As a podiatrist, foot care doctor, foot specialist one of the most frequent condtions I see in my office in Panama City, Fl; and seen by most foot doctors are fungus toenails. A fungus is a tiny parasite plant-like organism that grows and spreads in dark warm moist places , that can infect the skin and the toenails and are very common in this part of Florida.
A fungus toenail infection is when the fungus literally has invaded the nail and has started to live off of it. The toenail is like a “Big Mac” to the fungus. It just loves it. . This can cause the toenail to abnormally thicken, loosen, swell, change color to yellow green or black, and finally become very painful. A fungus can also cause the corner of the toenail to grow in abnormally giving you an ingrown toenail. This foot problem must be aggressively dealt with or the fungus can spread to all of your other toe nails. The longer the infection is allowed to go unchecked, the more difficult it is to treat, and the more complication you have from it.
One of these complications is when the fungus toenail is allowed to become abnormally thick. This puts greater pressure on the top of the toe bone with the result that a bone spur forms on the very tip of the toe, making this a very painful foot problem especially in shoes and may require surgery to remove.
There are many non-surgical treatments for this foot problem that can give long-term relief by treating the underlying parasite infection. It may take several visits to the podiatrist office to cut out all of the fungus tissue, but it is painless and works. A word about the “New” wonder drugs for fungus infection, I do not use them because have many side effects, in fact the drug compamys recommended that you have your blood tested monthly for some of these drugs. The normal cost of treatment for fungus toenails using these drugs to treat these foot problems is at least $500.00, that is just crazy to me! Foot surgery should always be a last resort for fungus toenails, but if needed, it is done right in the podiatrist’s office.
Thousands of people are told every day that they have gout when they don’t.
What is Gout Gout is a form of Arthritis, that is extremely painful and that can occur suddenly out of nowhere causing sore aching crushing feet, and exquisite pain. It is caused by a build up of a chemical substance in our body called uric acid. It is these crystals of urate that causes the pain, mostly in the big toe joint in the foot and also the ankles. These crystals can also invade the tendons of the feet causing great pain in that area. It is believed that gout is due to Inheritance, and affects men much more than women. It is also known that gout is diet driven. Certain foods such as shell fish, and red meats; among many others can trigger a gouty attack. We also know that other circumstance can bring on a gouty attack such as an infection, stress, accident, too much of the wrong food and/or drink, and surgery. In the clinic any patient that I feel has gout, I advise him/her of one thing: “GOUT CAN KILL YOU” It must be treated by a medical specialist who knows what he or she is doing. You see the pain in your big toe is just the tip of the iceberg. Without you knowing it, gout is affecting your heart, lungs, and kidneys. The pain from the worst gout attack will go away on its own in 2 weeks. Once this happens you think you are are cured. You are not!! The abnormal level of uric acid is still in your blood doing damage to many organs in your body, even though you are not aware of it. My first choice to treat gout would be an internist. If this is totally not possible, contact your family doctor and see what he says.
Many physicians will tell their patients that they have gout just because their feet hurt alot. This is incorrect information. The doctor should take a blood test to make this important diagnosis. After 35 years I have found that the vast majority of patients who do have severe foot pains DO NOT have gout, but just a crummy pair of feet cause by their feet not working right, not by a chemical imbalance that is seen in gout.
About the Author: Dr. Burton S. Schuler foot doctor, foot specialist, podiatrist of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center and is a leading authority on the Morton’s Toe, Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is published by the La Luz Press, Inc and is disturbed national by the Cardinal Publishing Group. Why You Really Hurt: It All Starts In The Foot, is the story of how one bone in your foot could be the real reason for pains thru out your whole body. It is important because it offer the public new information about why millions of people suffer everyday with aches and pains, and offers new hope to get rid of problems they believed they would have to live with forever. It literally can be the “medical missing link”
Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and other publications. Dr. Schuler has appeared on hundreds of radio and television programs both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Academy of Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis).
Warts are misdiagnosed everyday by physicians who are not really aware of what they really are.
