January has brought news stories across the country about a condition that affects people everywhere, including here in Columbus: bunions. Young people being treated for bunions has been prominently featured in the Wall Street Journal’s Health section last week, famed English celebrity chef Nigella Lawson announced she underwent two surgeries for a bunion on each foot and earlier this month a new padded device called the Bunion Bootie published online tutorials on its use.

Bunions are a bony prominence that develops on the middle side of the big toe at the metatarsophalangeal joint. This exostosis, or extra growth of bone, can become irritated by rubbing on shoe gear, or the bone itself can irritate nerves in its proximity causing pain. The removal of this bony growth is typically the first step the surgical treatment of a bunion, but other foot deformities that are major contributors to the painful deformity must also be addressed. The deviation of the big toe, or hallux towards the lesser toes, combined with the movement of the metatarsal bone at the base of the big toe away from the metatarsal creates the deformity known as hallux abducto valgus. A number of surgical options exist to correct hallux valgus and most include a cut in the metatarsal. A number of the surgical options, selected based on the severity of the deformity, exist and were discussed in last week’s Wall Street Journal article.

Other possible factors contributing to the development of hallux valgus and thus pain must be considered when selecting a treatment plan. Other biomechanical deformities that contribute to hallux valgus development include overpronation and what is known as a flexible plantarflexed first ray. In this first ray deformity, the foot compensates by moving the metatarsal bone at the base of the big toe upwards, increasing the chance for hallux abducto valgus to develop. These two deformities can be addressed using custom orthotics to help treat and slow the progression of a bunion. At Columbus Podiatry & Surgery, a state of the art foot scanner is used to quickly and comfortably create orthotics that will be a perfect match to correct biomechanical problems in the foot. Diseases that can affect the entire body also can contribute to the development of a bunion. Some of such conditions can include: rheumatoid arthritis, cerebral palsy and gout.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Belarusian tennis player Victoria Azarenka is the top ranked female tennis player in the world and current title holder of the 2012 Australian Open which she won last January. Her path to claiming the Open title for the second year in a row hit a road bump this week when an infected ingrown toenail forced her to withdraw from a Brisbane International semifinal match against Serena Williams just 30 minutes before the match was to begin. Azarenka says the injury is healed and is playing in the Austrailian Open this week.

Azarenka developed the ingrown toenail and subsequent infection after receiving a pedicure. At her pedicure, the toenail of her big toe was cut too short, and was jammed into the skin and soft tissue around the nail as she walked and played in her tennis shoes. When a nail grows into the skin and causes infection the condition is called “paronychia”. The skin will develop signs of infection including redness, swelling, warmth, pain and can even produce drainage. Ingrown nails can be extremely painful, which is why Azarenka underwent treatment for the condition and decided not to play at Brisbane to avoid any further complications. Other than improperly cutting the toenails, there are a variety of factors that contribute to the development of paronychia including having naturally curved toenails or onychocryptosis, improperly fit shoes that irritate the skin next to the nail, obesity, and even overpronation. If infection is not treated promptly, it can spread to the bone causing osteomyelitis or bone infection or to the blood causing sepsis.

The first step in the treatment of ingrown nails is the removal of the offending portion of nail. Your podiatrist should perform this procedure with sterile medical instruments, as attempting to remove the nail at home can further aggravate the condition by adding new bacteria to the wound or by not achieving complete removal of the necessary nail. A partial nail avulsion can be performed where the toe is numbed and a slice of nail is removed to temporarily prevent further pain and recurrence. Once infection has cleared, procedure may be performed to permanently prevent recurrence of painful ingrown toenails for those with curved toenails or who have frequently developed the condition in the past. This procedure is also performed quickly and with very little pain in your podiatrist’s office and is called a matrixectomy. A small amount of chemical is applied to the nail root to prevent its regrowth into the skin. After any of these procedures, strapping and bandaging will stop any further pain until the toe has healed. Luckily, Azarenka’s toe should be pain free and healed in time for her to defend her title at the Australian Open and hopefully she learned her lesson to be careful when choosing where to receive a pedicure in order to prevent future infections!

