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Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

MLS Laser Therapy is an FDA-approved technology designed to treat various painful conditions.  It is often sought out as a successful alternative to surgical treatment and prescription medication that may otherwise bring about negative side effects.  During MLS Laser Therapy, light energy enters the damaged cells to stimulate intercellular activity, reducing pain in the affected area and accelerating the recovery process.

MLS Laser Therapy is used in podiatry to treat various conditions.  These include heel pain, plantar fasciitis, sports injuries, wounds, Achilles tendonitis, arthritis, neuromas, neurological pain, musculoskeletal disorders, and sore muscles.  Aside from the specific conditions MLS Laser Therapy treats, patients can also gain from the treatment’s general benefits.  These benefits include a rapid relief of pain, the reduction of swelling caused by inflammation or bruising, faster healing, improved blood circulation, the reduction of scar tissue, and improved nerve function. 

MLS Laser Therapy is a non-surgical treatment with no side effects.  The treatment process is painless and typically takes a short amount of time to complete.  Several treatments may be required depending on the specific condition.

Extracorporeal Shockwave Therapy (ESWT) is an alternative treatment method that is used for bone and soft tissue disorders in the foot and ankle. EWST is a noninvasive option for pain relief and it was originally created to help dissolve kidney stones. This therapy works by focusing impulses to target the area in pain. This method has been proven to show a reduction in the amount of nerve fibers that transmit painful impulses, which leads to a reduction in pain. Shockwave therapy can also expedite the tissue which would, in turn, increase the amount of new blood vessels that are formed.

Conditions that can be treated with shockwave therapy include Achilles pain and heel pain. People with plantar fasciitis may opt for this therapy and the results are usually great after 18 months. Additionally, this method can also be used to treat fractures that have failed to heal correctly. Anesthesia is not required to perform this treatment. It usually is not painful, but it can be uncomfortable.

The duration of treatment sessions usually lasts 5-15 minutes each. This procedure is safe since there is no risk of infection from wound complications, if you are looking to try shockwave therapy to heal plantar fasciitis, it may take 3-4 sessions to start working. After treatment, patients typically notice a dull pain in the area which was treated. However, this pain rarely lasts more than 24 hours.

Nevertheless, there are pros and cons that come along with Shockwave Therapy. The most obvious pro is that this treatment is noninvasive, meaning surgery will not be required. Another upside is that there have been very little complications that have been found with this procedure. On the other hand, those who opt for surgery are at risk for continued pain, wound problems, and infections. The biggest con for ESWT is that it is very expensive; it typically costs around $1,000 before insurance. Another con is that the effectiveness of the treatment is questionable. Usually, if this treatment is helpful, the difference is small.

If you are curious about Shockwave Therapy, you should talk to your podiatrist to see if this treatment method is right for you. At times, patients will find that there are other treatment options that are more efficient for their individual cases.

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.

Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.

Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.