Some Of The Conditions We Treat
At KW-Foot & Orthotics Clinic we treat many conditions, if you don't see the condition listed below that you are suffering from please don't hesitate to give us a call, we have treated all forms of foot problems.
Athlete’s Foot
Athlete’s foot is a fungal infection of the foot, also known as tinea
pedis. It is usually caused by the fungus present in soil. They are four
different fungal dermatophytes that can cause infection but the most
common is trychophyton rubrum. It is fairly common condition and it is
estimated that about 70% of population will suffer from this condition
in their lifetime.
Anyone can get athlete’s foot but it is more common in people that are under a lot of stress, wear shoes that don’t fit well, favour nail salons, tend to go barefoot in warm places, such as public showers, swimming pools, locker rooms. The fungus can also spread on direct contact with individuals or with objects containing fungal spores such as socks, shoes, etc. Untreated fungus can spread to other parts of the body, nails, hands, legs, etc. If there is any excessive skin breakdown a secondary bacterial infection can occur which is potentially dangerous in individuals diagnosed with diabetes and those with suppressed immune system.
What are the signs and symptoms?
- Infection can occur on any part of the foot but it is most common between toes and on the bottom of the foot.
- The infection might appear wet or dry with redness, scaling, and itching, burning and occasional bleeding.
- Some people have no symptoms and they are not aware that they have a fungal infection.
Treatment
First, visit a chiropodist/podiatrist or your family physician to decide
if you have athletes foot and to recommend appropriate treatments. In
some cases athlete’s foot looks like other conditions, such as psoriasis
or eczema. Once diagnoses it can be effectively treated with certain
medications and creams.
In order to prevent fungal infections wash and dry feet every day, wear shoes and socks made of natural fibres and materials, do not share clothing, try not to walk barefoot in public places ( swimming pools, gyms) and avoid nail salons that are not steam sterilizing their tools.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Odour and Wetness
Excessive perspiration or hyperhidrosis of feet is a fairly common foot
condition considering that we have highest concentration of sweat
glands, over 250,000 in our feet. Excessive perspiration in combination
with overgrown bacterial presence on the skin will result in unpleasant odour
or bromidrosis emanating from the surface.
Anyone can suffer from these conditions but it seems that men are more prone to foot odour than women. Excessive sweating and foot odour can be contributed to high stress levels, obesity, diabetes, hyperthyroidism, or due to excessive stimulation of sweat glands.
What are the signs and symptoms?
A lot of perspiration and presence of foul odour.Treatment
Management of both perspiration and foot odour is needed in order to regulate these conditions. Conservative treatments are fairly successful in mild to moderate cases. In order to maintain dry environment use over the counter antiperspirants, wear cotton socks, use absorbent powders (Zeasorb) throughout the day or see your health practitioner for prescription strength antiperspirant. In order to reduce bacterial flora on your skin wash the feet using strong antibacterial soap followed with application of antifungal cream. Surgical treatment is also available but it rarely recommended due to an increased risk of morbidity, scaring and recurrence.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Ingrown toenail
Ingrown toenail or onychocryptosis is a fairly common and recurrent foot
condition. This condition is usually caused by the abnormal external
pressure on the nail bed causing the nail edge to grow sideways into the
surrounding skin of the toe. The toe is usually painfully red and
infected. Any presence of infection can be very dangerous especially in
people diagnosed with diabetes and those with immune suppressed system.
Anyone can suffer from ingrown toenails but they are often the result of
improper nail cutting, trauma to the nail, tight shoes, poor posture and
gait problems (flat feet), fungal infections and abnormal nail growths,
excessive foot sweating (hyperhidrosis), etc.
What are the signs and symptoms?
- Skin is shiny, red and tense.
- Pain at the tip of the toe extending down the side of the nail, especially when some pressure is applied.
- There is a presence of redness, swelling, thickening of the nail fold, possible presence of infection.
- Infected area will likely have pus or presence of yellow drainage.
