Nail Fungus

Nail fungus, or onychomycosis, is a condition that occurs when a microscopic fungus enters a toenail. It can also occur in fingernails but is more common in toenails.

Anyone can get nail fungus, but infections are more common in people over the age of 60 and people who have a weakened immune system.

Usually, nail fungus occurs when it enters the nail through a small trauma like a cut or break in the nail. Nail fungus is not caused by poor hygiene. It can spread from person to person. A warm, wet place like a locker room is a good place for fungus to grow.

Your nail will look thick and discolored. Uncommonly, you may feel pain in your toes.

Your doctor may be able to tell if you have fungus by looking carefully at your nails. He will do a scraping of some nail and tissue from under your nail and send it to a lab to determine for certain what kind of infection you have.

Treatment of nail fungus may include oral antifungal drug like Lamisil or a topical antifungal. Removal of the infected nail can be performed. At Advanced Footcare Clinic we offer to our patients a topical antifungal called Formula 3 which has been beneficial to our patients. It is not a prescription and is only sold in podiatry offices.

To prevent getting nail fungus infection you should avoid walking barefoot in public areas like locker rooms. Keep the inside of your shoes dry and change your socks frequently. If you have sweaty feet you should wear socks that wick away the moisture from your feet. At Advanced Footcare Clinic we offer to our patients socks that contain charcoal fibers that wick away the moisture from your feet. Wear proper fitting shoes that are long enough and the toe box is wide enough that isn't putting pressure on your toes. Use absorbent, antifungal powder.

On our website www.vailfoot.com we offer fungal soap which contains tea tree oil which is a natural antifungal in it that washes the fungus and bacteria off your skin when you use it in the shower.

Also we are offering to our patients a laser procedure that "zaps" away common fungus that causes the discolored nails. It is a Noveon laser and has been been very successful.

But people must understand that once they are successful in getting rid of the fungus that they still have to follow a good hygiene program, including antifungal spray for shoes, not going barefoot and keeping feet clean and dry.

Hammertoes

A hammertoe is a term that is commonly used to describe any type of toe deformity.

The deformity usually exists in one toe at the proximal interphalangeal joint or the base of the toe. It points upward and the end of the toe points down-and looks just like a hammer.

The symptoms are usually first noticed when a corn develops on top of the toe and becomes painful, usually when wearing tight shoes. Initially a hammer toe is usually flexible, bu

t when longstanding it becomes more rigid.

Hammertoes can be due to a number of things. Several factors are known to increase the risk of developing hammer toes: Some people are just structurally prone to develop hammertoes. (2) tight footwear is an important factor in the cause of hammer toes as well as providing the pressure that causes the symptoms.

A number of approaches can be undertaken to manage a hammer toe: It is important to have the shoes that are worn checked to make sure they are wide enough. You want enough space in the toe box to allow room for the toes without any excessive pressure. If a corn is present, this will need to be treated. If the toe is still flexible, it may be possible to use splints to try and correct the toe. Padding is often used to get pressure off the toe to help the symptoms. If

conservative treatment is unsuccessful at helping the symptoms, surgery is often a good option.

Surgery to correct for a hammertoe may be performed as a same day procedure. There are several different types of procedures that can be used depending on the foot structure and if the hammertoe is flexible or rigid.

On our website www.vailfoot.com we have numerous products that can help with hammertoes.

A budin splint is constructed of comfortable, but sturdy material that extend the hammertoe, allowing it to lie straight. It will help prevent the toe from becoming worse.

So if you have a hammertoe that is beginning to give you problems, give Dr. T. F. Vail's office a call at 419-423-1888 to set up an appointment.

Calluses and corns

Calluses are a thickening of the surface layer of the skin. The medical term for corns and calluses is hyperkeratosis. A callus refers to a more diffuse, flattened area of thick skin while a corn is a thick, localized area that usually has a conical or circular shape. Corns, also known as helomas, sometimes have a dry, waxy, or translucent appearance.

Corns and calluses occur on parts of the feet and sometimes the fingers. Corns can be painful to walk on, even when they are

small. Common locations for corns are on the sole, over the metatarsal arch-or the ball of the foot. They can be found on the outside of the fifth (small or pinky) toe, where it rubs against the shoe and between the fourth and fifth toes. Unlike other corns that are firm and flesh-colored, corns between the toes are often whitish and messy. They are sometimes called "soft corns". in contrast to the more common "hard corns".

