Foot conditions and treatments

Diagnosis

The diagnosis of an ingrown toenail can be made on the basis of the appearance of the toe. A history is also obtained to determine the cause of the ingrown toenail, and to address any predisposing conditions.

Treatment

In some cases, the edge of the nail can be separated from the side of the toe. Padding is the placed between the nail and the toe to encourage growth in the correct direction. Many cases require partial surgical removal of the toenail. A new, normal, slightly narrower nail then grows in over the next several months.

Without treatment

The nail may continue to grow into the side of the toe. This can lead to progressive pain or recurring infection. It is most serious in people with underlying medical problems such as diabetes or peripheral vascular disease.

Cause

Fungal infections are fairly common because microscopic fungal, yeast and mold organisms are present everywhere in the environment. Toenails are particularly susceptible to infection because they are often kept in warm, moist environments in which these microscopic organisms thrive.

Diagnosis

Your podiatrist may look for the symptoms listed below to diagnose or rule out the condition, or a sample may be obtained from the nail in question for further investigation under a microscope.

Symptoms

If you have any of these symptoms, give us a call to schedule a consultation. While toenail fungus infections can be stubborn, they are treatable. Left untreated, however, the infection will only get worse over time.

Common symptoms of a nail fungal infection include:

Discolored nails
Thickened, dull (shine-free) or distorted nails
Yellow streaked nails
Buildup of debris under the nail
Separation between the nail and skin
Brittle, ragged nails
White spots on the surface of the nail
Treatment Options

Your podiatrist may suggest one or more of the following courses of action to treat your toenail fungal infection:

Oral Antifungal Medications: A six to 12 week treatment may be prescribed to clear up your infection, which may take a full four months or longer to completely resolve. Your doctor may ask you to have a liver functioning test before prescribing oral antifungals.

Topical Antifungals: Available in the form of lacquers (nail polish) or ointments, your Podiatrist may use topical antifungals in addition to oral medications to assist in clearing up the infection.

Diagnosis

Your podiatrist will diagnosis athlete’s foot after conducting a physical examination of your feet. In some cases a skin scraping is obtained to look for fungus under a microscope, or a culture is taken to grow and identify it.

Treatment

Usually an anti-fungal cream or ointment applied to the affected area for 2 to 4 weeks will resolve the problem. Depending on the severity of the case, the medication will be available by prescription or over-the-counter. In certain cases, oral medications maybe prescribed via your GP.

Without treatment

The nail may continue to grow into the side of the toe. This can lead to progressive pain or recurring infection. It is most serious in people with underlying medical problems such as diabetes or peripheral vascular disease.

With expertise in Bio-mechanics, your Podiatrist can take a mould of your feet and have custom inserts made, by prescription, to treat your feet. We can make orthotics for kids, athletes and for everyday use.

About Orthotics

With years of specialised training in foot care, Bhavesh, is an expert in treating foot problems with orthotics. Just as contact lenses improve vision, orthotics improve foot function.

Custom orthotics are made from “casts” or moulds of your individual feet. Each orthotic exactly matches the contour of each foot. In addition, “angled posts” or wedges are added that match the angular relationship between your leg, rear foot and forefoot.

Unlike an arch support, a custom orthotic moves with your foot. It controls certain parts of your foot at certain times during your gait, or walking cycle. Although orthotic devices may look like simple pieces of plastic, they profoundly affect your entire musculoskeletal system.

Orthotics may protect the tender areas of your foot from the wear and tear of constant use. Even if your foot problem is best treated by surgery, orthotics may delay the need for surgery and help maintain your surgical correction afterwards.

An Orthotic for Everyday Needs

Orthotics come in a variety of materials, ranging from rigid plastics to soft foam. All of these materials can be shaped to fit your individual foot. The rigid orthotics offer the most control of movement, while the softer ones provide better cushioning and protection. When prescribing your orthotics, Bhavesh, will make the best match between your needs and the qualities of the materials.

Diagnosis

Your podiatrist will diagnosis a plantar wart based on physical exam and description of symptoms.

Treatment

If your Podiatrist determines that your wart needs to be treated, the usual choice of therapy is concentrated salicylic acid and/or monochloroacetic acid, which when applied under professional guidance, causing chemical desiccation. This process may take several weeks or months. Other treatment options for plantar warts include needling, freezing them with liquid nitrogen, and removing them with surgery.

Without treatment

Sometimes plantar warts go away on their own if left untreated. However, many warts can become increasingly larger and more painful and can begin to multiply into clusters of warts called mosaic warts. Walking and running will become difficult in these situations.

Diagnosis

A callus or corn is typically diagnosed upon examination.

Treatment

Your podiatrist can recommend simple over-the-counter treatments such as pads or pumice to decrease the calluses or corn. In severe cases calluses may require regular shaving to keep them from becoming too large.

Without treatment

While treatment for calluses and corns is not always necessary, it may provide you with more comfort. Larger calluses can cause significant pain. In some patients, especially when they become cracked, calluses can lead to wounds that can lead to serious problems, especially in people with diabetes.

Diagnosis

A neuroma is first diagnosed based on the history of the type of pain someone is having. There are also ways to examine the foot that can diagnose this condition. In some cases an MRI or ultrasound scan is done to obtain pictures of the tissue in the foot.

Treatment

The simplest form of treatment involves wearing a specialised insole along with shoes that allow the feet plenty of room on the sides. In some cases an injection can be given into the neuroma. In difficult cases surgery can be curative. The best remedy for such pathology is a combined approach of treatment modalities.

Without treatment

The pain caused by a neuroma can progress and become severe.

Diagnosis

The diagnosis of sesamoiditis is made based on the location of the pain and on the type of activities that make it worse. There is also pain when pressure is applied to the sesamoid, especially on the inside part of the ball of the foot.

Treatment

Treatment involves primarily rest. Special footwear with a rigid sole that minimizes movement of the joint at the base of the big toe may also be prescribed. In some cases a steroid injection along SPECIALISED INSOLES/ORTHOSES the sesamoid is given.

Without treatment

Pain may increase. In some cases the sesamoid can become fractured. In severe problems that involve the sesamoids the bone itself can be surgically removed.

Diagnosis

Your podiatrist will exam your foot for swelling, redness and tenderness of the area. This pathology is often misdiagnosed and often results in treatment failure. A good clinical examination is essential to maximise a good outcome.

Treatment

Initial treatment usually involves heel stretching exercises, night splints or shoe inserts. Anti-inflammatory medications may also be given. Treatment can span several months to two years before symptoms improve. Most patients will see an improvement within one year. Further treatment may include steroid injections into the sole of the foot, or in certain situations a surgical procedure that releases the plantar fascia.

Without treatment

Foot pain can continue, and progress into a severe condition that affects the ability to walk. Eventually, permanent damage to the plantar fascia or surrounding nerves may occur.

Diagnosis

Fractures can be diagnosed with the use of an X-ray, or other imaging such as a CAT scan or MRI. Sprains are often diagnosed on the basis of the type of injury and where the pain and tenderness is. Sometimes an MRI can help diagnose a specific sprain.

Treatment

The initial treatment of either a sprain or a fracture includes rest, elevation and ice. It is important to keep weight off of the affected foot or ankle. In some cases a cast or splint is applied to minimise motion so that the foot or ankle can heal properly. In other cases surgery may be needed to repair a ligament or to stabilise a fracture.

Without treatment

If the support of the foot is compromised, then permanent damage may result. If the tissues do not heal properly then pain may progress and not go away.