Posts for category: treatments

By Dr. Donna Barrese
January 17, 2017
Category: treatments
Tags: bunion treatment  

feetA bunion is a deformity in which a hardened, bony bump forms on the joint in the big toe. A bunion often causes long-term discomfort such as pain, swelling, and stiffness. While bunion pads, pain medications, and avoiding tight shoes may help to alleviate discomfort, a surgical bunion treatment, known as a bunionectomy, may be necessary to remove the deformity. The extent of the procedure will be determined by degree of the deformity, but it is generally done on as an outpatient surgery. Usually, the patient is given a regional anesthesia but remains awake and possibly sedated.


Who Should Consider a Bunionectomy?

Since potential risks and discomfort associated with post-surgery recovery is possible with surgical bunion treatment, patients should consider non-surgical options for pain relief first. A podiatrist may first suggest wider shoes to allow more room for the toes. Pads and supports placed in the shoe for foot protection and pain relief might also be recommended. However, if the patient finds that they still experience pain and difficulty walking despite the switch to adaptive footwear, they should consider surgery in order to regain their quality of life.

Qualifications for Surgical Bunion Treatment

Candidates for surgical bunion treatment have severe pain that limits their daily activities, inflammation or swelling of the big toe that does not subside with the use of medication or with rest, and stiffness in the big toe that prevents bending. Patients with a big toe that is drifting in toward the smaller toes may also be candidates for surgery.

When to Reconsider Getting a Bunionectomy

Patients should reconsider getting a bunionectomy if their main objective is to wear slim shoes again or to improve the appearance of their feet. In many cases, a person may find that they're still unable to wear the desired shoes after a surgical bunion treatment, and there's always a chance that this deformity may return if the foot is once again subjected to narrow shoes. Also, some patients will determine that fixing a purely cosmetic issue is not worth the weeks or months of post-surgery recovery and rehabilitation. Generally, bunions that are not painful do not require surgery.

Anyone dealing with the discomfort associated with this bone deformity may be a candidate for bunionectomy, but it is important that individuals carefully consider and discusses the best foot treatment options for their personal needs with a qualified podiatrist or physician.

By Dr. Donna Barrese
December 28, 2016
Category: treatments
Tags: Foot Care   Aging  
As people age, foot problems become more apparent due to several reasons. Diseases, poorly trimmed toenails, unfitting shoes, and poor blood flow can lead to several foot problems. Some foot problems could be symptoms of conditions, such as arthritis, diabetes and nerve disorders. With proper foot care and seeking the services of a podiatrist, it is possible to keep the feet healthy and avoid some conditions. Here are a few tips for taking care of the feet.

1. Regular Checkups

An important part of proper foot care is having a podiatrist to check the feet regularly. A check up can help to detect certain conditions or problems while they are still mild. If there is a corn, bunion, callus, blister, scrape or a cut in the foot, it is necessary to visit a doctor. Some people may attempt to treat conditions, such as corns, with over-the-counter medications; however, this is not advisable.

2. Keep the Feet Soft and Smooth

It is necessary to wash the feet daily and dry them well using cornstarch or powder. Gently applying a layer of lotion or jelly helps to keep the legs soft and prevent dry skin. Moisturizing the feet several times a day is important, especially during the winter months. When washing the legs, it's advisable to use warm water with liquid soap. Those who love soaking their feet should avoid Epsom salts as they can be somewhat drying.

3. Pick the Right Shoes

Since older people are more vulnerable to different foot problems, wearing the right shoes with maximum support is a good precautionary measure. Flat shoes and flip flops do not provide adequate arch support. Those who have shoes that lack enough arch support should try to minimize the time they wear them. A podiatrist can help with choosing the right shoes for a patient. Additionally, it is wise to have alternate shoes to wear every day and to change socks or stockings more than once in a day.

4. Exercises

Simple exercises, such as walking, swimming, and bicycling, can help to strengthen the muscles and improve health. As a result, blood circulation improves. Having a gentle foot massage improves circulation in the lower extremities. It is also good for people who have plantar fasciitis and flat feet.
While aging, foot care should be a continuous process. People should avoid spending a lot of time in shoes as this encourages bacterial and fungal infections. Whenever there is any physical change in the feet, making an appointment with a podiatrist for a diagnosis is necessary.


By Dr. Donna Barrese
December 15, 2016
Category: treatments
Tags: Diabetes   Foot Disorders  

Excess glucose in the blood resulting from diabetes can cause poor circulation and nerve damage. As a result, foot disorders may occur. Nerve damage can cause the patient to lose feeling in the feet, as the nerves may not send signals to the brain. Poor blood flow makes it much harder for foot problems to heal. Here are a few tips to minimize the swelling and help avoid trips to the podiatrist.