Treatment
There is a variety of treatments available in order to treat this
condition. In order to determine the best course of action consult
Chiropodist/ Podiatrist or your family physician. Treatment plan usually
depends on the presence or absence of infection and whether or not this
is a long standing condition. In most of the cases a portion of the
ingrown nail (corner/spike) can be removed with or without local
anaesthesia followed with proper antibiotics in order to treat possible
infection. Resistant and recurrent cases of ingrown nails and infections
may require an in office procedure which removes the offending portion
of the nail on permanent basis. Diabetic patients should not attempt any
self treatment and should seek immediate help.
In order to prevent ingrown nails always cut nails straight across, wear shoes that fit well, maintain good foot hygiene, DO NOT try to do a home surgery and remove the ingrown nail yourself.
Diabetic patient or any patient with impaired immune system and poor peripheral circulation should have regular foot treatments done by Chiropodist/ Podiatrist in order to prevent potential complications.
Hammer Toes
Hammer toe is a condition where the middle of the toe bends upward.
Joints at the end or in middle of the toe may be affected as well
causing the toe to contract and curl into the shape of a hammer. Hammer
toes vary in severity and in the number of joints affected.
Anyone can get hammer toes but the most common causes are related to faulty foot biomechanics (flat feet or high arched feet), muscle imbalance, tight fitting footwear, injury, arthritis and diabetes.
What are the signs and symptoms?
- A hammer/claw looking toe.
- Pain and difficulty moving toe.
- Difficulty wearing shoes.
- Painful corns and blisters on the top of toes and feet.
- Toe stiffness.
Treatments
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Choice of the treatment will depend upon the determination what is causing this abnormality and whether or not toes are flexible or rigid. In a lot of cases just recommending proper shoes, removing corns, calluses and providing custom made orthotics will eliminate a lot of problems and discomfort. If everything else fails and the pain is affecting your everyday life a surgery can be discussed as one of the options. However, patients should keep in mind that surgery is not without risks and it should not be considered just for cosmetic purposes.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Bunions
A bunion or Hallux abductovalgus (HAV) is a large bump on the side of
the big toe. This bump is caused by the misalignment of the bones
causing the big toe to point towards other toes. Bunions are a
progressive disorder and it is common to find the big toe overlapping or
resting under the second toe. Misalignment of the bones is usually
followed with arthritic changes within the joint causing pain and
discomfort.
Bunions are present in both men and women although there is a higher prevalence in females which is often contributed to the tendencies to wear high heel shoes with a tapered toe box. Bunions are not inherited but they do tend to run in families. Research indicates that bunions are more common in people that have flat feet leading to instability around the big joint causing the medial displacement of the 1st metatarsal bone leading to the abduction of the big toe (hallux), resulting in the toe pressing against the second toe.
What are the signs and symptoms?
- Pain, mild to extreme, redness, throbbing.
- Stiffness of the 1st joint, due to arthritic changes within the joint.
- Turning of the big toe towards the second toe.
- Development of hammer and claw toes and other soft tissue lesions (callus, corns, bursa, ingrown nails, etc).
Treatment
It is important that the diagnosis of HAV (bunion) is confirmed by
either a chiropodist/podiatrist or a family physician. Bunions are a
progressive condition and if the progression is not stopped it will
usually get worse over time. If the condition is not addressed as soon
as possible there is a chance that the patient will start altering the
way it walks causing more problems within the foot and the rest of the
kinetic chain. There is a lot of ways to prevent a progression of a
bunion from getting to a painful stage either through the prescription
of custom orthotics, recommendation of proper shoes, padding of the
joint, or prescribing certain medications to fight the pain and
inflammation. If everything else fails and the pain is affecting your
everyday life a surgery can be discussed as one of the options. However,
patients should keep in mind that surgery is not without risks and it
should not be considered just for cosmetic purposes.
