Quality Foot Care
that Lasts a Lifetime.
Peoria Office
5017 N. Glen Park Place
Peoria, IL 61614
P: 309-691-1589 F: 309-692-2032

Frequently Asked Question

Q: A few of my toenails are thick and have a yellow-brown color. Do I have a fungus?  
A: That is a very good possibility, although it is not certain.There are several signs that can indicate a fungal nail infection. These include but are not limited to thickening of the nail, discoloration, debris under the nail, brittle nail, separation from the nail bed and pitting.Unfortunately there are several other conditions that can mimic these findings, which include trauma to the nail, psoriasis, diabetes, aging, exposure to chemicals and other skin diseases. Therefore it is important to have a small sample of the nail sent to a pathology laboratory. Preferably a lab that is familiar with toenail specimens.
Q: I have pain in my left heel, which is worse when I get out of bed in the morning. I tried to start exercise walking to loose a few pounds but it makes my heel hurt more the next day. Is this a bone spur and what can I do to get rid of this problem?   
A: Most likely you are experiencing a condition known as “Heel Spur Syndrome.” This is actually due to inflammation of a ligament (Plantar Fascia) on the bottom of the foot and heel. The condition is properly termed “Plantar fasciitis.” This can spontaneously occur with no trauma or injury but is also common in athletes from overuse.

Home treatments commonly used include ice, heat, massage, Advil, Tylenol, aspirin, heel pads, soft inserts and supportive shoes. If you’re not able to relieve the condition within a few weeks I recommend you call our office.

Heel pain is one of the most common conditions treated by Podiatrists. An x-ray and exam is necessary to rule out other causes such as a systemic disease or broken bone/injury. The treatment is usually successful even without surgery.

Q: My big toe is pushing into the toe next to it. Is there a name for this problem and will a toe splint correct it?    
A: The medical term is Hallux Valgus but is more commonly referred to as a “bunion.” The first term (hallux valgus) refers to the big toe drift towards the 2nd toe and the bunion represents the bump on the side of the big toe. Both of these usually occur together.

When the big toe drifts into the 2nd toe it often creates a painful corn between the toes or dislocates the 2nd toe. The bunion makes it difficult to find comfortable shoes and often becomes irritated and painful.

The cause is varied but is most commonly inherited from a parent or grandparent. Other causes are various forms of arthritis, bone growth abnormalities, flatfeet, improper fitting shoes and congenital deformities.

Unfortunately splints and straps are not able overcome the deforming forces that cause your big toe to drift and will not prevent the complications of letting this condition go without proper treatment. These complications may include ulceration (tissue loss) and infection, which could result in hospitalization in severe cases.

We can evaluate your bunion and determine the best course of action. Simple steps may be instituted for initial care. Definitive care involves surgical correction of the bunion and Hallux valgus. This is usually performed as an outpatient in our office. In most cases you will be able to bear weight on your foot without having a cast or using crutches.

Q: I have a corn between the two smallest toes on my right foot. I have tried to shave it down but it keeps coming back. What can I do to get rid of it?   

A: The problem you are describing is called heloma molle or “soft corn.” This is fairly common and can be seen in both men and women. It can be present at any age but is most common in persons over 30. A corn is your skins attempt to protect from ulceration by thickening and hardening and is usually caused by excessive, repetitive pressure over a bone prominence of your toe or toes.

Soaking, padding, moisturizer, lubricants, toe separators and wider shoes are all methods of treatment. Most soft corns will not resolve without surgery to reduce the prominent bone.Surgery can be performed at an outpatient surgery facility without the need for hospitalization. Healing is usually quickly with a minimum of down time. No cast or crutches are required. Most people are able to wear a more fashionable shoe after the procedure.

Q: My doctor said I have a fungal infection of my toenails but didn’t talk about treating it. My neighbor recommends soaking in vinegar water. Does this work? What are my treatment options?

A: Fungal infection of the toenail has long been a difficult problem to treat. The reason for the difficulty is that fungus grows best in a warm, moist, dark environment. Shoes create that environment. Once fungus takes up residence, your toenails provide an excellent shield to protect it from penetration of chemicals and drugs. Recently a couple of products have made its cure a much greater reality.