What Are Warts
Warts are a viral infection that invades the foot through microscopic breaks or wounds in the skin. With time the wart grows into a rough hard growth on the skin. Plantar warts are the most common type of wart and are found on the bottom of the foot, but warts can appear anywhere on the foot. They can appear as a single round lesion, or as a cluster of lesions, which are caused Mosaic warts. They are very painful especially when they are squeezed from their sides. Contrary to the old wive’s tale, they are not caused by touching frogs, and for the most part, tend to be seasonal, generally appearing in the months of October, November and December; this is because warts spread in places like public pools and showers during the summer months, and it takes approximately three months for the virus to grow, once it invades your foot. They can also be passed from person to person in the same household. There are over 200 different treatments for warts. Conservative treatment can include by not limited to acid treatments, orthotic therapy, ultra sound, curettage and vitamin supplements. The main thing to remember about a wart is that it should receive immediate attention. If it is ignored, it may spread to other parts of the body, and since warts are extremely painful, it is best to check this condition in its earliest stages.
It is also very common for Calluses and Corns to be misdiagnosis as warts, and vice versa. Calluses are treated totally differently from warts and that is why it is vital to get the proper evaluation from a specialist who knows all about them.
For your information, Dr. Burton Schuler co-authored and published an article in the Journal of the American Podiatry Association about wart in May 1975.
About the Author: Dr. Burton S. Schuler foot doctor, foot specialist, podiatrist of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center and is a leading authority on the Morton’s Toe, Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot The book is published by the La Luz Press, Inc and is disturbed national by the Cardinal Publishing Group. Why You Really Hurt: It All Starts In The Foot, is the story of how one bone in your foot could be the real reason for pains thru out your whole body. It is important because it offer the public new information about why millions of people suffer everyday with aches and pains, and offers new hope to get rid of problems they believed they would have to live with forever. It literally can be the “medical missing link”
Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and other publications. Dr. Schuler has appeared on hundreds of radio and television programs both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Academy of Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis).
Tendinitis is a stressing or straining of a muscle or group of muscles which results in severe pain and or swelling. The most common tendinitis in the foot is found in the Achilles tendon. The Achilles tendon starts at the calf muscle then runs down the back of the leg into the heel bone. The major reason a tendon in the foot will become inflamed is due to overuse via Abnormal Pronation; that ia caused by a Morton”s Toe. Tendinitis can also be a side effects of Arthritis or Diabetes.
Many people have short Achilles tendons due to wearing high heel shoes. Over a period of speelautomaten online time the tendon becomes shorter because it is not being stretched. But this can be reversed with stretching exercises of the Achilles. The best way to treat this problem if the cause is due to Abnormal Pronation is to control it by making an Orthotic.
Other treatments for tendinitis include Physical Therapy, padding and strapping of the feet/heel, and anti-inflammatory medications. The good news is surgery is rarely needed for Achilles tendinitis.
Are your toes and or feet cold or numb? Do they burn?
When walking do you get pains in your calf or thigh?
Do you have sores on your toes, feet, or legs that won’t heal?
Do you notice a loss of hair on your feet or toes, or legs?
Do you have some black or blue marks on your feet or toes?
Do muscle cramps bother you especially at night or resting?
You may have Peripheral Vascular Disease if the answer to any of the above was yes.
WHAT IS P.V.D?
Peripheral vascular disease is the medical name of the group of medical problems that causes poor circulation to the toes, feet and legs. One of the major diseases in this group is called arteriosclerosis.
Arteriosclerosis, more commonly known as “hardening of the arteries” is a condition in which there is a gradual thickening, hardening, and loss of elasticity in the walls of the arteries. The arteries are the blood vessels that brings the blood from the heart, down to the feet and legs. Arterial insufficiency may also be caused by an obstruction in the artery wall, by the narrowing of arteries or by a spasm of the vessel. This disease is most common in men past fifty years of age. Diabetes is a major cause of peripheral vascular disease. The diabetic lacks the ability to make proper use of the sugar they ingests. As a result, of this sugar builds up, they have many changes in their blood vessels, causing them to have circulation problems, more often than the average person.
Besides diabetes other risk factors for circulatory disorders are heart disease, high blood pressure, smoking, family history of vascular disease, obesity, and elevatedcholesterol levels.
Exercise can help circulatory problems. The muscles of the legs have a massaging effect on the blood vessels and help maintain normal passage of the blood. Adequate exercise which is appropriate to a person’s general health and age will do much to benefit the entire circulatory system.
There are many highly successful non-surgical treatments for peripheral vascular disease that gives relief by increasing the circulation, to the feet and leg. This is done as always in the comfort and privacy of our clinic.
What is really happening in the case of an ingrown toenail is that the flesh around the nail is being forced to close in against the sides of the nail, forcing the nail itself to dig into the flesh. Inheritence, tight shoes and or socks are generally the major causes of ingrown toenails.
