Q: What are some of the facts about Heel Spurs? Ans: Heel spurs are small deposits of bone-like calcium on the heel bone (calcaneus), usuallyon or near the bottom of the foot where the long tendons of the arches (plantar fascia) insert into the bone. Being overweight, having abnormal foot biomechanics, or running regularly on hard surfaces can cause excessive stress on the foot, which may lead to the production of a spur. A heel spur may contribute to pain on the underside of the heel, which sometimes radiates throughout teh entire bottom of the foot. The pain is usually relieved by rest. The bottom or sides of the heel may be tender to the touch; a slight swelling may be noticed, and it may hurt to wiggle your toes. How can my chiropractor hemp me? The treatment you receive will probably focus in general on reducing swelling, relieving pain, restoring functional movement and position through manipulation (adjustment), protecting your foot from additional stress, and strengthening your foundation. Icing the heel can help bring down swelling. Most cases of heel spurs respond favorably to conservative care, and surgery isn't usually recommended. Your doctor will be able to make an informed decision regarding this matter. What can I do at home to help improve heel spurs? Custom-made Spinal Pelvic Stabilizers can protect the heel and help the adjustments hold better. Stabilizers can also be designed to provide a protective "cushion" around the heel area, and also change your foot's posture to help take pressure off the spurs and make you more comfortable. Decreasing or stopping running and jumping exercises can help reduce pain. Your doctor may suggest exercise to help build muscle strength and joint stability. The Thera-Ciser" is often recommended for heel spurs because it can be used to strengthen the foot arch, which helps keep the foot posturally stable. Top

Q: What is an Ingrown Toenail? Ans: Ingrown Nails are a common disorder of the toes. The nails curve into the side of the toes and curl into the skin of the nail borders. Ingrown toenails can be caused by genetics or trauma, less commonly due to nail cutting. Sighs and Symptoms of Ingrown Toenails The patient will feel pain on the sides of the nial skin fold. There may be swelling and redness to the area and even some pus that comes out if the area is squeesed. IF the ingrown nail is infected we then call it a Paronychia. Causes of Ingrown Toenails Tight shoes and steel toed boots, sweat and perspiration to the feet incerase risk of infection. Some patients are born with curved nails and others have trauma to the nail (i.e. a can falls on the foot) less common is the rounding of the nail with nail clippers. Treatment Plans If the nails are infected then the toe needs to be numbed with local anesthesia. The area is scrubbed down and the offending nail is taken out. The patient is started on antibiotic by mouth. The patient is instructed to wash their feet twice daily with phisoderm face soap or dial antibacterial soap. If the nail returns then the patient may require further intervention such as the Doctor applying phenol acid to the part of the nails in growing or performing surgery to remove the portion of the nail so it will not grow back ingrown again. Top

Q: Diabetic Guidelines and Foot Care Ans: Check your feet every day. Use a mirror or have a family member look at hard to see areas. Contact us if you notice redness, drainage, bleeding or unusual odor or swelling. Do not treat corns or calluses at home. Please do not use store bought corn pads that have acid in them. Wash your feet daily with warm not hot water and dry in-between the toes with a soft fluffy towel. I recommend dial or phisoderm soap. Apply lanolin based lotions to your feet and legs but not between the toes. Let us trim your toenails. Never go barefoot even indoors. Wear shoes and slippers with leather or hard rubber soles to prevent injury. Wear comfortable shoe gear. medicare covers 80% cost for extra depth diabetic shoes. I aslso recommend Dr. Scholl shoes which are extra wide. They can be purchased at Wal-Mart for a resonable price. Check your shoes inside to make sure nothing has fallen into them. Wear lightweight cotton socks. Some of my patients cut the top of the sock to give more ankles and leg room. Change your socks daily. I recommend baby powder or antifungual powder to keep the feet dry in the shoe. Remember we need to work together to keep your feet healthy! Top

Q: What is Fungus/Tinea Pedis? Ans: Fungus is an infection due to organisms called dermatopytes. The two most common types of fungus are T. rubrum and T. mentagrophytes. Fungus is very common especialy with the elderly population. I have noticed fungual infections in the nails of children too. Tinea Pedis is the fungual skin infection most commonly seen on the bottom of the patient's foot or in between the toes. Sighs and Symptoms The patient complains of burning itchiness, redness to their feet and notice skin peeling on the bottom of their feet this is the athlete's foot. The skin infection begins first and then spreads to the nails over time. The nails will become thick, hard and change colors to brown-yellow-black. Causes of Fungus Diabetes Mellitus with poor blood circulation, humid climates, increased sweat and moisture to the feet and heavy shoes and socks. Therapy Foot Hygiene-Clean feet daily in the shower and rub them with a soft clean towel especially in betweeen the toes and teh bottom of the feet. Socks should be lightweight. Shoes should be rotated. Spray shoes with a disinfectant (i.e. Lysol). Combination Therapy Topical antifungual creams (Lamisil and Lotrimin) and oral medications are recommended for the treatment plan. Currently Lamisil pills are being prescribed for fungual nails and Grisactin is prescribed for fungual skin infections. Please remember though the pills require nail specimen be sent to lab for a PAS Stain to check for fungus, and blood work to make sure your liver is o.k. and women of child bearing age are not pregnant. Topical Nail solutions include: Penlac and Onychol solution. Top

Q: What are Warts? Ans: Warts are small, generally harmless but painful growths on the skin. The warts are a viral infection due to the Human Papillloma Virus. They can be found on the hands, genital areas and feet. Warts are most common in children and teenagers. They are less common in patients over the age of 30. They can spontaneously resolve in 20% of the patients. Sighs and symptoms of warts The warts begin as a small itchy bumps that become bothersome to the patient. They become larger over time. They are contagious and can be easily spread to other people via the swimming pool, gym locker rooms, and wearing other peoples shoes. What does a wart look like? A wart starts out as small bumps and then enlarges over time into a hard callous with black dots. The dots are the warts own blood supply. If you scrape the wart you will see pinpoint bleeding. Causes of Warts Low/Poor Immine System, Sweat/Moisture to the feet, Small cuts, Enclosed shoes and heavy socks/Sharing shoes. Therapy There are multiple therapies including Cryosurgery (liquid nitrogen) - freeze the wart, Salicylic Acid, Laser Therapy, Surgical Excision, Duct Tape, Formaldehyde, Cimetidine (Tagamet), and Aldara Cream (Imiquimod) for warts. For the most part each of these therapies have a degree of success. Top