTC) cushions, pads, or medications to treat bunions and corns. However, if they're painful or if they cause your toes to become deformed, your doctor may opt to surgically remove them.

Don't pop any blisters on your toes. Popping blisters can cause pain and infection. Use OTC creams and cushions to relieve pain and keep blisters from rubbing against the inside of your shoes.

Gently stretching your toes can also help relieve pain and reposition the affected toe.

Source: http://www.healthline.com/health/hammer-toe

HEEL INJURIES AND ACHILLES HEEL INJURY
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DESCRIPTION

Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.

Noninsertional Achilles Tendinitis

In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.

Tendinitis of the middle portion of the tendon more commonly affects younger, active people.

Insertional Achilles Tendinitis

Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.

In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.

Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.

SYMPTOMS

Common symptoms of Achilles tendinitis include:

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Bone spur (insertional tendinitis)
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden "pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.

TREATMENT

Nonsurgical Treatment

In most cases, nonsurgical treatment options will provide pain relief, although it may take a few months for symptoms to completely subside. Even with early treatment, the pain may last longer than 3 months. If you have had pain for several months before seeking treatment, it may take 6 months before treatment methods take effect.

Rest. The first step in reducing pain is to decrease or even stop the activities that make the pain worse. If you regularly do high-impact exercises (such as running), switching to low-impact activities will put less stress on the Achilles tendon. Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you stay active.

Ice. Placing ice on the most painful area of the Achilles tendon is helpful and can be done as needed throughout the day. This can be done for up to 20 minutes and should be stopped earlier if the skin becomes numb. A foam cup filled with water and then frozen creates a simple, reusable ice pack. After the water has frozen in the cup, tear off the rim of the cup. Then rub the ice on the Achilles tendon. With repeated use, a groove that fits the Achilles tendon will appear, creating a "custom-fit" ice pack.

Non-steroidal anti-inflammatory medication. Drugs such as ibuprofen and naproxen reduce pain and swelling. They do not, however, reduce the thickening of the degenerated tendon. Using the medication for more than 1 month should be reviewed with your primary care doctor.

Exercise. The following exercise can help to strengthen the calf muscles and reduce stress on the Achilles tendon.

  • Calf stretch
  • Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch. Physical Therapy. Physical therapy is very helpful in treating Achilles tendinitis. It has proven to work better for noninsertional tendinitis than for insertional tendinitis. Eccentric Strengthening Protocol. Eccentric strengthening is defined as contracting (tightening) a muscle while it is getting longer. Eccentric strengthening exercises can cause damage to the Achilles tendon if they are not done correctly. At first, they should be performed under the supervision of a physical therapist. Once mastered with a therapist, the exercises can then be done at home. These exercises may cause some discomfort, however, it should not be unbearable.
  • Bilateral heel drop
  • Stand at the edge of a stair, or a raised platform that is stable, with just the front half of your foot on the stair. This position will allow your heel to move up and down without hitting the stair. Care must be taken to ensure that you are balanced correctly to prevent falling and injury. Be sure to hold onto a railing to help you balance.
  • Lift your heels off the ground then slowly lower your heels to the lowest point possible. Repeat this step 20 times. This exercise should be done in a slow, controlled fashion. Rapid movement can create the risk of damage to the tendon. As the pain improves, you can increase the difficulty level of the exercise by holding a small weight in each hand.
  • Single leg heel drop
  • This exercise is performed similarly to the bilateral heel drop, except that all your weight is focused on one leg. This should be done only after the bilateral heel drop has been mastered.

Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles tendon are rarely recommended because they can cause the tendon to rupture (tear).

Supportive shoes and orthotics. Pain from insertional Achilles tendinitis is often helped by certain shoes, as well as orthotic devices. For example, shoes that are softer at the back of the heel can reduce irritation of the tendon. In addition, heel lifts can take some strain off the tendon.

Heel lifts are also very helpful for patients with insertional tendinitis because they can move the heel away from the back of the shoe, where rubbing can occur. They also take some strain off the tendon. Like a heel lift, a silicone Achilles sleeve can reduce irritation from the back of a shoe.