Home treatment for ingrown toenails may be practiced if the ailment has not progressed to a very painful or infected toenails. Some treatments, such as soaking in warm water and packing the area between the nail and the flesh with cotton, preventing the edge of the nail from piercing the skin, have proven to be successful in the past for some people.
If, however, you are suffering from an infected painful toenail, it is not wise to attempt to cure it through self-treatment At this stage, it may be necessary for your podiatrist to remove the ingrowing border of the nail.
The simplest professional treatment for an ongoing ingrowing nail is to see your local Podiatrist on a regular basis. If you see them every 30-90 days, it is normally pain free to remove the nail. The nail will grow back, hence you must be seen again.
If you desire a more permanent treatment, where the nail should not come back, a relatively simply surgery can be done in the office setting, where the nail root is destroyed by using a chemical called phenol. No incisions is made or stitches used with this procedure.
There are many highly successful non-surgical treatments for toenail problems that give relief by treating the abnormal shape of the nail. Foot surgery for toenail problems is commonly done and desired; and if needed, it is done using minimal incision techniques, in the comfort and privacy of the our Clinic.
WHAT IS A HEEL SPUR? The heel bone is the largest bone in the foot and absorbs the most stress. A heel spur is an abnormal growth of bone either at the back of the heel, or most commonly on the bottom of the heel. The most common symptom of a heel spur is to have pain when first getting out of bed in the morning, or after resting for 20 minutes then getting up. WHY DO WE GET HEEL SPURS OR HEEL SPUR SYNDROME? The most common reasons for heel spurs and heel pain is due to excessive stress and stains applied to the heel bone and the soft tissues structures that attach to the heel bone when we walk. This abnormal stress and strain is caused by Abnormal Pronation, which is the result of having a Morton’s Toe Our modern-day society, where many jobs demand long hours of standing on hard concrete, that are unforgiving on our feet also contributes to heel problems. Over a period of years one of the major structures attached to the heel called the plantar fascia (this is the large rubber band structures that hold up your arch, and that goes from the heel to the ball of the foot) pulls away from the calcaneus (heel bone) and causes microscopic bleeding to occur. This bleeding can lead to new bone formation at the heel which eventfully leads to the formation of a bone spur. “Heel Spur Syndrome” is pain of the heel when the plantar fascia is just pulling abnormally at the heel without a spur being formed.
Heel Bursitis, Besides the heel itself being affected, there is a fluid containing sac covering the heel called a bursa. The bursa acts as a shock absorber for the tremendous forces that goes through the heel. This bursa will get abnormally swollen and inflamed when the heel is injured as noted above, resulting in a Bursitis. The medical term for this is a Calcaneal Bursitis and is the cause of the pain upon getting out of bed in the morning or pain upon raising after resting, either at the heel spur on the bottom and or back of the heel bone.
Plantar Fasciitis is a condition where the plantar fascia gets swollen and inflamed, again due to abnormal pronation. Normally it hurts upon standing but normally goes away walking awhile. Surgery is very rare, and conservative treatment is the same as heel spur (see below)
Other causes of heel pain include: physical injury, obesity, poor shoes, muscle inflammation, gout, nerve problem (Tarsal Tunnel Syndrome,) strain of the plantar arch,arthritis or simply excessive walking or standing.
I am of the firm belief that heel spurs lay dormant for years like volcanos. One of the most amazing thing about heel spurs is that at this very moment there are millions of people walking around the world who have massive heel spurs who are not having one drop of pain, and have no idea in the world that they have heel spurs. Many people go thru their entire life with heel spurs who don’t have any heel pain. It is not unusual for me to see a patient who complains of heel pain of about 2-3 months, to have a spur on x-ray that from its size, had to have been there for 20 years. Again I believe something will trigger the heel pain out of the blue when a large spur has been there for many years.
Self-treatment in the early stages of heel pain may include stretching exercises, elevation of the heel, using over the counter anti-inflammatory medications, ice or heat (I prefer heat), losing weight, padding the heel with a soft foam rubber material, or wearing shoes with a thick rubber heel which act as a shock absorber. If the condition does not respond to such treatment, it is time to consult a podiatrist who will compile a careful medical history and perform a detailed examination of the foot. X-rays are normally needed to assist in determining the nature of the problem. At the Ambulatory Foot Clinic we also employ Thermography in all of our exams for heel pain This allows us to see inside your foot and see your pain. There are only a handful of foot specialist in the Southeast who have this state of the art ability in their offices.
