My Blog http://www.mitchellwachteldpm.com/blog.html en-us Wed, 28 Jul 2010 15:07:18 -0500 Tue, 27 Jul 2010 13:52:26 -0500 http://blogs.law.harvard.edu/tech/rss Officite Development Scripting Why Do I Have a Corn On My Toe?http://www.mitchellwachteldpm.com/blog/post/why-do-i-have-a-corn-on-my-toe.htmlA 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.

]]>Thu, 15 Jul 2010 16:14:27 -0500Why Is My Arch So High?http://www.mitchellwachteldpm.com/blog/post/why-is-my-arch-so-high.htmlPeople 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.

]]>Thu, 15 Jul 2010 16:12:16 -0500There Is Pain In My Heel - Is That Normal?http://www.mitchellwachteldpm.com/blog/post/there-is-pain-in-my-heel---is-that-normal.htmlMany 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.

]]>Wed, 26 May 2010 12:48:31 -0500I Have A Painful Bump On The Back Of My Heelhttp://www.mitchellwachteldpm.com/blog/post/i-have-a-painful-bump-on-the-back-of-my-heel.htmlMany 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.

]]>Wed, 19 May 2010 14:13:23 -0500Why Is There A Callous On The Side Of My Big Toehttp://www.mitchellwachteldpm.com/blog/post/why-is-there-a-callous-on-the-side-of-my-big-toe.htmlMany 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.

]]>Wed, 19 May 2010 14:13:23 -0500My Big Toe Is Numbhttp://www.mitchellwachteldpm.com/blog/post/my-big-toe-is-numb.htmlMany patients come in to our office and state that they have lost feeling in their big toe. When you see a podiatrist for numbness the foot doctor will evaluate whether you truly have numbness or the fact that you may perceive your skin is numb. There are multiple instruments podiatrists use to decipher whether there is numbness or not. There are nerve tests we can perform to evaluate what the cause may be. Sometimes we can perform a nerve biopsy to decide whether you may have a condition called neuropathy which has multiple causes. If you have numbness and it is true; it is important for your podiatrist to investigate the reasons. If you have neuropathy you may be suffering from diabetes.

]]>Wed, 19 May 2010 14:13:23 -0500My Knee Hurts When I Runhttp://www.mitchellwachteldpm.com/blog/post/my-knee-hurts-when-i-run.htmlMany runners come in to the office complaining of pain in their knees. It typically occurs on the inner aspect of the knee. Many times patients take anti-inflammatory medication and the pain returns once the patient returns to running. Many people never think that about their feet and the impact of the way the foot and the ankle are aligned when they land. If your foot and your ankle are pronated or everted or closer to the ground and collapsing; when you land; this will put extra pressure on the inner aspect of your knee. When we run we put excessive pressure on our joints and if the foot is landing a certain way that can cause excessive stresses on different parts of then body. If you have pain in your knees or hip when running; I would recommend seeing a foot specialist. A podiatrist will evaluate the way you walk and see the way you land on your foot and many times by making a change in the way you land mechanically both via shoe style and possibly otrthotics ; your pain just may go away.

]]>Wed, 19 May 2010 14:13:23 -0500My Child Has Heel Painhttp://www.mitchellwachteldpm.com/blog/post/my-child-has-heel-pain.htmlChildren at a young age will get heel pain; it is usually caused by an interruption or a change in what we call a growth plate in the bones of the foot. A growth plate is an area of a bone that matures as a child grows older. This growth plate is an area where two seperate bones exist when we are born, and as we mature the plate or the interfaces between both bones join and the two bones fuse to become one bone.

When patients that are young get heel pain; the diagnosis for this problem is calcaneal (heel bone) apophysitis. Treatment for this usually starts off with an x-ray. Once the diagnosis is established, a heel cup usually helps, but many times we recommend a conservative approach such as icing and biofreeze to be applied several times a day. If simple treatments do not provide relief, a custom made orthotic device in sneakers is recommended.

Mitchell Wachtel, DPM is a podiatrist with offices located in Lowell, Methuen, Bradford and North Andover in Massachusetts

]]>Thu, 13 May 2010 12:10:26 -0500Shin Painhttp://www.mitchellwachteldpm.com/blog/post/shin-pain.htmlMy foot looks like a pancake but my pain is on my shin!

Many patients that are young come into the office complaining that there shins hurt. After evaluation it is noted that the foot usually is everted or the arch is very flattened throughout the entire foot. This is what we refer to as referred pain. The muscle bellies of the foot attach to the shins and the tendons that they control travel to the foot and attach there. Unfortunately for people with flatfoot deformity the foot is flat and pulls the tendons of the foot for very long periods of time and there is pain in the shin area called shin splints.

Many other long term problems such as knee, back and hip pain can occur if flatfoot deformity goes untreated. Patients that are runners cannot run for long periods of time because of the pain in the shin area and the arch area. In addition patients that are runners overpronate and cause excessive strain on the arch and increase tendonitis like pain in the foot. We have a multitude of bracing devices that are slimlined and fit in the shoe and or sneaker. There are a multitude of new styles of sneakers that can be used to help patients both walk and run comfortably. Besides bracing here are a multitude of stretching exercises and physical therapy that can help to decrease many of the painful scenarios that occur in the foot and ankle.

