Top Five Reasons Patients Visit My Office as a Podiatrist and Foot Surgeon

I would like to say one of the top reasons my patients visit me is to bring me cookies or just to say hello but in actuality, patience visit me for their medical needs, lower extremity limitations and pain. So, here are the top five reasons patients visit my office

1. Plantar Fasciitis

   By far, plantar fasciitis is the number one reason patients visit my office and it has been for the past 28 years. Plantar fasciitis is pain in the bottom of the heel near or at the insertion of the plantar fascia onto the heel bone. The plantar fascia becomes torn or injured, causing an inflammatory reaction, swelling and pain. The pain can feel like a bruise or even a sharp nail on the bottom of the heel and many times there is increased pain with first step in the morning.
   
   The majority of plantar fasciitis that I see is in the age group between 40 and 70 and I believe the reason for this is during these years, our bodies begin to change becoming less flexible and less elastic however, we are still very active with work, children, exercise, and home life. Also, the high incident is likely due to the chronic obesity epidemic in the United States. Every step we take, we put 2 to 3 times our body weight through each step so if you are 20, 30, 40 or 50 pounds overweight and you take 10,000 steps a day, you can easily see the added demand to our feet. I typically do not see 20-year-olds or even 30-year-olds and rarely 40-year-olds with plantar fasciitis. Although these ages have high activity levels, their tissues are still elastic and flexible. I also do not see many 70 to 90-year-olds with plantar fasciitis. Their tissues are certainly affected by inelasticity and diminished flexibility, however, their activity level is not the same as the younger age group.
   
   To combat this increased demand and possible increased weight through the foot, one of the most important treatments and preventions for plantar fasciitis is a supportive shoe type. I always tell my patience with plantar fasciitis to think of the shoe as the “brace” for this injury. Just like if you had an ankle sprain, I would recommend an ankle brace that the patient would wear for a month. Well, the shoe again is the brace for a plantar facial injury. A supportive shoe typically has a very firm soul with a proper flex point at the toe joints. It also will have a sturdy heel counter and high adjustability. For example, a laced shoes as opposed to slip on shoes.
   
   Arch supports are also a very important treatment and prevention for plantar fasciitis. As we walk our arches collapse, also known as pronation. This is our built-in shock absorber, however, as the arches pronate, it is putting a added stretch or strain through the fascia. By holding up the arch with an arch support, we can immediately start to rest and help under use the plantar fascia.
   
   

2. Ingrown Toenails

   The second most common reason for visiting my office is the condition known as ingrown toenail or onychocryptosis. An ingrown toenail occurs when the edge of the toenail grows into the surrounding skin, causing inflammation and pain. The most common causes that I see are improper nail trimming, tight fitting shoes, abnormally shaped toenails, injury to the toe or certain medical conditions, such as diabetes. An ingrown toenail is easily resolved with a procedure known as a partial nail avulsion. I quickly anesthetize the toe with a local anesthetic, and then using a special instrument remove the offending border. The toe is then dressed with a sterile bandage, and after a few days of home care, pain and swelling will resolve.
   
   

3. Orthotics

   Orthotics are custom-made medical devices that patients wear inside their shoes to help relieve pain. Orthotics can help reduce abnormal motion or improve motion where it is needed. Orthotics also help distribute pressure evenly throughout the entire plantar surface of the foot. The procedure to have a true custom prescription orthotic made includes a full lower extremity and gait exam, foot impressions performed by a three-dimensional scanner, a detailed prescription, and after all of this, the information is sent to a reputable orthotic laboratory, where the device will be constructed and then mailed back to my office to ultimately be dispensed to the patient.
   
   

4. Foot or Ankle Injuries

   This can include anything from ankle sprains to turf toe to foreign bodies. We see injuries every day that require a full evaluation, exams, x-rays, and ultimately, treatment. There are never two injuries alike, which, no pun intended, keeps us on our toes.
   
   

5. Diabetic Related Issues

   Diabetes mellitus is a group of metabolic disorders characterized by high blood sugar (glucose) levels. The three body parts that tend to be most affected by this disease are the eyes, the kidneys and the feet. High blood sugar levels over time can cause damage to the nerves of the foot which can lead to many other conditions. We see many diabetic related foot problems anywhere from dry skin, thicken toenails, infected ulcers, neuropathic arthropathy also known as Charcot foot disease and unfortunately, amputations.

Remember, an ounce of prevention is worth a pound of cure. However, any foot or ankle condition is easier to resolve if caught early. The feet are the foundation of the body so if you take care of them and they’ll take care of you. 

Written by
Dr. Jeffrey S. Hurless
DPM, FACFAS Board Certified Foot & Ankle Surgeon/Podiatrist
Medical Director, HealthyFeetStore.com