There are numerous home remedies for fungal infection of the toenails. Unfortunately, most of them are unsuccessful. Some of the methods include soaking in tea, vinegar or dilute bleach and over the counter paint on polishes. The FDA has never approved these chemicals and there are no valid studies to confirm their effectiveness.Recently the FDA approved the first product that can be applied to the surface of the nail. It comes in a ready to use bottle and is simple to apply. However, it must be applied daily for about 11 months and does not appear to be as effective in curing the infection as oral medication.Medications taken by mouth have been approved for several years. In the past few years’ oral therapy has become much safer, effective and does not require as long a duration of treatment.

Q: I’m 52 years old and developed Diabetes three years ago. My sugar levels are controlled with pills. I have a sore corn on the toe next to my big toe. Someone told me I could never have surgery because of the diabetes. What can I do?  
A: The first thing to do is have your feet examined by a Podiatrist. The American Diabetes Association recommends this at least every six months.

Conservative care for a corn includes soaking, padding, moisturizer, lubricants, toe separators and wider shoes. Most soft corns will not resolve without surgery to reduce the prominent bone.

A Podiatrist can evaluate the circulation, skin, bone, joint, muscle and nerve function of your feet and legs. If he or she finds you are not a candidate for surgery the Podiatrist can use a combination of the above treatments to keep you comfortable and help avoid complications. However, if your diabetes is controlled, recent onset and there are no other major illnesses you may very well be a candidate for corrective surgery. The only way to know for sure is to have a podiatric evaluation. We works closely with your physician to be sure all health matters are under appropriate control prior to surgical care.

Q: Is it possible to get skin cancer on the foot? Last month I noticed a small raised spot. I have a personal and family history of skin cancer. Should I be concerned?  
 A: Yes, it is possible to get a skin cancer on your foot and since you have a personal and family history I would be concerned. You should have your Podiatrist biopsy the lesion.

Several different types of growths can be found on skin and many of them have similar characteristics. There are basically three types of skin growths, benign (not dangerous), premalignant (possibly dangerous) and malignant (dangerous).

The Podiatrist will send the specimen to a pathologist who will evaluate the growth under a microscope and make a determination. Most of the time the biopsy will encompass the whole growth and no further treatment will be required. If some abnormal tissue remains the podiatrist will excise the remaining abnormal tissue. If the lesion is malignant we will see that you are referred to an oncologist for appropriate follow up care.
Q: Previously you described the injury known as Plantar Fasciitis. Can you recommend any strengthening or stretching exercises or activities to reduce the chances of the injury?  
 A: All forms of Achilles tendon stretching are helpful. A Runners stretch is performed by leaning against a fence or wall with one foot forward and one back. Point your toes straight ahead. Keep the back knee stiff and bend the front knee. Lean forward until you feel the calf tighten and hold for 20 seconds. Stretch both legs thoroughly.
Another is performed by standing erect with the ball and toes on a block and the heel hanging off the back while holding on to something. Allow your heels to fall thus putting a stretch on the Achilles tendon. Stretching should always be performed while wearing athletic shoes that have a good arch to avoid collapsing the joints of the foot.
Massaging the bottom of the foot and ice alternated with heat are also helpful. Avoid standing on hard surfaces for long periods of time, use a cushioned matt where possible. Walking barefoot and on soft surfaces such as the beach can also induce plantar fasciitis.
Q: I stepped on something while walking barefoot outside my home. It bled some and made a little hole. I couldn’t see what it was but it still hurts to put pressure on it. What do I need to do?  
A: If you have not been successful finding and removing an object I wouldn’t consider further attempts. At this point it is time to seek help from a Podiatrist. The tenderness is an indication something is wrong. There may be an infection and/or a foreign body imbedded in your foot. An improperly treated puncture wound can lead to deep infection with abscess formation and tissue destruction. If your foot is worsening it is most likely infected. If sore only when you press on the area and it is without redness, swelling or warmth it is probably a foreign body. Occasionally the foreign body comes out immediately but forms a deep cyst that makes it feel like something was left in the foot.
We  will examine your foot and take x-rays. Not all objects will be seen on x-rays and may require further studies such as an MRI. Many times it can be removed in the office with little or no discomfort. Occasionally a local anesthetic may be required prior to removal. In severe cases and in the presence of infection hospitalization with wide excision, wound packing, tetanus, antibiotics and non-weight bearing may be required.
Q: I have a sore corn on the outside of my little toe, which becomes very tender when I wear shoes. What are my treatment options?    
A: The problem you are describing is called heloma durum or “hard corn.” It is usually seen with a hammertoe or curly toe. This is fairly common on the 5th toe and can be seen in both men and women. A corn is your skins attempt to protect from ulceration by thickening and hardening. It is usually caused by excessive, repetitive pressure on the skin over a prominent bone in your toe.

