Get Answers About Foot Care
Q: What should I do if I have a corn on my toe?
A: Since corns are caused by tight shoes or sneakers, it’s important not to wear that same tight shoe/sneaker, or at least to get the shoe stretched in that particular area. It is also important to see a podiatrist and have it treated appropriately, which usually involves having the dead skin removed (which does not hurt) and having the area appropriately padded. There are many types of pads available to accommodate toe deformities and decrease pain. If conservative treatment fails, surgery can be done to straighten out the toe by removing a small piece of bone from the joint area.
Q: What special considerations should I think about with my diabetes?
A: Diabetes and chronic high blood sugar can result in damage to the arteries and nerves of the feet. Therefore, it is important to have your circulation and nerves evaluated at least one to two times per year by a doctor. Circulation problems may cause pain or cramping in the feet or legs, as well as a feeling of coldness. Nerve problems may present with a burning or tingling pain, or may cause no pain when there is a problem such as a sore. This can be especially disastrous if a person cannot see the affected area. Thus, it is important for everyone with diabetes to check their feet daily. Diabetes can also affect the skin and make it drier, so a moisturizer should be used daily.
Q: What can I do about deformed-looking nails?
A: It depends upon the cause. The most common causes of deformed nails are trauma and a fungal infection. When a toe is stubbed or something falls on a toe, the nail is usually damaged. The nail grows from its base, so if anything traumatizes that area, the nail may grow in thick, discolored, or in the wrong direction. This type of deformity is often permanent, but treatment by a podiatrist can make the nail look much better.
Deformity secondary to a fungal infection may be easier to cure. When an infection is suspected, the nail must be cultured (a small piece sent to a lab and analyzed) to confirm the diagnosis. Once the infection is confirmed, treatment can be either topical or systemic. If the infection is mild, a liquid medication can be applied daily in an attempt to kill the fungus. This usually works in mild to moderate cases. Keep in mind that it takes 10 to 12 months for a new toenail to grow in, so improvement will be seen gradually. Other products can also be applied to the nail to make it softer and let other medicines penetrate better.
For a severely infected fungal toenail, the best treatment option is taking a pill that affects the area under the skin where the nail grows from. The two most common pills must be taken by mouth for about three months, usually with blood tests to make sure there are no side effects.
There are other, less common causes of nail deformity such as psoriasis, that can cause pitting and discoloration of nails. These systemic problems are best treated by a medical doctor who specializes in the cause; sometimes a podiatrist can perform ancillary treatments which may improve the appearance of the nail.
Q: What causes heel pain and what can I do about it?
A: Heel pain can have many causes. The most common causes are heel spurs, a bone bruise or bursitis. A heel spur can become painful when a person increases their activity level suddenly, or walks or runs in poor shoe gear (insufficient padding). This activity can also cause a bone bruise. An X-ray should be taken to assess the heel bone. A stress fracture is sometimes seen on an X-ray, which can also result from the aforementioned activities. A less common but important cause of heel pain is systemic arthritis such as Reiter’s arthritis, Psoriatic arthritis or Ankylosing Spondilitis. If your heel pain does not subside with the usual treatments of padding/orthotics, stretching, soaking/ice massage and injection therapy, a systemic cause of the pain should be considered.
If you have any sort of foot trouble — blisters, calluses, arch, heel or ankle pain, athlete’s foot or any kind of fungal infection — Foot Center of New York’s team of doctors can help you, using the most modern medical equipment. To schedule an appointment or just to get more information, call (212) 410-8158. Both English and Spanish are spoken at FCNY. Visit The Foot Center on the Web at www.footcenterofny.org.