West Nashville / White Bridge Road
Call: 615.353.0626
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Dr. Therese Tlapek has provided podiatric care for all ages and foot types at the same Nashville location since 1987. She also performs surgery and is on staff at St. Thomas Hospital and St. Thomas Surgicare outpatient.
She graduated in 1986 from the Dr. William M. Scholl college of Podiatric Medicine in Chicago, IL and performed a surgical residency at the Baptist Memorial Specialty Hospital in Memphis, TN.
Her undergraduate studies were at Southeast Missouri State University in Cape Girardeau, MO, and Houston Baptist University in Houston, TX.
Dr. Tlapek is a member of the American Podiatric Medical Association, Tennessee Podiatric Medicine, and Middle Tennessee Podiatric Association.
Dr. Tlapek is Board Certified by the American Board of Podiatric Surgery since 1995 and continues to perform all re-certification requirements to maintain Board Certification in surgery.
Dr. Tlapek's friendly and efficient office staff makes an office visit a pleasant experience. Most all insurances are welcome and quick filing procedures ensure rapid reimbursements.
Call now to ask about GenesisPlus Cutera Laser Treatment for toenail fungus.
Toenail Fungus Infection: Before and 3 Months After Laser Treatment | Photos courtesy of Michael Uro, DPM
More information about laser treatment for toenail fungus.
This time of year everybody is on their feet more.
Keep the following in mind, and if you have any questions about your feet, don't hesitate to contact your local Nashville Podiatrist!
Ingrown Toenails
People that fiddle with pesky ingrown toenails can worsen their condition leading to bacterial and fungal infection.A quick, minor in-office surgical procedure can relieve the pain and prevent infections:
- Local block of affected toe
- Sterile equipment
- Consideration for aesthetics
- Postoperative follow up
Plantar Fasciitis
This is one of the most common podiatric conditions, and if it's left untreated, this can actually result in weight gain and time missed from work:- Proper education in daily foot care
- In-office treatment with heel injections
- Outpatient surgical procedures
Bunions / Hammertoes / Metatarsal Pain
Patients plagued with painful bony malformations seek podiatric treatment to help with both the appearance and the pain associated with daily activities and difficulties finding comfortable shoe gear:- In-office palliative treatment to relieve pain from corns and callouses
- Custom made orthotics and shoe gear to accommodate deformities
- Outpatient surgical procedures to correct deformities
Diabetes and Arthritis
Systemic conditions can lead to foot diseases that result in life threatening loss of limb and immobility:- Early detection and regular podiatric care can keep patients feet in healthy shape throughout a lifetime of systemic conditions.
West Nashville / White Bridge Road
Call: 615.353.0626
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Downtown Nashville
Call: 615.321.3668
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Dr. Berkeley Nicholls received his undergrad degree magna cum laude in London, England, and his Doctorate of Podiatric Medicine at New York college of Podiatric Medicine.
With the assistance of a friendly, courteous, and compassionate staff, he has practiced podiatric medicine and surgery for all age groups in the Nashville area since 1989, servicing offices in Hermitage, Downtown Nashville and Smyrna.
He has hospital and surgical privileges at Centennial Medical Center, St. Thomas Midtown Hospital, Stonecrest Medical Center, and Physicians Pavilion Surgery Center, Smyrna, Tennessee.
A preferred provider on most insurance plans, Dr. Nicholls is Board Certified in Foot Surgery and Podiatric Orthopedics by the American Boards of Podiatric Surgery and Medicine, and a member of the American Podiatric Medical Association.
Ask about PinPointe FootLaser treatment for toenail fungus.
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| Toenail Fungus Infection: Before and 3 Months After Laser Treatment Photos courtesy of Michael Uro, DPM |
Downtown Nashville
Call: 615.321.3668
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Brentwood & Franklin | North Nashville
Call: 615.370.8880
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Dr. Gary Cockrell graduated from Salem Stephen's Episcopal Prep School in 1975 and received his undergrad degree from Virginia Tech in 1979, a B.S. in Animal Science (Pre-Vet) with a minor in Biology (Pre-Med).
After graduating with his D.P.M. from California College of Podiatric Medicine, San Francisco, California in 1988, he did a podiatric surgical residency at Baptist Memorial Hospital, Memphis-Georgetown, Tennessee.
Dr. Cockrell is board certified by the American Board of Podiatric Orthopedics and Primary Podiatric Medicine, and by the American Board of Podiatric Surgery.
From 1989 to present he has been a member of the American College of Foot and Ankle Surgeons, the American Podiatric Medical Association, and the Tennessee Podiatric Medical Association.
He has served continuously on the TPMA Executive Board since 1995, holding all board positions: Scientific Chair, Treasurer, Secretary, Vice President, and President (elected to two terms 2001 - 2003).
Brentwood & Franklin | North Nashville
Call: 615.370.8880
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What are Orthotics?