Hyperkeratosis simply means thickening of the skin. This thickening occurs as a natural defense mechanism that strengthens the skin in areas of friction or pressure. Hammer toe or other toe deformities can lead to corn or callus formation as can bony prominences in the feet. Footwear that is too tight or that exerts friction at specific points can also cause skin thickening that le

ads to corns and calluses. Abnormalities in gait or movement that result in increased pressure to specific areas can also be the cause.

You should wear supportive shoes with a wide enough toe box. Moisturizing creams with urea help to exfoliate the thickened skin. By no means should you use a razor to trim away the thick skin, especially if you are diabetic.

At the Advanced Footcare Clinic we recommend Gormel 20. It has 20 percent urea which helps to exfoliate and moisturize the callus. This is the highest percent of urea that can be purchased at our office without a prescription.

If you are experiencing painful corns or calluses and have just can't seem to find anything that can help you give the office of Dr. T F. Vail, DPM a call at 419-423-1888 to set up an

appointment.

On our website: www.vailfoot.com we have many products to help with corns and calluses. Dr. Jill's felt pad helps to take the pressure off the area so that it is not so painful to walk.

tarsal tunnel

Tarsal Tunnel is a space in the foot formed between bones and overlying fibrous tissue. Within the tarsal tunnel lies a nerve called the posterior tibial nerve.

Tarsal tunnel syndrome results when the posterior tibial nerve is compressed within the tarsal tunnel. This is very similar to carpal tunnel syndrome that you can have in your wrist. Both of these conditions result when a nerve is pinched within a small space.

When the posterior tibial nerve is compressed in the tarsal tunnel, patients commonly complain of numbness over the bottom of the foot, as well as complaints of pain, burning and tingling over the base of the foot and heel. It can be confused with plantar fascitis.

The cause of tarsal tunnel is unknown in most cases, but can be the result of fractures, bone spurs, ganglion and other benign tumors or foot deformities.

Treatment can consist of anti-inflammatory medications and possibly injection of cortisone into the area around the nerve. Orthotics can help to relieve the symptoms.

Surgery may be indicated where an incision is made to open up the tarsal tunnel and decrease pressure on the posterior tibial nerve. This procedure is similar to a carpal tunnel release in the hand.

If you are experiencing burning or numbness in your feet, a podiatrist should be consulted to make sure of what is causing the problem. To contact the office Dr. T. F. Vail, DPM, call 419-423-1888

On our website at www.vailfoot.com we offer powerstep insoles if you do not have custom-made

orthotics.

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. This is actually a form of degenerative arthritis.

This can be very troubling and even disabling since we use the big toe whenever we walk, stoop down, climb up or even stand. This is a progressive condition, the toe's motion decreases as time goes on. The toe's range of motion gradually decreases until potentially reaches the end sta

ge of "rigidus" in which the big toe becomes stiff or what some people call a "frozen joint."

Common causes of hallux are structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. People with fallen arches or excessive pronation of the ankles are susceptible to developing hallux rigidus.

Symptoms include: pain and stiffness in the big toe while walking, bending etc. Pain and stiffness aggravated by cold, damp weather. Swelling and inflammation around the joint.

As the disorder gets more serious additional symptoms may develop including: pain even during rest, difficulty wearing shoes because bone spurs develop, dull pain in the hip, knee, or lower back due to changes in the way you walk.

The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a podiatrist 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 doctor 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.

Early treatment may prevent or postpone the need for surgery in the future. Treatment for mild cases may include: shoe modifications- shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended. Orthotic devices- custom orthotic would improve foot function. Medications- oral nonsteroidal anti-inflammatory drugs such as ibuprofen may be recommended to reduce pain and inflammation. Physical therapy- ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

On our website www.vailfoot.com we offer powerstep insoles. Even though a custom orthotic insole is the best device, these powerstep would help till you were able to make an appointment with a podiatrist to get your foot checked out. To make an appointment at the Advanced

Foot Care Clinic call 419-423-1888

Heel Pain

Heel pain is most often caused by plantar fascitis, a condition that is sometimes also called heel spur syndrome. Heel pain may also be due to other causes, such as a stress fracture, tendinitis, arthritis, nerve irritation. Because there are several potential causes, it is important to have heel pain properly diagnosed.