If your pain is severe, your doctor may recommend a walking boot for a short time. This gives the tendon a chance to rest before any therapy is begun. Extended use of a boot is discouraged, though, because it can weaken your calf muscle.

Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged tendon tissue. ESWT has not shown consistent results and, therefore, is not commonly performed.

ESWT is noninvasive-it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00147

HEEL PAIN (NON-SURGICAL OPTIONS)
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DESCRIPTION

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain.

SYMPTOMS

The symptoms of plantar fasciitis are:

  • Pain on the bottom of the heel
  • Pain in the arch of the foot
  • Pain that is usually worse upon arising
  • Pain that increases over a period of months
  • Swelling on the bottom of the heel

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.

TREATMENT

Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:

  • Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
  • Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
  • Ice. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
  • Limit activities. Cut down on extended physical activities to give your heel a rest.
  • Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
  • Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

Source: https://www.foothealthfacts.org/conditions/heel-pain-(plantar-fasciitis)

HEEL SPUR & HEEL BONE SPUR
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DESCRIPTION

Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping.

SYMPTOMS

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain -- especially while walking, jogging, or running -- if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.

Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning -- a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

TREATMENT

The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night's sleep, the pain may feel worse as the plantar fascia suddenly elongates, which stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking.

If you have heel pain that persists for more than one month, consult a health care provider. He or she may recommend conservative treatments such as:

  • Stretching exercises
  • Shoe recommendations
  • Taping or strapping to rest stressed muscles and tendons
  • Shoe inserts or orthotic devices
  • Physical therapy

Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid may be done to relieve inflammation in the area.

Source: http://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments#1

HIGH ARCHES
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DESCRIPTION

Babies and toddlers appear to have flat feet when they are standing because their feet have fat pads. A slight arch may appear when the child sits or stands on tiptoes. Children are born this way; doctors refer to it as flexible flat foot. Usually it's painless and doesn't interfere with a child's ability to walk or play sports. Most children outgrow it eventually as their feet get larger, their baby fat disappears and their foot muscles strengthen with weightbearing activity such as walking.

SYMPTOMS

Although painless in young children, flat feet in older children and adolescents can cause an aching pain. Sometimes the pain only occurs during or after sports or other physical activity. Sometimes the child complains that his foot, ankle or leg is tired or that he has aching pain at night. If the Achilles tendon (at the back of the ankle) is involved, it may become red and painful. Sometimes there are calluses under the sagging arches.

Call an orthopaedic foot and ankle specialist if your child complains of foot pain, the ankle is red, the feet or ankles feel tired, or calluses are forming under the arches. Be sure to take your child's shoes along to your appointment so the specialist can examine the pattern of wear. Adolescents who still have flat feet and complain of pain should also be evaluated.

TREATMENT

Treatment may include stretching exercises to lengthen the heel cord. Your doctor may also recommend shoe inserts called orthotics. These custom-molded arches made of composite materials provide support and relieve pain. Shoe inserts not only help people with flat foot to walk comfortably, they also extend the life of their shoes, which otherwise would wear unevenly. In certain cases, physical therapy is recommended, and sometimes children are put in casts if the heel cords are too tight. In a few cases where other treatments don't relieve pain, surgery is recommended.

Source: http://www.aofas.org/footcaremd/conditions/ailments-of-the-midfoot/Pages/Flat-Feet-High-Arches.aspx

INGROWN TOENAILS
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DESCRIPTION

Ingrown toenails are a common condition in which the corner or side of a toenail grows into the soft flesh. The result is pain, redness, swelling and, sometimes, an infection. Ingrown toenails usually affect your big toe.

Often you can take care of ingrown toenails on your own. If the pain is severe or spreading, your doctor can take steps to relieve your discomfort and help you avoid complications of ingrown toenails.

If you have diabetes or another condition that causes poor blood flow to your feet, you're at greater risk of complications of ingrown toenails.

