Q: I have had heel pain and bone spurs for over two years. Despite having cortisone injections and orthotics, I continue to have pain that is limiting my ability to exercise. Are there any other options besides surgery?
A: Although heel pain is usually very easy to treat and most patients respond nicely to simple measures, there will be the unusual occasion where relief is not achieved permanently. In those rare circumstances surgery is usually the only remaining option. This is a fairly minor procedure with release of a portion of the painful ligament. Although this is done in the hospital, crutches are not necessary and pain is usually relieved in two to four weeks, depending on the type of work the to which the patient returns.
Q: My feet hurt whenever I participate in an exercise program. I've been thinking about stopping exercise so that my feet won't hurt.
A: It is rare to have a foot problem that cannot be treated successfully to the point where one can exercise with good comfort. Foot pain is certainly not a reason for one to quit exercising and ironically, most foot problems worsen as one reduces ones activity or quits exercising. Usually something very simple such as supports, shoe changes, or stretching advise can make a tremendous difference in ones comfort during exercise and usual daily activities. Usually a doctor who exercises him or herself will take a greater interest in patients who have concerns about their exercise needs. Walking is an excellent, low stress exercise and one should be able to do this when he or she is 100!
Q: I have heard that laser surgery for bunions is the latest technique and makes the surgery much easier.
A: Laser surgery is used only in a few very specific conditions in foot surgery. These include warts, scar problems and other problems associated with the skin. Currently surgery for bunions does not include the laser. Bunions are bony deformities and usually require cutting bones and usually using screws for the repair. This usually takes some time to recover and nothing, including laser, will make it easier. Having evaluation and surgery by a well trained foot and ankle surgeon will make it as effective and easy as possible. Any potential patient has to take care in finding a well trained surgeon and to not get pulled in by high tech sounding phrases designed to attract patients under the guise of providing the latest and greatest techniques. Most successful, well trained surgeons will not need to advertise with glitzy phrasing.
Q: I have had problems with corns on several toes. I use medicated pads and the corns go away for a while but they keep coming back. Why won't they stay away?
A: While corns are a problem in the skin, their cause is due to irritation to the underlying bone and corns will occur where pressure occurs against a prominent bone. Removing the corn by trimming or medicated pads can help temporarily relieve pain but the mechanical cause is still present. One option is to treat the underlying bone problem so the corn will go away permanently. If keeping the corn trimmed or if it does not hurt that often, surgery may not be the best option.
Q: I sprained my ankle about ten years ago. Since then I have had several other sprains and it just seems to be getting more often that the ankle is twisted. Why won't it heal?
A: The majority of ankle sprains will heal and the individual will have no additional problems. A small percentage of those who sprain their ankles will have severe ligament damage at the time of the first injury. Tests are not routinely done to assess the condition of the ligaments because, again, most will heal just fine. If the ligaments are torn severely, there is no "door stop" to keep the ankle from going beyond its normal range of motion. This makes it very easy to twist the ankle. Even walking over uneven surfaces can be enough to cause a twist or even a sprain. Most people will have an ache in the ankle that gets worse with time. This is due to the abnormal motion occurring because of the torn ligaments. This problem should not be left alone. These ankles need to be braced or often restabilized with an ankle ligament stabilization procedure. These procedures are very effective and can help to prevent problems with arthritis that can happen in unstable ankles. Bracing can be effective but will still allow abnormal motion and probably allow degenerative joint changes to occur. There are tests to evaluate the condition of the ligaments and any ankle that continues to have frequent re-injury should be thoroughly evaluated so options can be discussed.
Q: My heel hurts especially when I first get up in the morning. I have not injured it but it will not get better. What is it?
A: You probably have the problem known as plantar fascitis. It is very common and fortunately pretty easy to get rid of. There are other conditions that need to be considered, so see your doctor. This generally will not go away on its own.
Q: I have been having pain in the ball of my foot and also a little tingling and numbness. What is it?
A: You may have what is commonly called a neuroma. This is basically a small nerve that is being irritated and inflamed by rubbing against the ligaments in the foot. Treatment is usually non-surgical.
Q: I keep getting ingrown toenails about every two or three months. I can usually trim them myself, but lately I am getting infections and more pain. What else can be done?
A: When individuals have repeated ingrown toenails, a nice option is to have just the portion of nail that is ingrown, removed permanently. This is a minor procedure done in the office under local anesthesia. Once it is healed, no special care needs to be done for the nail other than regular trimming.
Q: I have warts on the bottom of my feet. I have had them frozen off and I have also tried over-the-counter medicine, but they still keep coming back. What else can be done?
A: The skin on the bottom of the foot is more than twice as thick as the skin in the hand and often times treatment that is usually successful in the hands and other areas of the body may not be effective in the foot. Ablation of the wart can be done with a hyfrecator or laser, both under local anesthesia. These are ways to eliminate the blood vessels that "feed" the wart, and thereby getting rid of the wart for good.
Q: I have pretty big bunions but they do not really hurt. Should I be thinking about getting them fixed?
A: Almost without exception, if something does not hurt, surgical correction is not generally indicated. There are some conservative measures one can take to help slow the progression of the bunion and possibly prevent the need for correction. Each case is different and the best way to find out what you need to know is to schedule a consultation with a board certified foot and ankle surgeon to discuss your options.