Orthotics are shoe inserts that are intended to correct an abnormal, or irregular, walking pattern.
They perform functions that make standing, walking, and running more comfortable and efficient by slightly altering the angles at which the foot strikes a walking or running surface.
Doctors of podiatric medicine prescribe orthotics as a conservative approach to many foot problems or as a method of control after certain types of foot surgery; their use is a highly successful, practical treatment form.
Foot orthotics fall into three broad categories: those that primarily attempt to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.
Soft Orthotics
Soft orthotic devices help to absorb shock, increase balance, and take pressure off uncomfortable or sore spots.
They are usually constructed of soft, compressible materials, and may be molded by the action of the foot in walking or fashioned over a plaster impression of the foot.
Also worn against the sole of the foot, they usually extend from the heel past the ball of the foot to include the toes.
Soft orthotics are particularly effective for arthritic, diabetic, and badly deformed feet to provide extra support and comfort.
Rigid Orthotics
Rigid orthotic devices correct foot function, usually the motion of two major foot joints directly below the ankle joint.
They may be made of a firm material such as plastic or carbon fiber, generally fabricated from a plaster of paris mold of the individual foot.
The finished device normally extends along the sole of the heel to the ball or toes of the foot, and mostly worn in closed shoes. Because of the nature of the materials involved, very little alteration in shoe size is necessary.
Strains, aches, and pains in the legs, thighs, and lower back may be due to abnormal function of the foot, or a slight difference in the length of the legs.
In such cases, orthotics may improve or eliminate these symptoms, which may seem only remotely connected to foot function.
Semirigid Orthotics
Semirigid orthotic devices provides for dynamic balance of the foot while walking or participating in sports.
This orthotic is not a crutch, but an aid to the athlete. Each sport has its own demands and each sport orthotic needs to be constructed appropriately with the sport and the athlete taken into consideration.
This functional dynamic orthotic helps guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently.
The classic, semirigid orthotic is constructed of layers of soft material, reinforced with more rigid materials.
Orthotics for Children
Orthotic devices are effective in the treatment of children with foot deformities.
Most podiatric physicians recommend that children with such deformities be placed in orthotics soon after they start walking, to stabilize the foot.
The devices can be placed directly into a standard shoe or an athletic shoe.
Usually, the orthotics need to be replaced when the child’s foot has grown two sizes. Different types of orthotics may be needed as the child’s foot develops and changes shape.
The length of time a child needs orthotics varies considerably, depending on the seriousness of the deformity and how soon correction is addressed.
Other Types of Orthotics
Various other orthotics may be used for multidirectional sports or edge-control sports by casting the foot within the ski boot, ice skate boot, or inline skate boot.
Combinations of semiflexible material and soft material to accommodate painful areas are utilized for specific problems.
Research has shown that back problems frequently can be traced to a foot imbalance.
It is important for your podiatric physician to evaluate the lower extremity as a whole to provide for appropriate orthotic control for foot problems.
Orthotic Tips
Rigid Orthotics
Rigid orthotic devices correct foot function, usually the motion of two major foot joints directly below the ankle joint.
They may be made of a firm material such as plastic or carbon fiber, generally fabricated from a plaster of paris mold of the individual foot.
The finished device normally extends along the sole of the heel to the ball or toes of the foot, and mostly worn in closed shoes. Because of the nature of the materials involved, very little alteration in shoe size is necessary.
Strains, aches, and pains in the legs, thighs, and lower back may be due to abnormal function of the foot, or a slight difference in the length of the legs.
In such cases, orthotics may improve or eliminate these symptoms, which may seem only remotely connected to foot function.
Semirigid Orthotics
Semirigid orthotic devices provides for dynamic balance of the foot while walking or participating in sports.
This orthotic is not a crutch, but an aid to the athlete. Each sport has its own demands and each sport orthotic needs to be constructed appropriately with the sport and the athlete taken into consideration.
This functional dynamic orthotic helps guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently.
The classic, semirigid orthotic is constructed of layers of soft material, reinforced with more rigid materials.
Orthotics for Children
Orthotic devices are effective in the treatment of children with foot deformities.
Most podiatric physicians recommend that children with such deformities be placed in orthotics soon after they start walking, to stabilize the foot.
The devices can be placed directly into a standard shoe or an athletic shoe.
Usually, the orthotics need to be replaced when the child’s foot has grown two sizes. Different types of orthotics may be needed as the child’s foot develops and changes shape.
The length of time a child needs orthotics varies considerably, depending on the seriousness of the deformity and how soon correction is addressed.
Other Types of Orthotics
Various other orthotics may be used for multidirectional sports or edge-control sports by casting the foot within the ski boot, ice skate boot, or inline skate boot.
Combinations of semiflexible material and soft material to accommodate painful areas are utilized for specific problems.