SYMPTOMS

Ingrown toenail symptoms include:

  • Pain and tenderness in your toe along one or both sides of the nail
  • Redness around your toenail
  • Swelling of your toe around the nail
  • Infection of the tissue around your toenail

When to see a doctor

See your doctor if you:

  • Experience severe discomfort in your toe or pus or redness that seems to be spreading
  • Have diabetes or another condition that causes poor blood flow to your feet and you experience any foot soreness or infection
TREATMENT

If home remedies haven't helped your ingrown toenail, your doctor may recommend:

  • Lifting the nail. For a slightly ingrown nail (redness and pain but no pus), your doctor may carefully lift the ingrowing nail edge and place cotton, dental floss or a splint under it. This separates the nail from the overlying skin and helps the nail grow above the skin edge. At home, you'll need to soak the toe and replace the material daily.
  • Partially removing the nail. For a more severe ingrown toenail (redness, pain and pus), your doctor may trim or remove the ingrown portion of the nail. Before this procedure, your doctor may temporarily numb your toe by injecting it with an anesthetic.
  • Removing the nail and tissue. If you have the problem repeatedly on the same toe, your doctor may suggest removing a portion of the nail along with the underlying tissue (nail bed). This procedure may prevent that part of your nail from growing back. Your doctor will use a chemical, a laser or other methods.

Your doctor may also recommend using topical or oral antibiotics, especially if the toe is infected or at risk of becoming infected.

Source: http://www.mayoclinic.org/diseases-conditions/ingrown-toenails/diagnosis-treatment/treatment/txc-20273059

NAIL DISORDER
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DESCRIPTION

Your toenails and fingernails protect the tissues of your toes and fingers. They are made up of layers of a hardened protein called keratin, which is also in your hair and skin. The health of your nails can be a clue to your overall health. Healthy nails are usually smooth and consistent in color. Specific types of nail discoloration and changes in growth rate can be signs of lung, heart, kidney, and liver diseases, as well as diabetes and anemia. White spots and vertical ridges are harmless.

Nail problems that sometimes require treatment include

  • Bacterial and fungal infections
  • Ingrown nails
  • Tumors
  • Warts

Keeping your nails clean, dry, and trimmed can help you avoid some problems. Do not remove the cuticle, which can cause infection.

Source: https://medlineplus.gov/naildiseases.html

NEUROMA
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DESCRIPTION

A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.

The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.

SYMPTOMS

The symptoms of a neuroma include the following:

  • Pain in the forefoot and between the toes
  • Tingling and numbness in the ball of the foot
  • Swelling between the toes
  • Pain in the ball of the foot when weight is placed on it
TREATMENT

What can you do for relief?

  • Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.
  • Wear shoes with thick, shock-absorbent soles, as well as proper insoles that are designed to keep excessive pressure off of the foot.
  • High-heeled shoes over two inches tall should be avoided whenever possible because they place undue strain on the forefoot.
  • Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.
  • Use over-the-counter shoe pads. These pads can relieve pressure around the affected area.

When to Visit a Podiatrist

Podiatric medical care should be sought at the first sign of pain or discomfort. If left untreated, neuromas tend to get worse.

Diagnosis and Treatment

Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction.

For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, additional treatment or surgery may be necessary to remove the tumor.

The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatric physician will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case.

Padding and Taping: Special padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma.

Medication: Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma.

Orthotics: Custom shoe inserts made by your podiatrist may be useful in controlling foot function. Orthotics may reduce symptoms and prevent the worsening of the condition.

Surgical Options: When early treatments fail and the neuroma progresses past the threshold for such options, podiatric surgery may become necessary. The procedure, which removes the inflamed and enlarged nerve, can usually be conducted on an outpatient basis, with a recovery time that is often just a few weeks. Your podiatric physician will thoroughly describe the surgical procedures to be used and the results you can expect. Any pain following surgery is easily managed with medications prescribed by your podiatrist.

Source: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=987

PEDIATRICS FOOT CARE
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DESCRIPTION

Some parents (and even some pediatric specialists) believe children will outgrow a foot problem, and though this may happen, you should not take a chance with your child. If you suspect a pediatric foot problem, have us or a competent podiatrist check your child's feet.

