Q. I have a bunion but I don’t want surgery, so what can I do?
A. A bunion is a structural deformity, so your foot isn’t fitting into your shoes as before because the structure/shape of your foot has changed/is changing. Your foot is now too wide, and the bunion ‘bump’ is pushing on the shoe which hurts because soft tissue is becoming inflamed and nerves are getting “smushed”. The only way to change the structure of the foot is via surgery — going in and shaving the bump and decreasing the width by addressing the angular deformities. BUT, all conservative (non-surgical) measures should be exhausted first. They are (and there’s no miracle treatment), wearing wider shoes, wearing orthotics in sneakers and flats, anti-inflammatory meds or injections, stretching exercises, and physical therapy. A bunion is also a progressive deformity so it will continue to get worse over time, but implementing these conservative treatments MAY delay progression.
Q. I am hearing a lot about laser treatment and wondered if that’s a good idea. My toenails are discolored and yellowish.
A. Toenail fungus (onychomycosis) causes nails to become hard, yellow, and brittle. Laser treatment for onychomycosis is the newest treatment offering, and has been proved to be safe and effective. The laser targets and kills the fungus, but leaves the nail unharmed. The process takes less than 1 minute per nail.
Q. I am driving my wife crazy itching my feet at night. Help!
A. You may have athlete’s foot, which can manifest as dry, flaky skin on the bottom of the foot or between the toes. This needs to be diagnosed during an office visit – either visually or following a skin scraping. Athlete’s foot is usually a result of chronically sweaty fee. It is contagious, and can be passed from person to person in pools, showers, etc. Warm, dark, and moist conditions (i.e., the inside of your shoe) causes fungus to proliferate, and the condition is exacerbated.
Q. I have had heel pain for a year and it is not improving. One foot is a bit better but the other one still hurts. What am I doing wrong?
A. Heel pain is one of the most common foot complaints, and typically results from strain to the plantar fascia. If the long band of tissue connecting the heel and ball of the foot (plantar fascia) is stretched over time the result may be repeated tearing away of the lining or membrane that covers the heel bone, and/or microtears of the plantar fascia itself.
The cornerstone of treatment is stretching the Achilles and plantar fascia, in addition to supporting the arch, modification of shoes, and custom orthotics. Some podiatrists advocate steroid injections; however my studies proved that the condition is not inflammatory in nature, and therefore I usually stay away from painful foot injections.
A. Here are a few tips for proper fitting shoes-
- Don’t buy shoes that are too small and think they will stretch. There’s a good chance that they will never fit you right.
- Be sure you can wiggle your toes in the shoes easily.
- Walk around the store and be sure your feet are comfortable.
- Buy your shoes at the end of the day when your feet are at their largest
- Allow at least 3/8″ space from the tip of your big toe to the end of the inside of your shoes.
Q. My new job requires me to walk on hard city streets all day and my feet hurt like crazy at the end of every day. Any suggestions?
A. Buy shoes with a firm heel cup, which is the back part of the shoe in which the heel sits. The shank or sole of the shoe from the heel to the ball of the foot should be firm, with a good amount of cushioning and shock absorption, such as a shoe with Vibram soles.
Q. I have calluses on the bottom of both my feet and cut them off with a knife. Is that okay? They hurt when I walk a lot.
A. No! Do not ever cut calluses on your own. Skin removal is considered a surgical procedure. The most common cause of callus build-up is excessive friction between the plantar skin and your shoe. A custom-made orthotic device placed in your shoe can help keep the pressure off, and decrease friction.