Children can also have severe heel problems. Between the ages of 9 and 13 they can experience pain on the side of the heel caused by an irritation to the growth plate, and is called Calcaneal Apophysitis, or Sever’s Disease. This condition can become serious and should be immediately evaluated by a podiatrist.
Heel spurs and heel pain is the most common problems seen at the Ambulatory Foot Clinic-Podiatric Pain Management Center. Our treatments for these complex problems are not to give painful injections or perform surgeries immediately, but instead use the time proven, highly successful, relatively pain free treatments such as stress free Physical Therapy, medications and removal of the abnormal stress and strain on the heel (which were and are the real cause of the problem) with padding and strapping and then Orthotics to control the underlying Abnormal Pronation which many times is due to Morton’s Toe. There are many highly successful non-surgical treatments for heel spurs and related conditions that give long term relief by treating the abnormal bone pressure. Foot surgery for heel pain is rare and should always be a last resort, but if needed, it is done using minimal incision techniques, in the comfort and privacy of our Clinic.
Bursas are small fluid containing sacs, that are situated between areas of high friction such as bone against the floor (heel) and bone against other soft tissue structures like tendons, skin and or muscle.
The bursa job is to act as a shock absorber, and to allow stress free movement between the above noted structures. Bursitis is a swelling\inflammation of the bursa sac, due to constant micro trauma or overuse. In the foot Abnormal Pronation, most often caused by Morton’s Toe
In the 1920’s and 1930”s Dr. Dudley J. Morton of Yale Medical School and Columbia Medical School wrote that a problem with the 1st metatarsal bone, known as a Morton’s Toe could be the reason for most foot problems. Dr. Janet Travel, White House physician to Presidents Kennedy and Johnson, and Professor Emeritus of Medicine at George Washington University took this concept further by writing and teaching that the Morton’s Toe could cause pain all over your body. She wrote and taught for four decades that a Morton’s Toe could cause back, hip, knee, leg foot and ankles problems. She felt that the Morton’s Toe, was so important that at the age of 89 she made a video tape to teach other physicians about how to recognize it and how to treat it.
WHAT IS WHY YOU REALLY HURT: IT ALL STARTS IN THE FOOT, is the leading cause of this overuse. It is most commonly found on the foot, at the bottom (Heel Spur) and back of the heel bone; and underneath the metatarsal heads going toward the toes.
A bursa is a fluid-containing sac that is present at many areas of pressure on the body. Its job is to protect these areas of pressure by being a shock absorber. A bursitis is an abnormal inflammation of the bursa sac caused by abnormal excessive pressure, stress and/ or strain over the area it is protecting. On the heel bone, there are two bursa sacs: one on the bottom and the other on the back. Specifically on the bottom of the heel, it is known as an Inferior (bottom) Calcaneal (heel) Bursa. On the back of the heel, it is called the Retro (back) Calcaneal Bursa.
When either of these bursas become abnormally stressed, strained, or swollen, the result is bursitis of the heel. It is this bursitis that is the reason for pain in the heel upon arising (Poststatic Dyskinesia) in the morning or after resting for a while. You can either develop these bursitises with or without the presence of heel spur (explanation to follow). As stated before, Morton’s Toe can cause this by causing over pronation in the foot.
Metatarsalgia can also be caused by a bursitis. The big toe or Bunion joint is also a favorite spot to find bursitis in the foot. Bursitis is confused with Gout and infection by those who don’t deal with them on a daily basis. The most common complaint from the patient is upon rising in the morning, or after about 20 minutes or resting, then upon rising, there is great pain in the area of the bursa. This is due to the fact that the fluid in the sac has hardened up and can not flow as easy as it did, that is what is causing the pain. As with all foot problems, we choose first to treat Bursitis conservatively with the use of Physical Therapy and padding and strappings, and Orthotics. We have found that most (over 90%) patients’ problems are resolved by using this treatment protocol.
Here is a great video about Metatarsalgia that is really popular on YouTube
Dr. Burton S. Schuler is a Podiatrist, foot specialist of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center. He is a leading authority on the Morton’s Toe Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is disturbed national by the Cardinal Publishing Group. It will be translated to Greek this Year.
Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and many other publications. Dr. Schuler has appeared on hundreds of radio shows
Almost everyday a patient will ask me Doc, do I have arthritis in my feet ?. My answer is, if you can remember the Ed Sullivan Show on television, you most probably have some arthritis in your feet, or somewhere else in your body The fact is if your are about 40-50 you got it or are most likely getting it. Most of the foot problems that I treat daily are due to one form of arthritis or another. And it is a safe bet that the most spoken medical term by doctors, in this country today will be arthritis. Billions and Billions are spent on treating it every year, yet we still suffer with it.
WHAT IS ARTHRITIS
According to the Arthritis Foundation there are over one hundred types of Arthritis. Arthritis are conditions that affect the joints and the soft tissue around the joints. Osteoarthritis is the most common type of arthtitis and is due to excessive stress and strain, or just plain old wear and tear on the joints of the foot A joint is where two bones meet. In the foot as in the body Osteoarthritis is the most common form of the type of arthritis that effects the joints . A bunion is a form of osteoarthritis. But there is another type of arthritis that is more common in the foot; that does not attack the joints. These arthtitis are inflammatory conditions that effect the soft tissue and not the joints (bone) and are they are called non articulating arthritis. Such arthritis’s of the foot and body are
are very common foot problems that I, and most Podiatrist treat everyday. .
Rheumatoid arthritis is the most crippling form of arthritis. It not only affects the joints like osteoarthritis, but also can cause severe deformities of the joints, with an associated weakness and fatigue of the whole body. Its causes are presently unknown. Other causes of arthritis include physical injury, obesity, poor shoes, and Gout.
These conditions can cause as much pain as arthritis of the joints, and can appear either along or with arthritis involving the joints.
The most common self-treatment in the early stages of arthritis or its cousins is aspirin, or some of the other over the counter pain medications. If these foot conditions don’t respond to such treatment, it is time to consult a podiatrist who will compile a careful medical history and perform a detailed examination of the foot. X-rays are normally taken to determine the extent of the problem.
Arthritis, bursitis, tendinitis, tenosynovitis, capsulitis, and synovitis are some of the most common problem seen by podiatrist. The good news is that these problems are very treatable with the use of stress-free Physical Therapy, and padding and strappings that remove the abnormal stress and strains on the foot, caused by the Morton’s Toe which is the real reason of the arthritis in many cases. We also do this with Orthotics.
WHAT CAUSES ARTHRITIS IN THE FEET
Well like most of the other problems in this book it is caused by abnormal stress and strain put upon the joints and other soft tissue structures of the feet. If your foot is constantly being abused on a day in day out basis due to a Mortons Toe, or other foot problems, soon or later changes in these joints and other soft tissue structures will end up giving you some form of arthritis. Again this does not happen early in life but later on. One of the most common places for arthritis in the foot, is at the big toe joint. This joint is called the first metatarsal ‑phalange joint, and is where the first metatarsal bone connects with the big toe. This makes senses because if you have a short, or hypermobility of the first metatarsal bone , the big toe joint is taking a tremendous amount of abnormal stress and strain. The arthritis caused by this stress and strain can cause decrease motion at the great toe joint with a great deal of pain and swelling resulting.
THE 75 CENT PAD OR THE $7500.00 SURGERY
During my Career I have seen many different surgeries to repair the damage done by arthritis to the big toe joint. Most of them had marginal result, with nothing to write home about. Like most doctor I am called upon by representatives of drug companies or medical equipment company. Not to long ago a nice chap from one of these equipment company came to see me. He was there to tell me about a new surgical device, and surgery to repair the damage done to the big toe joint due to arthritis of the joint. He played a CD that showed the surgery and his new device. The surgery removed the old destroyed cartilage* at the head of the first metatarsal bone and replaced it with a state of the art titanium coated implant in its place. It was great!, It was wonderful! I really think this implant and surgery is going to work and help a lot of people. I told the representative what I thought and he seemed very pleased. He then invited me to a hands on workshop to learn how to do the surgery. I thanked him for the invitation but told him my philosophy of practice was geared toward preventing problems so surgeries were not necessary. You see I told him, if the patient in the CD had a simple little pad put under his first metatarsal bone as recently as lets say three to five years ago, the arthritis that destroyed is big toe joint probably wont have happened, or at worst would have been more manageable . He looked blankly at me and said I didnt know that. I said yeah I know. I get that a lot. Again, I told him he I thought he had a winner with this new device, but only time would tell. But make sure that after the surgery all of the patients get Toe Pads to treat the underlying real problem of the Morton’s Toe . If they don’t the surgery can fail.
