December 2022

Tuesday, 06 December 2022 00:00

Ingrown Toenails

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

Bunion surgery has been performed for over 100 years.  There have been many adaptations and changes since the first bunion surgery.  There are now over 150 different techniques to address bunion deformities.  It should be noted the majority of these can be divided up by anatomical location.  We now classify bunion surgery as either a head procedure of a base procedure.  Head procedures refer to operating on the head of the first metatarsal (out towards the toes) and base at the base of the first metatarsal (or near the arch). 

The decision on which bunion procedure to utilize typically involves the size of the bunion and the underlying foot type.  Typically we see smaller bunions are amenable to head procedure and large base procedures.  However it should be noted that certain foot types will require base procedures for even small bunions.  The goal for bunion surgery is to have lasting results and reproducible results. 

I personally perform a lot of Lapiplasty type bunion surgeries.  I find these have great long term results and provide incredible corrections.  The recovery from the Lapiplasty is longer than a head procedure but the results can be much better.  If you suffer from a bunion and would like to have it fixed schedule and appointment today, I can help. Give us a call at 425-391-8666 or make an apppointment online today. 

Sincerely,Dr. Brandon Nelson

heel pain out of bed in the morning

Heel pain
can have many causes and can be extremely challenging for all patients.  Not all sore heels are caused by plantar fasciitis and it is important to understand the underlying cause.  Identifying the underlying cause will help to assure patients get the best treatment options.  Even with many other causes of a severe heel pain, the number one cause continues to be plantar fasciitis.

Plantar fasciitis is basically an inflammatory process of the main supporting network of the foot.  The primary cause of inflammation seems to be overuse and repetitive stress.  The plantar fascia in general has a relatively poor blood supply and this can lead to chronic inflammation.  Once we see chronic inflammation set in it can become extremely difficult to reduce pain and resolve one's heel pain. 

Heel pain treatment options are vast.  It really boils down to what the primary cause of the heel pain was and the activity level of the patient.  I like to break it down to foot structure and rear foot pathologies.  What I mean by foot structure is does the patient have a high arched foot or a low arched foot.  Is there a lot of pronation that occurs with ambulating or overloading of the foot?  Rear foot pathology can have a large effect on heel pain.  Is there a tight calf muscle or is there a dysfunctional supporting tendon?  The best long term outcome and shortest course to a pain free heel is to appreciate the deforming forces.

If you have severe heel pain or pain under your heel or even pain with running I can help! Give us a call at 425-391-8666 or make an appointment online today.

Sincerely,

Dr. Brandon Nelson

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