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Monday, 11 February 2019 00:00

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

Monday, 04 February 2019 00:00

Blisters are small pockets of fluid that occur on the top layers of the skin for several reasons. Friction, burns, and diseases are all known causes of blisters.  Smaller blisters are known as vesicles, while larger blisters are referred to as bulla. The fluid inside the bubble can be blood, pus, or serum; which is a clear liquid that protects the skin. In most cases, blisters are not a major health issue, but they can be an indicator of a more serious condition.  

Causes of blisters vary. Blisters are commonly caused by wearing poorly fitted shoes that rub against the foot. However, there are many other causes besides from friction; including burns, sunburn, insect bites, frostbite, poison ivy/oak, chemical exposure, impetigo, eczema, viral infections, and more.

Most blisters heal by themselves and do not require immediate medical care. If you have a blister, do not pop it since this may cause infection; it is advised to put a bandage over the blister to protect it. If the blister is large, causes pain, or if you have a fever, it is recommended that you see a doctor who can provide proper care. Blisters are easy to diagnose, and if considered prudent by the doctor, can easily be drained of fluid with a sterile needle as well.

To prevent blisters on the feet, wear shoes that fit properly and don’t cause rubbing. Socks can help prevent friction and it is recommended that you wear them if you are wearing shoes. Hand blisters can be avoided by wearing gloves during activities that cause friction against the hand. If you have a blister that pops, do not remove the dead skin, wash the area, apply antibiotic ointment, and cover with a bandage. It is okay in most cases to not seek immediate medical care for a blister if it was just caused by friction. However, if the blister causes pain or does not go away, it is suggested that you see a doctor for a diagnosis.

Monday, 28 January 2019 00:00

Cuboid Syndrome

Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome.  This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.

Causes of Cuboid Syndrome

  • Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
  • Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
  • Over-pronation can exacerbate the condition if not corrected.

Disagreements Amongst Podiatrists Regarding Cuboid Syndrome

  • Some refer to it as the dislocation of the calcaneal-cuboid joint only.
  • Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.

It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.

Monday, 21 January 2019 00:00

The natural weight that pregnant women gain causes their center of gravity to be completely altered. This causes them to have a new weight-bearing stance which adds pressure to the knees and feet. As a result, pregnant women often experience severe foot pain. The two most common foot issues experienced by women in their pregnancies are edema and over-pronation. It is important for all pregnant women to learn more about how to take care of their feet so they are more comfortable during their pregnancy.

Over-pronation, which is commonly referred to as flat feet, is caused when a person’s arch flattens out upon weight bearing. This causes the person’s feet to roll inward while walking. Pregnant women often experience this due to the sudden weight they gain.

Edema, also referred as swelling in the feet, typically occurs in the later part of the pregnancy. It is the result of the extra blood accumulated in the pregnant woman’s body. The enlarged uterus puts more pressure on the blood vessels in the pelvis which causes leg circulation to slow down. This causes blood to pool in the lower extremities.

Fortunately, there are ways to treat both edema and over-pronation. Edema can be treated by elevating the foot as often as possible. Wearing proper fitting footwear will also be helpful for those with edema. A treatment method for over-pronation could be orthotics. Orthotic inserts should be designed with appropriate arch support and medial rear foot for your foot.

It is best for pregnant women to buy new shoes during the day, because this is the time where swelling is at its peak. Pregnant women also shouldn’t rush when buying shoes. It is always advised that you make sure your shoes fit properly but this is especially important during pregnancy.

If you are a pregnant woman, you should consult with a podiatrist in order to make sure your feet are healthy throughout the entirety of your pregnancy.

Monday, 14 January 2019 00:00

A corn is a lesion that forms in the skin of the foot, and it is typically circular in shape, small in size, and thick and rough in texture.  A corn generally occurs as a result of repeated pressure on the skin; one example of this is the rubbing of a shoe against the skin.  Corns differ from calluses in that their central cores are harder in texture.

A corn is a relatively common condition with a wide variety of treatment options.  If a corn becomes overly uncomfortable or painful, consult with your podiatrist; he can determine the best method of treatment that is appropriate for you.  Corns may return if the underlying cause of its development is not treated or removed.  Avoid removing corns at home, as improper removal may cause infection.

