Here at Friendly Foot Care we provide our patients with the latest in leading edge foot and ankle care. In fact, between Drs. Nirenberg and Minhas there are few foot or ankle problems we cannot treat. Here are some of the more common problems we see:
Friendly Foot Care is now using new, breakthrough techniques which can often alleviate burning, tingling, numbness and shooting pain. These techniques were learned from hands-on experience with the doctor who developed them—Lee Dellon M.D., professor of Plastic Surgery and Neurosurgery at Johns Hopkins University School of Medicine in Baltimore.
We are among a handful of physicians who alleviate nerve and neuropathy problems using techniques developed by Dr. Dellon – one of the top peripheral neurosurgeons in the world (http://www.dellon.com). Patients who experience burning, numbness, tingling, shooting pain or abnormal sensation in their feet or ankles, could have neuropathy or a “pinched” nerve. Alleviating these problems is something that we specialize in.
Heels get a bad rap. The dictionary defines a heel as a dishonorable person, and the term “Achilles’ heel” refers to a fatal weakness. The reality is our heels are quite strong, though no other part of our foot malfunctions more. Heel pain is the number one problem we treat.
Heel pain can be very complicated and may have a variety of causes, including a stress fracture, pinched nerve, bone cyst, or tumor. Most patients with heel pain believe they have a heel spur (also called heel spur syndrome). This may be part of the problem, but the most common cause of heel pain—whether or not a heel spur is also present—is inflammation of the largest ligament in our foot, the plantar fascia. In doctor-speak this problem is called plantar fasciitis.
Treatments for plantar fasciitis range from custom-made arch supports (called orthotics), to special stretching exercises, to the revolutionary, high-tech shockwave treatment. In some cases, we will use a hi-tech camera (called an endoscopic camera) to enter the heel through a tiny opening and with a very small surgical instrument we loosen (release) the inflamed ligament. To learn more about this “endoscopic” procedure Click Here.
Degenerative joint disease, osteoarthritis, or just plain old “Arthur” is a deterioration of the joints between our bones. When Arthur visits people’s feet or ankles, many believe they just have to live with it. This is far from the truth. The reality is we have many techniques that may help alleviate arthritis for you, including a high-tech, tiny arthroscopic camera that can remove arthritis from sore ankles. To learn more about our arthroscopic procedures for arthritis, please Click Here.
Often, flat feet or fallen arches can not only cause pain in the feet and ankles, but amy affect the knees, legs, hips and back. Usually, these problems can be alleviated with our foot orthotics.In some cases, particularly with younger patients, we can actually create an arch for persons with flat feet by sliding a small implant between the bones of the foot.
We love fixing bunions and bunion surgery has become quite advanced and hi-tech these days. We use a variety of methods to remove bunions, from the Swiss technique, to minimal incision surgery methods, to implants and tendon balancing procedures. Often, bunion removal surgery is done on an “out-patient” basis with the patient sedated or under “twilight sleep.” Usually, the procedure takes about 25 to 30 minutes and you can walk that day in a special “surgery” shoe without crutches or even a cane, though most people need to limit their activity initially.
To learn more about how our podiatrists treat bunions, please visit our bunion surgery page by Clicking Here.
When your big toe has arthritis (hallux rigidus) it may look normal; however the inside of the joint at the base of the big toe becomes deteriorated and painful. Sometimes the big toe won’t bend completely or in severe cases, not at all. We usually start by taking an x-ray of the foot to see the extent of the arthritis. Like bunions, simple treatments can lessen the pain, and in on some cases surgery is necessary.
Runners, walkers, dancers, and other athletes experience a wide range of sport medicine problems, from simple heel or arch pain to tendonitis to ankle sprains, shin splints, weak ankles or ankle sprains, and fractures. We know how important athletics are to these people and we work with them to get them well while trying to find ways to keep them active. A big part of sports medicine is using gait analysis and custom made orthotics to alleviate pain, improve biomechanics, and prevent injury. To learn more about sports medicine click here.