Soaking, padding, moisturizer, lubricants, wider shoes and trimming are all methods of treatment. Most hard corns will not resolve without surgery to reduce the prominent bone.

Surgery can be performed at our outpatient surgery facility without the need for hospitalization. Healing is usually quickly with a minimum of down time. No cast or crutches are required. Most people are able to wear a more fashionable shoe after the procedure. We can perform an evaluation to determine if you are a candidate for the procedure.
Q: I have fungal infection of my toenails. I heard that the pills used to treat fungus cause liver damage. Is this true?   
 A: The most current oral medication for treating fungal nail infection is relatively safe and effective. The chance of liver damage is extremely rare especially if you are appropriately monitored during your treatment. I prescribe the oral medication for three to four months. You will be given a few signs and symptoms to watch for that may indicate the need to stop the medication. I also run two to three liver function tests to be sure no damage is occurring. Rarely adverse effects may occur such as stomach upset, diarrhea or rash.

The liver also metabolizes many other medications but there is no contraindication to using the safer fungal medication at the same time, however dosage adjustments may be required. Monitoring as noted above should significantly limit the chances of any liver injury.

Q: I need to have my bunion fixed but a Podiatrist told me I’d wear a cast and be on crutches for about two months. Is there any other way to correct it without such a long recovery period?  
A: For those who are not familiar with the term bunion it is commonly used to describe a bump on the side of the big toe joint. Along with the bunion, many times the big toe will drift towards the 2nd toe. This is referred to as hallux valgus.
Prior to surgery a through history of your concern, past medical history and physical exam are performed. I always take x-rays to determine which bunion correction (bunionectomy) will work best for you. No one procedure works for all. I follow the protocol of the American Board of Podiatric Surgery to determine which procedure is appropriate. The more severe the bunion and hallux valgus the more aggressive the procedure must be. However, there are new procedure modifications that can be performed without the need for a cast or crutches. This will allow you to walk on your foot in a post-operative shoe. Bunion correction is usually performed as an outpatient in our surgery center.
Q: Do podiatrists prescribe medications and perform surgeries?    
A: Yes, the practice of podiatric medicine means the diagnosis or medical, surgical, palliative and mechanical treatment of ailments of the foot and leg. This includes prescription medications, surgery and any other modalities of treatment.
Let me take this opportunity to outline the medical training of a Podiatrist or Doctor of Podiatric Medicine (D.P.M.).
Most students upon entering podiatry school have received a four-year college degree. Podiatry school is an additional four years of study. The first two years consist of basic medical sciences as are taught at M.D. and D.O. schools. The third and fourth years focus on the study of the lower extremity with rotations in the school clinic and affiliated medical training facilities.

After graduation the Doctor of Podiatric Medicine obtains a residency program where they gain experience and knowledge in hands on care of patients. The residencies are surgical, general medicine or a combination of the two. After this one goes into private or group practice. Podiatrists attend continuing medical education courses to keep abreast of new information and technologies in medicine.

Q: I’ve had a “sore” on my leg for several months. I’ve used Neosporin and gauze but it won’t heal. The sore hurts, drains and my legs swell. What can I do?    
A: Most likely you are describing a venous stasis ulcer. Disease of the veins causes blood to pool in the legs, which creates swelling and fullness. The ulcers commonly occur on the anterior or medial portion of the leg and tend to drain much fluid. They may appear spontaneously or after bumping your leg against something. A hallmark for these ulcers is rust or brown pigment of the skin of the legs caused by leakage of iron from slow moving blood.

Treatment must involve reduction of fluid in the lower limb via diuretics (fluid pills), compression bandages and elevation. Proper wound care is a must since some bandages and topical ointments may actually prevent healing. Certain exercises, when not contraindicated by other medical problems, may improve the situation by allowing the calf muscles to pump the blood out of the leg. Standing or sitting for long periods of time will aggravate the problem. Our physicians specialize in wound care and can evaluate your concern and begin appropriate treatment.