A callus, similar to a corn, is an area of skin that has become thickened due to repeated pressure and rubbing.  The rubbing causes the skin to create a layer of protective skin, which is the formed callus.  Calluses can differ in size between people, and they can also become painful.

Multiple treatments are available for calluses.  At-home treatment and removal should be avoided, as this can potentially lead to infection.  Your podiatrist can best determine the cause of your calluses and suggest the treatment most appropriate for you. 

Tuesday, 08 January 2019 00:00

While not a serious issue, toenail fungus, or onychomycosis, can be an embarrassing and uncomfortable condition to experience. Toenail fungus is often caused from public areas that harbor fungi and improper cleaning/drying of the foot. Once infected, the fungus grows deeper into the nail and can be very hard to get rid of.

There are different types of fungus that cause toenail fungus. Dermatophytes, yeasts, and molds are the most frequent forms of fungus to infect the toenail. Dermatophytes are the most common among the three. Symptoms associated with fungal nails include the discoloration of the toenail, brittleness, and in some circumstances, a smell. Pain is rarely a symptom caused by toenail fungus.

Diagnosis of fungal nails is generally a rather quick process. However podiatrists will make sure that the cause is not another condition such as lichen planus, psoriasis, onychogryphosis, or nail damage. Podiatrists will make use of fungal cultures and microscopy to verify that it is fungus.

While over-the-counter ointments are readily available, most are ineffective. This is due to the fact that the nail is very protective and that the fungus slips in between the nail plate and bed. Podiatrists can offer oral medication which currently provides the best results.

Ultimately, prevention is the best line of defense against toenail fungus. Avoid unsanitary public showers. If you do use a public shower, use shower shoes to provide your foot with protection. Once you are finished showering, make sure to thoroughly dry your feet. Fungi thrive in warm, dark, and moist places like sweaty, warm feet that are left dark in shoes all day.

Wednesday, 02 January 2019 00:00

Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.

The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.

Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.

Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.

If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.

Wednesday, 26 December 2018 00:00

The purpose of the body’s circulation system is to transport blood, oxygen, and nutrients throughout the body. A reduction of blood to a specific part of the body may cause one to experience symptoms of poor circulation. The most common causes of poor circulation in the feet are obesity, diabetes, and heart conditions such as peripheral artery disease (PAD). Common symptoms of poor circulation include tingling, numbness, throbbing, pain and muscle cramps.

Peripheral artery disease is a common cause of poor circulation in the legs. Symptoms of PAD are cramping, pain or tiredness in the leg or hip muscles while walking or climbing stairs. This pain tends to go away with rest and starts back up when you begin to walk.  It is a condition that causes the blood vessels and arteries to become narrow. Although PAD is more common in adults over the age of 50, it may also occur in younger people.  A similar condition called atherosclerosis causes arteries to stiffen up due to a buildup of plaque in the arteries and blood vessels.

Blood clots are also a common cause of poor circulation in the feet. Clots may obstruct blood vessels and if they occur in the legs, they may eventually lead to pain and discoloration. This occurrence is commonly known as deep vein thrombosis (DVT) and it may travel to the lungs. Varicose veins are another condition that may lead to poor circulation, and it is caused by incompetence of the valves in the veins. Women who are overweight are prone to developing this condition. Lastly, diabetes, which is correlated with poor blood sugar metabolism may lead to chronic poor circulation. Those with diabetes often suffer from cramping in the legs, calves, thighs and buttocks.

If you are looking for ways to avoid poor circulation there are some tips you can follow. One tip is to avoid sitting for too long. If you plan to sit down for a long period of time, you should try standing up occasionally, to improve your circulation. Another great way to avoid poor circulation is to exercise. Exercise is an excellent way to pump the heart and increase blood flow. Those who suffer from poor circulation should also avoid smoking, reduce their salt intake, and try to lose weight.

If you are experiencing symptoms from poor circulation in your feet, you should consult with your podiatrist to determine the best method for treatment for you. He or she may prescribe medication in addition to recommending specific lifestyle changes to improve your circulation.

