- Ankle Sprains
- Arthritis in the big toe joint
- Bunion
- Hammer Toe
- Heel Pain
- Ingrown Toenail
- Neuroma
- Toe and Metatarsal Fractures
Ankle Sprain is an injury to one or more ligaments in the ankle, usually on the outside of
the ankle. The severity of an ankle sprain depends on whether the ligament(s) is stretched, partially torn, or completely torn, as well as on the number of ligaments involved.
There are four reasons why an ankle sprain should be promptly evaluated and treated by a foot and ankle surgeon;
- First, an untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort. You may also develop weakness in the leg or difficulties walking on uneven surfaces.
- Second, you may have suffered a more severe ankle injury along with the sprain. This might include a serious bone fracture or torn ligaments in the leg that can lead to troubling complications if it goes untreated.
- Third, an ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far.
- Fourth, rehabilitation of a sprained ankle needs to begin right away to prevent avoidable long term problems.
Dr. Di Nucci will examine the area, may order X-Rays, an MRI study or a CT scan to help determine the severity of the injury.
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Hallux rigidus is a disorder of the joint at the base of the big toe. It is a form of degenerative arthritis.
This disorder can be very troubling and even disabling, since we use our big toe whenever we walk, stoop down, climb up, or even stand. It can be confused with a bunion, which affects the same joint, but they are very different conditions requiring different treatments.
Early signs and symptoms include;
- Pain and stiffness in the big toe during use
- Pain and stiffness aggravated by cold, damp weather
- Difficulty with certain activities
- Swelling and inflammation around the joint
As the disorder gets more serious additional symptoms may develop;
- Pain, even during rest
- Dull pain in the hip, knee, or lower back due to changes in the way you walk
- Limping
Non-surgical treatments include shoe modifications, orthotic devices, medication, injection therapy and physical therapy. If these treatments fail to provide adequate relief, there are several types of surgery for treatment of hallux rigidus. Dr. DiNucci will take into consideration the extent of your deformity based on your x-ray findings, your age, activity level and other factors.
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A bunion is often described as a bump on the side of the big toe. A bunion is much more than a visible bump. The bone protrusion actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead.
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years. A Bunion may be inherited and is commonly aggravated by shoe pressure. Certain foot types that make a person prone to developing a bunion.
Symptoms may include:
- Pain or soreness
- Inflammation and redness
- A burning sensation
- Possible numbness
Early treatments are aimed at easing the pain such as; changes in the shoe wear, padding, activity modifications, medication, icing, injection therapy and orthotic devices.
If non-surgical treatments fail, it might be time to consider surgical options.
Patients decide with Dr. DiNucci if surgery is the best option for them. He will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors.
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Hammertoe is a contracture or bending of one or both joints of the second through fifth toes. This abnormal bending can put pressure on the toe when wearing shoes, which may lead to painful soft tissue lesions developing on the top of the toe. Hammertoes may be inherited, and they occasionally caused by trauma such as a previously broken toe.
Common symptoms are:
- Pain or irritation of the affected toe when wearing shoes.
- Corns on the top, side, or end of the toe, or between two toes.
- Calluses on the bottom of the toe or on the ball of the foot.
Hammertoes usually begin as mild flexible deformities and become progressively worse over time. If left untreated, hammertoes can become stiff and may not respond to non-surgical treatments.
Heel pain is most often caused by plantar fasciitis. This overuse condition is occassionally referred to as heel spur syndrome. It represents an injury to a supportive ligament on the bottom of the foot. Heel pain may also be due to other causes, such as stress fracture, tendonitis, arthritis, nerve irritation, or, rarely development of a cyst or bursae.
Symptoms are;
- Pain on the bottom of the heel.
- Pain that is usually worse upon arising in the morning or following periods of rest.
- Pain that increases over a period of months
Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia which may lead to plantar fasciitis. This particularly evident when a person’s job requires long hours on their feet. Prolonged barefoot walking is also a common contributor to plantar fascitiis.
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When a toenail is ingrown, the nail is curved downward and grows into the skin created pain and inflammation. This usually occurs at the toenail borders. This is commonly caused by one of two factors; abnormal growth of the toenail or improper trimming. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage, foul odor and increased pain.
If an infection is not present, soaking of the toe in room-temperature water and use of anti-inflammatory medications to help reduce the inflammation is helpful.
Following proper evaluation, Dr. DiNucci will select the best treatment for you. Treatment may include, oral antibiotics, a temporary procedure to remove a corner of the nail, or permanent removal of the ingrown toenail portion of the nail.
Neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs at the base of the third and fourth toes.
Symptoms of a Morton’s neuroma;
- Tingling, burning, or numbness
- Pain
- A feeling that something is inside the ball of the foot, or that there’s a rise in the shoe or a sock is bunched up
Symptoms first occur intermittently when wearing narrow-toed shoes or performing certain aggravating activities. Symptoms may go away temporarily, but overtime they worsen and may persist for several days or weeks.
For mild to moderate cases of neuroma, treatment options include;
- Padding. Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve.
- Icing. Placing an icepack on the affected area may help reduce swelling.
- Orthotic devices. Custom orthotic devices may be made to provide support needed to reduce pressure on the nerve.
- Activity modifications. Activities which put repetitive pressure on the neuroma should be avoided.
- Medications.
- Injection therapy.
Surgery may be considered in patients who have not received adequate relief from other treatment.
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The structure of your foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in your foot, 19 are toe bones and metatarsal bones (the long bones in the mid foot). A fracture is a break in the bone. Fractures can be divided into two categories:
Traumatic fractures; These are caused by a direct blow or impact such as a heavy object dropped on your foot or stubbing your toe. These fractures can be displaced or nondisplaced. Treatment of a traumatic fracture depends on the location, extent of the break, and whether it is displaced. Surgery is sometimes required for displaced fractures. The statement "there is nothing which can be done for a broken toe" is untrue. Proper evaluation is necessary to determine which treatment is best to prevent future problems.
Stress fractures; These fractures are hairline breaks that are usually caused by repetitive stress.
Stress fractures often afflict athletes whom are wearing worn out shoes, too rapidly increase their running mileage, or change their terrain of running to a hard surface from a treadmill.
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