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AUTHOR: Marc Mitnick DPMREVIEWED BY: Podiatric Medical Review Board
How do you treat a Tailors bunion?
A Tailors bunion is a protrusion of the fifth metatarsal head. In most cases where it becomes painful it is usually due to excessive shoe pressure.
The simplest thing to try is to stop wearing shoes that put too much pressure on the bunion itself. Since the bunion protrudes, it essentially makes the foot wider and certain shoes will no longer be comfortable.
The main cause of pain in a Tailors bunion is from the formation of a bursitis on the outside of the bunion. If the outside area is red, slightly swollen and painful to touch then there is a good chance it is from a bursitis.
If that is the case, then a cortisone injection may be very helpful. You can try rubbing the area with any of the topical anesthetics out there, but generally they only give marginal relief.
In cases where you cannot stop the pain with conservative measures, surgical intervention is an option that needs to be considered.
Want more information on Tailors bunions? CLICK HERE
Complex Regional Pain Syndrome, a new treatment
Complex Regional Pain Syndrome (CRPS) is a poorly understood neurological condition.
The condition is basically a short circuit of the nervous system where nerves misfire thus sending constant pain signals to the brain even though there is no real or limited pain going on. In other words, it is a completely abnormal response by the nervous system to external stimuli.
This condition is usually the result of trauma, including surgery to a portion of the body, most notably the feet and legs.
Australian researchers are embarking on a study, using mirror therapy, where the brain is "retrained" by doing a series of exercises in a mirror on the "good" hand or foot as a means to trick the brain into thinking it is the damaged hand or foot. The idea being that brain will stop emitting abnormal nerve sensations.
continue reading about CRPS CLICK HERE
Small Fiber Neuropathy
The incidence of small fiber neuropathy has been increasing over the last 2 decades due to more awareness and better testing.
Most commonly a result of diabetes, there are other causative factors with obesity being one of them.
When you do not have Covid toe
One of the manifestations of Covid 19 is a condition known as Covid toe. In Covid toe the patient presents complaining of a red discoloration in some or all of their toes along with swelling, possible itching and sometimes pain. When I saw my first case, my first thought was that of superficial frostbite which has a similar presentation. My second thought was that of an eczema on the toes. For most of us who treat feet, we were just guessing until news of this type of foot condition started to spread.
It is postulated that Covid toe is the body's response to the inflammation associated with the virus.
Typically symptoms will last on average for about 15 days, with pain and itching subsiding sooner, just leaving the discoloration and some swelling. Long haulers, those who have Covid symptoms for a longer period of time, will tend to have Covid toe for a longer period as well.
In older individuals and those suffering from diabetes or poor circulation into the toes, there is the problem of a breakdown of the tissue with a resulting infection. Those at risk, who experience Covid toe symptoms should see a doctor.
There is no definitive protocol for treating Covid toe. For those in good health with virtually no symptoms other then the toe discoloration, nothing need be done. In others where Covid toe is more symptomatic such as pain or itching, one can try topical cortisone cream, or a short dose of oral steroids. Anti-inflammatory medication may also be helpful.
The good news is that for most, this is a temporary condition that will resolve on its own.
In the case of Aaron Rodgers, he does not have Covid toe even though he did have Covid.
How Likely Will I get relief from Plantar Fasciitis if Still Having Pain Four Days After Cortisone Injection?
When I give a cortisone injection I tell my patients that the injection may do absolutely nothing…..all the way to giving relief for the rest of your life……and anything in between. In other words, you do not know what the response will be.
I will tell you, however, that over the years, people have called to tell me that after a few days they still have pain and by the time they come back in for me to check on them, many of them feel completely better. So I now tell patients to give the injection up to 10–14 days to see if it “kicks in”.
You are only at four days so I would give it another week. If in a week from now you do not see any improvement, then you may want to see you doctor and consider a different strategy.
How do you ease swelling and tenderness of an ingrown nail?
Although some painful ingrown nails will eventually clear up on their own, many will need professional medical care.
Until you can get to a podiatrist, the best thing to do is soak the toe in salt water; one tablespoon of table salt per quart of warm (not hot) water. Soak for 15 minutes, two to three times per day.