Research has shown that back problems frequently can be traced to a foot imbalance.
It is important for your podiatric physician to evaluate the lower extremity as a whole to provide for appropriate orthotic control for foot problems.
Orthotic Tips
- Wear shoes that work well with your orthotics.
- Bring your orthotics with you whenever you purchase a new pair of shoes.
- Wear socks or stockings similar to those that you plan on wearing when you shop for new shoes.
- Return as directed for follow-up evaluation of the functioning of your orthotics. This is important for making certain that your feet and orthotics are functioning properly together.
Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis and treatment of all manner of foot conditions.
This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin, and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet.
The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas. Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist’s instructions.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
Flat feet- or fallen arches- refers to a condition of the foot in which the arch of the foot collapses while standing (or in some extreme cases, even when no weight is applied to the feet), causing the sole of the foot to become flat.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
Diabetes: Startling Statistics
Diabetes mellitus is a chronic disease that affects the lives of nearly 24 million people in the United States, nearly 6 million of whom are unaware that they even have the disease.
In 2007 alone, 1.6 million new cases of diabetes were diagnosed in people aged 20 years or older. The disease is marked by the inability to manufacture or properly use insulin and impairs the body’s ability to convert sugars, starches and other foods into energy. The long-term effects of elevated blood sugar (hyperglycemia) are damage to the eyes, heart, feet, kidneys, nerves and blood vessels.
Symptoms of hyperglycemia may include frequent urination, excessive thirst, extreme hunger, unexplained weight loss, tingling or numbness of the feet or hands, blurred vision, fatigue, slow-to-heal wounds and susceptibility to certain infections. People who have any of these symptoms and have not been tested for diabetes are putting themselves at considerable risk and should see a physician without delay.
Part of keeping your diabetes in control is testing your blood sugar often. Ask your doctor how often you should test and what your blood sugar levels should be. Testing your blood and then treating high blood sugar early will help you to prevent complications.
The socioeconomic costs of diabetes are enormous. In 2007, the total annual economic cost of diabetes was estimated at $174 billion -- about $116 billion of which are direct costs from the disease with $58 billion indirectly related. Diabetes is the sixth leading cause of death by disease in the United States, and individuals with diabetes are two to four times as likely to experience heart disease and stroke.
The growth of the disease worldwide is especially alarming. The World Health Organization (WHO) expects the number of new diabetes cases to double in the next 25 years from 135 million to nearly 300 million. Much of this growth will occur in developing countries where aging, unhealthy diets, obesity, and sedentary lifestyles will contribute to the onset of the disease.
According to a recent survey, about 86,000 lower limbs are amputated annually due to complications from diabetes. Diabetes is the leading cause of end-stage kidney disease, accounting for about 44 percent of new cases. Diabetes is also the leading cause of new cases of blindness among adults aged 20 to 74.
While there is no cure for diabetes, there is hope. With a proper diet, exercise, medical care and careful management at home, a person with diabetes can keep the most serious of the consequences at bay and enjoy a long, full life.
Causes of Diabetes
No one knows why people develop diabetes, but once diagnosed, the disease is present for life. It is a hereditary disorder, and certain genetic indicators are known to increase the risk of developing diabetes.
Type 1, previously known as insulin-dependent diabetes mellitus or juvenile-onset diabetes, afflicts five to ten percent of diagnosed cases of diabetes. This type occurs most frequently in children and adolescents, and is caused by the inability of the pancreas to produce the insulin needed for survival.
Type 2, previously called noninsulin-dependent diabetes mellitus or adult-onset diabetes, affects the other 90-95 percent of all diagnosed cases of diabetes, many of whom use oral medication or injectable insulin to control the disease. The vast majority of those people (80 percent or more) are overweight; many of them obese, as obesity itself can cause insulin resistance.
Certain characteristics put people at a higher risk for developing Type 2 diabetes. These include:
- A family history of the disease
- Obesity
- Prior history of developing diabetes while pregnant
- Being over the age of 40
- Being a member of one of the following ethnic groups: African American, Native American, Latino American, Asian American, Pacific Islander
African Americans are 1.7 times more likely to have diabetes than the general population, with 25 percent of African Americans between the ages of 65 and 74 diagnosed with the disease.
Hispanic Americans are almost twice as likely to develop type 2 diabetes, which affects 10.6 percent of that population group.
Native Americans are at a significantly increased risk for developing diabetes, and 12.2 percent of the population suffers from the disease. In some tribes, as many as 50 percent of its members have diabetes.
Of all the risk factors, weight is the most important, with more than 80 percent of diabetes sufferers classified as overweight.
The Role of Your Podiatric Physician
Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputations.
The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician.
In addition to these check ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist.