In order to decrease chances of developing bunions use wide comfortable shoes, get orthotics if you have fallen arches, see a chiropodist/podiatrist if you have any concerns about your feet.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Calluses and Corns
Calluses or hyperkeratotic tissue is a result of high pressure points
area and friction against the skin. In order to prevent further damage
to these areas skin responds by building up multilayer of thick, hard
skin, creating calluses. They usually develop on the plantar surfaces
(bottom) of the feet, ball of the foot, on heels, or on the top of the
bony protuberances. If the pressure is not removed a painful central
core or plug of hardened skin forms crating a corn (heloma durum).
Callus in combination with corn can create a painful area.
Anybody can get corns and calluses but the chances are higher if there
is presence of fallen arches, bunions, hammertoes, arthritis, certain
skin types, wearing shoes that don’t fit well and cause friction and
high point pressure areas.
What are the signs and symptoms?
Corns
- Corns have an area of callus that have deep central layer of cells called a nucleus. This nucleus is usually seen as a hard bump which can be painful when pressed.
- Appearance of the corn depends upon the mechanical stress and their location.
- Hard corns are usually found over high pressure areas (bottom of the feet, tips of the toes (hammer toes, claw toes), while soft corns are usually located between toes.
Calluses
- Calluses are mostly found in the areas that experience a lot of friction and weight bearing pressure, often on the ball of the foot and the heel.
- Calluses are often larger than corns but they can become painful over time as the skin thickens.
- Calluses on the ball of the foot.
Treatment
Before any treatment is recommended a proper assessment by either
Chiropodist/Podiatrist or family physician is required. Hard corns and
calluses are often mistaken for warts while acute infection of athlete’s
foot can mimic soft corns. There is a variety of treatments available in
treating calluses and corns through use of certain medications or by
addressing the biomechanical issue that is contributing to these high
pressure areas. This is often done by recommending shoes or by
prescribing custom orthotics. There is also a possibility of surgical
removal of corns. Care should be exercised in the use of over the
counter corn and callus removing products. These products quite often
result in biomechanical burn of the skin increasing the risk of possible
infection.
People who are diagnosed with diabetes or other circulatory problems shouldn’t attempt to treat any of these conditions on their own and should see a Chiropodist/Podiatrist for the treatment as soon as possible.
Plantar Warts
Plantar warts are one of the most common viral skin infections. Warts
are caused by Human papilloma varus and similar to fungal infections
they are usually acquired through the use of un-sterilized tools in nail
salons, swimming pools, locker rooms, and other areas where barefoot
walking is common. They are contagious and care should be taken that
they don’t spread to others or to other body parts by touching or
scratching.
Anyone can be exposed to plantar warts but children, especially teenagers and people with weakened immune system are more susceptible.
What are the signs and symptoms?
- Plantar warts are often found on weight bearing surfaces of the foot. Depending on how deep they are and on the location they can be very painful.
- They often appear as thick, rough skin with well defined boundaries. In a lot of cases there is a presence of dilated capillaries which are usually seen as dark and brown spots within the skin.
- Warts can appear very small or large in multiple clusters, covering different foot areas.
Treatment
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Plantar warts are often mistaken for calluses or corns. There is a variety of treatments available but they depend on the location, size, and depth of the wart and as well on the age, skin texture, circulation, neuropathy and availability of the patient. Existing methods include use of chemical cautery, immunotherapy medications, cryotherapy, surgical curettage and laser surgery.
To reduce your risk of plantar warts avoid going barefoot, practice good foot hygiene, avoid direct contact with warts, and don’t pick at warts.
People who are diagnosed with diabetes or other circulatory problems shouldn’t attempt to treat any of these conditions on their own and should see a Chiropodist/Podiatrist for the treatment as soon as possible.
Fungal Nails
A fungal nail (onychomycosis) is a fairly common foot condition. It is
estimated that about 5 % of the population gets fungal infection of
nails. In most of the cases it is caused by the same dermatophytes that
cause athlete’s foot. These dermatophytes feed on the nail’s keratin
causing changes within the nail.
