Our Foot and Ankle FAQ
Will I need surgery for my bunions? Will my son’s ankle pain eventually go away? Why do I need to see a foot specialist instead of my regular doctor? We answer questions like these and many more in our foot and ankle FAQ.
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If I go to a foot and ankle surgeon, does that mean my problem will be treated surgically?
No. In fact, foot and ankle surgeons are trained to make all reasonable efforts to treat foot and ankle problems nonsurgically if at all possible. Surgery is recommended only if other options are not feasible or do not adequately relieve your problem.
How Bad Will It Hurt After Surgery?
Keeping you comfortable following surgery so that your surgical experience is positive is our top priority. Less pain helps with a speedy recovery and the good news is that we have many techniques to keep you comfortable. Yes some pain will accompany the process of healing following surgery but with the proper care you can be more comfortable than you might expect.
First, immediately following surgery you will receive a long acting local anesthetic block so that when you wake up following surgery your foot will be numb. This usually will last most of the day and often even into the evening so that you can get home and back in a comfortable environment.
The RICE method – Rest, Ice, Compression and Elevation is used to reduce swelling and pain. Most pain following surgery is caused by swelling. Using the RICE method will help minimize the swelling following surgery. In many cases a Cryo Cuff or boot that continuously circulates cold water around the surgical site is used.
In todays healthcare climate where efforts to reduce prescription drug addiction, there are stronger ant-inflammatory medications available to help reduce the amount of pain relievers containing narcotics. Most patients will usually only require a few days of pain medication.
Are Over the Counter Orthotics Effective?
Many radio and television commercials promote custom arch supports, my advice is never pay more than $70.00 for an “orthotic” or arch support. If you are paying more than this, you should be receiving a device made from a mold of your foot that also includes a detailed exam, diagnosis and prescription written by a foot and ankle specialist.
How do Custom Foot Orthotics work?
A custom orthotic is much more than an arch support. Orthotics realign the joints of your foot and leg to reduce abnormal strain on muscles, tendons and ligaments. Small malalignments can cause significant discomfort. Over time, abnormal function can lead to problems such as bunions, hammer toes, heel pain, tendonitis, knee, hip and back pain. Once your foot is supported properly by the orthotic, it is consistently directed into the correct position for walking, running and standing.
What Are Custom Orthotics?
“Orthotics” can refer to any device worn inside a shoe. These items can be found in infomercials, retail stores and at the state fair or home show. With various sales pitches and information about orthotics, making an informed decision and understanding the facts can be difficult.
True custom foot orthotics are prescription medical devices created from a non-weight bearing molds or scans of the foot. Orthotics are designed to control the position and function of your foot to treat specific conditions and reduce risk for injury. A properly made orthotic should effectively reduce abnormal rolling in or rolling out motions of the foot and ankle. In addition, they can redistribute pressure on the bottom surface of the foot to relieve pain or reduce friction and pressure contributing to calluses or ulcerations.
What foot conditions may require surgery?
At Center Grove Foot and Ankle Care, our focus is on non-invasive, non-surgical treatment to relieve your foot or ankle pain. However, when the conservative approach fails to give you the results you want, I will talk to you about your surgical options. Three of the conditions that most commonly require surgery in my office are bunion deformities, hallux rigidus, and hammer toe deformity.
When You May Need Surgery
As a board-certified surgeon, I am qualified to perform surgery if other treatment options don’t work for you. The conditions I most frequently operate on include the following:
- Bunion deformities. A bunion is a bony bump at the base of the big toe, often caused by wearing narrow shoes or as a result of arthritis. The pain and discomfort caused by a bunion may be alleviated with special pads, splints, orthopedic shoes, or with pain relievers and ice packs. When that fails and you want a permanent solution, a bunionectomy may be performed. This outpatient procedure involves shaving off excess bone and realigning the toe.
- Hallux rigidus. Affecting the joint at the base of the big toe, this condition is a form of arthritis that may be caused by a structural abnormality or foot alignment issues. When conservative treatments such as shoe modifications, anti-inflammatories, and physical therapy fail to relieve the pain, surgery may be considered. In the early stages of the condition, surgery may be used to remove bone spurs, but more advanced conditions may require a joint replacement or joint fusion procedure.
- Hammertoe deformity. Toes that bend upward in the middle are known as hammertoes. The deformity can be accompanied by painful corns between or on top of the toes and calluses on the bottom of the toes. When padding or stretching footwear fails to relieve the discomfort, surgery may be required. Depending on the type of hammertoe you have, I will either perform a tendon transfer procedure or a joint resection or fusion procedure.
These procedures can usually be performed as outpatient surgeries and require six to eight weeks for full recovery.
