Burning and tingling in the toes or even electrical shooting type pains can often be the result of nerve injury. Nerve pain or injury often produces a shooting style pain and can be quite painful. Often it is worse with shoe gear, especially tight-fitting shoes, standing or activities. There does not need to be any previous trauma to get nerve pain in can be causally related to anatomical issues or even genetic.

The most common cause of nerve pain in the foot is a neuroma or a nerve entrapment like tarsal tunnel syndrome. Neuromas typically cause shooting pain to the 3rd and 4th digit of the feet and are more common in woman than men. Tarsal tunnel syndrome is usually located around the ankle and causes electrical pain around the inside of the ankle. Patients with tarsal tunnel often have a history of carpal tunnel in the wrist.

It is important to get an accurate diagnosis of a neuroma or tarsal tunnel. The best place to start is an x-ray. However, some patients will require a MRI or Nerve conduction studies to further support the diagnosis.

Treatment is centered around the cause. It can be useful to remove pressure and decrease inflammation around the nerve. If you are experiencing nerve pain we can help. Give us a call at 425-391-8666 or make an appointment online. 

Thinking about bunion surgery can be overwhelming. I like to help my patients at least a week before surgery so we can prepare together. It is important to think about all the factors that can influence your outcome. I have patients make a list of questions before we meet and advise them to bring a family member or friend to their pre-operative appointment.

A few suggestions to think about before surgery are:

1. Set up a general operation center, i.e the couch with everything you need

2. Think about how you will use the shower and bathroom

3. Supplements, these can be important, examples are calcium and collagen

4. Exercise plan, what can you still do?

5. Review your timeline, how long will you be down?

6. Do you have all your post-operative appointments?

7. Consider side effects of mediations, constipation/nausea

8. Make and freeze a few meals

This list is not exhaustive but it is a good place to start. The majority of your questions will be answered at your pre-operative appointment.

The Surgery itself:

Bunion surgery usually takes about 1 to 2 hours and is done in an outpatient setting. Our practice is set up to provide the most convenient and cost-effective approach to your bunion surgery by having a surgery center on site. The day of surgery most patients will have nothing to eat or drink 8 hours before surgery and will show up at the practice about an hour before their operation.

You will see the surgeon again and meet your anesthesia provider. Next you will be brought into the operating room and an IV will be started and you will wake up after the surgery is completed. Typically, most patients have a nerve block that will last about 24 hours. You will then have your first post-operative appointment with 4-10 days.

Recovery:

Recovery really depends on the procedure selected. All our bunion surgery patients can walk after surgery. We also help our athletes stay in shape by helping them tailor a recovery period workout. Recovery can be influenced by your diet and how well you follow the post-operative course.

If you are struggling with bunion pain we are here to help! Give us a call 425-291-8666 or make an appointment online. 

The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three phalanges except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.

Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.

Another type of toe fractures is a stress fracture. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity instead of a single injury. Stress fractures occur when the muscles in the bone become too weak to absorb impact. Consequently, the toe bone becomes vulnerable to any pressure and impact it endures. Symptoms for a stress fracture in the toe include swelling without bruising, tenderness to the touch, pain that goes away with rest, and pain after walking or running.

If you suspect that you have a broken toe, you should make an appointment with your podiatrist. He or she will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more. 

Most bunion surgeries require screws or plates (or a combination). It’s important during bunion surgery, in order to get full correction and realign the bones and joints, the bone is typically resected or effusions are done to realign the first metatarsal.  This requires hardware such as plates and screws. Once the hardware has done his job and the bone has healed and maintained the new corrected alignment and position, many of our patients elect to have hardware removed. The hardware can be medical grade stainless steel or titanium. These are the most common metal/metallic implants used. 

Sometimes the head of the screw causes minor irritation or part of the threads protrudes enough that there is irritation with some of the adjacent soft tissue. 

In other instances some patients seem to be sensitive to having a foreign body or a non-human item in the body. Some patients have minor skin manifestations although this isn’t common.  In general patients feel better once the hardware is out. 

If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today. 

The Achilles tendon is the work horse of the lower extremity. It provides forward propulsion and is the thickest, strongest tendon in the human body. It basically never has a chance to rest if you are walking. The tendon itself is made of three different muscles and contracts to provide power. That is why it is one of the most common tendons to experience tendonitis in.

It is probably the most common type of tendonitis we see in the office. I would also say it is one of the most challenging to treat. The challenge is it's constantly in use and the number one cause of Achilles tendonitis is overuse. We see a fair amount as the summer starts and people get outside. The other big culprit is a new exercise program. Most of these patients are usually men and around the age of 40.

I encourage patients to get in early and treat this aggressively. The Achilles tendon is notorious for taking a long time to return to a normal state and recover from tendonitis. The earlier and more aggressive the treatment the better the long-term outcomes. Focusing on eliminating the abnormal pull of the Achilles and stretching provide relief. There are numerous opportunities to administer more advanced treatment options that utilize the body's own ability to heal. These techniques seem to have the best long term outcomes. If you are suffering from Achilles’ tendon pain we can help.

Give us a call at 425-391-8666 or make an appointment online today. 

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise. Referrals will then be made to specialists that handle the greater health problems.

Some podiatrists have their own independent, private practices or clinics where they have a small staff and administrative personnel. Many podiatrists work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals, or visit patients in nursing homes. Podiatrists typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that results from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

Most bunion surgeries require screws or plates (or a combination). It’s important during bunion surgery, in order to get full correction and realign the bones and joints, the bone is typically resected or effusions are done to realign the first metatarsal.  This requires hardware such as plates and screws. Once the hardware has done his job and the bone has healed and maintained the new corrected alignment and position, many of our patients elect to have hardware removed. The hardware can be medical grade stainless steel or titanium. These are the most common metal/metallic implants used. 

Sometimes the head of the screw causes minor irritation or part of the threads protrudes enough that there is irritation with some of the adjacent soft tissue. 

In other instances some patients seem to be sensitive to having a foreign body or a non-human item in the body. Some patients have minor skin manifestations although this isn’t common.  In general patients feel better once the hardware is out. 

If you are experiencing bunion pain, give us a call at 425-391-8666 or make an appointment online today.