These occur in the toes of people of all ages, and can become very sore and even infected. Ingrown toe nails are also one of he most common problems we see. They are usually taken care of with a simple procedure that only takes a couple of minutes.
Toenails take a lot of abuse and thick, dark, yellow, cracking or brittle toenails may be a sign that fungus (ringworm) has infected them or other problems. These nails may or may not be painful, but we should still check them. In rare cases, toenails can develop cancer and if we suspect a serious problem, we work with a pathology lab that specializes in analyzing these types of problems. For most routine toenail problems, treatments include topical creams and gels, pills or in severe cases, removal of the toenail.
Bent or crooked toes are often unsightly and can develop painful corns. A hammertoe is not the same as a hammer-thumb, which occurs when I try to put a nail in the wall! A hammertoe occurs when a toe becomes bent or contracted. These toes may be sore or have a painful corn on them. Bent and crooked toes often start to form slowly and worsen with time. We often correct these problems with a short out-patient procedure.
Many people believe they have to live with weak ankles, frequent ankle sprains or ankles that “give out” on them. This is not the case! Our doctors use a variety of treatments for people who have ankle weakness or who endure repeat ankle sprains, and the good news is that most of these people do not need surgery.
A neuroma (Morton’s neuroma) is a condition that arises from irritation of a nerve and the possible formation of scar tissue around the nerve. It occurs most commonly in the small nerve that runs through the ball of the foot. Most neuromas can usually be alleviated in the office, without surgery.
Almost everyone has heard of carpal tunnel syndrome which affects the hands, but few people realize the same problem occurs in our feet. Tarsal tunnel syndrome may cause burning, tingling, shooting pain, or a cramping pain in our heel or the bottom of our foot. The good news is that there is a light at the end of this tunnel. Tarsal tunnel syndrome is often easily treated with orthotics, injections or a short, outpatient procedure.
Sore, achy heels or feet and foot cramps can come on suddenly and go away in a few minutes or they can persist for days and even months. Foot cramps may occur when people try to walk or at night when lying in bed. Foot cramps can be due several different reasons, including a pinched nerve, muscle spasms, poor circulation or poor footwear. Our doctors can often alleviate sore, cramping feet quickly and without the need for surgery.
Ligaments are special important tissues that help hold the bones of our feet and ankles in their proper position. When ligaments become sprained, strained, injured or outright torn, our feet and ankles can become weak or painful. We may feel unsteady while walking or our feet or ankles may give out at times. Often these problems can be treated without the need for surgery.
Some people may be born with an abnormality or deformity of their foot, ankle or toes, or they may develop a deformity over time. Problems can also be the result of a traumatic injury or accident. Sometimes just the strain of walking day in and day out can cause pain or problems to develop. Regardless, of how the deformity came about, our doctors see these types of problems often.
As people in Northwest Indiana and elsewhere age, our heels, feet and ankles
often begin to develop painful conditions and problems. These problems can range from heel pain (heel spurs or plantar fascistic) to foot and ankle arthritis or osteoporosis to simply a feeling of weakness in the ankles. It is important that the feet and ankles of our seniors get all the help they can and our doctors are pros at giving our older, mature patients feet and ankles special attention.
Our feet take a beating and as a result, may develop an open wound (foot ulcer) or even become infected. Sometimes even simple problems, such as ingrown toe nails, can become infected. It is important to treat any open sores, wounds or infections promptly.
Even when we walk in the safest places, if we are not careful, we can step on foreign objects such as pieces of glass or metal. When these foreign objects (or foreign bodies) become stuck inside our foot, they can become painful. Often, the doctor will perform a small procedure to remove the object or splinter.
Dry, cracked skin on our heels and feet occurs when skin thickens and breaks open (fissures), and since our heels are the first part of our body to hit the floor, dry skin can make our heels very sore and painful. Infection can also occur if this problem is left untreated. Fortunately, the treatment is relatively is easy when caught early. Our doctors will usually prescribe a topical medication.
Our doctors do not treat poor circulation (PAD) but they do treat foot and ankle problems that can be caused by a lack of good circulation to the feet. These types of problems may include pain, infections, wounds, and open sores.
