Monday, 16 November 2020 00:00

Foot and Ankle Surgery

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

Tuesday, 10 August 2021 00:00

What Can Cause an Ingrown Toenail?

An ingrown toenail is defined as a nail that grows into the outside edges of the skin. It generally affects the big toe and can cause severe pain and discomfort. It can occur as a result of wearing shoes that do not have adequate room for the toes to move freely in, or possibly from genetic factors. Additionally, the shape of the nail may be conducive to developing an ingrown toenail. Research has indicated that ingrown toenails may happen more often in children and pregnant women. This can be a result of the accelerated speed of the nail growth. Mild relief may be found when the affected toe is soaked in warm water which can be beneficial in pulling the nail away from the softened skin. An ingrown toenail can easily become infected if not promptly treated. If you are afflicted with this ailment it is strongly suggested that you speak with a podiatrist who can properly treat this condition.

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, contact one of our podiatrists of New England Foot and Ankle. Our doctors can provide the care you need to keep you pain-free and on your feet.

Ingrown Toenails

Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

  • Improper toenail trimming
  • Genetics
  • Improper shoe fitting
  • Injury from pedicures or nail picking
  • Abnormal gait
  • Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

If you have any questions, please feel free to contact one of our offices located in Chelmsford and Newburyport, MA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Ingrown Toenail Care
Tuesday, 10 August 2021 00:00

Ingrown Toenail Care

An ingrown toenail is a toenail that grows sideways into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.

Several factors affect whether a person is at risk from an ingrown toenail. The many causes include being overweight, diabetes, participating in sports, having a fungal infection of the toe, and cutting your nails too short. Ingrown toenails also have a genetic predisposition, causing some people to be more prone to receive the condition than others. Other causes include improperly fitting shoes and shoes that keep the feet damp.

Ingrown toenails can be preventable with certain measures. For starters, allowing your toe nails to grow slightly longer in length will help prevent them from becoming ingrown. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help prevent an infection from forming. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is also suggested, as this may help the toenail grow upwards and not into the nail bed. Swelling and redness can be reduced by resting with your feet elevated.

A podiatrist should be seen if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact a podiatrist immediately. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.

An ingrown toenail can be easily treated with a Band-Aid. Simply wrap the affected toe with a Band-Aid to prevent infection and keep the nail from growing out at a painful angle.

In more serious cases, your podiatrist may decide to make a small incision to remove a portion of your toenail. To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day. Afterwards, normal activities can be resumed.  

Monday, 12 October 2020 00:00

Ways to Prevent Hammertoe

Hammertoe is a deformity of the toes that causes the small toes to bend at the joint. If left untreated, hammertoes can be permanent. Common signs of hammertoe include curling toes, thickening of the skin on the affected toe, trouble finding shoes that fit correctly, and pain. One of the leading causes of hammertoe is poor fitting shoes. Avoid shoes that have a narrow and pointed toe, that are too tight, or that have a high heel. Shoes that have wide toe boxes and are roughly a half inch longer than your longest toe are generally best to reduce the risk of hammertoe. A proper diagnosis and treatment plan for hammertoe will require visiting a podiatrist, so if you believe that you are suffering from hammertoe, consult with a podiatrist as soon as possible. 

Hammertoe

Hammertoes can be a painful condition to live with. For more information, contact one of our podiatrists from New England Foot and Ankle. Our doctors will answer any of your foot- and ankle-related questions.

Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.

Symptoms

  • Pain in the affected toes
  • Development of corns or calluses due to friction
  • Inflammation
  • Redness
  • Contracture of the toes

Causes

Genetics – People who are genetically predisposed to hammertoe are often more susceptible

Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur

Trauma – Direct trauma to the toes could potentially lead to hammertoe

Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe

Treatment

Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it

Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used

Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option

If you have any questions please contact one of our offices located in Chelmsford and Newburyport, MA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about What Are Hammertoes?
Monday, 12 October 2020 00:00

What Are Hammertoes?

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

Monday, 29 March 2021 00:00

What Is Sever’s Disease?

