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Tips For Patients With Toenail Fungus | The Podiatrist and yourfeetnz

fungal nail infections need not ruin your summer

Now that summer is here, many people begin to lose sight of the appearance of their toes. While people will begin to bring out their open- toed shoes and sandals, it is important to continue to maintain healthy, happy toes during the summer.
Toenail fungus is a fungal condition that develops when fungus enters and grows beneath the toenail. Although it can also affect fingernails, toenail fungus is more likely to occur in feet rather than hands. Patients can develop toenail fungus from an array of different sources. In many cases, it can be hard to diagnose the exact cause of toenail fungus, which makes it harder to prevent reoccurrence. The fungus that is responsible for the infection tends to thrive best in warm and wet environments, such as the shower or locker room.
By following basic foot care guidelines patients can head off most common foot fungus problems. Toenail fungus thrives in warm, damp places. For this reason, The Podiatrist urges patients to take extra precautions in pools and locker rooms. Patients should also wear dry cotton socks-changing them two or three times a day if needed.
It is also important to remember not to share shoes or socks with anyone, as this fungus can easily spread through sharing of shoes or socks. This is the same for nail clippers or nail files-don’t share. By taking extra precautions you can ensure the health of your toes and fee.
For all your foot problems, see The Podiatrist
http://www.thepodiatrist.co.nz

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Pain in the ball of the foot- The Podiatrist | YourFeetNZ

forefoot pain

Pain at the ball of the foot, or the forefoot, is a common complaint in athletes. The forefoot is the part of the foot in front of the ankle consisting of groups of bones that include the metatarsals (five long bones in the forefoot) and phalanges (the bones that make up the toes). There are many medical issues that can arise in this region due to trauma, overuse, or other factors. Forefoot pain can range from mild pain causing a slight limp to severe pain that prevents walking. Common causes include: stress fracture, interdigital neuroma (also known as Morton neuroma), and sesamoiditis.
Stress fractures
A stress fracture is one of the more concerning potential causes of your discomfort. Metatarsal stress fractures result from repetitive stress to the forefoot, usually from running, jumping, dancing, and other repetitive weight-bearing activities. Patients with stress fractures of the metatarsal shaft describe a history of gradually worsening pain in the forefoot. Initially the pain is intermittent and occurs only with use. The patient may present with poorly defined forefoot pain or point tenderness over a metatarsal shaft. If the causative activity continues, the injury can progress, with swelling, severe pain even with normal activities, and frank fracture.
Diagnosis is made using history, physical exam, and potentially imaging studies. They usually respond well to cessation of the causative activity. Crutches and partial weight-bearing for several weeks may be helpful in patients who have pain with walking. A short-leg cast and non-weight-bearing may be used for short periods of time in patients with severe pain.
Interdigital neuroma
Interdigital neuromas are thought to be due to swelling and scar tissue formation on the small interdigital nerves. They most commonly involve the third webspace, but may also be seen in the second and fourth. Symptoms associated with a neuroma may include sharp or shooting pain, numbness, or pins and needle sensation. Many patients describe it as feeling like something is wadded up under the toes. It frequently can be temporarily relieved by removing the shoes and massaging the area.
Neuromas can be caused by trauma or chronic irritation. Chronic irritation can be in the form of wearing shoes that are not wide enough in the forefoot area causing compression of nerve. The irritation may also occur from abnormal mechanics of the foot causing excess motion of the metatarsal bones.
Diagnosis can be made by using elements of the history and physical exam, or by imaging studies such as ultrasound or MRI. Conservative treatment may include use of properly fit shoes (well cushioned with wide forefoot), metatarsal foot pads (to evenly distribute pressure to the metatarsal heads), and physical therapy (to address mechanics and strengthen the intrinsic muscles of the foot). If conservative treatment fails, injection therapy and surgery are also considerations.
Inflammation
Inflammation or injury of the sesamoid bones located on the plantar surface of the big toe joint can also cause pain in athletes. The sesamoids are pea-sized bones that function as pulleys for tendons (just as the patella does for the knee extensors) and assist with weightbearing. The athlete with sesamoiditis typically complains of pain at the area of the big toe joint with weightbearing that is exacerbated by walking, and even more so by running. Exquisite tenderness of the sesamoids is present, and is exacerbated by pushing off with the great toe. Imaging may be required to differentiate between sesamoiditis and a stress fracture. Both may require a short period of immobilization followed by prolonged rest from weightbearing activity. Athletes can use alternative, nonweightbearing forms of exercise to maintain fitness. Treatment with custom orthotics, soft pads cut to relieve pressure on the sesamoids, and in severe cases, glucocorticoid injections may be helpful. Consultation with a foot surgeon is reasonable in persistent cases.
These are just a few of the potential causes of your pain, however there are many other potential causes of forefoot pain. Discussion with The Podiatrist is advised. A specific diagnosis can then be made, after a full history and physical is performed. Appropriate treatment can also then be discussed.

See The Podiatrist for all your foot problems.
http://www.thepodiatrist.co.nz