Common Pediatric Children's Foot Problems

Pediatric foot problems are referred to by podiatrists as podopediatrics. Foot problems in your child may appear at birth, shortly thereafter, or once your child is walking. Walking abnormally is often the first sign that something is wrong with your child's foot or their feet.

Adolescents and teenage children may develop foot or ankle problems and these should not be ignored. It is important to watch for any foot deformities or limping in your adolescent or teenage child, and see our podiatrists or an expert in pediatric podiatry if you notice any foot issues.

Pediatric Heel Pain

Heel pain in a child is a common problem. One of the first signs you may notice is your child limping. Pediatric heel pain is differs from adult heel pain in that the child's foot is still growing, and as a result, more flexible. Your child's heel pain may be due to an abnormality of the heel bone's growth area. In these cases, the growth area of the heel bone becomes inflamed, and pain worsens when your child tries to walk or participate in sports. Other heel pain causes include a fracture, bone tumor, bursitis or infection.

If you notice your child limping or complaining of heel or arch pain, you should have the child's evaluated by one of our podiatrists as soon as possible.

In-toeing or Out-toeing in Children

In-toeing is often referred to as walking pigeon-toed. Instead of the foot pointed straight-ahead, the foot turns inward. Sometimes in-toeing occurs with only one foot, or it may affect both feet. The child may limp, stumble or even trip and fall when running or walking. In-toeing may be due to a structural issue with the foot itself or related to the leg or hips.

Out-toeing is the reverse of in-toeing, where the child's foot points outward when they are walking. Again, this problem can affect one or both feet, and it can cause the child to stumble or even fall when running or walking. Both in-toeing and out-toeing are considered structural problems and when these problems are caught early they are easy to correct. Most parents are able to spot in-toeing or out-toeing in their child, usually shortly after the child begin to walk. If you suspect in-toeing or out-toeing, you should bring your child in for an evaluation with one of our podiatrists.

Toe-Walking in Children

Some toddlers or even older children may walk more on their toes or the front of the their foot, rather than putting their heel down on the ground. The child who toe-walks may appear to “bounce” as they walk.

This problem may be due to bone abnormality in the child's foot or a neurologic issue, though more often is due to the tendon at the back of the leg, called the Achilles tendon, being too short.

Most of the time, a tight Achilles tendon can be treated conservatively, though in severe cases our podiatrists may do a small procedure to help lengthen the tendon.

Bunions in Children

Some people mistakenly believe bunions is an “old person's” problem. The truth is many children develop bunions. Often a child develops a bunion secondary to another, more significant, deformity of the foot.

Most of the time, bunions in children can be treated without any type of surgery. It is important for parents to bring in their child as soon as they see a bunion beginning to form. In some cases, surgery may be necessary and our podiatrists may do a small out-patient surgery to correct the child's bunion.

Flatfeet in Children

Flatfeet is called pes planus, and it is common foot problem our podiatrists treat. In basic terms, a flatfoot is a foot that has a very low arch or no height to the arch. A child with a flatfoot may or may not have pain. Flatfeet are related to the development of all kinds of foot, ankle and leg pain and problems. Your child may have difficulty walking or may complain of “tired” feet.

Fortunately, treating flatfeet is easy. Often we make a simple arch support that molds to your child's foot, called an orthotic. Orthotics are custom-made to your child's foot and slip in your child's shoes. Generally, the younger your child is when he or she begins wearing orthotics the better.

Ingrown Toe Nails in Children

Ingrown toe nails are common in people of all ages and children are no exception. Ingrown toe nails can be painful and cause your child to limp or avoid wearing their shoes. Our podiatrists treat ingrown toe nails just about every day. In fact, a painful ingrown toe nail is one of the most common problems our podiatrists treat. Alleviating an ingrown toe nail is easy and fast when it is addressed promptly. It is important that you do not ignore an ingrown toe nail in your child's foot as it can become infected and lead to other complications.

Plantar Warts

Plantar warts show up on the bottom of a child (or adult's) foot, though warts can occur anywhere on the foot. Dr. Nirenberg has even had children where warts were under toe nails.

