Common Foot and Ankle Conditions page 3
Alaska Foot & Ankle Specialists (AFAS) is an entire clinic dedicated exclusively to diseases and conditions of the foot and ankle. Whatever your condition, the providers at AFAS have the training and experience to provide a solution.
Below is an interactive list with 14 more foot and ankle conditions. Click on each title to learn more:
Morton’s neuroma is an enlarged nerve that usually occurs between the third and fourth toes. The pain can be sharp or dull and is worsened by wearing shoes and walking.
Pain is usually less severe when the foot is not bearing weight. Flat feet can cause the nerve to be pulled, thus causing irritation and possibly enlargement of the nerve. The syndrome is more common in women than men, possibly because women wear more confining shoes and high heels.
Staphylococcus aureus is a type of bacteria that can be spread through the skin or open wound contact and is known to cause serious illness and infection if contracted.
In recent years, certain types of staph bacteria, such as drug-resistant MRSA (methicillin-resistant staphylococcus aureus), have become more common in high-traffic community areas, such as pool decks, locker rooms and schools. Those walking barefoot and suffering from common, relatively minor foot problems, such as cuts, cracks in the skin, athlete’s foot, eczema, ingrown toenails, puncture wounds or corns and calluses, can be at higher risk for infection. These conditions can cause minor tears in the skin, which can act as portals for the bacteria to enter the body.
AFAS foot-and-ankle doctors recommend simple steps to help prevent community-associated MRSA infections:
• Wash and bandage cuts.
• See a doctor within 24 hours for any puncture wound.
• Never perform “bathroom surgeries” to cut or dig out an ingrown toenail.
• Keep feet clean and dry to prevent fungal infections, such as athlete’s foot.
Osteoarthritis is a condition characterized by the breakdown and eventual loss of cartilage in one or more joints. Cartilage (the connective tissue found at the end of the bones in the joints) protects and cushions the bones during movement. When cartilage deteriorates or is lost, symptoms develop that can restrict one’s ability to easily perform daily activities.
Osteoarthritis is also known as degenerative arthritis, reflecting its nature to develop as part of the aging process. As the most common form of arthritis, osteoarthritis affects millions of Americans. Some people refer to osteoarthritis simply as arthritis, even though there are many different types of arthritis.
Osteoarthritis appears at various joints throughout the body, including the hands, feet, spine, hips and knees. In the foot, the disease most frequently occurs in the big toe, although it is also often found in the midfoot and ankle.
Osteoporosis, which means “porous bone,” is a condition in which bones become weak and thin due to lack of calcium and/or vitamin D. People with osteoporosis have an increased risk of bone fractures (breaks).
Osteoporosis is often called the “silent disease” because many people do not realize they have it. However, pain can occur when a bone becomes so weak that it breaks.
Osteoporosis is most commonly seen in women over age 50, but younger people and men can also have it. While the bones of the spine, hip and wrist are the most common bones to become fractured as a result of osteoporosis, metatarsals and other bones in the feet can be affected. In fact, some people first find out they have osteoporosis because of a fracture in the foot.
Commonly referred to as “poor circulation,” peripheral arterial disease (PAD) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.
The presence of PAD may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke, or the heart, causing a heart attack.
Most people have no symptoms during the early stages of PAD. Often, by the time symptoms are noticed, the arteries are already significantly blocked.
Common symptoms of PAD include:
• Leg pain (cramping) that occurs while walking
• Leg pain (cramping) that occurs while lying down
• Leg numbness or weakness
• Cold legs or feet
• Sores that will not heal on toes, feet or legs
• A change in leg color
• Loss of hair on the feet and legs
• Changes in toenail color and thickness
If any of these symptoms are present, it is important to discuss them with a foot and ankle doctor. Left untreated, PAD can lead to debilitating and limb-threatening consequences.
Pigeon toes (intoeing) is a condition in which the feet point inward when walking. It is commonly seen in children and may resolve in very early childhood with no treatment or intervention.
The child should be examined by a foot-and-ankle doctor if the intoeing causes significant tripping, difficulty with normal activity, pain, difficulty with shoes or is not resolved in early childhood.
There may be structural problems causing the intoeing, which require treatment by a foot and ankle surgeon.
