WFAI Blog

Posts for category: Foot pain

By Dr. Frost & Dr. Campbell
July 31, 2013
Category: Foot pain

Ever been afraid to go to the doctor's office because you knew that he/she might recommend a painful procedure?  You're not alone, many patients have anxiety when it comes to needles and scalpels.  This fear has led many to neglect their foot health and put off needed work.  Now there’s a solution – conscious sedation podiatry.

Nitrous oxide has been safely used in dental offices for years as a method to ease anxiety and pain associated with in-office procedures.  Our physicians have unique training in the admission of nitrous oxide and offer it for various in-office procedures.  Conscious sedation allows us to offer truly anxiety free podiatry.

Not all foot ailments need to be taken to the operating room for correction.  Conscious sedation podiatry allows us to treat you in the comfort and convenience of our office.  At Wasatch Foot & Ankle Institute, we realize that everyone is different, that each person has a different level of comfort.  We understand that podiatric procedures don’t have to be painful, or scary.  Call today and get ready to experience an entirely new level of worry-free patient care.

By Dr. Frost
May 24, 2013
Category: Foot pain
Tags: Bunion  

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When I was younger, I had absolutely no idea what a bunion was.  I actually thought that a bunion was something that you could “catch” from someone, or that you only would be stricken with it when you were older!  I was very wrong……..even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.  Here's what a bunion looks like in cartoon, clinic, & x-ray (*these are not all the same bunion, but you get the idea):

 

What is a Bunion?

A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

Causes
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.

Symptoms
Symptoms, which occur at the site of the bunion, may include:

·         Pain or soreness

·         Inflammation and redness

·         A burning sensation

·         Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Diagnosis
Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred.

Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Non-Surgical Treatment
Sometimes observation of the bunion is all that’s needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised.

In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they won’t reverse the deformity itself. These include:

·         Changes in shoewear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition.

·         Padding. Pads placed over the area of the bunion can help minimize pain. These can be obtained from your surgeon or purchased at a drug store.

·         Activity modifications. Avoid activity that causes bunion pain, including standing for long periods of time.

·         Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

·         Icing. Applying an ice pack several times a day helps reduce inflammation and pain.

·         Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.

·         Orthotic devices. In some cases, custom orthotic devices may be provided by the foot and ankle surgeon.

When Is Surgery Needed?
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it’s time to discuss surgical options with a foot and ankle surgeon. Together you can decide if surgery is best for you.

A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the “bump” of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain.

In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed. 

 

References:

-http://www.foothealthfacts.org/footankleinfo/bunions.htm 

-http://www.mayoclinic.com/health/bunions/DS00309 

-http://www.wasatchfai.com/library/1776/BunionPrevention.html

 

 

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

The American College of Foot and Ankle Surgeons offers five warning signs parents should watch for:

1. Your Kids Can’t Keep Up with Their Peers

If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

2. Children Voluntarily Withdraw from Activities they Usually Enjoy

If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

 3. They Don’t Want to Show You Their Feet

Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Surgeons encourage parents to make a habit of inspecting their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails.

4. Your Child Often Trips and Falls

Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.

5. The Child Complains of Pain

It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.  A child with any of these signs or symptoms should be promptly examined by a foot and ankle surgeon for proper diagnosis and treatment.

References:
-http://www.mayoclinic.com/health/flatfeet/DS00449
-http://www.foothealthfacts.org/Content.aspx?id=1625
-http://www.wasatchfai.com/pediatric-patients.html

 

I often hear this phrase regarding broken toes.  Below, you'll learn 5 ways to treat a toe fracture.

Of the 26 bones in the foot, 14 are toe bones (phalanges). Fractures of the toes are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.

What Is a Fracture?

A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.

Traumatic fractures (also called acute fractures) are caused by a direct blow or impact, such as seriously stubbing your toe. Traumatic fractures can be displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated).

Signs and symptoms of a traumatic fracture include:

•    You may hear a sound at the time of the break.

•    “Pinpoint pain” (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.

•    Crooked or abnormal appearance of the toe.

•    Bruising and swelling the next day.

•    It is not true that “if you can walk on it, it’s not broken.” Evaluation by a foot and ankle surgeon is always recommended.

Consequences of Improper Treatment

Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:

•    A deformity in the bony architecture which may limit the ability to move the foot or cause difficulty in fitting shoes

•    Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected

•    Chronic pain and deformity

•    Non-union, or failure to heal, can lead to subsequent surgery or chronic pain.

Treatment of Toe Fractures

Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:

•    Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.

•    Splinting. The toe may be fitted with a splint to keep it in a fixed position.

•    Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned.

•    “Buddy taping” the fractured toe to another toe is sometimes appropriate, but in other cases it may be harmful.

•    Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.

**Below are x-rays of a 5th toe fracture before and after closed reduction and conservative care**