If the solution burns it means there is too much salt in the solution so add some more warm water.
After each soaking, apply a topical antibiotic like Neosporin or Bacitracin with a bandaid to reduce the chance of the toe becoming infected.
If the toe does not appreciably improve over 24 hours or you start to see pus coming from the toe, get yourself immediate medical care.
Pain shooting up little toe, fractured toe three years ago
If the pain has been present since you broke your toe three years ago, then my first thought would be that of a non-union where the fracture did not completely heal.
A fracture that has not completely healed can continue to cause pain particularly when wearing shoes or pressing on the toe.
Other things to consider would be a corn either on the inside or outside of the toe. A corn is a build up of hard skin and this causes pain when pressed on by a shoe.
Additionally, a bursitis in the toe may also cause pain especially when wearing shoes or pressing on the toe. A bursitis will usually present itself as slightly red and slightly swollen and will hurt when pressed upon.
A visit to a podiatrist might not be a bad idea.
How do you ease swelling and tenderness of an ingrown nail?
Although some painful ingrown nails will eventually clear up on their own, many will need professional medical care.
Until you can get to a podiatrist, the best thing to do is soak the toe in salt water; one tablespoon of table salt per quart of warm (not hot) water. Soak for 15 minutes, two to three times per day.
If the solution burns it means there is too much salt in the solution so add some more warm water.
After each soaking, apply a topical antibiotic like Neosporin or Bacitracin with a bandaid to reduce the chance of the toe becoming infected.
If the toe does not appreciably improve over 24 hours or you start to see pus coming from the toe, get yourself immediate medical care.
How Likely Will I get relief from Plantar Fasciitis if Still Having Pain Four Days After Cortisone Injection?
When I give a cortisone injection I tell my patients that the injection may do absolutely nothing…..all the way to giving relief for the rest of your life……and anything in between. In other words, you do not know what the response will be.
I will tell you, however, that over the years, people have called to tell me that after a few days they still have pain and by the time they come back in for me to check on them, many of them feel completely better. So I now tell patients to give the injection up to 10–14 days to see if it “kicks in”.
You are only at four days so I would give it another week. If in a week from now you do not see any improvement, then you may want to see you doctor and consider a different strategy.
What are the reasons for women's cold hands and feet?
Although cold hands and feet tend to occur more in women, there are also men who suffer from the same condition.
In older individuals one has to be concerned about arteriosclerosis, or hardening of the arteries. Diminished circulation into the hands and feet will cause them to be cold and pale, but sometimes they can be red as well.
I am assuming your question is in regards to younger women. There are a number of possible causes for the hands and feet to be cold.
The first is neurological in the sense that young anxious women tend to have this condition more so then other women of similar age.
Other conditions to consider are hypothyroidism (under functioning thyroid gland), anemia (low red blood cell count), Raynaud’s disease, Rheumatoid arthritis, Scleroderma, Lupus, hypertension and smokers.
Obviously, in order to find the particular cause in any one patient, a complete work up would be necessary.
Ancestry and and the shape of your foot
In my forty years of clinical practice, I estimate that I have treated over 27,000 different patients.
Despite this I have never casually observed foot structure in the sense of how it relates to one's heritage.
Yes, I treat a lot of different toe problems and at times will point out to patients how their toe architecture relates to the particular problem they came to see me about, but I never made the connection to a person's ancestry based on the way their toes lined up.
Well just because I have not made the connection does not mean someone else has not either. In the following article the study places different toe alignments with different heritages.
Perhaps because I am a podiatrist, I found the article interesting but there is a good chance it will interest you as well.
Read the full article CLICK HERE
I have had plantar fasciitis for a year and cannot walk
At this point you may have more then just plantar fasciitis. When someone presents to my office with similar complaints, the first thing I do is send them for either an ultrasound or MRI to see if there is a tear in the plantar fascial ligament.
This happens quite frequently and there does not have to be trauma involved either.
In most cases of plantar fasciitis, the heel or the arch will hurt when you first stand up on it, then as you walk the pain will diminish. If you have a situation where the pain worsens, the more you walk then you have to look beyond simple plantar fasciitis.