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

After hectic holiday travels, shopping hurdles and trail runs in the unseasonably warm weather in Columbus lately, foot and ankle pains may begin piling up. The Achilles tendon is the largest, and one of the most injury plagued tendons in the body. Runners, weekend warriors, and athletes in almost any sport may develop any one of the many disorders that can plague the Achilles tendon at various times in their sporting career.

Achilles tendonitis often occurs at the attachment of the Achilles tendon to the back and sides of the heel bone. Pain is felt along the back of the heel and a bony bump may also be felt in the area of pain. This condition is typically caused by repetitive microtraumas that cause enough irritation to the tendon to induce its degradation. Eventually, the tendon attachment may develop calcifications that potentiate the process of irritation and further predispose to the Achilles’ rupture. Luckily, in most cases, if diagnosed before extensive calcifications have developed, Achilles tendonitis can be successfully treated without surgery. Conservative means used to treat tendonitis of the Achilles exert their effect by relieving the stress placed on the tendon and working to decrease inflammation.

A pump bump, or Haglund’s deformity may also be identified as an underlying source of chronic irritation to the Achilles tendon. This pump bump is an outgrowth of bone on the upper back portion of the heel bone that can serve as a source of microtrauma by regularly jabbing into the tendon. In cases of tendonitis with a pump bump, surgery may be needed to remove the aggravating portion of bone.

Further imaging studies, including an MRI, may be needed to achieve the most accurate diagnosis in painful Achilles disorders. A growth or tumor may develop in the tendon that can also trigger an inflammatory process. Xanthomas are a lump of cholesterol that can develop in the Achilles tendon in individuals with high cholesterol. These lumps are benign, other than possibly causing tendon irritation, but need to be diagnosed to rule out other more dangerous growths.

Athletic shoe choices may also play a role in the prevention or development of Achilles disorders. Switching from running in a stability shoe with a lot of cushion to a barefoot style shoe may aggravate an already irritated tendon by suddenly increasing tension on the tendon if the runner continues to run in a heel-to-toe fashion. However, it is believed that running in a forefoot or midfoot strike pattern in a minimalist shoe may actually help prevent Achilles irritation. Forefoot running has this effect because when a runner lands on their forefoot with each stride, the calf muscles are placed under less tension with the heel elevated instead of striking the ground first. Before making the transition to any new running shoe, be sure to talk to your podiatrist about what the impact may be on your foot and ankle.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Diets, gym memberships and workouts are involved in the plan to reach New Year’s resolutions for many. Looking your best in 2013 should literally start from the ground up, not only by putting on your workout sneakers, but also by choosing what types of socks or stockings you wear on a daily basis. Socks and stockings for both men and women can be used as more than just another accessory by choosing compression socks that can help to improve both your overall health and the appearance of your feet and legs in the long run.

Compression socks have come a long way from their early origins. These socks now come in a wide variety of colors and fabrics that make them hard to distinguish from any other sock. Compression socks can be used in the treatment of venous insufficiency, where blood pools leg veins instead of being efficiently pumped back up to the heart by the leg veins. This disorder affects both men and women and can result in unsightly varicose veins and venous stasis ulcers. Other, less obvious signs of venous stasis disease include swelling of the legs and feet, corona phlebectasica or a pattern of prominent veins along one side of the foot, and dark discoloration of skin just above the ankle area. The lowest part of the legs may also develop an itchy, blistering eczema or skin rash in this condition.