Warning signs:
- Skin color changes
- Elevation in skin temperature
- Swelling of the foot or ankle
- Pain in the legs
- Open sores on the feet that are slow to heal
- Ingrown and fungal toenails
- Bleeding corns and calluses
- Dry cracks in the skin, especially around the heel
- Wound Healing
Ulceration is a common occurrence with the diabetic foot and should be carefully treated and monitored by a podiatrist to avoid amputations.
Poorly fitted shoes, or something as trivial as a stocking seam, can create a wound that may not be felt by someone whose skin sensation is diminished. Left unattended, such ulcers can quickly become infected and lead to more serious consequences.
Your podiatric physician knows how to treat and prevent these wounds and can be an important factor in keeping your feet healthy and strong.
New to the science of wound healing are remarkable products that have the appearance and handling characteristics of human skin. These living, skin-like products are applied to wounds that are properly prepared by the podiatric physician. Clinical trials have shown impressive success rates.
If You Have Diabetes Already:
Wash your feet daily.
Using mild soap and lukewarm water, wash your feet in the mornings or before bed each evening. Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily but avoid getting it between the toes.
Inspect feet and toes daily.
Check your feet every day for cuts, bruises, sores or changes to the toenails, such as thickening or discoloration. If age or other factors hamper self-inspection, ask someone to help you, or use a mirror.
Lose weight.
People with diabetes are commonly overweight, which nearly doubles the risk of complications.
Wear thick, soft socks.
Socks made of an acrylic blend are well suited but avoid mended socks or those with seams, which could rub to cause blisters or other skin injuries.
Stop smoking.
Tobacco can contribute to circulatory problems, which can be especially troublesome in patients with diabetes.
Cut toenails straight across.
Never cut into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners or snags. If your nails are hard to trim, ask your podiatric physician for assistance.
Exercise.
As a means to keep weight down and improve circulation, walking is one of the best all-around exercises for the diabetic patient. Walking is also an excellent conditioner for your feet. Be sure to wear appropriate athletic shoes when exercising. Ask your podiatric physician what’s best for you.
See your podiatric physician.
Regular checkups by your podiatric physician—at least annually—are the best way to ensure that your feet remain healthy.
Be properly measured and fitted every time you buy new shoes.
Shoes are of supreme importance to diabetes sufferers because poorly fitted shoes are involved in as many as half of the problems that lead to amputations. Because foot size and shape may change over time, everyone should have their feet measured by an experienced shoe fitter whenever they buy a new pair of shoes.
New shoes should be comfortable at the time they’re purchased and should not require a "break-in" period, though it’s a good idea to wear them for short periods of time at first. Shoes should have leather or canvas uppers, fit both the length and width of the foot, leave room for toes to wiggle freely, and be cushioned and sturdy.
Don’t go barefoot.
Not even in your own home. Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls, and infection. When at home, wear slippers. Never go barefoot.
Don’t wear high heels, sandals, and shoes with pointed toes.
These types of footwear can put undue pressure on parts of the foot and contribute to bone and joint disorders, as well as diabetic ulcers. In addition, open-toed shoes and sandals with straps between the first two toes should also be avoided.
Don’t drink in excess.
Alcohol can contribute to neuropathy (nerve damage) which is one of the consequences of diabetes. Drinking can speed up the damage associated with the disease, deaden more nerves, and increase the possibility of overlooking a seemingly minor cut or injury.
Don’t wear anything that is too tight around the legs.
Pantyhose, panty girdles, thigh-highs or knee-highs can constrict circulation to your legs and feet, as can men’s dress socks if the elastic is too tight.
Never try to remove calluses, corns, or warts by yourself.
Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot of a diabetic sufferer.
Never try to cut calluses with a razor blade or any other instrument because the risk of cutting yourself is too high, and such wounds can often lead to more serious ulcers and lacerations.
See your podiatric physician for assistance in these cases.
Diabetic Foot Ulcers
A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes, and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.
Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States, and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer have an amputation. Research, however, has shown that the development of a foot ulcer is preventable.
Who Can Get a Diabetic Foot Ulcer?
Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics and older men are more likely to develop ulcers.
People who use insulin are at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.
How do Diabetic Foot Ulcers Form?
Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes.
Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time.
The nerve damage often can occur without pain and one may not even be aware of the problem. Your podiatric physician can test feet for neuropathy with a simple and painless tool called a monofilament.
Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection. Elevations in blood glucose can reduce the body’s ability to fight off a potential infection and also retard healing.
The Value of Treating a Diabetic Foot Ulcer
Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers in patients with diabetes should be treated for several reasons such as, reducing the risk of infection and amputation, improving function and quality of life, and reducing health care costs.
How Should a Diabetic Foot Ulcer be Treated?
The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection.
There are several key factors in the appropriate treatment of a diabetic foot ulcer:
- Prevention of infection.
- Taking the pressure off the area, called “off-loading.”
- Removing dead skin and tissue, called “debridement.”
- Applying medication or dressings to the ulcer.