Plantar fascitis is an inflammation of the band of tissue that extends from the heel to the toes. This band is called the

plantar fascia. The fascia first becomes irritated and then inflamed, resulting in heel pain.

The most common causes of plantar fascitis relates to faulty structure of the foot. People who have problems with their arches, either overly flat feet or high-arched feet are more prone to developing plantar fascitis.

Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fascitis. Obesity may also contribute to plantar fascitis.

The symptoms are: Pain on the bottom of the heel, pain that is usually worse upon arising in the morning and when sitting and getting up and pain that increases over

a period of months.

To arrive at a diagnosis, the podiatrist will examine your foot and rules out all the possible causes for your heel pain other than plantar fascitis.

X-rays or other imaging modalities may be used to distinguish the different types of heel pain.

Treatment will contain some or all of the following:

stretching exercises- exercises that stretch out the calf muscles help ease pain, (2) avoid going barefoot-when you walk barefoot you put undue strain and stress on your plantar fascia (3) ice- this helps reduce inflammation. Do not apply ice directly the skin. (4) limit activities-cut down on extended physical activities to give your heel a rest, (5) she modifications-wearing supportive shoes that have good arch support, (6) medications-oral non steroidal anti-inflammatory drugs such as ibuprofen may be recommended to reduce pain and inflammation, (7) orthotics-custom orthotics that fit into your shoe help correct the underlying structural abnormalities causing the plantar fascitis, (8)

night splint wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients, (9) physical therapy exercises and ultrasound therapy may be used to help provide relief, (10) injections- corticosteroid injections are used to help reduce the inflammation and relieve pain.

So if you are experiencing heel pain give the office of Dr. T. F. Vail's office a call at 419-423-1888 to set up an appointment to make sure that it is plantar fascitis and not another condition.

Check out our website at www.vailfoot.com. There are numerous products that we offer to patients that are experiencing heel pain.

This is what a night splint looks like that you should wear at night. It stretches the plantar fascia at 90 degree angle so that in the morning you will not experience heel pain.

Peripheral Neuropathy

Peripheral neuropathy is a term that refers to disorders of the peripheral nerves. This nervous system is made up of the nerves that branch out of the spinal cord to different parts of the body.

The peripheral nervous system consists of motor (to help move) nerves and sensory (to help feel) nerves. Either or both sets of nerves can be affected in neuropathy.

If a sensory nerve is damaged, the predominant symptoms are pain, numbness, tingling, burning or a loss of feeling. They often begin gradually. There may be tingling sensation or numbness that starts in the toes or the balls of the feet and spreads up.

Diabetic neuropathy is the most common type and can lead to serious complications in those with diabetes. Diabetic peripheral neuropathy means damage of nerve fibers in people with diabetes. There are three types of diabetic peripheral neuropathy: Sensory which is loose the ability to detect sensations such as heat, cold, pain. Motor: is loss of strength to control movement and autonomic which regulate functions such as heart rate and digestion.

The treatment for peripheral neuropathy will differ, depending on the cause. For example, if it is caused by diabetes the therapy involves better control of the diabetes. If it is caused by a

vitamin deficiency, then supplementation will help.

As numbness is common in peripheral neuropathy, damage to the foot can go undetected and lead to serious complications especially in those who also have diabetes. It is best to protect the foot with good fitting footwear and the foot should be inspected daily for damage. Particular attention should be paid to corns and calluses as these may need treatment by your podiatrist.

If you are diabetic it is very important to have your feet evaluated by a podiatrist Give the office of Dr. T. F. Vail a call to set up an appointment if you experience any of the above symptoms or you a diabetic. 419-423-1888.

Or you can go to our website and there are various products for diabetics and if you are experiencing neuropathy.

This product is called Corganics Relief Topical Analgesic Cream. It is specially formulated for diabetic neuropathy, restless leg syndrome and deep muscle and joint pain.