A corn is a development of thickened dead tissue on a toe due to irritation. Corns can quite painful. It is typically due to mechanical irritation of the toe up against the shoe. The reason hammertoes are painful is either due to a corn or bursitis, which is an inflammation of the toe. Swelling sometimes occurs under the toe where the pressure is. It is important to be evaluated if you have a corn because the corn can become quite thick and can also cause an infection or ulceration (breakdown in the skin). Infections and ulcers can be dangerous with risk of bone infection and/or gangrene.

We commonly see this in diabetic patients who do not pay attention to their feet and present to the doctor's office with a swollen toe after weeks of bleeding and swelling. Most importantly we recommend being evaluated for this problem by a podiatrist. Multiple treatment options are available. Simple peeling of the corn can usually provide relief and a shoe gear change. Accommodative shoe gear is one way of conservatively treating the problem with an extra depth shoe or very wide sneaker. Many times the shoe is more the offending factor. If the toe is still swollen and painful after debridement we recommend possible cortisone injection. Lastly if conservative treatment fails we recommend a surgical procedure where we remove a small piece of bone and straighten the toe with very little post-op course.

People with high arches come into my office with a multitude of foot and ankle problems. A high arch is when the foot is shaped like a "c". This shape of the foot can cause various problems in the foot and the ankle. The mere shape of the foot causes many patients to land on- the heel and foot in an unstable manner. High arch, also called cavus foot, causes rigidity in the foot and the body's natural ability to absorb shock is hampered. Several other problems typically occur due to high arches, such a heel pain, Achilles tendinitis, painful bumps on the back of the heel called bone spurs and arch pain. The way the foot is shaped and high arched feet can be surgically corrected to change the way that it lands. The arch is typically stretched in a weird way and arch tissue gets inflamed and painful. Due to the instability bunions, or knob like structures on the side of the foot, occur and can get larger. Tendons on top of the foot and ankle typically will get strained because of the structure of the foot.

Treatment varies from patient to patient. It is important to have x-rays to see if there is what we call spurring, or bony growths (also called degenerative joint damage), that occurs due to this foot type. Caves or high arched feet can be surgically corrected, but we usually try a conservative treatment, which is usually is the treatment of choice. Typically custom orthotics, which are custom casted to your feet, will provide relief for our patients. Another device we use is an ankle foot orthotic, a bulkier device that completely encapsulates the foot and ankle. Shoe gear that is not structurally sound for a high arched foot could be quite problematic. We recommend that if you have a cavus foot type that you be evaluated by a podiatrist. Lastly, if you have a child that has this type of foot it would be best if the patient is evaluated because early detection is the key to healthier and less problematic scenarios that will occur in the foot.

Many people wake with a cramp in the heel area. The pain in the foot, heel and arch area typically eases after the first several steps. This type of pain in the foot is typically called plantar fasciitis and can be very debilitating. Plantar fasciitis is caused by an inflammation of the arch cord that supports the foot called he plantar fascia. There are many causes of plantar fasciitis such as weight gain, change in shoe gear, walking on uneven surfaces and even trauma, This type of foot pain can be extremely painful and can stop people from walking due tot he severity at timers. It is one of the most common ailments a podiatrist will see in their office. Treatment options for plantar fasciitis range from simple stretching exercises to custom made orthotics, a heel cup to cradle the foot and heel area, icing regimens and possibly even a cortisone shot, Physical therapy is a wonderful way to compliment the treatment of plantar fasciitis. Many times a physical therapist will stretch the tissue called the plantar fasci along with relaxation of the arch tissue via ultrasound therapy. Prescription anti-inflammatory medication is another viable option for people with this type of foot pain. So it is not normal for your heel and arch area to hurt. If you have pain in your heel and arch area; you probably have some from of plantar faciitis and you should seek the advice of a foot specialist.

Many patients come in with a painful red swollen area on the back of their heel. This may be caused by irritation of the skin at the site, may be shoe gears such as high heels; might be a bony deformity or possibly a fracture. Typically a foot doctor will evaluate the area with an xray. Which is very helpful in the treatment plan. If the problem is a bone spur there are a multitude of treatments. We typically try to treat he problem conservatively with a custom orthotic and try to change the pitch or the angle of the way the heel lands in the shoe. Obviously trying to decrease heel height may be helpful. Other forms of treatment are trimming callous tissue and applying a pad in the area to decrease pressure at the site. Surgical intervention is only used when conservative therapy fails.

Many patients come in for painful sore with hard skin on the side of their big toe. If left alone the hard skin becomes tender due to thickness. If left untreated the callous get so thick that the area becomes ulcerated or infected. There are a multitude of reasons for this. Skin irritation from the big toe rubbing against the skin is one problem; trauma caused by an improper fitting shoe may be the cause and lastly you may not be properly walking because of a joint problem in your big toe. A podiatrist will cut down the callous or hard skin with a scalpel blade and make you comfortable. A range of motion exam of the foot and ankle is usually performed. A gait exam is usually performed (watching the way a person walks). Foot doctors typically examine the shoes you wear and can provide a treatment plan for you according to the shoes you wear. Sometimes a simple type of pad can be applied to the foot and the "hard skin" will either go away or not be so painful.