Q: Recently I’ve been having pain in the ball of my foot under the area of the 2nd toe. It aches after a full day of work when I am wearing my “dress” shoes. What could this be?  
 A: You are describing a condition known as metatarsalgia. However, this is a general term. A number of problems may be the specific cause. These include but are not limited to neuroma, capsulitis, bursitis, tendonitis, stress fracture, soft tissue tumor, hammertoe, arthritis and over-pronation. Tight calf muscle and high heeled or narrow toe shoes can aggravate this condition.

The most common cause for the pain you are describing is due to an imbalance in the forefoot causing weight to shift to the 2nd toe joint area. The toe may contract and further aggravate the problem. The treatment would involve re-balancing the forefoot and reduction of any digital contraction. Some of this can be addressed with the use of custom inserts made from a mold of your foot. Prevention of excessive pathological motion and accommodation to relieve pressure in the area of your pain should help reduce or eliminate your problem.

Q: I’ve been treated for plantar fasciitis with cortisone shots, naproxen, heel pads and ultrasound but it has not helped. I was told the surgery would “lay me up” for a long time. What’s left to do? 
A: Since nothing has worked I’d recommend that you be evaluated for other causes. If no other cause can be determined custom inserts made from a mold of your foot would be the next step. Prevention of excessive pronation in a flat foot or supporting a high arch foot will relieve the pull on the fascia and the pressure on the heel to help reduce or eliminate your problem.

If orthotics are not successful newer approaches to heel spur surgery can be employed to reduce the recovery period and return you to your usual activities in much less time. Endoscopic equipment and instruments designed to work through small incisions can greatly reduce your post-operative recovery period.

Q: I’ve been treating a wound on my big toe for six months and it has not healed. I have type II diabetes and worried it won’t heal.    
A: Treatment must begin with strict control of your blood sugar levels under the supervision of your primary care physician or internist. Elevated blood sugar levels will impede healing.

The doctors at ACPM Podiatry Group are trained in wound care. We will obtain a thorough history of your concern, past medical history and perform a physical examination to determine the exact cause of the wound. Based on the findings a specific therapy will be developed to obtain the quickest healing. Some or all of the following will be required to allow healing to occur: antibiotics, wound cleansers and dressings, devices to relieve pressure from the area, restoration of blood supply when needed and removal of unhealthy tissue. New developments and technologies in wound care are improving outcomes and helping prevent lower limb amputations.

Q: I have started walking everyday for exercise. What brand of shoes do you recommend?  
A: There is no one brand of shoes that will fit all people well. But, I will give you some information on shoes that will help you find what will work best.

Buy a shoe made specifically for walking. Do not wear a running shoe to walk and vice versa. Have the salesperson measure your foot since our feet elongate and widen over time.

The soles should be thick enough to dissipate pressure on your heel as it contacts the ground. If you have a rigid high arch buy a softer sole, if your arch tends to collapse a harder sole works best. The upper and heel counter should allow for firm support and complete contour to your foot. The toe box should be roomy and not pinch your toes from side to side or from top to bottom. The vamp (tongue) should be comfortable and not irritate the top of your foot. The shoe should be comfortable when you first put it on, it should not need a “break in period” to feel good.

Q: My child is 12 months old and just started walking. Her feet look very flat. Her pediatrician said she’d grow out of it. What do you think?  
A: Children at that age tend to have a lot of fat padding in the arch area. This is normal but it tends to make the foot appear flat. Often times as they mature the padding reduces and the arch appears more noticeable. But there are times when a child truly has a flat foot even after the pad shrinks.

From infancy to adulthood your child’s lower limb and feet will go through many developmental changes. Sometimes these changes are not normal and can create permanent deformities. Therefore, if you see something that does not look right you should seek podiatric consultation. A podiatrist can perform and thorough examination of your child’s lower limb and feet.

Most of the time at this young age the problem can be addressed with the use of custom inserts. Prevention of excessive pathological motion while supporting the arch may allow correction and normal development. Our physicians who are trained in casting for prescription orthopedic foot appliances can take impressions of her feet and order the proper devices.

Frequently Asked
Patient Information
Privacy Policy
Copyright © 2012 ACPM Podiatry Group, Ltd.
Website designed by Peoria Logo