Monday, 17 December 2018 00:00

Our feet are arguably one of the most important parts of the body. When it comes to health and beauty routines, the feet and toenails are usually ignored. You should always practice proper footcare to avoid any fungal infections or ailments that can not only ruin the appearance of your feet, but also cause pain. Ignoring any foot problems could potentially lead to an expensive doctor’s visit.

The most important step in proper foot care is to wash your feet daily. You should wash them with soap and water. Doing this will cleanse your feet of dirt, sweat and bacteria. It is crucial that you clean between the toes and pat your feet dry with a towel afterward. Your toenails are also an important part of the feet and you may find that they get dirtier in the summer when you wear sandals. It is important that you practice proper toenail care in addition to cleaning the rest of your feet. When trimming your nails, you should always trim straight across instead of in a rounded shape. Trimming in a curved shape may lead to ingrown toenails.

Moisturization is also important for foot care, and you should be moisturizing your feet every day. The best way to prevent dry feet is to rub lotion or petroleum jelly on your clean feet at night and put socks over them. In the morning, your feet should be soft and moisturized.

Another crucial step in proper foot care is to wear the right shoes for whichever activity you are going to partake in. In warmer weather, you should wear shoes that allow your feet to breathe. It is best to avoid shoes such as flip-fops that do not provide arch support. Tight shoes may also be harmful, and they may even cause you to develop bunions.

If you plan on taking a shower in a public area, you should be especially careful, so you do not pick up any fungi. Showers are prone to harboring different types of bacteria and fungi. You should always wear shower shoes or flip flops when walking around in locker rooms and public showers. Avoid sharing shoes with other people because this is another way that fungus may be spread.

If you are experiencing any problems with your feet you should speak with your podiatrist to determine the best method of treatment for you.

Monday, 10 December 2018 00:00

The foot and ankle area works with 26 bones, 33 joints, and more than 100 different muscles, tendons, and ligaments. Problems with any parts of this network can result in some kind trauma within the foot and ankle area. Most foot and ankle trauma is a result of aging or intense activities such as sports. However, trauma in this area can also be the result of simple things such as wearing heels too much or even walking on an uneven pavement. There are several kinds of symptoms related to specific injuries, and there are also several different treatments that could be used as well.

Foot Injuries and Symptoms

Some common injuries in the feet include stress fractures and bunions. Stress fractures are small cracks in a bone or severely bruised parts of the bone. This type of injury is caused by intense and repetitive activity, which is found in actions involved with sports and exercise. Symptoms of this injury include pain, swelling, tenderness, and possible bruising. Another common injury with bones is also bunions, which are bony bumps typically formed on the big and little toes. This injury is typically a result from wearing high heels and unfit shoes. Some common symptoms are swelling around the big and little toe areas, as well as pain and restricted movement.

Ankle Injuries and Symptoms

The common injuries associated with ankle trauma consist of sprains, strains, and fractures. These injuries are defined by the type of tissue that has been damaged. Fractures are breaks within the bones caused by sudden impacts to the area. Sprains relate to any damage of the ligaments, commonly caused by being stretched beyond their normal range of motion. Strains are attributed to damage of the muscles and tendons from being pulled too far. Symptoms of these injuries include severe pain, limited range of motion, and swelling.

Diagnosis and Treatment

Since there are several types of injuries with a variety of symptoms, it is important to see a podiatrist about your condition. Podiatrists can run a variety of tests to diagnose an injury accurately. This includes physical examinations, X-rays, or MRIs. A podiatrist may even run a stress test, which is an X-ray taken while pressure is applied to the damaged area. Once your injury has been diagnosed, the doctor may have you wear a cast or a splint, or gradually develop your range of motion. Severe injuries may require physical therapy or even surgery if necessary. If you have any concerns from past foot and ankle trauma experiences, consult with Dr. James Kutchback from James Kutchback, DPM, ABLES, CWS-P. Our doctor can assess your condition and provide you with quality foot and ankle treatment.   

If you have any questions, please feel free to contact our offices located in The Woodlands and Woodville, TX. We offer the newest diagnostic and treatment technologies for all your foot care needs.

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