The point of this story is this. It is marvelous we have these new surgeries and devices to repair these serious conditions. But, if the patient in the CD or their doctor knew about the work of Dudley Morton, that patient would not have never been in the CD to start with.
Many things can cause arthritis in the feet but either directly or indirectly, it is caused a great deal of the time by Morton’s Toe , Long Second Toe. If your foot is constantly being abused on a day-in day-out basis due to a Morton’s Toe or other foot problems, sooner or later the damage to these joints and other soft tissue structures will end up giving you some form of arthritis. These conditions can cause as much pain as arthritis, and can appear either along with arthritis, or by themselves. Glucosamine is a very popular treatment
There are many reasons for your heels and arches to hurt especially upon raising or by the end of the day, some of them are
• Plantar Fasciitis
• Heel Spurs
• Heel Bursitis
Plantar Fasciitis is a condition where the plantar fascia gets swollen and inflamed, again due to abnormal pronation.
WHAT IS A HEEL SPUR? The heel bone is the largest bone in the foot and absorbs the most stress. A heel spur is an abnormal growth of bone either at the back of the heel, or most commonly on the bottom of the heel. The most common symptom of a heel spur is to have pain when first getting out of bed in the morning, or after resting for 20 minutes then getting up. WHY DO WE GET HEEL SPURS OR HEEL SPUR SYNDROME? The most common reasons for heel spurs and heel pain is due to excessive stress and stains applied to the heel bone and the soft tissues structures that attach to the heel bone when we walk. This abnormal stress and strain is caused by Abnormal Pronation, which is the result of having a Morton’s Toe
Hammer toes is when the joint of the toes curl down. The reason they curl abnormally is due to a muscle imbalance which results in the tendons becoming unnaturally tight. They are due to Heredity, improper shoes, and Arthritis
There are two types of hammer toes:
1. flexible
or
2. rigid.
These classification are based on the mobility of the toe joints. A flexible hammer toe is one with a flexible toe joint that allows it to be straightend with your finger. In time a flexible joint may turn into a rigid hammer toe. Normally flexible hammer toes are much less painful than rigid hammer toes. A rigid hammer toe is one with a rigid toe joint, one that is not moveable with your finger. These rigid toe joints can be very painful and limit the ability to move. As I write about in my book Why You Really Hurt: It All Starts In The Foot, hammer toes are caused by a problem known as Morton’s Toe to move. Corns that appear on the toes especially the 5th and 2nd toes are a direct result of hammer toes, due to the rubbing of the top of the toes on the shoes. Treating the Morton’s Toe can help this problem. Also a shoe with what is known as a “high toe box” can help. Avoid using the over the counter “corn medications” espically if you are a diabetic. They do nothing but burn the skin off of your toes.
Sometimes surgery can not be avoided. If needed, the surgery chosen is decided by whether we are dealing with a flexible or rigid hammer toe. If the surgery is on a flexible hammer toe, it is performed on soft tissue structures like the tendon and or capsule of the flexor hammer toe. I describe this surgery in the section under Calluses
Rigid hammer toes need bone surgeries into the joint of the toe to repair it. This bone surgery is called an arthroplasty. As I wrote in my book The Agony Of De-Feet, all hammer toe surgeries should be done out of the hospital in the doctor’s office or surgical center.
Plantar Fasciitis is a straining and or stressing of the Plantar Fascia (Plantar Arch) resulting in inflammation, swelling and pain in the arch of the foot. The Plantar Fascia (Plantar Arch) is like a rubber band that runs from the heel to the bones in the front part of your foot. The function of the Plantar Fascia is to form a bridge between the front and the back part of the foot. The pains caused by Plantar Fasciitis is a first cousin to the pains of Heel Spurs and/or other Heel Problems. When the arch is strained it normally hurts in the morning when you first get out of bed or after getting up after 20 minutes or so after sitting.
The bones,ligaments and tendons in the arch are subjected to considerable stress throughout the day. And,if your foot does not work properly because of Abnormal Pronation that is due to a Morton’s Toe or other reasons, it will quickly result in arch pain which is a sign that this part of the foot is being overworked and is suffering from fatigue. The pains caused by Plantar Fasciitis is a first cousin to the pains of Heel Spurs and/or other Heel Problems.
