Clinical Services Heel Spur & Plantar fasciitis When the plantar fascia (a thick ligamentous connective tissue that runs from the heel bone to the ball of the foot) becomes inflamed due to excessive stretching, too much pressure, or trauma, the condition of plantar fasciitis results. The plantar fascia can become partially detached at the heel.. A heel spur is a spur of bone that can form on the heel bone (calcaneus) as a result of this condition. Often the pain is most severe when you first stand on the foot in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking. Neuroma A neuroma is an inflammation of nerve tissue usually located in the ball of the foot and occasionally into the toes. This inflammation is caused by two metatarsal bones that rub and pinch the nerve. The feeling of a neuroma is sometimes equated to a bunched up sock or stepping on a pebble but symptoms may also include tingling, burning, cramping and/or aching in and across the ball of the foot or toes or periods of numbness. Over time, the top of the foot may become painful because these tendons work harder to alleviate the discomfort caused by the neuroma. In general, the longer a neuroma is present, the more difficult it is to treat. Flat Feet Flat feet are usually hereditary and commonly associated with symptoms in the foot, leg, knees, hips and/or back. This condition is associated with boney deformities such as spurs, hammertoes, bunions and arthritis from abnormal, excessive bone and joint motion. Conservative treatment includes treatment for any related deformity, but ultimately, custom functional foot orthoses are necessary to control the abnormal position and function of the feet and legs. This condition tends to be progressive in both the actual collapsing of the arch of the foot and also on all the parts of the foot and leg that move abnormally because of the collapsed arch. If conservative measures fail, then an outpatient procedure can be performed to correct the collapsed arch and related deformities. Corns and Calluses These ailments are often caused by repeated friction or rubbing within the shoe. Improper footwear or a bony prominence such as a hammertoe is often to blame. Corns and calluses can be treated by wearing proper shoes with cushioned insoles, or by using over-the-counter corn/callus pads. Bunions Although these foot deformities tend to be hereditary, shoes that are too narrow in the forefoot often aggravate them. Bunions are caused by a large bony prominence located behind the great toe. They tend to become more pronounced and painful over time. Hammertoes Hammertoes occur in the lesser toes and often become painful when wearing shoes with inadequate depth, such as loafers or women's pumps. Surgical correction of these deformities is usually recommended when they become painful. Ingrown Toenails This ailment occurs when the toenail digs painfully into the surrounding skin, often causing infection. Ingrown nails are usually caused by improper trimming, but improper or tight-fitting shoes, fungal infections or heredity can be a contributing factors. Preventative steps include trimming toenails straight across and wearing proper shoes. Corrective treatment for ingrown nails usually entails a minor in-office procedure performed under local anesthesia. Heel Pain Heel pain is a common condition in both men and women. There are a number of possible causes for heel pain, including injury, overuse syndromes, soft-tissue inflammation, arthritis-related conditions, and/or improper footwear. Depending upon the individual cause, treatment may include placing a simple cushion in the shoe, stretching exercises, cortisone injections, prescription medication, or orthotics. On rare occasions, surgery may be needed. Heel pain can become chronic and debilitating if left untreated. Plantar Warts The sole of the foot is known as the plantar surface. Plantar warts are caused by a virus in the skin, and are usually contracted from walking barefooted around community pools, locker rooms or showers. These warts are most commonly found in children and young adults, but can affect people of all ages. The treatment for plantar warts will vary depending upon the size, number and location of the lesions. Wearing protective footwear around wet, dirty floors can effectively prevent plantar warts. The first line of treatment is often the use of topical acids to dissolve the wart. If this proves unsuccessful, Dr. Sobel may need to apply other medications in the office or surgically remove the lesions. Arthritis Arthritis is a general term used to describe swelling and pain associated with joints in the body. There are several forms of arthritis, including osteoarthritis or degenerative joint disease (DJD), rheumatoid arthritis, gouty arthritis, etc. Since each foot contains 33 joints, it is easy to understand why many individuals suffer from arthritic conditions in their feet. The pain associated with arthritis can often be relieved with medications such as acetaminophen (e.g. Tylenol), aspirin or other anti-inflammatory medications (e.g. Advil, Aleve, Rx medications). Certain arthritic conditions can be relieved by simply wearing proper footwear, or with the use of orthotic devices. Occasionally, surgery is necessary to relieve the pain associated with arthritis of the feet. Foot Odor Foot Odor (also called bromhydrosis) is something that few people wish to discuss, even with their doctor. The root cause of foot odor is excessive perspiration, leading to bacterial overgrowth. Changing shoes and socks frequently, special foot soaks and certain topical medications can control foot odor. Fungal Nails Fungal toenails are one of the most common conditions affecting the feet. The unpleasant appearance of the fungal nail is often a source of embarrassment. Caused by a variety of fungal elements or yeast, this condition causes the nails to become thickened and discolored. It can even cause pain due to pressure on the nail bed. Although generally benign, fungal nails are now treated with much success by oral medications approved by the FDA. In cases where the nail is extremely thick or painful, it can be thinned or removed at our offices.