- Managing blood glucose and other health problems.
Not all ulcers are infected; however if your podiatric physician diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
There are several important factors to keep an ulcer from becoming infected:
- Keep blood glucose levels under tight control.
- Keep the ulcer clean and bandaged.
- Cleanse the wound daily, using a wound dressing or bandage.
- Do not walk barefoot.
For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches.
These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.
The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist.
The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.
Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.
For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.
Controlling Blood Glucose
Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. Working closely with a medical doctor or endocrinologist to accomplish this will enhance healing and reduce the risk of complications.
Surgical Options
A majority of noninfected foot ulcers are treated without surgery; however, when this fails, surgical management may be appropriate. Examples of surgical care to remove pressure on the affected area include shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony “bumps.”
Healing Factors
Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound. Healing may occur within weeks or require several months.
How Can a Foot Ulcer be Prevented?
The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis. He or she can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.
You are at high risk if you:
- have neuropathy,
- have poor circulation,
- have a foot deformity (i.e. bunion, hammer toe),
- wear inappropriate shoes,
- have uncontrolled blood sugar.
Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose are important in the prevention and treatment of a diabetic foot ulcer.
Wearing the appropriate shoes and socks will go a long way in reducing risks. Your podiatric physician can provide guidance in selecting the proper shoes.
Learning how to check your feet is crucial in noticing a potential problem as early as possible. Inspect your feet every day—especially between the toes and the sole—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality.
Each time you visit a health care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your podiatrist as soon as possible, no matter how “simple” it may seem to you.
The key to successful wound healing is regular podiatric medical care to ensure the following “gold standard” of care:
- lowering blood sugar
- appropriate debridement of wounds
- treating any infection
- reducing friction and pressure
- restoring adequate blood flow
The old saying, “an ounce of prevention is worth a pound of cure” was never as true as it is when preventing a diabetic foot ulcer.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
Immediate Treatment
Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatric physician.
This advice is universal, even though there are lots of myths about foot and ankle injuries. Some of them follow:
Myths
- "It can't be broken, because I can move it." False; this widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: Breaks in the smaller, outer bone of the lower leg, small chip fractures of either the foot or ankle bones, and the often neglected fracture of the toe.
- "If you break a toe, immediate care isn't necessary." False; a toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatric physician usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatric physician will help prevent improper or incomplete healing. Often, fractures do not show up in the initial X-ray. It may be necessary to X-ray the foot a second time, seven to ten days later. Many patients develop post-fracture deformity of a toe, which in turn results in a deformed toe with a painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.
- "If you have a foot or ankle injury, soak it in hot water immediately." False; don’t use heat or hot water on an area suspect for fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing sensation, and prevents swelling and pain. Your podiatric physician may make additional recommendations upon examination.
- "Applying an elastic bandage to a severely sprained ankle is adequate treatment." False; ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. X-ray examination, immobilization by casting or splinting, and physiotherapy to ensure a normal recovery all may be indicated. Surgery may even be necessary.
- "The terms 'fracture,' 'break,' and 'crack' are all different." False; all of those words are proper in describing a broken bone.
Before Seeing the Podiatrist
If an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatric physician are easy to remember if you can recall the word “rice.”
- Rest. Restrict your activity and get off your foot/ankle.
- Ice. Gently place a plastic bag of ice wrapped in a towel on the injured area in a 20-minute-on, 40-minute-off cycle.
- Compression. Lightly wrap an Ace bandage around the area, taking care not to pull it too tight.
- Elevation. To reduce swelling and pain, sit in a position that allows you to elevate the foot/ankle higher than your waist.
- For bleeding cuts, cleanse well, apply pressure with gauze or a towel, and cover with a clean dressing. See your podiatrist as soon as possible. It’s best not to use any medication on the cut before you see the doctor.
- Leave blisters unopened if they are not painful or in a weight-bearing area of the foot. A compression bandage placed over a blister can provide relief.
- Foreign materials in the skin—such as slivers, splinters, and sand—can be removed carefully, but a deep foreign object, such as broken glass or a needle, must be removed professionally.
- Treatment for an abrasion is similar to that of a burn, since raw skin is exposed to the air and can easily become infected. It is important to remove all foreign particles with thorough cleaning. Sterile bandages should be applied, along with an antibiotic cream or ointment.
Prevention
- Wear the correct shoes for your particular activity.
- Wear hiking shoes or boots in rough terrain.
- Don't continue to wear any sports shoe if it is worn unevenly.
- The toe box in “steel-toe” shoes should be deep enough to accommodate your toes comfortably.
- Always wear hard-top shoes when operating a lawn mower or other grass-cutting equipment.
- Don’t walk barefoot on paved streets or sidewalks.
- Watch out for slippery floors at home and at work. Clean up obviously dangerous spills immediately.