Please feel free to visit our shoe store in the office as well as get a physical evaluation with our new physical therapist Suzanne Pierri, PT.

Dr. Mitchell Wachtel is a podiatrist in Lowell, Bradford, Methuen and North Andover - all located in North Andover, MA

]]>Mon, 10 May 2010 15:34:30 -0500Oh, The Pads of My Feet Achehttp://www.mitchellwachteldpm.com/blog/post/oh-the-pads-of-my-feet-ache.htmlWhen we are more active during the warmer months we notice the bottoms of the natural pads of our feet begin to hurt. Aching and or burning sensation at the padded areas of our feet is not a normal sensation and should be evaluated. Many times the pain is due to a condition called metatarsagia and signifies a soreness or inflammation of the pads of the foot and is due to irritation. Other times a patient may have a nerve that is entrapped. Lastly sometimes as we age the pads on the bottom of our feet breakdown just like the soles of our shoes. Pain in this area can be quite problematic in the foot and should be evaluated and treated by a foot specialist. There are many ways to treat all of these problems ranging from minor treatment with a strapping with certain types of padding to shoegear. Don't let a painful foot stop you from enjoying the best days of the year.

]]>Wed, 05 May 2010 15:59:02 -0500Springhttp://www.mitchellwachteldpm.com/blog/post/spring.htmlSpring is now upon us and running season has begun. It is quite common thatmany injuries occur in the foot and ankle. Stretching is extremely important before a long run. Stretching can prevent things like tendonitis which is an inflammation of the tendons; usually due to overuse. The achilles tendon is a very common tendon and nuscle which gets sore and tight after a long run. a simple stretching exercise can decrease fatigue of the muscles of the foot ankle and leg. Linements such as biofreeze create a deep heaty of the foot and ankle and help to relieve the soreness which may occur from long runs. Make sure you wear light clothing which is breathable. The science of footwear hasbecome high tech. For patients that are overpronators(which basically means the arch flattens more when walking) there are a multitude of special sneakers that can help control the mechanics of the foot and ankle when running. With overpronation which occurs typically in running muscles and tendlons are pulled abnormally and torqued in different directions. Custom made orthotics help to provide balance and control of the foot and ankle and can prevent injury. We know that the device that controls the foot is only as good as the shoe that holds it. We now have a shoe store in our our office where we have a large assortment of running shoes, walking shloes and dress shoes that accomodate orthotics as well as patients with multiple bony deformities and large widths.

]]>Wed, 28 Apr 2010 14:31:19 -0500Pediatric Bloghttp://www.mitchellwachteldpm.com/blog/post/pediatric-blog.htmlWe treat many forms of pediatric conditions in the foot and ankle. In toeing and out toeing are commonly seen problems in young children. This type of gait or walking cause abnormal stresses on the foot and ankle as well as hip, knee and back.

Many deformities in the foot such as flatfoot and a high arch foot can cause a weakening of musculature and multiple types of braces can help a patient walk better. Sometimes the muscle of the upper leg and torso are weakened by the foot deformity; certain types of physical therapy and muscular strengthening exercises need to be addressed.

Toe walkers don't land on their heels when walking; because of it certain muscles in the back of the foot, leg and ankle area become very tight and certain stretching exercises will help along with certain types of braces.

The shoe a child wears is extremely important to the way they land on their foot and need to be evaluated.

If you notice your child has a clumsy type style of walking, trips a lot, arch pain is noticed or has tendon type pain on the shins called shin splints it might be a great idea for a podiatrist to evaluate the patient.

In our office we take x-rays to evaluate the bone structure and see if there is a structural problem, evaluate the child's walking; the way they stand and look for a limb length discrepancy (one limb sometimes is longer than the other). After all of the above are evaluated a long term treatment plan is provided. Conservative treatment ranges from stretching exercises, shoe changes, braces supporting the arch, braces supporting the arch and ankle or even a brace supporting the foot, ankle and leg. If you are in need of an evaluation please feel free to call our office 978-794-8406.

]]>Tue, 30 Mar 2010 15:43:15 -0500Oh, my Painful Red Toehttp://www.mitchellwachteldpm.com/blog/post/oh-my-painful-red-toe.htmlIngrown toenails are quite common and occur on the side of your toes and result in swelling and drainage which occurs in the toes. Ingrown toenails occur because of an indentation and slice in the toe which creates a pocket of drainage and many times causes an infection or what is called a paronychia. These painful problems can occur from trauma, shoegear which is tight or from improper nail cutting. Usually with some anesthesia we can remove the infection by removing the ingrown toenail. If infected we usually prescribe an antibiotic and soaking instructions. After the infection is healed we recommend a procedure where we remove the ingrown portion of the nail down to the root. This procedure will usually remove the painful ingrown nail and then the pain and the possibility of reinfection will probably not recur.

]]>Sun, 28 Mar 2010 09:17:13 -0500Welcome to Our Blog!http://www.mitchellwachteldpm.com/blog/post/welcome-to-our-blog.htmlWhether you are an existing patient or searching for a podiatrist in the North Andover , MA area, we're excited you are here. With the podiatry industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.

As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle. Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from Dr. Wachtel and his staff.

We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.
As always, feel free to contact us with any questions or concerns.

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