Foot Pain Treatment Videos | Issaquah Podiatry Services | Issaquah Foot & Ankle Specialists

Are you wondering what your foot will look like after surgery? Our videos offer a wealth of hard to explain (but easy to see) information, including before and after views of common foot conditions. Click here for a fast and easy way to learn more about our podiatry treatments.
  • Extracorporeal Pulse Activation Technology (EPAT) Demonstration
    This video demonstrates EPAT technology being used on a pro wind surfer. After receiving EPAT treatments, his pain is relieved and he's able to compete on a professional level again.
  • Washington Foot & Ankle Surgery Center Tour
    Washington Foot & Ankle Surgery Center Tour
  • Washington Bunion Center
    Welcome to the Washington Bunion Center
  • Best Foot Doc Intro Video
    Issaquah Foot & Ankle Specialists introduction video.
  • Ankle Fractures Explained
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    What is an Ankle Fracture?

    A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula, or both.

    Ankle fractures are common injuries that are most often caused by ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quiet different and therefore require an accurate an dearly diagnosis. They sometimes occur simultaneously.
  • Hallux Rigidus
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What is Hallux Rigidus?

    Hallux Rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. “Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

    This disorder can be very troubling and even disabling, since we use the big toe whenever we walk, stoopd down, climb up or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint but they are very different conditions requiring different treatment.

    Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. IN its earlier stage, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of “rigidus,” in which the big toe become stiff, or what is sometimes called a “frozen joint.”

    Causes

    Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.

    In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. IN other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases such as rheumatoid arthritis or gout. Your foot and ankle surgeon can determine the cause of your hallux rigidus and recommend best treatment.

    Symptoms

    • Early signs and symptoms include:
    • Pain and stiffness in the big toe during use (walking, standing, bending, etc.)
    • Pain and stiffness aggravated by cold, damp weather
    • Difficulty with certain activities (running, squatting)
    • Swelling and inflammation around the joint

    As the disorder gets more serious, additional sypmtoms may develop, including:

    • Pain, even during rest
    • Difficulty wearing shoes because bone spurs (overgrowths) develop
    • Dull pain in the hip, knee, or lower back due to changes in the way you walk
    • Limping (in severe cases)

    Diagnosis

    The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a foot and ankle surgeon is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.

    In diagnosing hallux rigidus, the surgeon will examine your feet and move the toe to determine its range of motion. X-rays help determine how much arthritis is present as well as to evaluate any bone spurs or other abnormalities that may have formed.

    Nonsurgical Treatment

    In many cases, early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include:

    Shoe modifications. Shoes with large toe box put less pressure on your toes. Stiff or rocker-bottom soles may also be recommended.

    Orthotic devices. Custom molded prescription orthotic devices may improve foot function.

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

    Injection therapy. Injections of corticosteroids may reduce inflammation and pain.

    Physical therapy. Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

     

    When is surgery needed?

    In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery for treatment of hallux rigidus. 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.

  • Ganglion Cyst
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    A ganglion is a soft tissue mass that most commonly occurs on the wrist in women between 25 and 45 years of age. They are also seen commonly on the foot. A ganglion is a firm, rubbery mass that occurs on the top of the foot. On the foot, the most common area of involvement is in front of the ankle or on the outside of the ankle. A common characteristic of a ganglion is that they will enlarge and then shrink is size. They generally occur without any apparent cause. Ganglions arise spontaneously from a weakness in the soft tissue covering of a joint or tendon sheath. Ballooning out of the tissue occurs and it fills with a thick mucoid fluid. In many instances, ganglions are not painful until they reach a size that causes irritation from shoe pressure. On occasion they will compress a nearby skin nerve and cause tingling into the top of the toes. Tapping on the ganglion will often result in this same tingling sensation into the toes. Other common masses on the foot are giant cell tumors, fibromas and lipomas.

    Diagnosis

    The diagnosis is made by taking a thorough history of the clinical course of the condition. Physical exam will reveal a firm, rubbery mass that appears encapsulated and will have a discreet boundary. They tend to be firmly adhered to the underlying deep tissues under the skin. A x-ray will reveal the shadow of the soft tissue swelling. On occasion there may be a small bone spur in the area of the ganglion. Spurring indicates a level of arthritis in the joint near the ganglion. A MRI or CT scan will clearly define the mass but is not necessary to make the diagnosis. If a ganglion were suspected within the deep structures of the foot a MRI would be useful to identify the size and extent of the mass.

    Treatment

    Small ganglions that are not symptomatic or painful usually require no treatment. A non-surgical form of treatment is termed "needling". This involves numbing the area with a local anesthesia. Once the area is numb a large gauge needle is placed into the ganglion. Aspiration of ganglion fluid is attempted, however, because of the thickness of the fluid it is often difficult to draw the fluid out. The ganglion is then punctured with the needle several times. A steroid medication may then be placed into the mass and a snug bandage applied. This treatment has a 70% recurrence rate. The definitive treatment for a ganglion is surgical excision. (See surgical excision of a ganglion)

  • Fungal Toenails
    Timothy W. H. Young, DPM
    by Timothy W. H. Young, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What Is Toenail Fungus?

    Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair your ability to work or even walk. The resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

    Causes
    Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where you are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.

    Symptoms
    Toenail fungus is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

    Home Treatment
    A daily routine of cleansing over a period of many months may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the-counter liquid antifungal agent. However, even the best over-the-counter treatments may not prevent a fungal infection from coming back.

    When to Visit a Podiatrist
    You should visit a podiatrist when you notice any discoloration, thickening, or deformity of your toenails. The earlier you seek professional treatment, the greater your chance at getting your nails to clear.

    Diagnosis and Treatment
    Treatments may vary, depending on the nature and severity of the infection. Your podiatrist can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

    Newer oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Your podiatrist may also prescribe a topical treatment, which can be an effective treatment modality for fungal nails.

    In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.
    Trying to solve the infection without the qualified help of a podiatrist can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

    Prevention
    Proper hygiene and regular inspection of the feet and toes are the first lines of defense against fungal nails. Clean and dry feet resist disease.

    • Wash your feet with soap and water, remembering to dry thoroughly.
    • Wear shower shoes when possible in public areas.
    • Change shoes, socks, or hosiery more than once daily.
    • Clip toenails straight across so that the nail does not extend beyond the tip of the toe.
    • Wear shoes that fit well and are made of materials that breathe.
    • Avoid wearing excessively tight hosiery to decrease moisture.
    • Wear socks made of synthetic fiber that “wicks” moisture away from your feet faster than cotton or wool socks do.
    • Disinfect instruments used to cut nails.
    • Disinfect home pedicure tools.
    • Don't apply polish to nails suspected of infection (those that are discolored, for example).