- If you get up during the night, turn on a light. Many fractured toes and other foot injuries occur while attempting to find one’s way in the dark.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
When is Foot Surgery Necessary?
Many foot problems do not respond to more conservative management. Your podiatric physician can determine when surgical intervention may be helpful. Often when pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot.
Bunions
A common deformity of the foot, a bunion is an enlargement of the bone and tissue around the joint of the big toe. Heredity frequently plays a role in the occurrence of bunions, as it does in other foot conditions. When symptomatic, the area may become red, swollen, and inflamed, making shoe gear and walking uncomfortable and difficult. If conservative care fails to reduce these symptoms, surgical intervention may be warranted. Your podiatric physician will determine the type of surgical procedure best suited for your deformity, based on a variety of information which may include X-rays and gait examination.
Hammertoes
A hammertoe deformity is a contracture of the toe(s), frequently caused by an imbalance in the tendon or joints of the toes. Due to the “buckling” effect of the toe(s), hammertoes may become painful secondary to footwear irritation and pressure. Corn and callus formation may occur as a hammertoe becomes more rigid over time, making it difficult to wear shoes. Your podiatric physician may suggest correction of this deformity through a surgical procedure to realign the toe(s).
Neuroma
An irritation of a nerve may produce a neuroma, which is a benign enlargement of a nerve segment, commonly found between the third and fourth toes. Several factors may contribute to the formation of a neuroma.
Trauma, arthritis, high-heeled shoes, or an abnormal bone structure are just some of the conditions that may cause a neuroma. Symptoms such as burning or tingling in the ball of the foot or in the adjacent toes and even numbness are commonly seen with this condition. Other symptoms include swelling between the toes and pain in the ball of the foot when weight is placed on it.
Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe.
Your podiatric physician will suggest a treatment plan. If conservative treatment does not relieve the symptoms, then your podiatric physician will decide, on the basis of your symptoms, whether surgical treatment is appropriate.
Bunionette (Tailor’s Bunion)
A protuberance of bone at the outside of the foot behind the fifth (small) toe, the bunionette or “small bunion” is caused by a variety of conditions including heredity, faulty biomechanics (the way one walks) or trauma, to name a few. Pain is often associated with this deformity, making shoes very uncomfortable and at times even walking becomes difficult. If severe and conservative treatments fail to improve the symptoms of this condition, surgical repair may be suggested. Your podiatric physician will develop a surgical plan specific to the condition present.
Bone spurs
A bone spur is an overgrowth of bone as a result of pressure, trauma, or reactive stress of a ligament or tendon. This growth can cause pain and even restrict motion of a joint, depending on its location and size. Spurs may also be located under the toenail plate, causing nail deformity and pain. Surgical treatment and procedure is based on the size, location, and symptoms of the bone spur. Your podiatric physician will determine the surgical method best suited for your condition.
Preoperative Testing and Care
As with anyone facing any surgical procedure, those undergoing foot and ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, the podiatric physician will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered by the podiatric physician, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulatory status of the foot/legs), and a biomechanical examination. A consultation with another medical specialist may be advised by a podiatric physician, depending on your test results or a specific medical condition.
Postoperative Care
The type of foot surgery performed determines the length and kind of aftercare required to assure that your recovery from surgery is rapid and uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression, and elevation. Bandages, splints, surgical shoes, casts, crutches, or canes may be necessary to improve and ensure a safe recovery after foot surgery. A satisfactory recovery can be hastened by carefully following instructions from your podiatric physician.
Your Feet Aren’t Supposed to Hurt
Remember that foot pain is not normal. Healthy, pain-free feet are a key to your independence. At the first sign of pain, or any noticeable changes in your feet, seek professional podiatric medical care. Your feet must last a lifetime, and most Americans log an amazing 75,000 miles on their feet by the time they reach age 50. Regular foot care can make sure your feet are up to the task. With proper detection, intervention, and care, most foot and ankle problems can be lessened or prevented. Remember that the advice provided in this pamphlet should not be used as a substitute for a consultation or evaluation by a podiatric physician.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
What are Plantar Warts?
Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus, which generally invades the skin through small or invisible cuts and abrasions. They can appear anywhere on the skin, but technically only those on the sole are properly called plantar warts.
Children, especially teenagers, tend to be more susceptible to warts than adults; some people seem to be immune.
Identification Problems
Most warts are harmless, even though they may be painful. They are often mistaken for corns or calluses—which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.
It is also possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart. It is wise to consult a podiatric physician when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis.
Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown (but the color may vary), with a center that appears as one or more pinpoints of black. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.
Source of the Virus
The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. The virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.
If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts; these are often called mosaic warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed, another route for spreading.
Occasionally, warts can spontaneously disappear after a short time, and, just as frequently, they can recur in the same location.
When plantar warts develop on the weight-bearing areas of the foot—the ball of the foot, or the heel, for example—they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.
