One of the most common foot problems seen by podiatrists is a bunion. Typically recognized as an unsightly bump at the base of the big toe, a bunion is actually a deformity of the framework of the foot. It develops when the joint at the base of the big toe becomes unstable, causing both the bone and soft tissues to move out of place. The bunion’s characteristic bony knob appears on the foot just behind the big toe and angles outward as the big toe angles inward toward the smaller toes. Occasionally, a bunion may develop at the base of the little toe on the outside of the foot. This is known as a tailor’s bunion or bunionette.
Foot mechanics that put too much pressure on the big toe joint may be the reason behind the development of bunions. Factors such as gait, inherited foot type, wearing ill-fitting or poorly designed footwear, as well as having an occupation that puts a lot of stress on the feet can increase the risk that a bunion will form. Individuals affected by injuries to foot alignment, neuromuscular disorders, congenital deformities, or joint conditions are also more likely to develop bunions.
Without the appropriate care, a bunion can widen the foot, make wearing shoes more difficult and impair daily function. A shifting big toe can put so much pressure on the smaller toes, that they too develop abnormalities. Moreover, the toe joint damage associated with a bunion can cause stiffness, bursitis, or arthritis and give rise to additional complications.
Dr. Wright will evaluate your bunion and develop an appropriate treatment plan. If non-surgical, conservative methods of care fail to provide relief, and the bunion is interfering with your daily life, Dr. Wright may recommend a surgical procedure.
One of the most common toe deformities seen by our office is a hammertoe. Most often attributed to wearing ill-fitting, tight footwear or high-heeled shoes that squish the toes into a bent position, a hammertoe can also be influenced by genetic factors, the result of a bunion, or caused by arthritis in the toe joint.
Just as the name implies, a hammertoe resembles a “hammer” with the toe bending at the middle joint into a claw-like deformity. Hammertoes can develop in any of the small toes of the foot, but most often affect the second and third toes. Hammertoes usually affect women, but men can develop them as well.
Hammertoes can cause you discomfort while walking or when you simply try to move or stretch your toes. You may also develop corns or calluses on the top of the toe and the ball of the foot and have difficulty fitting into your shoes.
While in the early stages of a hammertoe, the joint may still be flexible and conservative therapy will provide sufficient relief. Left untreated, your toe will become more rigid and less responsive to these methods of care.
Dr. Wright will develop an appropriate plan to treat your hammertoe, taking into consideration the severity of the toe deformity, existing medical conditions, your level of activity as well as any other factors that may influence your care. A non-surgical, conservative approach may include strategically placed foot padding, wearing shoes with a roomy toe box, custom orthotics, splinting and taking anti-inflammatory medication as needed to reduce pain and inflammation. In severe cases, surgery may be required to straighten the joint. A combination of procedures may be recommended when a hammertoe is accompanied by other foot deformities.
Whether due to repetitive strain (overuse injuries) or a sudden accident (acute injuries), sports injuries to the stress-bearing lower limbs are a frequent occurrence among athletes and casual exercisers alike. Common sports injuries to the foot, ankle and lower leg range from blisters, contusions, and toenail trauma to turf toe, heel pain, Achilles tendon problems, sprains or strains, as well as fractures from repeated stress or sudden impact.
It is recommended that individuals who have sustained an injury seek treatment in a timely manner and refrain from continued stress to the affected site, to prevent further trauma or the onset of other complications.
After taking a comprehensive patient history and performing a clinical exam of the injured site, including ordering diagnostic tests as needed, Dr. Wright will determine the exact nature and extent of the problem, and design an individualized treatment plan based on the specific needs of the case. In addition to promoting healing and restoring mobility, Dr. Wright will recommend treatment to prevent re-injury. While sports injuries to the foot, ankle and lower leg can be frustrating to those who enjoy regular physical activity, it is important for patients to prioritize treatment and recovery to ensure they can make a healthy return to their daily routine and recreational pursuits.
The feet contain a high concentration of nerve endings, around 200,000 per sole. This allows the feet to be extremely sensitive to external stimuli, yet also leaves them susceptible to nerve pain. Foot pain is a common problem, with the underlying reasons ranging from problems in the bone, soft tissue or skin to the onset of medical conditions such as gout or arthritis as well as trauma, certain foot syndromes and other problems. Lower back problems often produce referred nerve pain and altered sensation that can affect the legs and feet. Likewise, individuals with diabetes can develop peripheral neuropathy that is accompanied by pain, burning, tingling and numbness in the lower extremities.
Pain is the body's natural method for alerting the brain to a problem. If you are experiencing a mysterious pain in the feet—whether sharp, throbbing, or dull—contact our office as soon as possible for diagnosis and treatment. In cases of foot pain, timely treatment is important to prevent a continued downturn in foot health and function.
Minimally invasive foot surgery involves the use of advanced methods of care and specialized instruments to perform surgical procedures through small, minute incisions. With minimally invasive surgery a range of painful foot conditions such as bunions, recurring corns, hammertoes, big toe arthritis, heel pain, and many others can be successfully treated.