Anyone can get fungal infection but it is more common in people that are under a lot of stress, wear shoes that don’t fit well, favour nail salons, tend to go barefoot in warm places, such as public showers, swimming pools, locker rooms. The fungus can also spread on direct contact with individuals or with objects containing fungal spores such as socks, shoes, etc. Untreated fungus can spread to other parts of the body, nails, hands, legs, etc. If there is any excessive skin breakdown a secondary bacterial infection can occur which is potentially dangerous in individuals diagnosed with diabetes and those with suppressed immune system.
What are the signs and symptoms?
- Changes in toenail colour (yellowish, green).
- Presence of thickening, scaling and crumbling of the nail plate.
- Presence of odour.
Treatments
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Other conditions such as psoriatic nail, onychogryphotic nail (trauma to the nail), white nails, can look similar to fungal nails therefore proper diagnosis is essential. Treatment of nail fungus can include both topical and oral medications; however it depends on the patient health status and the stage of infection. Chronic infections are much harder to treat. If there is any change in the appearance of the nails it could be a good indication that something is happening in the nail bed.
In order to prevent fungal infections wash and dry feet every day, wear shoes and socks made of natural fibres and materials, do not share clothing, try not to walk barefoot in public places ( swimming pools, gyms) and avoid nail salons that are not steam sterilizing their tools.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Morton’s Neuroma
Morton’s neuroma is caused by the entrapment of the thickened nerve tissue between bones. It most often occurs between 3rd and the 4th metatarsal bone (80%) of the foot. Thickening of the nerve is usually caused by irritation and pinching of the nerve. Pain is usually worse when walking in high heel shoes or in shoes that have a tapered toe box. In a lot of cases massaging of the foot and not wearing narrow shoes brings some relief.
This condition is more prevalent in people that wear narrow high heel shoes and individuals that have certain foot pathologies such as bunions, hammer toes, flatfeet, etc. It is fairly common in people that are involved in activities that require constant irritation of the forefoot (i.e. soccer, running, tennis, etc.) Also, a trauma to the foot can result in irritation of the nerve and formation of the intrametatarsal neuroma.
What are the signs and symptoms?
- Pain to the toes and up to the leg.
- Tingling, burning and numbness.
- A constant feeling that there is something inside of your foot or a rise inside the shoe.
This is the most common area for intrametatarsal neuroma to occur.
Treatments
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Other conditions such as bursitis and capsulitis can also occur in this area and present with similar signs and symptoms. In order to recommend and start appropriate treatment cause and the stage of the intrametatarsal neuroma needs to be determined. In a lot of cases a high success rate is achieved through the use of physical modalities and combination of wide toe box shoes and custom made orthotics. Other treatment modalities are use of corticosteroid injections, sclerosing injections (chemical sympathectomy type procedure) and surgery. Surgery is considered when everything else fails and it consists of complete excision of the irritated nerve.
In order to prevent Morton’s neuroma wear wide shoes and reduce activities that are putting a lot of stress on your feet. Don’t ignore the pain; have it checked out by the foot specialist.
People who are diagnosed with diabetes or other circulatory problems shouldn’t attempt to treat any of these conditions on their own and should see a Chiropodist/Podiatrist for the treatment as soon as possible.
Heel pain/Plantar fasciitis
Heel pain is one of the most common complains in podiatric medicine. It
is also known as heel spur or plantar fasciitis. In most of the cases
pain is usually caused by the inflammatory condition known as plantar
fasciitis. Plantar fasciitis is caused by the inflammation of the
plantar fascia (fibrous tissue on the bottom of the feet). Plantar
fascia is attached to the heel bone and it fans forward inserting into
the ball of the foot. Main function of the plantar fascia is to support
the arch of the foot when walking. The problem usually occurs when there
is a presence of some abnormal motion or stress resulting in the
breakage of the fibres. This will result in pain and swelling. With the
pulling of the plantar fascia on the heel bone development of the heel
spur is common. The presence of the spur doesn’t cause pain but
overstretching, swelling and degeneration of collagen fibres at the
insertion point (heel bone) does.
