The following conditions can be treated with orthotics and or a combination of orthotics and Laser Care:
- Heel & Arch Pain
Heel pain can generally be traced to faulty biomechanics, which places too much stress on the heel bone, ligaments or nerves in the area. Stress could result while walking or jumping on hard surfaces, or from poorly made footwear. Being overweight is also a major contributing factor. Some general health conditions including arthritis, gout, and circulatory problems, for example also cause heel pain.
- Plantar Fascial Strain / Plantar Fasciitis:
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Over -pronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
- Heel Spur Syndrome:
Heel spur syndrome, is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, laser or Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Heel spurs are growths of bone on the bottom of the heel bone. They are not the cause of heel pain, rather they are the result of repeated inflammation to the area caused by improper biomechanics of the foot.
- Achilles Tendonitis:
Achilles tendinitis is inflammation and an irritation of the tendon that connects to the back of the heel bone. The Achilles tendon, which is the biggest and the strongest tendon in the body and joins the leg to the foot as it extends from the lower leg to the heel bone. This tendon is crucial to normal walking habits because it enables the foot to increase up on the toes.
Achilles tendonitis is best treated early in the development of the condition. If you’re experiencing discomfort and/or swelling in this region, a consultation with our skilled podiatry specialists will provide you with the very best chance for a complete recovery. It can be treated with ice, relaxation, anti-inflammatory medications, specific workouts and laser care when persistent.
- Flat Feet:
Also known as fallen arches, the condition of flat feet is characterized by a lack of appropriate arch in the inner foot. It can be a genetic condition or the result of improper body mechanics. Often the whole of the foot will contact the ground. Because a healthy foot is structurally able to support the weight of the body thanks to the bone structure that comprises the arch, a flat foot often is unable to properly support this weight and will cause extreme pressure in the joints above, such as the ankles, knees and hips.
If you have flat feet, you may also experience pain throughout the lower body and into the lower back. Orthotics can be prescribed to create a system of support for the body.
Prefabricated orthotics (Prefabs)
A prefabricated orthotic is an arch support with a small, generic correction for pronation. They can be customized to improve function and are used for mild pronation related symptoms, particularly with children. These are less costly and less corrective than custom orthotics, but more expensive and more corrective than arch supports. I offer both adult prefabricated orthotics and prefabricated orthotics for children from toddlers to teens.
Arch supports are over the counter devices meant to bolster up the arch. They can be modified to a degree and may be helpful for absorbing shock or as a framework for holding pads meant to off weight areas, such as metatarsal pads. It is difficult to get an exact fit with an arch support. An example of this is simply looking at the packaging and seeing the sizing chart which will state made for men’s size 7-8 or 9-10 foot, or women’s 7-8 or 9-10 foot. Arch supports are helpful for mild symptoms.
A neuroma is a thickening of nerve tissue that can develop in various parts of the body creating nerve damage. Morton’s neuroma is the most common neuroma in the foot. It most often occurs at the base of the second and third, or third and fourth toes.
If you have a Morton’s neuroma, you will likely experience the following symptoms:
A feeling that something is inside the ball of the foot
The symptoms begin gradually and occur only occasionally at first. This generally happens when one is wearing narrow shoes or performing certain activities. The symptoms may go away temporarily by massaging the foot or by avoiding activities that brought on the pain.
However, over time, the symptoms progressively worsen and may persist for several days or weeks at a time. The symptoms become more intense as the neuroma grows in size and the nerve damage becomes more permanent.
People with certain foot deformities such as bunions, hammertoes, flat feet or hypermobile feet, are at high risk for developing a neuroma. Individuals who participate in activities that require a repetitive irritation to the ball of the foot are also at risk.
Treatments generally include wearing corrective shoes or orthotics and/or receiving cortisone injections. Newer on the scene is laser treatment to shrink the neuroma. The benefit of this is that it is non- invasive and the neural pathway is not interrupted. In severe cases, surgical removal of the growth may be necessary.
Toenails often serve as barometers of our health; they are diagnostic tools providing the initial signal of the presence or onset of systemic diseases. For example, the pitting of nails and increased nail thickness can be manifestations of psoriasis. Concavity-nails that are rounded inward instead of outward may signal iron deficiency anemia. Some nail problems can be conservatively treated while others require partial or total removal of the nail.