If you are experiencing toe joint pain or have a bunion, schedule an appointment with me today. Often, when a condition is treated early, these surgical procedures can be avoided.
What is shockwave therapy and should I consider it for my heel pain?
Don’t let the name scare you. There is no electrical shock involved in shockwave therapy. Instead, it is a completely painless treatment to relieve pain and reverse tissue damage. If you have tried other options to treat your plantar fasciitis or Achilles tendonitis and have had no luck, schedule a visit to Center Grove Foot & Ankle Care to talk about this innovative treatment.
How Does Shockwave Therapy Work?
In my podiatry clinic, I use Extracorporeal Pulse Activation Therapy (EPAT) to treat some patients. While this treatment has been around for over 20 years, it is new to many people, but there is nothing to fear. Using a wand that emits low-frequency sound wave pulses, the affected area is treated for approximately 5 to 10 minutes. Patients usually require three or four treatments at one-week intervals. The sound waves stimulate chemical processes in the damaged tissue, increasing blood flow in the region and promoting tissue growth and natural healing. It is an FDA-approved and pain-free treatment.
What Conditions Can EPAT Treat?
Any condition of the foot or ankle involving damaged tissue can be treated with EPAT, including the following;
- Plantar fasciitis
- Achilles tendonitis
- Sports injuries
When anti-inflammatories, stretching, and other treatments are not effective in treating your pain, we will talk about using shockwave therapy.
What Are the Advantages of EPAT?
As a non-invasive option, EPAT eliminates the risks associated with surgery, including infection, anesthesia, and long recoveries. It is painless and patients can return to normal activity almost immediately. It is cost effective, only requiring three or four in-office treatments. While it is not usually covered by insurance, it is often eligible for flexible spending account dollars and we also offer payment plan options.
I Always Start With the Least Invasive Option
When you come to me for evaluation and treatment of foot or ankle pain, you can be sure that I will begin with the least expensive, least invasive treatment options. Together, we will find a solution to your pain and get you back on your feet.
Why do I have to worry about my feet if I have diabetes?
If you have diabetes, you have probably been told to take special care of your feet. You may have even heard of people with diabetes having to endure foot amputations. But what is it about diabetes that causes damage to your feet? I’ll tell you, and also give you some tips for taking care of your feet when you have diabetes.
High Blood Sugar Damages Nerves
At the root of the problem is the fact that uncontrolled high blood sugar causes damage to your nerves. Although doctors aren’t sure why exactly, they think that blood sugar affects cells and enzymes in the nervous system. Damaged nerves can cause neuropathy, which is a loss of feeling in the hands and feet. Because you don’t often look at your feet, even minor problems can grow worse without you realizing it, especially if you can’t feel pain and discomfort. Some common problems caused by neuropathy include the following:
- Dry skin. Because the nerves in your feet can no longer send and receive messages from the brain, you will not sweat and your skin will become dry and cracked. Cracks in the skin can allow germs to enter and lead to a serious infection.
- Calluses and bunions. Nerve damage can cause changes to the shape of your feet and your shoes may no longer fit correctly. This can lead to the formation of calluses and bunions, which can continue to rub against your shoes until they become raw and irritated.
- Infections. When you can’t feel your feet, you may not notice small cuts and sores which can grow and become infected. Because diabetes affects blood flow, it becomes harder to fight these kinds of infection, which can be very dangerous.
In general, the loss of feeling and poor blood flow in the feet can create a multitude of problems if you do not take care of them.
Avoiding Foot Injuries
The most important thing you can do to avoid these kinds of potentially catastrophic foot problems is to control your blood sugar according to your doctor’s orders. Test your blood and take the medication that has been prescribed. The following tips will also help:
- Inspect your feet every day, or have someone else take a look if it’s hard for you to see the bottoms of your feet.
- Don’t go barefoot in the house or outside.
- Keep your feet moisturized with lotion, but dry them off thoroughly after bathing—including between the toes.
- Wear diabetic-friendly shoes and socks.
- See a podiatrist regularly.
If you have diabetes, make an appointment with my diabetic foot care team to develop a plan to keep your feet healthy. We will treat blisters, calluses, and bunions before they become a problem and will help you find the supportive, comfortable footwear you need.
Is my heel pain caused by plantar fasciitis?
Nine times out of ten, patients who come to me complaining of heel pain are suffering from plantar fasciitis. The fact that this is a fairly common condition doesn’t make the pain any easier to bear. Is your heal pain caused by plantar fasciitis? Find out here.
What Is Plantar Fasciitis?