Anyone can suffer from plantar fasciitis but the most common causes are related to faulty foot biomechanics (flat feet or high arched feet), inflexibility in the calf muscle, poor footwear, arthritis, diabetes, irritation or repetitive microtrauma to the heel tissue, etc. Symptoms usually resolve much quicker if the treatment is offered as soon as possible, preventing further damage to the tissue.
What are the signs and symptoms?
- Sharp pain and tenderness on the sole and at the heel bone when standing and walking.
- Heel pain is usually worst first thing in the morning or after sitting for longer periods of time.
- Heel or the sole pain after exercising or standing.
- Presence of mild swelling.
Treatment
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Other conditions such as bursitis, pinched nerve, or tendonitis could have similar signs and symptoms. There is a variety of treatments available to treat this condition ranging from a simple advice about proper footwear and stretching to the use of custom orthotics, ultrasound treatment, night splints, corticosteroid injections or extracorporeal shock wave therapy.
In order to prevent plantar fasciitis wear good supportive shoes, don’t go barefoot and avoid activities that put a lot of stress on your feet.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Diabetic Foot
People diagnosed with diabetes can and often do suffer from diabetic related foot problems. In most of the cases lack of sensation, weak circulation and foot injuries are the main culprit. Fortunately most of these problems can be prevented with proper foot care and proper shoe selection.
All individuals diagnosed with diabetes should have their feet checked by a Chiropodist or Podiatrist on a regular basis in order to avoid serious complications. Assessment should include vascular, neurological exam and skin integrity should be assessed, especially between toes and under metatarsal heads. The presence of heavy callus and warmth may indicate potential breakdown areas. Bony deformities (bunions, hammertoes, etc.), joint mobility, and problems with gait and balance should be immediately addressed through use of custom orthotics, braces or custom made shoes.
Potential serous complication of diabetes is presence of ulceration and
possible infection.
Deep ulcer on the 1st metatarsal head is a common place for ulceration
to occur due to the high pressure point area.
Prevent diabetic foot problems
- Preventative foot care and yearly assessments by a Chiropodist or Podiatrist is a key to decrease the likelihood of potential foot complications.
- Wear recommended footwear.
- Check your feet daily (your foot specialist can show you how).
- Have nails, corns, calluses and other foot problems treated by Chiropodist or Podiatrist.
- Don’t go barefoot, even indoors.
- Don’t soak your feet or put hot bottles on your feet.
- Don’t have pedicures. If the individual is not a health professional you are running the risk of cuts and possible infection.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Arthritic feet
Arthritis is a degenerative disorder of joints resulting in progressive
loss of cartilage that lines the joint surface. It most commonly affects
hands, feet and large joints such as the knees, hips and spine. As the
cartilage brakes down movement of the joint is greatly reduced and can
cause severe pain and swelling. Arthritis can also be caused as a
secondary condition due to presence of diabetes, psoriasis, obesity,
gout, etc.
In feet arthritic joint changes are usually caused by foot and joint deformities such as hammer toes, bunion, flatfeet, high arched feet or as a result of a trauma to the feet (running, sports, surgery, etc).
What are the signs and symptoms?- Pain and stiffness of joints.
- Swelling, cracking and warmth of the affected joints.
- Formation of bony enlargements within the joint.
- Difficulty in shoe fitting.
- Muscle atrophy and muscle spasm.
Treatments
Before any treatment is recommended a proper assessment by either Chiropodist/Podiatrist or family physician is required. Each management plan must be tailored to each individual. The goal of the treatment is to reduce pain, inflammation and to maintain and improve joint function.Treatment is usually a combination of lifestyle adjustment (exercising, reducing weight), heat therapy (wax baths, warm baths), physiotherapy, padding and strapping, custom made orthotics, braces, custom made shoes, anti-inflammatory medications, cortisone injections, referral to the rheumatologist, etc.
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Children's Feet
There are many misconceptions about children’s foot problems. In a
lot of cases children’s foot problems are ignored unless severally
deformed or troublesome.
Children’s feet are an important part of an overall developmental process. Any abnormalities within the feet will affect the general posture causing changes within the skeletal structure. Strong, healthy feet begin in childhood. Early recognition and management of the actual and potential foot problems would prevent a lot of medical and structural problems in later life.