Any discoloration or infection on or about the nail should be evaluated by a podiatrist. The most common nail problems include the following:
- Ingrown Toenail
Although they can start out as a small nuisance, ingrown toenails can become a real problem if left untreated. Caused by a segment of the toenail that embeds in the skin around the nail, an ingrown toenail is characterized by pain, swelling, redness and a feeling of warmth in the affected toe. If the nail digs into the flesh around the nail and causes the skin to break, bacteria can enter, resulting in an infection. The infection can increase the level of pain in the toe and create additional problems. While some people are prone to ingrown toenails and others are caused by improper nail trimming techniques, ingrown toenails can also be caused by trauma from repeated impact or stubbing the toe.
Treatment for minor ingrown toenails can often be done in the home if you are in good health and if no infection is present. Soaking the foot to soften the skin and massaging the affected area with antibiotic ointment can loosen or soften the troublesome part of the nail.
If physician care is necessary, antibiotics may be prescribed to manage the infection and an outpatient surgery may be necessary to remove the offending nail. The nail or nail border may be removed permanently if the nail border is free of infection and the problem is chronic. If you are in need of care for your ingrown toenail or are unsure how to properly care for your toenails, contact a podiatrist. Ingrown toenails can be a serious condition for people with impaired circulation, diabetes, or other systemic diseases.
Onychomycosis is a fungal infection of the toenails or fingernails. This ailment causes nails to thicken, discolor, disfigure, and split. It may cause pain and difficulty in walking due to pressure inside the shoe and secondary bacterial infection in skin surrounding the nail. Onychomycosis is not easily identified by its appearance. There are conditions such as psoriasis and trauma that can mimic the appearance of onychomycosis
Warts are benign (noncancerous) growths which can occur when the human papilloma virus (HPV) invades the body. Plantar warts appear on the plantar surface, or sole of the foot. They are really no different than any other wart, although because of their location, they are more likely to look relatively flat as opposed to raised. Most warts are diagnosed based on their appearance. They are generally rough and spongy, and most are gray, brown, or yellow with dark pinpoints—these pinpoints are tiny capillaries that supply blood to the wart.
When first identified, people often feel a “lump” on the bottom of the foot when standing, related to having a stone in the shoe. If left untreated, plantar warts can develop and may spread into clumps (called mosaic warts). In serious cases, they cause a change in gait or posture that leads to leg or back pain.
The virus is often present on contaminated surfaces, such as the tile floors of public locker rooms, showers, and swimming pools.
Some people are more prone to the virus that causes plantar warts than others including:
Age – Children, especially teenagers, tend to be more susceptible to warts than adults.
In some instances, the virus can be transmitted to the toes from other areas of the body. This is called remote location seeding.
A corn is a small area of skin which has become thickened due to pressure on it. A corn is roughly round in shape. Corns press into the deeper layers of skin and can be painful.
Hard corns commonly occur on the top of the smaller toes or on the outer side of the little toe. These are the areas where poorly fitted shoes tend to rub most.
Soft corns sometimes form in between the toes, most commonly between the fourth and fifth toes. These are softer because the sweat between the toes keeps them moist. Soft corns can sometimes become infected.
A callus is larger and broader than a corn and has a less well-defined edge. These tend to form on the underside of your foot (the sole). They commonly form over the bony area just underneath the balls of your feet. This area takes much of your weight when you walk. They can become painful when they become thicker.
What causes corns and calluses:
Friction or pressure causes the skin to thicken. This may lead to corns or calluses forming.
The common causes of rubbing and pressure are tight or poorly fitting shoes which tend to cause corns on the top of the toes and side of the little toe. Biomechanical abnormalities can lead to too much or unequal forefoot pressure causing calluses under the balls of the feet.
If you develop a painful corn or callus it is best to get expert advice from a podiatrist, as this would be the medical professional best qualified to diagnose and treat foot disorders. You should not cut corns yourself, especially if you are elderly or have diabetes.
Advice and treatments usually considered include the following:
- a) Trimming (paring down)
The thickened skin of a corn or callus can be pared down by a podiatrist by using a scalpel blade. The pain is usually much reduced as the pressure on the underlying tissues eased. Sometimes, repeated or regular trimming sessions are needed. Once a corn or callus has been pared down, it may not return if you use good footwear.