Warts are due to a virus and they tend to affect children's feet more than adults. Plantar warts are easy to catch and they can spread rapidly-they are highly contagious. Worse, plantar warts can be irritating or even painful. Parents who notice a plantar wart on their child's foot should see our podiatrists immediately, before the wart spreads. Most of the treatments for plantar warts are easy and painless. In more advanced or resistant cases, our podiatrists may use a laser to destroy the wart or other methods.

Source: http://www.friendlyfootcare.com/childrens-pediatric-podiatry-care/

PLANTAR FASCIITIS
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DESCRIPTION

Plantar fasciitis (say "PLAN-ter fash-ee-EYE-tus") is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk.

Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet.

SYMPTOMS

The classic symptom of plantar fasciitis is heel pain when you take your first steps after getting out of bed or after sitting for a long period of time. You may also have:

  • Stiffness and pain in the morning or after resting that gets better after a few steps but gets worse as the day progresses.
  • Pain that gets worse when you climb stairs or stand on your toes.
  • Pain after you stand for long periods.
  • Pain at the beginning of exercise that gets better or goes away as exercise continues but returns when exercise is completed.

Plantar fasciitis may be mistaken for other conditions with similar symptoms, such as arthritisor a nerve problem such as tarsal tunnel syndrome.

TREATMENT

The goals of treatment for plantar fasciitis are to:

  • Relieve inflammation and pain in the heel.
  • Allow small tears in the plantar fascia ligament to heal.
  • Improve strength and flexibility and correct foot problems such as excessive pronation so that you don't stress the plantar fascia ligament.
  • Allow you to go back to your normal activities.

Most people recover completely within a year. Out of 100 people with plantar fasciitis, about 95 are able to relieve their heel pain with nonsurgical treatments. Only about 5 out of 100 need surgery.

Source: http://www.webmd.com/a-to-z-guides/tc/plantar-fasciitis-treatment-overview#1

PLANTAR WART
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DESCRIPTION

Plantar warts are small growths that usually appear on the heels or other weight-bearing areas of your feet. This pressure may also cause plantar warts to grow inward beneath a hard, thick layer of skin (callus).

Plantar warts are caused by HPV. The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet.

Most plantar warts aren't a serious health concern and usually go away without treatment eventually. You may want to try self-care treatments or see your doctor to have the warts removed.

SYMPTOMS

Plantar wart signs and symptoms include:

  • A small, fleshy, rough, grainy growth (lesion) on the bottom of your foot, usually the base of the toes and forefoot or the heel
  • Hard, thickened skin (callus) over a well-defined "spot" on the skin, where a wart has grown inward
  • Black pinpoints, which are commonly called wart seeds but are actually small, clotted blood vessels
  • A lesion that interrupts the normal lines and ridges in the skin of your foot
  • Pain or tenderness when walking or standing

When to see a doctor

See your doctor for the lesion on your foot if:

  • The lesion is bleeding, painful or changes in appearance or color
  • You've tried treating the wart, but it persists, multiplies or recurs
  • Your discomfort interferes with activities
  • You also have diabetes or poor sensation in your feet
  • You also have a weakened immune system because of immune-suppressing drugs, HIV/AIDS or other immune system disorders
  • You aren't sure whether the lesion is a wart
TREATMENT

Most plantar warts are harmless and go away without treatment, though it may take a year or two. If your warts are painful or spreading, you may want to try treating them with over-the-counter (nonprescription) medications or home remedies. You may need many repeated treatments before the warts go away, and they may return later.

If your self-care approaches haven't helped, talk with your doctor about these treatments:

  • Stronger peeling medicine (salicylic acid). Prescription-strength wart medications with salicylic acid work by removing layers of a wart a little bit at a time. They may also stimulate your immune system's ability to fight the wart.
  • Freezing medicine (cryotherapy). Cryotherapy done at a doctor's office involves applying liquid nitrogen to the wart, either with a spray or a cotton swab. This method can be painful, so your doctor may numb the area first.

Your doctor will likely suggest you apply the medicine regularly at home, followed by occasional office visits.

