FOOT & ANKLE

When arthritis affects the foot or ankle, it’s usually osteoarthritis: a type of degenerative, wear-and-tear type of arthritis that occurs slowly, over time. While this most often occurs in older adults, it can affect young people, too. Being overweight or having a previous foot or ankle injury can make you more susceptible to arthritis in the foot or ankle, and at a younger age.

Dr. Benenati at Movement Orthopedics will closely review your medical history, current symptoms, and may order diagnostic imaging to determine whether arthritis may be causing your symptoms, as well as it’s severity, which can help determine your treatment options.

Conservative measures such as anti-inflammatories, pain-relieving injections, and physical therapy may be recommended. Orthotics can also sometimes help.

If surgery is necessary, it may include:

• Debridement – removal of loose cartridge or other debris at the joint, as well as removing any bone spurs that may be contributing to your symptoms.
• Fusion (arthrodesis) – using surgical pins or screws to join bones together, in order to eliminate movement of the arthritic joint, which prevents the pain currently occurring with movement of the joint.
• Joint replacement (arthroplasty) – replacing the damaged joint with an artificial one. This may be recommended for patients with advanced arthritis of the foot or ankle.

Foot or ankle joint repairs can usually be done arthroscopically, which is a same-day, minimally invasive procedure.

Hard, bony growths at the end of bones are called bone spurs, or osteophytes. When a bone spur occurs in the foot, it tends to develop at the heel, big toe, or top of the mid-foot. The spurs may cause pain or other symptoms – or no symptoms at all.

Bone spurs develop in response to an irritant; the extra bone may be the body’s way of attempting to strengthen a weakened joint. Bone spurs may develop due to arthritis, tight ligaments (such as with plantar fasciitis), poorly fitting shoes, or anything that puts added stress on the feet, such as high-impact activities or being overweight.

If Dr. Benenati at Movement Orthopedics determines a bone spur is contributing to your symptoms, it can typically be removed during an arthroscopy or during a procedure to address another foot or ankle issue, such as a joint replacement.

A bunion looks like a bony protrusion along the inside of your foot, near the base of your big toe. It is the result of your big toe repeatedly pushing against the other toes, ultimately moving the bones out of alignment. What you’re seeing when you see a bunion is really the joint at the base of your big toe sticking out due to that pressure.

Bunions may form due to the natural shape of your foot. Arthritis and/or wearing tight, narrow shoes are believed to contribute to the development of bunions.

Sometimes, orthotics, and proper footwear is enough to relieve the pain of bunions. Other times, surgery to realign the bones of your foot may be required.

Patients with diabetes need to pay special attention to the care of their feet. Make sure you visit a podiatrist like Dr. Benenati at Movement Orthopedics for regular check-ups, as well as when any signs or symptoms of a problem with your feet appear between doctor visits.

Diabetes can cause nerve damage (neuropathy), especially in the limbs. This means you may be unable to experience proper sensation in your feet and simply may not feel an ulcer or cut on your foot. In addition, diabetes damages blood circulation, so your extremities may not get enough oxygenated blood, making healing difficult.

Thus, is not uncommon for patients with uncontrolled diabetes to have nonhealing foot sores that they cannot feel. This is a very serious condition because if not treated right away, infection can set in, tissue may die (a condition called gangrene), and this may require amputation to prevent its spread.

If you have diabetes or are already suffering from peripheral neuropathy affecting your feet, Dr. Benenati can help ensure your feet remain healthy.

Even the tiniest crack in a bone of your ankle, foot, or toe can cause enormous pain when you walk.

Foot surgeon and podiatrist Dr. Benenati at Movement Orthopedics can make sure you get the fracture care and treatment needed to heal quickly and completely.

Immobilization is key to allowing your bones to heal. This may include a cast, removable brace, or orthotics If your toe is fractured, it may just need to be taped to its neighbor to keep it still enough to heal properly. Your treatment will depend on the severity and location of your fracture. In the most severe cases, surgery and the use of surgical-grade pins or screws may be necessary to keep the bones together, so they can heal.

Hammertoe and mallet toe describe abnormal bends in the joints of your toes – typically, any of the toes in the center of your foot – all except for the big and little toes. These issues can occur due to ill-fitting shoes, trauma, or a muscular imbalance in your toes.

• Hammertoe is a deformity at the middle joint of the toe.
• Mallet toe occurs at the joint nearest the toenail.

Orthotics, physical therapy, and surgery may be recommended as treatment, depending on the severity of the deformity and the accompanying symptoms.

If you notice pain or redness at the side of a toenail, you may have an ingrown toenail. This is just what it sounds like: when your toenail, rather than sitting atop the skin of your toe, grows into it. In most cases, ingrown toenails occur on the big toe. Ingrown toenails are very common.

You should see your podiatrist about an ingrown toenail if home care has not improved the situation after a couple of days, pain worsens, or warmth or redness appears to spread. Patients with diabetes are especially at risk of serious complications from ingrown toenails. When in doubt, call your podiatrist.

The nail bed is the skin under your toenail. It most commonly gets injured from trauma, as when something heavy falls on your foot. You may notice blood pooling under your toenail, the toenail itself may become loose, and your toe could become swollen and painful.

If the nail bed is cut, there is a risk of infection. Also, there is always the risk that the toe bone may be fractured.

See a podiatrist like Dr. Benenati at Movement Orthopedics in case bleeding under the toenail needs to be drained to relieve pressure. He may order diagnostic imaging to determine if there was a fracture. Medication may be necessary in the event of infection.

If you suffer from heel pain that is especially painful when taking the first steps after waking, you may have plantar fasciitis.

Plantar fasciitis occurs when the ligament that connects your heel bone to your heels, called plantar fascia, becomes weak and swollen. This ligament helps to support the arch of your foot and acts as a shock absorber when you move. The plantar fascia can become inflamed for a variety of reasons, including any physical activity that places added stress on the feet, being overweight, a tight Achilles tendon, and improper arch support.

Treatment for plantar fasciitis will depend on the severity of your condition. Treatment may include orthotics, anti-inflammatory medication, cortisone injections, and physical therapy. In severe cases, surgery to partially release the ligament can effectively relieve the pain of plantar fasciitis.

These warts – sometimes called verrucae warts – appear either on the heel or ball of your foot. Plantar warts are caused by the human papillomavirus (HPV), which is easily transmitted in moist environments, usually via a cut in the skin of the foot. Swimming pools and locker rooms are common points of infection.

Due to their location, these warts often cause pain. They are especially common among children, teens, and adults with compromised immune systems.

There are a number of ways to treat plantar warts, including topical creams as well as excising or freezing the warts. Ask your podiatrist what type of treatment is right for you – it may vary, depending on how deep the wart has grown under the skin.