1. Compression Socks and Bandages

Wearing compression stockings or bandages exerts pressure to the foot to reduce fluid buildup. This pressure allows the flue to flow to the lymphatic system and also enhances the flow of blood. Diabetes patients with edema can wear mild compression stockings to reduce foot and calf swelling without imperiling vascularity. A patient can seek the help of a podiatrist to select the right socks.


2. Regular Exercises

Diabetic individuals can engage in physical activities that are easy on the feet. Some of these activities include swimming, bicycling, dancing and walking. It is advisable to avoid activities that are rough on the feet such as jumping and running. Aerobic exercises help to improve blood flow and the health of the feet.


3. Proper Shoes Are Important

Wearing shoes that fit well helps to prevent foot issues that will prolong swelling. The shoes should have ample toe room. Diabetics should not wear pointed or heel shoes as they put pressure on the toes. Plastic or vinyl shoes are not appropriate options because they don't stretch and have poor aeration. A podiatrist will recommend athletic or walking shoes as they offer great support.


4. Keep the Feet Healthy and Clean

The feet should be washed every day with warm water and dried well to keep them clean and healthy. The areas between the toes should be dry and patients can use cornstarch or talcum powder to dry them. After drying the feet, it is advisable to apply a thin layer of cream, petroleum jelly or lotion to the feet to keep them soft and smooth. Those who have calluses and corns should not cut them as this damages the skin.


Other ways to reduce swelling include avoiding salt intake to avoid swelling and elevating the legs to drain excess fluids. Proper foot care is important for diabetics to prevent worsening of any foot issues. Patients should always make an appointment with a podiatrist when there are physical changes.

If you notice pain or stiffness in your heel during activity, plantar fasciitis could be the culprit. Understanding the sources of plantar fasciitis can help ease the symptoms of this condition and prevent it from recurring.


Common Causes

Plantar fasciitis is caused by swelling of the fascia, a band of muscle tissue at the bottom of the foot, connecting the heel bone to the toes. This tendon can become inflamed with overuse, causing the symptoms associated with this condition. This injury is most common among: long-distance runners, especially those who run uphill or on uneven surfaces, people who are obese, particularly if they've gained weight suddenly, individuals who spend long hours on their feet, such as factory workers, and those who have started a new type of exercise, notably after a period of inactivity. Inflammation of the fascia can also be caused by poorly fitting shoes and by the natural anatomy of the foot, such as flat feet, high arches, or a tight Achilles tendon.

This condition is most common among those ages 40 to 60, although earlier onset may occur among athletes and others in high-risk categories.


Symptoms & Diagnosis

While there are many potential sources of foot pain, plantar fasciitis is often characterized by sharp pain that's worse first thing in the morning or upon standing after you've been sitting for an extended period. If you suspect you have this condition, it is recommended to have a full exam conducted to make a diagnosis. In some cases, X-rays are required to confirm the swelling of the fascia.



The good news is that although painful, this condition is quite treatable. In many cases, patients see relief with a combination of over-the-counter pain medication to reduce inflammation, stretching exercises, splinting the foot at night, resting the foot whenever possible, and icing the affected area twice a day for 15 minutes. Wearing shoes with good support is also essential.

In more severe cases, casting, steroid shots, or custom-made orthotics may be required to relieve plantar fasciitis symptoms.

By Dr. Donna Barrese
June 27, 2016
Category: treatments
Tags: toenail fungus  

Toenail fungus is a common condition that starts as a yellow or white spot underneath the nail. As it develops, it can cause the nail to thicken, become discolored, dull, misshapen, or crumbly at the edges. Toenail fungus can also cause the nail to detach from the nail bed, and patients with an infection may detect a foul odor from the infection site.


socksFungal infections are usually caused by the dermatophyte fungus, a microscopic organism that thrives in dark, damp environments. Toenails are particularly prone to fungal infections due to regular exposure to the moisture and darkness inside shoes and socks. Also, toes receive less blood flow than hands and fingers, which makes it more difficult for the body’s immune system to ward off an infection in the area.

Older people are more likely to develop toenail fungus since poor blood circulation often occurs with advanced age. People with diabetes, lowered immune function, and other conditions that cause poor circulation are also at higher risk. Additionally, frequent and heavy perspiration and walking barefoot in damp communal areas, like gym showers and swimming pool areas, increase the risk of exposure.

Toenail fungus may or may not cause pain, but the condition can spread, and even if treatment is successful, the patients often experience a return of the infection. A severe fungal infection in the toenail can cause permanent damage to the nail and cause other infections that spread beyond the feet.

If your condition is mild, self-care strategies and over-the-counter anti-fungal medications may help. To help reduce your risk, keep your feet clean and dry and wear moisture-absorbing socks, such as wool or nylon. Wear open-toed shoes whenever possible and discard old shoes that may harbor fungi. Wear flip-flops in any communal showers, locker rooms, and pool areas, and keep your toenails short and dry. If your condition is more severe or causing pain, other treatments are available from the podiatrist, such as nail removal or laser therapy.