Tips for Wart Prevention
- Avoid walking barefoot, except on sandy beaches.
- Change shoes and socks daily.
- Keep feet clean and dry.
- Check children's feet periodically.
- Avoid direct contact with warts—from other persons or from other parts of the body.
- Do not ignore growths on, or changes in, your skin.
Visit your podiatric physician as part of your annual health checkup.
Foot Wart Remedies
Self treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue.
Self treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use them in the presence of an active infection.
Professional Wart Treatment
It is possible that your podiatric physician will prescribe and supervise your use of a wart-removal preparation. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthetic, may be indicated.
Lasers have become a common and effective treatment. A procedure known as CO2 laser cautery is performed under local anesthesia either in your podiatrist’s office surgical setting or an outpatient surgery facility. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions.
Tips for Individuals with Warts
- Avoid self treatment with over-the-counter preparations.
- Seek professional podiatric evaluation and assistance with the treament of your warts.
- Diabetics and other patients with circulatory, immunological, or neurological problems should be especially careful with the treament of their warts.
- Warts are contagious. Make sure you have your warts evaluated to protect yourself and those close to you.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
I. Heel Pain Has Many Causes
Pain, such as may occur in our heels, alerts us to seek medical attention. This alert is of utmost importance because of the many afflictions that contribute to heel pain.
a.) Heel Spurs
A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch.
Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone.
These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.
b.) Plantar Fasciitis
Both heel pain and heel spurs are frequently associated with an inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. The inflammation is called plantar fasciitis. It is common among athletes who run and jump a lot, and it can be quite painful.
The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads to inflammation, pain, and possibly the growth of a bone spur where it attaches to the heel bone.
The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that can accompany an athletic lifestyle.
Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel. As you walk, the heel pain may lessen or even disappear, but that may be just a false sense of relief. The pain often returns after prolonged rest or extensive walking.
c.) Excessive Pronation
Heel pain sometimes results from excessive pronation. Pronation is the normal flexible motion and flattening of the arch of the foot that allows it to adapt to ground surfaces and absorb shock in the normal walking pattern.
As you walk, the heel contacts the ground first; the weight shifts first to the outside of the foot, then moves toward the big toe. The arch rises, the foot generally rolls upward and outward, becoming rigid and stable in order to lift the body and move it forward.
Excessive pronation—excessive inward motion—can create an abnormal amount of stretching and pulling on the ligaments and tendons attaching to the bottom back of the heel bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back.
d.) Disease and Heel Pain
Some general health conditions can also bring about heel pain.
i.) Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, can cause heel discomfort in some cases.
ii.) An inflamed bursa (bursitis), a small, irritated sack of fluid; a neuroma (a nerve growth); or other soft-tissue growth can also call heel pain. Such heel pain may be associated with a heel spur or may mimic the pain of a heel spur.
iii.) Haglund's deformity ("pump bump") is a bone enlargement at the back of the heel bone, in the area where the achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure against the shoe and can be aggravated by the height or stitching of a heel counter of a particular shoe.
Pain at the back of the heel is associated with inflammation of the achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called achilles tendinitis.
It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone.
This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon.
iv.) Bone bruises are common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.
v.) Stress fractures of the heel bone also can occur, although infrequently.
vi.) Children’s Heel Pain occurs most commonly between ages 8 and 13, as children become increasingly active in sports activity in and out of school.
This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur.
When the bones mature, the problems disappear and are not likely to recur. If heel pain occurs in this age group, podiatric care is necessary to protect the growing bone and to provide pain relief.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you!
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you!
II. What Is a Bunion?
A bunion is an enlargement of the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place.
This forces the toe to bend toward the others, causing an often painful lump of bone on the foot. Since this joint carries a lot of the body’s weight while walking, bunions can cause extreme pain if left untreated.
The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. A bunion– from the Latin "bunio," meaning enlargement– can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor’s bunion."
a.) Bunion Symptoms
- A firm bump on the outside edge of the foot, at the base of the big toe.
- Redness, swelling, or pain at or near the MTP joint.
- Corns or other irritations caused by the overlap of the first and second toes.
- Restricted or painful motion of the big toe.
b.) Bunion Causes
Bunions form when the normal balance of forces exerted on the joints and tendons of the foot becomes disrupted. This can lead to instability in the joint and cause the deformity.
They are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk, and our inherited foot type, our shoes, or other sources.
Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions.
Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.
Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women.
c.) Bunion Remedies
- Apply a commercial, nonmedicated bunion pad around the bony prominence.
- Wear shoes with a wide and deep toe box.
- If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling.
- Avoid high-heeled shoes over two inches tall.
See your podiatric physician if pain persists.
d.) Podiatric Treatment For Bunion Pain
Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery.
Podiatric medical attention should be sought at the first indication of pain or discomfort because, left untreated, bunions tend to get larger and more painful, making nonsurgical treatment less of an option.