Children who are growing and physically active can put excessive wear on the growth plate of their heel bone, which attaches to the Achilles tendon. Repetitive pulling on the growth plate causes inflammation and pain in the heel and is known as Sever’s disease. Although this condition is painful and can reoccur, it is not dangerous, and should go away once the growth plate closes and your child stops growing. There are several things you can do at home to help reduce the pain of Sever’s disease. Have your child stretch their calf muscles several times a day and make sure your child sits out activities rather than playing through the pain. You can also ice the area, give your child over-the-counter painkillers, and have them wear supportive shoes. If pain persists, severe swelling occurs, or your child develops a fever, contact a podiatrist right away. The podiatrist will first rule out a heel fracture, and then may suggest custom orthotics and specific stretching exercises to heal the pain and avoid permanent damage.

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see one of our podiatrists from New England Foot and Ankle. Our doctors can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.

If you have any questions, please feel free to contact one of our offices located in Chelmsford and Newburyport, MA . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.

Read more about Sever's Disease
Monday, 29 March 2021 00:00

Sever's Disease

Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.

Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.

Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.

Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.

If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.

Tarsal tunnel syndrome occurs when there is a compression or squeezing of the posterior tibial nerve as it travels through the tarsal tunnel. The tarsal tunnel is a narrow space that lies on the inside of the ankle and it contains arteries, veins, tendons and nerves, including the tibial nerve. There can be a variety of causes for this compression such as an abnormal structure in the area, a cyst or bone spur, an injury that causes inflammation like an ankle sprain, and diseases like arthritis and diabetes. Those who have flat feet are also at a higher risk for tarsal tunnel syndrome because the heel tilts and can strain or stress to the nerve. Symptoms individuals experience consist of pain or numbness to the affected area, or a burning or tingling sensation which is often described similar to “pins and needles." Common treatment options for tarsal tunnel syndrome include orthotics, braces, rest, physical therapy, and in severe cases, surgery. If you are suffering from any symptom of tarsal tunnel syndrome it is important to visit a podiatrist for a proper diagnosis.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact one of our podiatrists of New England Foot and Ankle. Our doctors can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

  • Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
  • If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

If you have any questions please feel free to contact one of our offices located in Chelmsford and Newburyport, MA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Treating Tarsal Tunnel Syndrome
Monday, 07 December 2020 00:00

Treating Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Tuesday, 03 August 2021 00:00

Facts About Orthotics

Orthotics are inserts that you wear inside your shoes. They can be used to treat or manage a variety of foot conditions, such as plantar fasciitis and acquired flat foot. Orthotics are typically not used to prevent overuse injuries like stress fractures or tendonitis. There are two types of orthotics: over the counter and custom. Over the counter orthotics can be bought in most major drug, department, and shoe stores. Custom orthotics are made especially for your foot. The type of orthotic you should get depends on the specific foot problems that you are dealing with. Over the counter orthotics that are appropriately selected can be beneficial for treating a variety of common foot problems, while custom orthotics are especially useful for those who have foot deformities. To find out if orthotics are right for you, please consult with a podiatrist.

If you are having discomfort in your feet and would like to try orthotics, contact one of our podiatrists from New England Foot and Ankle. Our doctors can provide the care you need to keep you pain-free and on your feet.

What Are Orthotics?

Orthotics are inserts you can place into your shoes to help with a variety of foot problems such as flat feet or foot pain. Orthotics provide relief and comfort for minor foot and heel pain but can’t correct serious biomechanical problems in your feet.

Over-the-Counter Inserts

Orthotics come in a wide variety of over-the-counter inserts that are used to treat foot pain, heel pain, and minor problems. For example, arch supports can be inserted into your shoes to help correct overarched or flat feet, while gel insoles are often used because they provide comfort and relief from foot and heel pain by alleviating pressure.

Prescription Orthotics

If over-the-counter inserts don’t work for you or if you have a more severe foot concern, it is possible to have your podiatrist prescribe custom orthotics. These high-quality inserts are designed to treat problems such as abnormal motion, plantar fasciitis, and severe forms of heel pain. They can even be used to help patients suffering from diabetes by treating foot ulcers and painful calluses and are usually molded to your feet individually, which allows them to provide full support and comfort.

If you are experiencing minor to severe foot or heel pain, it’s recommended to speak with your podiatrist about the possibilities of using orthotics. A podiatrist can determine which type of orthotic is right for you and allow you to take the first steps towards being pain-free.

If you have any questions please contact one of our offices located in Chelmsford and Newburyport, MA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Ankle Foot Orthotics for Athletes
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