The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. Cryotherapy may also stimulate your immune system to fight viral warts. You may need to return to the doctor's office for repeat treatments every two to four weeks until the wart disappears.

Some studies suggest that cryotherapy combined with salicylic acid treatment is more effective than just cryotherapy, but further study is needed.

Surgical or other procedures

If salicylic acid and freezing medicine don't work, your doctor may recommend one or more of the following treatments:

  • Other acids. Your doctor shaves the surface of the wart and applies trichloroacetic acid with a wooden toothpick. You'll need to return to the doctor's office for repeat treatments every week or so. Side effects include burning and stinging. Between visits, you may be asked to apply salicylic acid to the wart.
  • Immune therapy. This method uses medications or solutions to stimulate your immune system to fight viral warts. Your doctor may inject your warts with a foreign substance (antigen) or apply a solution or cream to the warts.
  • Minor surgery. Your doctor cuts away the wart or destroys it by using an electric needle (electrodesiccation and curettage). This procedure can be painful, so your doctor will numb your skin first. Because surgery has a risk of scarring, this method usually isn't used to treat plantar warts unless other treatments have failed.
  • Laser treatment. Pulsed-dye laser treatment burns closed (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. This method requires repeat treatments every three to four weeks. The evidence for the effectiveness of this method is limited, and it can cause pain and potentially scarring.
  • Vaccine. HPV vaccine has been used with success to treat warts even though this vaccine is not specifically targeted toward the wart virus that causes the majority of plantar warts.

Source: http://www.mayoclinic.org/diseases-conditions/plantar-warts/home/ovc-20319385

SHOES FOR DIABETIC PATIENTS
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DESCRIPTION

Two complications people with diabetes may be at risk for are poor circulation and the absence of sensation, according to John Giurini, DPM, Chief, Division of Podiatry at Beth Israel Deaconess Medical Center. (Beth Israel Deaconess Medical Center is an affiliate of the Joslin Diabetes Center). People with these diabetes complications may not be aware of whether or not their shoes fit correctly, so their feet must be properly measured and fitted before purchasing shoes.

Tips for Buying Shoes with Diabetes

  • Have feet measured periodically, because feet change over time.
  • Shop later in the day, because feet swell throughout the day, especially if you have heart disease and kidney problems.
  • Have shoes fitted with the socks you'll be wearing with those specific shoes. That way you'll know they will fit properly.
  • The distance between your longest toe and the tip of the shoe should be 1⁄2 of your thumb's width, so you have the right amount of space to fit your feet.

When you buy a new pair of shoes, break them in before wearing them for a long period of time. Wear them for one to two hours, then check your feet for any cuts or blisters. Wear them three to four hours the next day, and so on, until they feel comfortable, Giurini says.

Important Shoe Features for People with Diabetes

  • Shoes should be made of soft leather, because they can stretch.
  • Choose a cushioned sole over a thin, leather sole, because the shock absorption is better.
  • The back of the shoe should not collapse to one side or the other, because it won't provide good support.
  • Choose laced shoes over loafers, so they fit better and provide better support.

People with diabetes and specific foot deformities should buy shoes that match the width of their foot, perhaps with extra depth. Those with diabetes and severe foot deformities can get a custom molded shoe made, but Giurini says to only do this if it's absolutely necessary.

When To Replace Shoes

It's a good idea to alternate your shoes everyday so you don't wear one pair down too quickly, the heel doesn't lose support and the sole doesn't lose shock absorption. You should replace your shoes when:

  • the heel starts to collapse to one side or the other
  • the heel itself is worn down
  • the inner lining of the shoe is torn
  • the mid-portion of the shoes is worn down

It's important that people with diabetes visit a podiatrist on a regular basis based on their risk for diabetes complications. If you're at a higher risk for diabetes complications and already have foot problems, you should go more frequently.