The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity. A podiatric physician may recommend these treatments:
- Padding and taping the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain.
- Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammations caused by joint deformities.
- Physical Therapy is also used to provide relief of the inflammation and from bunion pain.
- Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement.
- Orthotic shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity.
e.) Podiatric Surgical Options for Bunions
When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint.
Several surgical procedures are available to the podiatric physician. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.
A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint.
Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatric physician.
f.) Bunion Tips
- Wear comfortable shoes that conform to the shape of your foot.
- Wear shoes with a wide and deep toe box.
- Always fit the larger foot and have your feet sized each time you purchase shoes.
- Apply a commercial, nonmedicated bunion pad around the bony prominence.
- If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling.
- Avoid high-heeled shoes over two inches tall.
- Seek professional podiatric evaluation and assistance with uncomfortable or noticeable bunions.
Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis and treatment of all foot conditions.
This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin, and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
III. What is a Hammertoe?
A hammertoe is a contracture—or bending—of the toe at the first joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down V when looked at from the side.
Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammertoes are more common to females than males.
There are two different types:
Flexible Hammertoes:
These are less serious because they can be diagnosed and treated while still in the developmental stage.
They are called flexible hammertoes because they are still moveable at the joint.
Rigid Hammertoes:
This variety is more developed and more serious than the flexible condition. Rigid hammertoes can be seen in patients with severe arthritis, for example, or in patients who wait too long to seek professional treatment.
The tendons in a rigid hammertoe have become tight, and the joint misaligned and immobile, making surgery the usual course of treatment.
a.) Hammertoe Symptoms
- Pain upon pressure at the top of the bent toe from footwear.
- The formation of corns on the top of the joint.
- Redness and swelling at the joint contracture.
- Restricted or painful motion of the toe joint.
- Pain in the ball of the foot at the base of the affected toe.
b.) Hammertoe Causes
A hammertoe is formed due an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture.
Heredity and trauma can also lead to the formation of a hammertoe.
Arthritis is another factor, because the balance around the toe in people with arthritis is so disrupted that a hammertoe may develop.
Wearing shoes that are too tight and cause the toes to squeeze can also be a cause for a hammertoe to form.
c.) Hammertoe Remedies
- Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area.
- Wear a shoe with a deep toe box.
- If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling.
- Avoid heels more than two inches tall.
- A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician’s office will be necessary to repair the toe to allow for normal foot function.
- Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly.
See your podiatric physician if pain persists.
d.) Podiatric Hammertoe Treatment
The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery.
Podiatric medical attention should be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option.
Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.
i.) Padding and Taping:
Often this is the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain.
ii.) Medication:
Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity.
iii.) Orthotic Devices:
Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.
iv.) Surgical Options:
Several surgical procedures are available to the podiatric physician. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain.
Severe hammertoes, which are not fully reducible, may require more complex surgical procedures.
Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatric physician.
Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis and treatment of all foot conditions.
This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin, and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
IV. Your Feet Aren’t Supposed to Hurt
Remember that foot pain is not normal. Healthy, pain-free feet are a key to your independence. At the first sign of pain, or any noticeable changes in your feet, seek professional podiatric medical care.
Your feet must last a lifetime, and most Americans log an amazing 75,000 miles on their feet by the time they reach age 50. Regular foot care can make sure your feet are up to the task. With proper detection, intervention, and care, most foot and ankle problems can be lessened or prevented.
Remember that the advice provided on this website should not be used as a substitute for a consultation or evaluation by a podiatric physician.
What are Ingrown Toenails?
Ingrown nails, the most common nail impairment, are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling.
Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh.
The big toe is usually the victim of this condition but other toes can also become affected.
How to Prevent Ingrown Toenails
Ingrown toenails may be caused by:
- Improperly trimmed nails
- Heredity
- Shoe pressure; crowding of toes
- Repeated trauma to the feet from normal activities
Be sure to trim your toenails straight across, not longer than the tip of the toes. Do not round off corners. Use toenail clippers.
Ingrown Toenails Home Treatment
People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self treatment and seek podiatric medical care as soon as possible.
If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.
Other "do-it-yourself" treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided.
When to See a Podiatrist
Nail problems should be evaluated and treated by your podiatrist, who can diagnose the ailment, and then prescribe medication or another appropriate treatment.
You should see a podiatrist immediately if any drainage or excessive redness is present around the toenail; or if a short trial of home treatment has not resulted in improvement.
A podiatrist will carefully remove the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection.
Permanent Correction
If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of that piece of nail, are removed by use of a chemical, a laser, or by other methods.
Make an appointment
With our seven locations across Middle Tennessee, Nashville Foot and Ankle Group has an office near you.
Call your nearest Nashville podiatrist today and a member of our courteous and smiling staff will be happy to assist you.