Even in those who do not develop the most serious form of venous stasis, varicose veins are certainly, at the very least, a cosmetic issue that both women and men would like to avoid. Compression stockings help in both the treatment of venous insufficiency by forcing blood to flow and in the prevention of vein disease and varicose veins. When purchasing compression stockings there is some specific criteria you should look for. The compression should be graduated. This means that the socks will be the tightest at the foot and gradually decrease in pressure as you move up the leg. The amount of compression will be indicated on the package in millimeters of mercury, or as “mm Hg”. For individuals looking to prevent varicose veins and vein disease or to treat mild varicose veins and disease, 20-30 mm of Hg will be adequate. If an individual has already developed a venous ulcer, once it is healed, 40-50 mm Hg compression socks should be worn. Before deciding to purchase compression stockings, individuals should always talk to their podiatrist to see if they have any health problems, including diabetic neuropathy in the feet that would preclude the use of compression.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

The snowy, wet weather and chilly temperatures we have experienced in Columbus the last few weeks can lead to a variety of conditions. The extremities, and especially the feet are at risk for cold injury due to the lesser blood circulation compared to the trunk of the body.

Cold injury occurs from a combination of cell damage and decreased blood supply to the tissues. Ice crystals form in cells and the cold itself causes a disruption of the cell machinery that maintains life. Blood thickens and clogs small vessels reducing the flow of vital nutrients to tissue. Body parts with small blood vessels, usually beginning with the toes, can then develop gangrene if the condition is allowed to progress without treatment.

Some cold injuries are caused solely by the body being exposed for to an extremely low temperature for a time period longer than the body can withstand. These injuries include frost bite and types of eczema. In the above freezing temperatures around Columbus lately, frost bite is less likely to occur, but other cold injuries can develop after a previously undiagnosed disease process is exacerbated by the cooler temperatures. One condition known as pernio or chilblains looks very similar to first degree frost bite, in that the toes, feet and legs will develop bluish red patches after being chronically exposed to a cool damp environment. Cold rainy climates are where this condition is most commonly found in winter. Pernio only occurs in individuals with inherently high tone in the walls of their blood vessels in the extremities, leading to poor circulation in the feet. In individuals with normal vascular tone, pernio or chilblains would not develop. Chilblains initially presents in an acute form in which skin findings are typically only present for one week before resolving, sometimes leaving a residual area of darkened skin behind. Over time, if these acute episodes of the disease are allowed to occur repeatedly by continued cold exposure, a chronic form of chilblains can occur with swelling, ulcers and bleeding. Feet may also itch or burn in this chronic state.

The best treatment of pernio, frost bite or any other cold injury is prevention. Warm clothing with moisture wicking fabric and staying out of cold environments are the best way to avoid pernio development. Moisturizing creams or ointments can be helpful in keeping cells hydrated. If the chronic form of pernio develops with ulcers, avoiding infection and gaining skin closure of the wound will be paramount and involve regular visits with your podiatrist.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

While winter in Columbus is not the time of year when people are running around barefoot, the holidays can mean a veritable maze of wrapping paper, tree pine needles and ornament hooks to navigate around in stocking covered feet at parties. Stepping on a Barbie or stray Lego is usually just an “ouch” moment, but puncture wounds of the foot can lead to serious consequences.

Puncture wounds are very common foot injuries. Unfortunately, most people only contact their doctor about these wounds after signs of infection or serious illness have begun. The greater the depth of the wound, the higher the potential is for serious consequences to develop. For most superficial punctures with no signs of infection such as redness, swelling, drainage or warmth, your podiatrist will simply need to clean the injury and check and ensure no foreign bodies remain in the foot. When a foreign body remains in the tissues of the foot, the body reacts to the material and may form a wall of tissue around it called a granuloma or an inclusion cyst. Over time, the granuloma or inclusion cyst may become more irritating than the initial injury and feel as though a mass or lump has grown in the bottom of the foot. Such masses, along with the foreign body that caused them will need to be removed by your podiatrist to alleviate symptoms.

