Gerry L. Hash, D.P.M.
Board Certified Foot Surgeon
417 S. Landmark Ave.
Bloomington, IN 47403
812-339-2446
CONDITIONS AND TREATMENTS
BUNIONS
Nail fungus, otherwise known as Onychomycosis, has been recognized as being a very difficult type of fungal infection to treat. It is a cosmetic condition that most often affects the toenails. Risk factors for nail fungus include increased age, male gender, diabetes, nail trauma, hyperhydrosis, peripheral vascular disease, athlete's foot, immunodeficiency, poor hygiene, and chronic exposure of the nails to water. There are many species of fungus that can infect the nail. Often in nail infections several types of fungus will be present at the same time. All nail fungus infections result in thickened, discolored, and distorted nails.
Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes.
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches.
Heel Spurs
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
Hammertoes
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery.
Ingrown nails when the nail grows into the flesh instead of over it -- usually affect the toenails, particularly the big toe. People with curved or thick nails are most susceptible, although anyone can suffer from ingrown nails as a result of an injury, poorly fitting shoes, or because of improper grooming of the feet. Diabetics and people with vascular problems need to be aggressive in treating and preventing minor foot ailments such as an ingrown toenail because they can develop into serious medical problems such as loss of a limb.
Warts normally grow out of the skin in cylindrical columns. These columns do not fuse when the wart grows on thin skin such as the face. On thicker skin, the columns fuse and are packed tightly together giving the surface the typical mosaic pattern. Black dots can sometimes be seen in a wart. These are actually blood vessels that have grown rapidly and irregularly into the wart and have thombosed or clotted off.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
Surgical Treatment
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.