It is vital that all diabetic patients be committed to taking care of their feet properly and schedule an annual visit with us or another foot and ankle specialist. Diabetics are at risk for developing foot ulcers and infections, which if left untreated, could lead to gangrene or amputation. Common ailments, such as corns, calluses and ingrown toenails can become very serious and threatening conditions for a diabetic.
The doctors specialize in fitting diabetic patients with special diabetic shoes and custom – made diabetic inserts.
Corns and calluses are often due to areas of excessive pressure or friction between a shoe and a bony prominence or spur. Calluses are areas of thickened, tough skin generally found on the bottom of the foot. Corns are the rough, thickened skin irritations found on the tops and sides of the toes, very often the little toe, and are generally associated with bent or crooked toes. Most corns and calluses can be alleviated with a short out-patient procedure.
People who have Achilles tendon problems experience pain at the back of their leg or at the back of their heel. The Achilles tendon may be inflamed, irritated or even have a tear in it. By using our in-office, computerized ultrasound machine, we can often quickly examine the tendon and diagnosis the problem. We treat these problems in a variety of ways including sometimes making a special brace to limit the tendon’s movement, injections, or surgery.
One of the most common problems with patients is pain in the ball of one or both feet. This can be due to a number of different causes, such as a stress fracture, pinched nerve, tendon injury, arthritis or simply inflammation. Oftentimes, more than one problem will contribute to causing the pain in the ball of the foot. The majority of people who have pain in the ball of their foot can be treated easily, quickly and usually without surgery.
Known as the “rich man’s disease,” gout doesn’t just affect the rich. Gout is a type of arthritis that most often occurs in the joint at the base of the great toe, causing redness, swelling, and pain. Some patients say the pain was so severe that they couldn’t stand their bed sheet resting on their toe. Other patients describe less intense pain.
Gout occurs when too much uric acid is present in our body. Uric acid is a natural chemical that our bodies manufacture, and we ingest in certain foods, like pork or liver. Treatment consists of altering the patient’s diet to limit the amount of uric acid they ingest, and if that isn’t enough, medication is prescribed. For immediate relief, sometimes the doctor will give patients an injection
It’s important that your children start off on the right foot! Foot pain and problems in children is rarely normal and if your child is having pain, he or she needs to see us. Some of the common foot problems we see with children are warts, in-toeing, out-toeing, flat feet, ingrown toe nails, fractures and heel pain. Sometimes the first sign of foot problem is the child walking abnormally, or even tripping, falling or just not keeping up with their peers.
Athlete’s foot is not only for athletes! Athlete’s foot is a fungal infection of the foot and anyone can get them. These infections can make your feet smell awful and may make your skin dry, itchy, or red. You may even get open sores, blisters or fluid weeping from the skin. Sometimes fungal infections can occur between the toes, making the skin look whitish or macerated. We often clear up these problems quickly by prescribing cream or pills.
As foot doctors, we do not treat knee, hip or back problems. But, if your feet are affecting how your body is aligned, contributing to causing the pain in your knees, hips, back or elsewhere, we can address your foot issues. Often, flat feet (or even high arched feet) can throw off the alignment of your body, contributing to pain in your knees, hips, or back. Dr. Nirenberg first became interested in becoming a podiatrist when his father’s knee pain was alleviated by wearing custom-made orthotics (arch supports). Our doctors are big believers in the power of custom-made orthotics to help you walk better and feel better.
Spurs are protrusions of bone that form on your feet. Most people think of spurs as occurring on the bottom of heels, but spurs can be just about anywhere on the foot. They are usually associated with a muscle or ligament, and often are painful. We have numerous techniques to treat spurs.
Many people have tired, achy feet or ankles and believe these foot problems are due to growing older. Although aging may contribute to tired, achy feet, often other causes contribute to feet and ankles becoming tired, achy or outright sore. Our doctors will start by examining your feet and by identifying the underlying problem or problems. Your feet will soon be on their way to feeling strong and pain free.