Source: http://www.joslin.org/info/the_best_shoes_for_people_with_diabetes.html

SPORT & INDUSTRIAL TRAUMAS
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DESCRIPTION

“Sports injuries” are injuries that happen when playing sports or exercising. Some are from accidents. Others can result from poor training practices or improper gear. Some people get injured when they are not in proper condition. Not warming up or stretching enough before you play or exercise can also lead to injuries. The most common sports injuries are:

  • Sprains and strains
  • Knee injuries
  • Swollen muscles
  • Achilles tendon injuries
  • Pain along the shin bone
  • Fractures
  • Dislocations.
SYMPTOMS

There are two kinds of sports injuries: acute and chronic. Acute injuries occur suddenly when playing or exercising. Sprained ankles, strained backs, and fractured hands are acute injuries. Signs of an acute injury include:

  • Sudden, severe pain
  • Swelling
  • Not being able to place weight on a leg, knee, ankle, or foot
  • An arm, elbow, wrist, hand, or finger that is very tender
  • Not being able to move a joint as normal
  • Extreme leg or arm weakness
  • A bone or joint that is visibly out of place.

Chronic injuries happen after you play a sport or exercise for a long time. Signs of a chronic injury include:

  • Pain when you play
  • Pain when you exercise
  • A dull ache when you rest
  • Swelling.
TREATMENT

Treatment often begins with the RICE method. Here are some other things your doctor may do to treat your sports injury.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Your doctor may suggest that you take a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. These drugs reduce swelling and pain. You can buy them at a drug store. Another common drug is acetaminophen. It may relieve pain, but it will not reduce swelling.

Immobilization

Immobilization is a common treatment for sports injuries. It keeps the injured area from moving and prevents more damage. Slings, splints, casts, and leg immobilizers are used to immobilize sports injuries.

Surgery

In some cases, surgery is needed to fix sports injuries. Surgery can fix torn tendons and ligaments or put broken bones back in place. Most sports injuries don't need surgery.

Rehabilitation (Exercise)

Rehabilitation is a key part of treatment. It involves exercises that step by step get the injured area back to normal. Moving the injured area helps it to heal. The sooner this is done, the better. Exercises start by gently moving the injured body part through a range of motions. The next step is to stretch. After a while, weights may be used to strengthen the injured area.

As injury heals, scar tissue forms. After a while, the scar tissue shrinks. This shrinking brings the injured tissues back together. When this happens, the injured area becomes tight or stiff. This is when you are at greatest risk of injuring the area again. You should stretch the muscles every day. You should always stretch as a warmup before you play or exercise.

Don't play your sport until you are sure you can stretch the injured area without pain, swelling, or stiffness. When you start playing again, start slowly. Build up step by step to full speed.

Rest

Although it is good to start moving the injured area as soon as possible, you must also take time to rest after an injury. All injuries need time to heal; proper rest helps the process. Your doctor can guide you on the proper balance between rest and rehabilitation.

Other Therapies

Other therapies include mild electrical currents (electrostimulation), cold packs (cryotherapy), heat packs (thermotherapy), sound waves (ultrasound), and massage.

Source: https://www.niams.nih.gov/health_info/sports_injuries/sports_injuries_ff.asp

TOE NAIL FUNGUS
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DESCRIPTION

Toenail fungus is an infection that gets in through cracks in your nail or cuts in your skin. It can make your toenail change color or get thicker. It can also hurt. Because toes are often warm and damp, fungus grows well there. Different kinds of fungi and sometimes yeast affect different parts of the nail. Left untreated, an infection could spread to other toenails, skin, or even your fingernails.

SYMPTOMS

Infected nails are usually thicker than normal and could be warped or oddly shaped. They can break easily. Nails with fungus might look yellow. Sometimes a white dot shows up on the nail and then gets bigger. When fungus builds up under your nail, it can loosen and even separate the nail from the bed. The fungus can also spread to the skin around your nail.

TREATMENT

The way you treat toenail fungus depends on which fungus you have and how bad the infection is. Your doctor may try one thing or a combination:

  • A topical cream that goes directly on the nail
  • A topical nail lacquer
  • An antifungal prescription pill
  • Removing the damaged area of the nail or skin

In some cases, you might need to have the nail removed completely with surgery.

Source: http://www.webmd.com/skin-problems-and-treatments/ss/slideshow-toenail-fungus