Some of the common children’s foot conditions are:- Flat feet
- In-toe and out-toe walking in children
- Toe walking- heels are not touching the ground.
Treatments
Before any treatment is recommended a proper assessment by either a paediatrician, Chiropodist/Podiatrist, family physician or orthopaedic surgeon is needed. Treatments, if required, must be carefully managed to prevent substituting one deformity for another. Treatments usually consist of monitoring, manipulations, exercises, activity alteration, orthotics, serial casting, splints, braces, footwear, altering sleeping or sitting habit, surgical referral.
In order to prevent future problems arrange an appointment if there are some of the following present:- Shoe wear is uneven
- Lumps or bumps are evident on the feet
- Pain in the feet, heel or leg exists
- Tripping or falling occurs
- Skin or toenail problems are present
People with diabetes and other circulatory problems should always consult health care professional before beginning any treatments.
Metatarsalgia
Metatarsalgia is a general term that marks the pain and inflammation in
the metatarsal region of the foot (ball of the foot). Pain is usually
more present when weight bearing, jumping, running or wearing high
heels.
Anyone can suffer from this condition but it is more present in people
that are involved in high impact sports, have other foot problems
(hammer toes, flat feet, high arched foot, bunions, etc.), wear ill
fitting shoes or spend a lot of time on hard surfaces( concrete,
ceramics, hard wood floors).
- Pain in the ball of the foot when weight bearing.
- Sharp, aching pain.
- Pain worsens when you flex your feet.
- Increase in pain when walking barefoot or on hard surfaces.
Treatments
Before any treatment is recommended a proper assessment by either
Chiropodist/Podiatrist or family physician is required. Each management
plan must be tailored to each individual. The goal of the treatment is
to specifically address the cause of the problem, reduce pain,
inflammation and to maintain foot function. However, there are many
conditions that could be causing pain in this area ranging from bone
deformity (hammer toes, bunions, sesamoiditis) to interdigital nerve
pain, stress fractures, capsulitis, etc. Therefore, treatment will
depend on the cause of the problem and it is mostly a combination of
rest, anti-inflammatory medications, padding and strapping, custom made
orthotics, wearing proper shoes, activity modifications, cortisone
injections, etc.
In order to prevent future problems and to maintain healthy feet wear
proper shoes and have your feet regularly checked.
Flat feet
Flat feet or pes planus is a common foot condition that can be present in both children and adults. It is characterized by an abnormally low or absent medial longitudinal arch, especially on weight bearing. There are many causes of flat feet. In many cases it is a result of subtalar joint overpronation in the process of developmental unwinding or as a result of aging, injury or overuse. It should be noted that it is normal for infants and toddlers to have low arches but they should be observed for any abnormal in-toeing, out-toeing, excessive limping, etc. Kids that overpronate often complain of night cramps, shin splints or heel pain.
Signs and symptoms- Lack of medial arch (flat feet).
- Fatigue, night cramps, foot strain, tendonitis, shin splints, metatarsalgia, heel pain.
- Pain on the inside of the ankle.
- Lateral displacement of heel pad.
- Pain up the lower limb.
- Sciatica.
- Development of adventitious bursa.
- In children, clumsiness when walking or running is often observed.
Treatments
Flat feet with collapsed medial arch.
Before any treatment is recommended a proper assessment by either a
Chiropodist/Podiatrist, family physician or orthopaedic surgeon is
needed. Treatments, if required, must be carefully managed to prevent
substituting one deformity for another. Treatments might include
activity alteration, orthotics, serial casting, splints, braces,
footwear, altering sleeping or sitting habit (mostly in children’s
case). It is important to address excessively flat feet otherwise they
can be a cause of digital contractures (claw and hammer toes), bunions
or result in knee, hip and lower back problems.
In order to prevent damage or to slow a progression of problems
associated with flat feet wear good shoes, don’t go barefoot and if
there is a family history of this problem have your children evaluated
early.