If signs of infection do appear, you should contact your podiatrist immediately. Deep wounds can reach the bone and cause an infection of the bone, or osteomyelitis. It can take days to weeks before redness, swelling, severe pain and drainage develop in osteomyelitis, and once they have appeared, the faster bone and joints are destroyed by the underlying infection. So don’t wait until 2013 to take care of any foot punctures caused by stepping on a broken ornament, holiday light or pine tree needle – the faster you receive care the better your feet will heal!

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

With the holidays fast approaching, many individuals may feel the mounting pressure of finding the perfect gift by spending hours at the mall. The pressure placed on feet dashing from store to store can add up, and in individuals with diabetes can become dangerous. Even though the holiday of St. Nicholas passed this past week, in which children leave their shoes out to be filled with treats, individuals with diabetes may still want to leave their old shoes out for good and opt for a better, pressure relieving pair.

High pressure in a healthy foot signals pain, and subsequent alleviation of the inciting pressure by the person moving their foot or changing their shoe to stop the pain from occurring. In diabetic individuals with peripheral neuropathy, pain and areas of high pressure cannot be felt due to loss of sensation. This loss of sensation causes of loss of protection to the foot and wounds may develop in areas of abnormally high pressure. Any deformity that predisposes the foot to rub in a shoe creates an area that is more likely to ulcerate. Surgery to remove deformities including bunions, hammer toes and bony bumps in the ball of the foot are one of the ways that your podiatrist may remove an area of increased pressure that is likely to develop or has previously developed an ulcer. Surgery to lengthen the tendon that attaches the calf muscles to the heel bone is also used to lessen pressure on the ball of the foot. When this tendon is too tight, the heel is lifted and the front of the foot is levered down towards the ground, creating an area of high pressure.

Along with surgery, regular callus and corn removal by your podiatrist is also very helpful in removing pressure. Shoes, casting and custom orthotics are all used to better disperse pressure on the foot. These treatment means are also useful to prevent ulcers from developing or recurring. By custom molding shoes to the foot, deformities are accommodated for and areas of high pressure are relieved. Custom orthotics for diabetic patients with neuropathy are made with several layers of material so that any friction that would normally be imparted to the foot is instead absorbed by the orthotic. Talk to your podiatrist about taking pressure off this holiday season and keeping your feet healthy!

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Holiday parties filled with colorful drinks and rich meals are an integral part of this time of year for many people. However, all of this drinking and feasting can increase your risk of a painful attack of the arthritic condition that tends to strike in the foot known as gout.
Gout is a disease of the metabolism or breakdown of purines. Purines are nucleotides that are essential to the survival of all the cells in our bodies because they are vital building blocks of DNA. While we naturally make proteins, they are also found in many foods. When purines are broken down by the body, uric acid is created. Abnormally high levels of uric acid in the body, or hyperuricemia, precede the development of gout.

When the excess uric acid causes crystals to form in the joint, the joint will become inflamed and often extremely painful. Gout more commonly affects men, but its prevalence increases in women after menopause. The most commonly affected joint is at the base of the big toe, or hallux called the metatarsophalangeal joint (MPJ). Other than the MPJ of the hallux, gout also occurs in the ankle, wrist and knee. The affected joint will most often become red, hot and so painful that even the weight of a bed sheet will feel unbearable. A bump, or mass filled with the urate crystals is also often seen at the joint affected.

It is important to rule out a paronychia which is an infection of an ingrown toenail, a painful fracture, and other types of arthritis of the foot before being able to offer relief from gout. With proper diagnosis, gout can be managed and the pain eliminated with various medications. Lifestyle changes can also be helpful in gout management and prevention. Excessive alcohol consumption and a diet rich in meat and seafood are associated with a greater risk of gout. So while it may be difficult to resist this holiday season, you will certainly regret not limiting your intake of these items if you are unfortunate enough to develop painful gout later on!