If the skin seems to be thickening up again, a recurrence may be prevented by rubbing down the thickening skin with a pumice stone once a week. Many people can do this themselves. It is best to soak your foot in warm water for 20 minutes to soften the thick skin before using a pumice stone or emery paper. A moisturizing cream used regularly on a trimmed corn or callus will keep the skin softened and easier to rub down.
- b) Shoes and footwear
Tight or poorly fitting shoes are thought to be the main cause of most corns and calluses. Sometimes a rough seam or stitching in a shoe may rub enough to cause a corn. The aim is to wear shoes that reduce pressure and rubbing on the toes and forefeet. Shoes should have plenty of room for the toes, have soft uppers and low heels. In addition, extra width may be needed if corns develop on the outer side of the little toe. Wear on the outside edge of the heel can also cause corns in this area. Extra height is needed if corns develop on the top of abnormal toes such as ‘hammer’ or ‘claw’ toes.
Correcting poor footwear will reduce any rubbing or friction on your skin. In many cases, a corn or callus will go away if rubbing or pressure is stopped with improved footwear. Some people with abnormalities of their feet or toes will need special shoes to prevent rubbing. A podiatrist can advise you about this.
- c) Footpads and toe protection
Depending on the site of a corn or callus, a cushioning pad, shoe insole or orthotic may be of benefit. For example, for a callus under the foot, an orthotic may be used to off weight the pressure area. If there is a corn between your toes, a special pad around or between your toes may ease the pressure by creating space between the toes. A podiatrist will be able to advise you on any appropriate padding, insoles or appliances you may need.
- Athlete’s Foot:
Athlete’s foot is a common infection of the skin by fungus and can be characterized by itching, scaling, redness or the formation of small blisters. The most common areas affected are the bottom of the foot and between the toes. The fungus has the potential to spread to the toenails, causing them to become thickened, discolored and painful. While this infection is common among athletes, keep in mind that it can affect non-athletes as well.
- Foot Odour & Sweaty Feet (Hyperhydosis)
The feet and hands contain more sweat glands than any other part of the body, with roughly 3,000 glands per square inch. Smelly feet are not only embarrassing, but can be physically uncomfortable as well.
Feet smell for two reasons: 1) shoe wear, and 2) sweating of the feet. The interaction between the perspiration and the bacteria that thrive in shoes and socks generates the odor. Therefore, any attempt to reduce foot odor has to address both sweating and footwear.
Smelly feet or excessive sweating can also be caused by an inherited condition, called hyperhidrosis, which primarily affects men. Stress, some medications, fluid intake, and hormonal changes also can increase the amount of perspiration our bodies produce.
Persistent foot odor can indicate a low-grade infection or a severe case of hereditary sweating. In these cases, a prescription ointment may be required to treat this condition.
Poor circulation in the feet is a major concern because it may signal other health problems. Circulatory problems may be marked by persistent, unusual feeling of cold, numbness, tingling, swelling, burning or fatigue in feet and legs. Other symptoms may include discoloured skin, dry skin, absence of hair on feet or legs, or cramping or tightness in leg muscles.
Diabetes affects the circulation and immune system, which in turn impairs the body’s ability to heal itself. Over time, diabetes can damage sensory nerves (this is known as neuropathy”), especially in the hands and feet. As a result, people with diabetes are less likely to feel a foot injury, such as a blister or cut. Unnoticed and untreated, even small foot injuries can quickly become infected, potentially leading to serious complications. Prevention is key in dealing with diabetes. Once the skin ulcerates, it becomes chronically prone to re-ulceration.
Arthritis is a disabling disease that affects millions of Canadians. It is characterized by inflammation of the body’s joints. Symptoms can include swelling, recurring pain or tenderness, redness or heat, with limitation of motion in one or more joints. Early morning stiffness as well as skin changes including rashes and growths may be present as well. Common forms of arthritis include osteoarthritis, rheumatoid arthritis and gouty arthritis. Because each foot contains 33 joints and bears a tremendous amount of weight and pressure, feet may be more susceptible to arthritis than other parts of the body.