The thick band of tissue that runs along the bottom of your foot connecting your heel bone to your toes is known as the plantar fascia. Normally, it acts as a shock absorber, supporting the arch of your foot, but with overuse and stress, it can become stretched and torn, causing irritation and inflammation near the heel. Runners—even recreational ones—often experience this condition, but it is also common in people who are overweight or who wear shoes that don’t offer sufficient arch support.
Symptoms of Plantar Fasciitis
Plantar fasciitis is characterized by a sharp, stabbing pain in the bottom of the foot near the heel. In most people, it is at its worst first thing in the morning, making those first few steps you take when you get out of bed almost unbearable. As you get moving, the pain may subside. Standing for long periods of time can also trigger the pain.
How Is the Condition Treated?
As with any foot or ankle pain, the longer you wait to get treatment, the more extensive the treatment may need to be. You can always take a pain reliever and anti-inflammatory such as ibuprofen or naproxen sodium to get you through the day, but you should also explore more permanent solutions, such as the following:
- Exercise and stretching. Sometimes, patients find relief with simple stretches to loosen the plantar fascia and Achilles tendon. Exercises that strengthen the lower leg can also relieve pressure on the bottom of the foot.
- Night splints. Wearing a splint that stretches your arch and calf at night can give you relief the next day.
- Orthotics. These shoe inserts offer arch support that can take the pressure off the plantar fascia and relieve the pain.
- Injections. Injecting a steroid into the sore tissue can offer pain relief, but is not a permanent solution. At Center Grove Foot and Ankle Care, we offer a cutting-edge treatment where we inject your own platelet-rich plasma into the tissue to offer relief.
- Shockwave therapy. Another promising treatment we offer is Extracorporeal Pulse Activation Technology (EPAT). In this treatment, sound waves are directed at the damaged tissue to stimulate healing.
- Surgery. As a last resort, we offer surgery to remove the plantar fascia from the heel bone to relieve the pain.
At Center Grove, We Always Start With the Most Conservative Treatment
When you come to us to treat your heel pain, we will always start with the least-invasive, least-expensive treatment options. Our goal is the same as your goal—to treat your foot and ankle symptoms and get you back on your feet. Make an appointment for an evaluation of your pain today.
When do I need to see a doctor for my ingrown toenail?
Ingrown toenails can be more than just a nuisance. If left untreated, they can become a painful and even debilitating condition. If treated early, you may be able to take care of the problem on your own, but in certain cases, you will want to schedule an appointment with me to discuss your options.
What Is an Ingrown Toenail?
Usually affecting the big toe, an ingrown toenail is when the corner or side of the nail grows into the skin surrounding it. It is usually caused by tight shoes, cutting your toenails too short, or by an injury to the nail. Some people are more prone to ingrown toenails due to the shape of their nail. While you might not be able to see exactly what is going on with your nail, you can identify an ingrown toenail by the pain and redness around the toenail. Because your feet often come in contact with dirt and germs, this area can easily become infected, causing increased pain and redness.
Can I Treat it at Home?
If you have diabetes, you should come in and see me right away for an ingrown toenail. Otherwise, there are some simple things you can try at home if you start as soon as you notice a problem:
- Soak the toe in warm water to soften the flesh and possibly release the nail.
- Apply antibiotic cream to the sore to prevent infection.
- Wear loose shoes and socks to allow the toe space for healing.
- Take a pain reliever to manage tenderness.
If these remedies don’t work, you are at risk for infection and should make an appointment with us.
What a Podiatrist Can Do for an Ingrown Toenail
As with all of my treatments, I will start with the least-invasive option first and move on to more aggressive treatments as needed. Generally, I will do the following:
- Lift the nail. In this simple procedure, I will carefully lift the ingrown edge of the nail and place material under it to help the nail grow above the skin edge. You will have to soak the toe and replace the material each day until the condition is resolved.
- Partially remove the nail. If the ingrown nail is lodged more deeply in the toe, I may have to remove part of the nail to allow a new nail to grow in correctly. This procedure is done with a local anesthetic.
- Remove the nail entirely. If you have a chronic problem in the same area with an ingrown toenail, we may need to consider removing the nail and the nail bed underneath. This would mean that the nail will not grow back, but we can discuss cosmetic solutions as well.
As I mentioned above, if you are diabetic, you likely have decreased blood flow to your feet. For you, an ingrown toenail could become a much more serious problem than for other people. You should seek medical attention as soon as possible when you discover an ingrown toenail.
Center Grove Foot & Ankle Care Addresses All of Your Foot Care Needs
Whether you have an infected ingrown toenail or any other foot or ankle discomfort, schedule an appointment in our friendly office today. We treat everyone from high-level athletes to hard-working moms.