Besides a possible tear in the ligament there are other conditions that can make the heel hurt the more you are on your foot. These include conditions like a heel bursitis, a heel neuroma (a pinched nerve in the heel) and even a possible heel fracture.
If you have had heel pain for a year it is fairly safe to say it is not going away on its own,.
My best advice would be to seek medical attention.
Read the full article CLICK HERE
Avoiding cold weather injuries
As the temperatures drop the risk for cold weather injuries increases.
This includes individuals who make their living outdoors, people who should not be outside for prolonged periods due to health concerns and those who exercise outdoors.
When the temperature drops too much, with "too much" depending on personal factors such as the amount of time your are outside, the type of protective clothing you are wearing, the amount of moisture in the air and on the ground. Additionally, health risks which can further exacerbate exposure to cold include, older age individuals, dehydration, alcohol use, tobacco use and disease states such as diabetes.
The body attempts to protect itself from cold by redirecting blood flow from the extremities to the central core of the body. This adversely affects the feet by constricting blood flow to the extremities so that more blood goes to the central portion of the body.
Reduced blood flow to the tissues of the feet, particularly the toes can lead to conditions such as frostbite, both superficial and deep. If the feet are also exposed to moisture you can end up with immersion foot
Read the full article CLICK HERE
When should a person get bunion surgery?
Bunions should only be surgically corrected when they affect the quality of your life. What I mean by this is if you stop doing certain activities because you know your bunion will flare up, then the condition is affecting your life.
Bunions come in varying degrees of severity and in most people will worsen over time. The pain, if any, associated with bunions can come in varying degrees of severity.
Most cases of bunion pain can be alleviated by changing the style of shoe that you wear.
Although taking an anti-inflammatory agent once in a while to reduce bunion pain is acceptable, you should not rely on them on any regular basis as they themselves can cause medical issues.
Since the tendency for bunion formation is inherited due to your underlying foot structure, having bunion surgery at an early age may end up with you having to have a second operation years down the road, simply because correcting your bunion will not change the underlying foot structure that caused the bunion in the first place and after surgery you will be walking in the same manner as prior to surgery, so the chance of bunion formation, a second time, certainly exists.
Read more about bunions CLICK HERE
How do you take care of your toe without a nail?
Initially, after losing the nail for whatever reason such as trauma, nail fungus, or surgical removal, the nail bed which is the skin underneath the nail will be tender, particularly if it has been surgically removed or came off as the result of trauma. If the nail loosened up and came off due to nail fungus, generally, the nail bed will not be very painful.
If the nail bed is tender and is bleeding you need to care for the nail to prevent infection, both bacterial and fungal. Initially you want to treat the possible bacterial infection, by washing the toe with soap and water, followed by an antiseptic and a dressing. You should do this until the nail bed dries out and is no longer bleeding and has hardened up. For most people this is about 7–10 days. Keeping the wound covered will protect against bacterial infection and allow you to wear a shoe.
Once the nail bed has dried out and is no longer painful, you run the risk of the new nail growing out with fungus on it. Typically the nail will be somewhat thicker, discolored, and may or may not be flaky. I usually have my patients use a topical antifungal medication on the nail bed and the new nail growing out, until the nail has fully grown out. For a big toe nail this can be 9–12 months, for smaller toe nails, perhaps six months.
Can I fix my flatfeet with anything other then arch supports?
Unless you want surgery on your feet there is no other option.
In most instances flat feet is a structural condition that is inherited in the same way your facial features are inherited. You can thank your parent or grandparents for the condition.
There is no way to build an arch by exercise just like there is no way to improve poor eyesight with eye exercises.
The problem with flat feet is two fold. The first is you may be experiencing some degree of pain any where from your feet to your lower back which may be attributed to your flat feet.
Secondly, having flat feet which may not be an issue for you now, ( I do not know your age) may lead to issues later on in life, again, anywhere from your feet all the way up to your lower back.
Arch supports, or orthotics which are customized foot supports attempt to put your arch back up where it belongs thus eliminating the present and potential problems associated with flat feet.