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

For those passing Columbus City Hall this month, you may have noticed that the building has been lit in an unusual hue of blue. This special lighting has been put in place to raise awareness of diabetes as part of National Diabetes Month. Blue for awareness of diabetes is great, and preventing your toes from turning blue is one reason that diabetic foot care should be an integral part of the health of an individual with diabetes or pre-diabetes.

Individuals with diabetes, are at an increased risk for a vast array of problems in the lower extremity.

Seemingly minor problems in an individual with diabetes can evolve much more rapidly than they would in a healthy individual to become a life threatening condition. Tinea pedis or athlete ’s foot is four to five times more prevalent in individuals with diabetes versus those without. This fungal foot infection can break down the skin, especially when it occurs between the toes, to allow bacteria to enter into the deep spaces of the foot and lead to more serious infection. Lower extremity infection and its sequelae have become the leading cause of hospitalization of diabetic patients. A variety of factors in diabetes lead to the development of serious infection in the feet. High blood sugar damages many tissues in the body including nerves, blood vessels and immune cells. Without healthy nerves, sensation is lost in the foot and wounds develop because the individual cannot feel the pain that healthy nerves would detect. When blood vessels are damaged, tissues normally supplied with blood and nutrients from these vessels die from lack of oxygen and gangrene occurs. When the immune cells are damaged, infection cannot be fought off. It is for all of these reasons that self-foot exams and regular lower extremity exams from your podiatrist are critical in stopping diabetic foot infections before they get the chance to progress.

In order to prevent ulcers and life and limb threatening infections, diabetic foot exams should be conducted once per year in an otherwise healthy diabetic individual. If upon routine exam, a patient is found to have diminished sensation or an absent pulse (indicating nerve and artery damage) a foot assessment should be conducted every three to six months. When a patient has these signs of nerve and artery damage along with calluses and deformities of the feet, such as bunions and hammer toes, they are at a higher risk of ulceration and should see their podiatrist every three months. Along with regular exams, other preventative measures such as custom orthotics or padding may be deemed necessary to reduce the risk of ulceration and possible need for amputation in the future.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

While some people enjoy both their mashed potatoes and their gravy to be a little lumpy, finding a lump on your foot is not desired by anyone! While the odds of a soft tissue mass in the foot being a life threatening cancer are very low, diagnosis should be sought to rule out the possibility and to deal with any symptoms that may be occurring due to the location of the growth.

The overall incidence of soft tissue tumors in the foot has been difficult to estimate because many of these lesions are unnoticed, or not reported because they are not causing pain or irritation. The most common soft tissue growths in the foot are ganglion cysts and plantar fibromatoses. Ganglion cysts are thought to form from an irritation of joint capsule or tendon sheath that forms a fluid filled out-pouching that eventually becomes rather dense. In the foot, these cysts most commonly develop on the top of the middle portion of the foot. The size of a ganglion cyst can change over time, growing and shrinking and even completely disappearing before returning. While these cysts are not malignant, surgical removal may become necessary if the cyst interferes with the ability to wear shoes, the movement of the foot or causes pain by impinging on nerves in the area.

Plantar fibromatosis is a disease in which lumps, or plantar fibromas develop in the plantar fascia. The plantar fascia is the band of connective tissue that connects the heel bone to the toes to help maintain the arch, and becomes inflamed in the common condition of plantar fasciitis. Most commonly, these bumps form in the highest point of the arch and can become painful overtime with irritation by shoe gear or the ground. While the exact cause of the development of these growths is unknown, it is believed that small cuts in the plantar fascia heal with an excessive healing response causing their formation. Plantar fibromatosiss has also been associated with epilepsy, diabetes, and a family history of their occurrence. Orthotics may be used to provide cushion and off-load the area of the mass.

While it has been estimated that only one out of 100 soft tissue lesions is malignant, any changes in a mass or development of a new mass are certainly worth being evaluated for both peace of mind and overall health. MRI imaging study or biopsy will often be deemed necessary by your podiatrist to further evaluate any mass.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.