Pump bumps are growths of bone that form at the back of your heel or heels. They can protrude from the back of your heels and cause pain when trying to wear shoes or walk. If you have heel pain at the back of your heel you may be starting to get a pump bump. We treat these with a simple brace, injection or out-patient surgery.
People with high arches often have more foot problems. High arches cause the force of us walking to be directed onto a smaller area—just our heel and ball of our foot. The result is often heel pain, forefoot pain and problems, and even ankle pain.
A bursa is a tiny bag of fluid found at various places throughout our body. In the foot these can occur at the back of the heel and the bottom of the heel. When these bursa become sore and inflamed, it is called bursitis. Bursitis of the heel is painful and people often find themselves limping.
Pronation and supination are normal motions that our foot goes through as we walk. Supination and pronation are mirror or opposite motions. Whenever we are walking, our foot is either supinating or pronating (or in-between the two, which we call neutral). Too much pronation can cause problems, such as heel pain (or plantar fasciitis), neuromas or other problems. Too much supination can lead to other painful conditions, such as weak ankles, stress fractures or other problems.
Plantar warts are viruses that can occur anywhere on our feet and even can form under toenails. Sometimes they can be painful and unsightly. Children tend to get warts more than adults do because their immune system is not fully developed. Warts are contagious and often continue to grow and spread—so the sooner we can treat them the better! We use a variety of measures to treat plantar warts, including topical medications and hi-tech lasers.
Persons with a tight Achilles tendon may suffer with pain at the back of the heel, ankle or lower leg when walking or standing. Often the achilles tendon is tight. At times, this Achilles tendon tightness may cause the ankle to not flex upward as much as it should and the patient may develop an equinus deformity.
Our doctors often alleviate tight Achilles tendons (or an equinus deformity) with a simple 10 to 15 minute out-patient procedure that lengthens the tendon through a very small incision
Often injuries or other problems can leave people with painful scars and scar tissue. We offer numerous treatments to alleviate them.
Any lump, bump, growth, or other lesion on our feet or ankles is often not normal. These may be simple cysts or moles, or in some cases aggressive tumors or cancer. Our doctors may treat these problems with creams or other medications, or may use the hi-tech laser.
Swelling of the feet or ankles can be due to many problems. You may have arthritis, and underlying medical problem or even a fracture or tumor.
Many of our patients have a difficult or painful time when walking or even standing. Other people experience excessive tiredness (or fatigue) when trying to walk. Some of our more senior patients relate that they feel unsteady when they walk. If you suffer with any of these problems when you walk or you simply become sore or achy, you are not alone. We see patients with these types of walking-related issues often. Our doctors will work to alleviate the problem quickly and make walking fun and invigorating again.
Shin splints can cause pain in your legs and around the ankles. Athletes, particularly runners or aggressive walkers, are prone to developing shin splints, but anyone can get them. Often, shin splints are due to faulty foot mechanics and in these cases, our doctor may make custom-made arch supports (orthotics) to alleviate the problem.
Our feet are often banged, bumped, kicked and if we drop our bowling ball, it seems to find our foot! With the variety of activities we do nowadays, our feet and ankles tend to end up sprained, strained and even fractured. Tendon tears, ankle sprains and other traumatic injuries can be serious. Most of these problems do not require surgery, much to our patients’ relief!
The doctors treat all foot and ankle work-related injuries, including fractures, sprains and tendon tears. In most cases, the doctors send regular reports to your employer’s workers compensation insurance carrier to keep them apprised of your medical care and work status.
Some people lose the fat under their heel or foot, either due to aging, systemic medical issues or other reasons. The fat on the bottom of our foot acts as important cushioning for us. Our foot and ankle experts utilize artificial skin substitutes, grafts and other “fillers,” to repair and replace areas under the foot that need more padding.
Patients who have complicated problems that may be the result of treatment or surgery from other podiatrists, orthopedic surgeons or other physicians should have Dr. Nirenberg review their prior care or medical records to see what options are available for them to feel better again. Dr. Nirenberg is one of the few forensic podiatrists in the U.S. Click Here.