There are complex surgeries and some simpler procedures to correct flat feet. In younger individuals with what is known as a flexible flatfoot where there is an arch when off weightbearing that flattens out when you stand up, there are some relatively simple procedures to keep the foot from flattening out.
In older individuals where the foot has completely broken down and there is constant pain, complex procedures are performed where multiple joint in the hind foot are fused to eliminate pain.
I don’t know about you, but if I suffered from flatfeet and I was told all I needed to do was wear something in my shoes to put my feet back in alignment, I would be very happy.
I have a dark line across my toenail, is it cancer?
As others have stated in response to your question, the best thing to do is have a doctor take a look at it.
Most cases of melanoma grow from the cuticle, forward to the end of the nail, but like most medical issues anything is possible.
The vast, vast majority of nail discoloration that I see in the office are not cancer. Every now and then if the nail appears suspicious to me, I will remove it and have it and the adjacent skin biopsied. Even in those cases, most come back as normal.
You are probably doing more harm to your overall health by worrying about the possibility of cancer of the nail. Go see a podiatrist, let he or she take a look at it and then put your worries at ease.
These sensations in your hands and feet could be signs of blood sugar damage
The peripheral nervous system is the body's electrical system. It sends electrical impulses from the brain to the hands and feet as well as sending impulses back up to the brain.
There are many causes of neuropathy including certain medications, nerve injury, cancer, Lyme disease and vitamin deficiencies to name but a few. Idiopathic neuropathy or neuropathy of unknown origin is very common in people over age 60.
In my experience, along with idiopathic neuropathy, the other two more common causes are radiculopathy which is a nerve irritation of the nerves as they come out of the spinal column and diabetes.
The following article discusses diabetic neuropathy, the signs and symptoms of neuropathy and what you can do about it.
Read the full article CLICK HERE
Recent Articles
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How the Foundation of Your Success Lies at the Health of Your Employees’ Feet
May 23, 22 06:48 PM
An interesting article on how malfunctioning feet can have a negative impact in the workplace.
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Reasons to wear shoes around the house
May 22, 22 09:37 AM
Most people tend to not wear shoes around the house.
Here is an article as to why you might start wearing shoes when you are home.
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Gabapentin overdose deaths
May 21, 22 10:56 AM
The CDC has found that between 2019 and 2020 there has been a significant uptick in Gabapentin (Neurontin) overdoses.
In most cases it has been due to a combination of Gabapentin and Opiods.
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The seven best sandals for plantar fasciitis
May 20, 22 05:43 PM
I tend to find that plantar fasciitis is more prevalent in the summer simply because people wear flimsy sandals or go barefoot a lot more.
This article lists the best sandals available to control plant…
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Are biological therapies good for neuropathic pain?
May 19, 22 07:24 PM
Apparently no.
Researchers at Mayo clinic performed a meta-analysis of studies investigating the effectiveness of biologics such as mesenchymal stem cell and PRP as aides in treating all types of neuro…
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Latest advice for Achilles tendon repair
May 18, 22 10:44 AM
In a recent symposium, the speaker stressed Achilles strengthening rather then increasing range of motion in post Achilles surgery rehabilitation.
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Arterial stiffness may be better indicator of Type II diabetes then other risk factors
May 16, 22 05:26 PM
An interesting study where it was observed that people with hardening of the arteries had a higher incidence of Type 2 diabetes.
This was evident regardless whether the participants had high blood pres…
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Fascia stretching exercises
May 14, 22 10:28 AM
Fascia is a soft tissue covering surrounding muscles. To me it has always appeared as "saran wrap" around the muscle.
Here is a good review on fascia stretches will which help increase mobility and red…
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Why your feet hurt when you wake up in the morning
May 14, 22 10:21 AM
A good review from the Cleveland Clinic on the various causes of foot and ankle pain that may be experienced when you wake up in the morning.
Plantar fasciitis is notorious for causing morning pain, bu…
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Injury Prevention for Runners
May 10, 22 07:22 PM
Even though running is a contactless sport, runners are prone to injuries.
There is nothing worse then being out of commission and not being able to run, simply due to a prolonged injury.
This is a good…