People with arch problems should find out if they do have a Morton’s Toe . If they do many times they can easily treat their Plantar Fasciitis themselves. I believe shoes really have very little to do with heel or arch problems. In the end it all depends on the fact if your parents gave you a foot that worked right. Read the section on Inheritance to learn more about this.
If your arch pain does not subside within a reasonable time, it is best to look further in attempting to treat this very painful problem. A podiatrist will determine, through a careful examination and x-ray evaluation, what areas of your foot are under the greatest amount of stress. He may perform an additional lab test to determine if Arthritis is a factor. Plantar Fasciiti can be treated in a variety of ways through anti-inflammatory medications, or injections; by padding & taping of the arch, or by using various combinations of Physical Therapy methods. In some cases, a nerve is injured in the arch area, and a injection is needed to reduce the inflamed nerves. If the problems is due to Abnormal Pronation then an Orthotic device placed inside the shoes will help the arch (Plantar Fascia) from re-injuring itself.
Corns are thickening of the skin created by Mother Nature, in order to insulate and protect the toes against abnormal friction and bony pressure in our shoes. They can be located on the top of any of the toes, or in between the toes. The corns that form between the toes or in the toe webs is called “soft corns” and appears most often in between the 4th and 5th toes. Soft corns are primarily caused by perspiration that collects between the toes, and since this moisture is always present, the corn tissue does not have an opportunity to harden.
These abnormal bony pressures are most commonly caused by bone spurs of the toes, Arthritis or a Hammer Toe condition. A Morton’s Toe either directly or indirectly can cause a hammer toe. The reason’s that corns hurt are due to the irritation of the skin, nerves and other tissues that are being constantly rubbed by the abnormal bone, when it is in a shoe. In many cases there is a related Bursitis of the toe. This is an inflammation of the fluid contain sac that covers, and protects the toe.
Many people attempt to treat corns themselves with over-the counter medicines. These medications contain acid and while they may dissolve the corn tissue, they do nothing to get rid of the underlying bone problems, and can be very dangerous especially if the person is a Diabetic or has poor circulation.
Another popular self-treatment is “bathroom surgery” or “trimming of the corn”, but like the acid all that this does is to temporarily remove the corn tissue without treating the real problem of the bone. I feel it is extremely dangerous to do this bathroom surgery since thousand of people a year lose their toes, feet, legs, and life as a direct result of it.
The good news is this vicious cycle, can be avoided for this chronic condition. I am pleased to advise there are a number of ambulatory techniques that can be performed in an office setting to alleviate the painful corn. Hospital-based surgery is not always necessary to fix this problem, and can easily be ina office, through the utilization of ambulatory surgery But do not forget, it could be the untreated Morton’s Toe that is the real cause of your corns.
Dr. Burton S. Schuler, Podiatrist, Foot doctor, Panama City Fl
Like Corns, a callus is a protective thickening of the skin created by Mother Nature, that develops as a result of abnormal recurrent friction and pressure. Most calluses are found on the ball of the foot, although they may form elsewhere including the heels. Its job is to act as defense mechanism, to, insulate and protect the balls of the feet and other areas on the feet against the abnormal bony pressure put upon it. Footwear is commonly blamed for the formation of calluses, but more often than not, the truth is calluses are most usually caused by a Morton’s Toe which affects how the bones in our forefoot are formed and how they bear our bodies’ weight. When one or more of these bones are misformed, other bones are then forced to bear an excessive amount of weight. Calluses are then formed to help these other bones support this excessive weight on the ball of the feet.
The patient will normal complain of a Burning Pain on the ball of the foot, a condition that has generally spanned anywhere from a few weeks, to a number of years. Or the patient might complaint that they have a “stone bruise type of feeling.” They will claim they think they have a pebble in their shoe. Such a sensation is common and is also commonly caused by a misalignment of the 2nd-5th metatarsal bones; and there may or may not be any sign of callus tissue. PLEASE NOTE!! CALLUSES ARE FREQUENTLY MISTAKEN FOR WARTS. A week rarely passes when someone does not come into my office with a complaint that quickly tells me that they have misdiagnosed their condition. If a family physician has performed a little surgery on this area, the callous is usually compounded by the formation of scar tissues, and of course the patient is in considerable pain. It is not unusual for someone to tell me: “Doctor, I’ve had these warts on my feet for 30 years.” You can imagine how surprised they are when I tell them that they most probably never had warts and never suffered from warts. It takes a while for me persuade them, but once they had accepted the fact that the warts were indeed calluses, they were most eager to learn what could be done about them. Like Corns, conservative therapy of callus is done by “trimming” the callus which only gives temporary relief and does nothing to effect the underlying bone problem. You see if you just trim the calluses away you are doing nothing about the real problem, and Mother Nature is adamant about providing her defenses. Remember you can’t fool her !