Performing surgical procedures on the feet through small incisions means less injury to the adjacent tissues and the need for fewer sutures (stitches). Healing with this method of care is quicker, and recovery time reduced. With minimally invasive foot surgery less anesthesia is typically required, and patients are often awake during the procedure while their foot is completely numbed. Because of this, even patients with complex medical histories can have surgical procedures.
For patients, it is very reassuring to know that with minimally invasive foot surgery the chances of post-operative pain and scarring are significantly reduced, and a quicker return to normal activity is anticipated. In many cases, Dr. Wright can perform minimally invasive foot surgery as an outpatient procedure with patients returning home the same day.
Not every injury requires surgery, and with advances in modern medicine like extracorporeal pulse activation technology (EPAT), you may be back running in a few hours.EPAT, or sometimes referred to as shockwave, is a revolutionary use of pressure waves to stimulate various cells involved in distinct metabolic pathways to heal and restore scar tissue.EPAT has quickly become one of the most sought after treatment modalities amongst high performance athletes because its ability to provide therapy without limiting daily activities.Unlike surgery, EPAT requires no recovery time, nor latent periods.As EPAT is a medical treatment, it must be administered by a doctor.If you are interested in exploring EPAT as a treatment option, contact our office for a consultation.
Botulinum toxin's effect of inhibiting muscular contraction has been extensively observed in medical literature for more than 10 years.We as a medical community have also learned that botulinum toxin can be used as an effective treatment of plantar hyperhidrosis (sweaty feet) or plantar bromhidrosis (odorous feet).The reduction in sweat production by inhibiting certain nerve fibers in the feet leads to a less optimal environment for bacterial growth that are responsible for the odor.
As we age, the fat cushioning across the ball of the foot tends to migrate distal (toward the toes) exposing the bones (metatarsal heads) in the forefoot to the hard floor.This combined with overall atrophy of the fat pad can lead to inflammation of the underlying soft tissue structures and resulting pain.A novel treatment with regard to this pathology is Sculptra, a synthetic poly-L-lactic acid construct used to reconstitute the cushioning in the ball of the foot.By providing a shock-absorber to this area of high impact, patients usually notice a dramatic improvement in pain after standing for longer periods of time.
PRP, or platelet rich plasma, utilizes the components of the body’s own growth factors to accelerate the healing process.The process by which PRP works is by concentrating the patient’s own platelets and re-introducing them back into the body at the point of pathology.Usually, this therapy is targeted toward tendons and ligaments as these tissues have limited blood supply when compared to other tissues.Because PRP uses growth factors, it is very important that patients not take anti-inflammatory medications, such as ibuprofen while undergoing treatment.If you have recently suffered an injury to your lower extremity, you may be a candidate for PRP.
The term stem cell is used to denote the presence of an undifferentiated cell with the potential to become many different cells. Although current targeted therapy is not inducing differentiation, it is utilizing the ability of the cells to regulate various different regenerative pathways. This is best evidenced with the use of stem cells in restoration of scarred tissue or acutely inflamed areas. The use of these therapies has quickly gained traction with major pharmaceutical companies as a result of various supporting clinical trials. At Quantum Foot and Ankle Group, we believe in offering our patients the most up-to-date treatments that have proven effective - stem cell injections is one of these treatments.
A neuroma is an aberrant growth of nerve tissue resulting in a "pinched nerve". Patients will many times remark that they get a sharp pain in their foot, or that it has an "electrical sensation". This is usually due to aberrant firing of the nerve fibers as a result of mechanical stimulation. Neuromas can become very debilitating / activity altering when they become large. Treatment options exist from a series of injections to surgery to remove the mass entirely.
Fungal nails, or onychomycosis, is a common presenting infection of the lower extremity. Patients will usually notice that their nails have become thickened or discolored. A definitive diagnosis of fungal nails is made by taking a biopsy and submitting it to pathology. Many times fungal nails can be confused with microtrauma (repetitive trauma to the nail bed that causes irreversible damage). It is important to determine the underlying cause in order to provide the best treatment. There are numerous types of treatment available for fungal nails. One of our medical professionals will discuss these with you at the time of your visit.
Plantar warts, or verruca plantaris, is a common presenting pathology of the lower extremity caused by an infection with certain strains of the human papilloma virus or HPV. This particular type of wart is very difficult to treat and will require a series of office visits and topical medications to resolve. Given your specific presenting severity, one of our medical professionals will review the best treatment options for you and devise a treatment plan.
Verity CT imaging is one of the latest developments in medical imaging. Using extremely low dose radiation (approximately 1/10 of that from a standard CT) the verity system is able to produce the highest quality of images to date, enabling our doctors to make a definitive diagnosis and better treatment plan. Given its low radiation exposure, the Verity system is one of the only imaging modalities approved for the use in pediatric patients. It is currently being used in various clinical trials to plan the construction of custom 3D printed plates and screws for patients requiring significant reconstruction.
At Quantum Foot and Ankle, we understand that life can be unpredictable, and many times hectic. For this reason, we have tailored a list of concierge / in-home services for those patients that have unique schedules that don’t allow for an 8am-5pm office visit. If you are interested in learning more about our in-home concierge services, please contact us for more information.