Bunion

Bunion is a lateral deviation of the great toe with a bony prominence noted at the inside of the great toe joint.

Bunions, also known as Hallux Abducto Valgus, occur when the great toe is angled toward the smaller toes with a bump noted on the inside of the great toe joint.  This bump can make it difficult to properly fit a shoe.  This condition has a strong genetic predisposition.  Bunions can be painful or have a complete absence of pain.  Bunions are usually noted from a difficulty in fitting shoes or from pain due to pressure of ill fitting shoes. 

Treatment of Bunions:

• Alteration of style and fit of shoes
• Accommodative padding
• Over the counter arch supports
• Custom orthotics
• Anti-inflammatory medications
• Bunion splints
• Surgery

Hammertoe

Hammertoe is a deformity of the smaller toes resulting in a bending of the toe.  The first joint of the toe is affected and bends up resembling a hammer. 

This is a very common toe deformity with a strong genetic predisposition.  Hammertoes occur due to a muscle imbalance in the foot.  This resultant change in position can lead to shoe irritation, foot pain, and ulceration.

Treatment of Hammertoes:

• Shoe alteration
• Accommodative padding
• Hammertoe splints
• Arch supports
• Custom orthotics
• Surgery

Neuroma

Neuroma is a fibrous tissue that develops around an irritated nerve. 

The condition presents with pain at the bottom of the ball of the foot and results in numbness and tingling to the affective toes.   This condition is aggravated by barefoot walking on hard surfaces.  Neuromas are caused by increased pressure on a nerve.  The irritated nerve responds by padding itself with fibrous tissue.  The larger the pad the more irritated the nerve becomes. 

Treatment of Neuroma:

• Resting the foot
• Better fitting shoes
• Anti-imflammatory drugs
• Ice packs
• Local cortisone injection
• Surgery

Onychomycosis

Onychomycosis is a fungal infection of the toenails.

This is a very common condition resulting from fungus living in and around the toenails.  The toenails will appear thick and discolored.  The discoloration can be yellow, brown and sometimes even black.  Fungal toenails do not necessarily hurt.  The fungus is created by the environment the toenails are exposed to.  This usually is a result of moisture within shoes. 

Treatment of Onychomycosis:

• Debridement (this is thinning and trimming of the toenails)
• Keratolytics
• Topical Antifungals
• Oral Antifungals
• Surgical removal (temporary or permanent)

Plantar Fasciitis

Plantar Fasciitis is the inflammation of the Plantar fascia.

The plantar fascia is a ligament that attaches to the heel and runs to the end of the foot.  At the end of the foot it attaches at the ball of the foot and into the toes.  Upon weight-bearing this ligament is stretched.  This stretch sometimes exceeds the capability of the ligament and thus small tears occur.  The tearing typically occurs at the bottom of the heel on the inside.  The pain can radiate around the heel and sometimes up the side of the ankle.  Patients usually report pain in the morning upon initial weight-bearing or upon initial weight-bearing after a period of rest.  The pain usually subsides after a few minutes of walking, but can last longer. 

Treatment of Plantar fasciitis:

• Stretching
• Icing
• Arch support (over the counter or custom orthotics)
• Anti-imflammatory drugs
• Steroid injections
• Night Splints
• Physical Therapy
• Ultrasound Therapy
• Platelet Rich Plasma Injections
• Surgery