Professional Treatment
As always it is my philosophy that “foot surgery should be a last resort”. Because of that we have created a treatment protocol to treat this problem initially without the need of surgery. We have learned that besides the callus there is almost always an associated Bursitis causing some of the pain, and an associated strain of many of the tiny muscles in the feet, especially on the ball of the feet. By using a great deal of Physical Therapy you can rehabilitate these painful areas. Besides that you must also take the strain off the front of the foot with proper padding and strapping. Finally once the patient is feeling better we fabricate an Orthotic which will rebalance the forefoot to its most ideal position. In the rare case where these procedures don’t resolve the problem, we have available two minimal traumatic surgeries to help the condition. In order for you to understand the logic behind these surgeries you must sit through your first anatomy lesson. Here we go! Once the metatarsal bones have fallen out of place, there is a certain amount of contracture or Hammering of the Toes to become tight or bulge. If the toes are pulled back, then chances are that the metatarsal heads are painfully depressed and that there is a burning sensation on the ball of the foot. The action between the toes and metatarsal heads are closely intertwined. You will see that this is so if you take your hand and push hard against the ball of your foot. This pressure, known as retrograde force, will cause your toes to come down, a condition that is more pronounced in cases where people have hammer toes. If the toes can be brought down to a normal position, this in turn will allow the metatarsal heads to pop up, thus taking the pressure off the ball of the foot.
SURGERY
When a person has a large diffused callus with burning (throughout the second and fifth metatarsal heads), we can alleviate his problem by performing a relatively simple but highly effective bit of ambulatory surgery. It involves putting a local anesthetic under the skin on top of the foot and releasing the abnormal pressure on the tight tendons (sometimes we also have to release the pressure at the joint capsule). Once this has been done, the toes will come down, which allows the metatarsal heads to come up, so that the foot may be more properly realigned. At this stage, Mother Nature once again steps in and attempts to reattach these tight tendons over a period of 3 to 6 months. The patient is given simple exercises to do to stretch out the tendons, and after the surgery, leaves the office wearing a bandage inside his shoe. While this is a highly effective procedure, it will not always get rid of the callus tissue that has formed and I never fail to make a point of this, although the patient rarely decides against the procedure on that account. What he will generally say is: “Look, I can live with a little callus tissue. It’s the pain I want to get rid of.” Moving on to the second procedure, in cases of more severely depressed metatarsal bone, we begin by performing a minute incision into what’s called the neck of the metatarsal bone; with a side-cutting burr, we cut right across the neck of the metatarsal bone, allowing that part of the bone to move up and down; hence getting the pressure off of the ball of the foot. With the aid of a little local anesthetic, it is a quick, relatively painless procedure. Afterwards, we do not put a cast on the foot, do not insert wires or tell the patient that he will have to walk around on crutches. Rather, we encourage them, or even insist that he put his own shoe back on and walk around in it, which is the actual secret in achieving a rapid recovery. With only a minimum amount of discomfort, Mother Nature will take care of the situation in short order (usually six to eight weeks) and during that time, the patient is able to perform the vast majority of their normal activities. Of course, we do not mean to suggest that they should go dancing, skiing, or try to play tennis, golf or bowl, during this recuperative period since the bone is broken, but they are free to work or perform normal chores around the house, and may resume any normal, reasonable activity. There are many highly successful non-surgical treatments for calluses that give long term relief by treating the abnormal bone pressure. Foot surgery for calluses is rare and should always be used as a last resort, but if needed, it is done using minimal incision techniques, in the comfort and privacy of our Clinic.
ost common tendinitis in the foot is found in the Achilles tendon. The Achilles tendon starts at the calf muscle then runs down the back of the leg into the heel bone. The major reason a tendon in the foot will become inflamed is due to overuse via 
WHY DO WE GET HEEL SPURS OR HEEL SPUR SYNDROME? The most common reasons for heel spurs and heel pain is due to excessive stress and stains applied to the heel bone and the soft tissues structures that attach to the heel bone when we walk. This abnormal stress and strain is caused by 
The patient will normal complain of a 