Podiatry Reference Guide

Podiatry Reference Guide

Achilles Tendon Rupture

Symptoms include pain and swelling near the heel of the foot, inability to bend the foot downward, and inability to stand up on the toes. Treatment includes simply wearing a cast or walking boot for less severe cases. Most cases, however, will require surgery to repair the damage.

Ankle Sprain

Signs of a sprained ankle include pain with weightbearing, swelling, possible bruising, and restricted movement. Treatment options for an ankle sprain depend on the severity of the sprain. The majority of the time over-the-counter pain medications can reduce the pain, and resting the ankle can allow it to heal within a few days. In severe cases, wearing a brace or wrapping the ankle may be necessary. If there are ligament tears, surgery may be needed. 

Athlete’s Foot

Symptoms of athlete’s foot include itching, stinging, and burning of the toes and feet; blisters; and cracking and peeling skin. Treatment options include over-the-counter and prescription topical medications and oral medications in severe cases.

Bunion

Symptoms of a bunion include a large bump on the outside of the big toe; swelling, soreness, and redness around the joint; calluses or thickening of the skin in the area; pain; and restricted movement. Treatment options depend on the severity of the bunion but can include conservative nonsurgical treatment such as changing footwear, using shoe inserts, or taking anti-inflammatory drugs. If the bunion is severe or extremely painful, surgery may be warranted.

Calluses and Corns

Symptoms of calluses and corns include thick, roughened areas of skin; hardened and raised bumps; dry, flaky, or waxy appearance to the skin; and pain or tenderness under the skin. Treatment involves wearing shoes that fit properly, using protective pads, and avoiding repetitive activities which contribute to the development of calluses and corns. If these measures do not work, then methods such as trimming away thickened skin or the corn itself, the use of salicylic acid, orthotics, or antibiotics may be enlisted. Surgery may be used in extreme cases in which there is bony misalignment.

Diabetic Foot Ulcer

Symptoms of a foot ulcer include a painful, reddish sore on the foot. If there is infection, there can be pus oozing from the wound and a foul smell to the area. Treatment consists of keeping the ulcer site clean and dry. Antibiotics may also be used to try and clear up any infection. Because this ailment is linked to diabetes, controlling blood sugar levels and maintaining good circulation and blood flow to the feet are very important.

Flat Foot Disorder

Symptoms of flat feet include a flat appearance to the feet, uneven shoe wear, pain and swelling on the inside of the ankle, foot pain, and lower leg pain. With some people there may be no symptoms at all. Treatment includes rest; the use of orthotics; weight loss; additional foot support such as braces, walking boot, or cast; over-the-counter pain medicines; and tendon surgery in severe cases.

Gout

Symptoms of gout include severe joint pain that most often affects the big toe, discomfort, redness, and inflammation. Treatment typically involves medications such as nonsteroidal anti-inflammatory drugs, corticosteroids, colchicine, and medications that block the production of uric acid.

Hammer Toe

Symptoms include a hammer-like appearance of the toe, pain, difficulty with movement of the toe, and possible development of corns and calluses. Treatment includes switching to footwear that is more comfortable and provides more room and using shoe inserts. If the toe is tight and inflexible, surgery may be indicated.

Heel Spur/Plantar Fasciitis

Symptoms include a sharp pain in the heel that may be worse upon taking the first steps after waking. Long periods of standing on the feet and standing up from a seated position may also cause pain. Treatment includes medications such as nonsteroidal anti-inflammatory drugs and corticosteriods. Orthotics, splints, and physical therapy may also be prescribed. In some cases surgery may be necessary.

Ingrown Toenail

Symptoms consist of redness and swelling around the toenail along with tenderness and pain. Treatment options can include soaking the foot in warm water, placing cotton under the nail, removing part of the nail, or removal of the entire nail and nail bed. Antibiotics may also be used for severe infections. 

Jones Fracture

Symptoms include swelling, tenderness, and pain located on the outside of the foot; difficulty with walking; and occasionally bruising. Treatment includes initial conservative measures of rest, ice, compression, and elevation along with immobilization and surgery.

Lisfranc Injury

Symptoms include inability to bear weight, tenderness along the TMT joints, compartment syndrome, and plantar ecchymosis sign. Treatment options include wearing a short-leg cast in less severe cases or surgical repair if indicated.

Morton’s Neuroma

Symptoms typically include burning pain in the ball of the foot radiating to the toes and toe tingling or numbness. Treatment options depend on the severity of symptoms. If conservative measures such as change in footwear, using orthotics, or taking over-the-counter medications do not improve the symptoms, then corticosteroid injections or surgery may be needed.

Paronychia

Symptoms consist of pain, redness, and swelling around the nail. Blisters filled with pus may also be seen as well as changes to the nail such as change in shape or color. Treatment options include soaking the nail in hot water at least 2-3 times a day, the use of antibiotics for bacterial infections and antifungal medications for fungal paronychia. If necessary, the area may be cut open and drained, or part of the nail may be removed.

Plantar Warts

Symptoms include small bumps located on the soles of the feet, hard growths that have well-defined boundaries and rough surfaces, brown or gray lumps that have black dots on them, and tenderness or pain with walking. Treatment options include the use of over-the-counter salicylic acid, cryotherpay or liquid nitrogen, medications such as cantharidin, imiquimod, Bleomycin, or surgery if needed.

Sesamoiditis

Symptoms of sesamoiditis include pain under the big toe on the ball of the foot and difficulty and pain with bending and straightening the big toe. Bruising and swelling may also occur. Treatment consists of conservative measures primarily, such as ceasing activity that causes pain, taking pain relievers such as aspirin or ibuprofen, resting, icing the foot, and wearing soft-soled shoes. Steroid medication injections may also be beneficial. If relief does not come with these measures then surgery may be performed.

Calcaneal Apophysitis (Severs Disease)

Symptoms include heel pain, especially with running and jumping. Treatment includes resting, limiting activities to ones that do not cause pain, and wearing shoes with good arch support and heel pads. Anti-inflammatory medications may also be helpful.

Shin Splints

Symptoms of shin splints include soreness, mild swelling, tenderness, or pain on the lower leg. Treatment options include self-care measures such as rest, ice, elevation, wearing proper shoes, using arch supports, and if needed taking an over-the-counter pain medication.

Stress Fractures

Symptoms include pain with activity, increased pain over time, swelling, and tenderness and pain in a certain location. Treatment options depend on where the stress fracture is located and the patient’s activity level. Pain relievers such as acetaminophen may be helpful. Wearing a brace or using crutches may speed up healing time. In severe cases, splinting and/or surgery may be warranted.

Tarsal Tunnel Syndrome

Symptoms include a tingling, burning, or electrical shock sensation; numbness to the area; and pain. The symptoms most frequently occur on the bottom of the foot or on the inside of the ankle. They can also occur at the heel, arch, calf, and toes. Treatment includes rest; ice; immobilization; the use of nonsteroidal anti-inflammatory drugs; anesthetic injections; the use of orthotics, braces, and supportive shoes; and physical therapy. Surgery is an option is needed.

Turf Toe

Symptoms include pain with motion of the toes, tenderness underneath the big toe joint, stiffness, limping, redness, swelling, bruising, and warmth of the big toe. Treatment options include rest, ice, elevation, gentle range-of-motion exercises, wearing stiff shoes, and taping the big toe. Cortisone injections may be needed for chronic symptoms, and surgery may be necessary if the above measures do not prove successful.