Raynaud’s phenomenon is a condition that results in a bluish-white discoloration of fingers and toes, often as a result of exposure to cold. Stress, smoking and certain medications may trigger or worsen symptoms. The color change, which occurs from spasms in small blood vessels, becomes red then returns to normal when blood flow resumes.
The condition most often affects women, with symptoms varying depending on the severity of the condition. Because there are no specific blood tests to diagnose this condition, the diagnosis is based on symptoms.
However, your doctor may order blood tests to determine whether the Raynaud’s phenomenon is associated with certain autoimmune diseases or other medical conditions.
Treatment for Raynaud’s phenomenon is aimed at prevention and protection of the toes and fingers.
Shin splints is a term to describe pain and swelling in the front of the lower legs. It is an inflammation in the shin resulting from the repeated pull of a muscle in the leg from the shin bone (tibia).
Pain usually appears after and is aggravated by repetitive activities, such as running or walking. Contributing causes are flat feet, calf tightness, improper training techniques, worn-out or improper shoes/sneakers as well as running or walking on uneven surfaces.
This condition usually occurs bilaterally (both legs) and can be alleviated by rest, use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, icing, a change in training habits, stretching exercises and properly fitted shoes.
AFAS doctors and nurses can treat the condition, recommend proper shoe gear and evaluate whether orthotics are needed. If not treated, shin splints may eventually result in a stress fracture of the shin bone.
Depending on the sport, your feet and ankles can certainly take a beating from repetitive play. For more information on injury-risk factors while playing your favorite sport, see the topics listed below.
• Field Hockey
• Football Injuries
• Golf Injuries
AFAS doctors and nurses offer a range of treatment options for virtually every sports injury.
Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. The tunnel is covered with a thick ligament (the flexor retinaculum) that protects and maintains the structures contained within the tunnel—arteries, veins, tendons and nerves. One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space.
Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve:
• A person with flat feet is at risk for developing tarsal tunnel syndrome, because the outward tilting of the heel that occurs with fallen arches can produce strain and compression on the nerve.
• An enlarged or abnormal structure that occupies space within the tunnel can compress the nerve. Some examples include a varicose vein, ganglion cyst, swollen tendon or arthritic bone spur.
• An injury, such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve.
• Systemic diseases, such as diabetes or arthritis, can cause swelling, thus compressing the nerve.
Ulcers, which are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed.
Ulcers can be caused by excess pressure due to ill-fitting shoes, long periods in bed or after an injury that breaks the skin. They are commonly seen in patients living with diabetes, neuropathy or vascular disease. Open wounds can put patients at increased risk of developing infection in the skin and bones.
The signs and symptoms of ulcers may include drainage, odor or red, inflamed, thickened tissue. Pain may or may not be present.
Diagnosis may include X-rays to evaluate possible bone involvement. Other advanced imaging studies may also be ordered to evaluate for vascular disease, which may affect a patient’s ability to heal the wound.
Ulcers are treated by removing the unhealthy tissue and performing local wound care to assist in healing. Special shoes or padding may be used to remove excess pressure on the area. If infection is present, antibiotics will be necessary. In severe cases that involve extensive infection or are slow to heal, surgery or other advanced wound-care treatments may be necessary.
Varicose veins are usually due to improperly functioning valves within the veins. The veins typically appear prominent or look raised.
The condition can cause swelling of the legs, ankles and feet. The skin may become discolored due to leakage of blood into the surrounding tissues, and ulcers may form on the skin.
A wart is a small growth on the skin that develops when the skin is infected by a virus.
Warts can develop anywhere on the foot, but they typically appear on the bottom (plantar side) of the foot. Plantar warts most commonly occur in children, adolescents and the elderly.
Plantar warts are caused by direct contact with the human papilloma virus (HPV). This is the same virus that causes warts on other areas of the body.
There are two types of plantar warts:
• A solitary wart, which often increases in size and may eventually multiply, forming additional satellite warts.
• Mosaic warts are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts.
The symptoms of a plantar wart may include:
• Thickened skin. A plantar wart often resembles a callus because of its tough, thick tissue.
• Pain. Walking and standing may be painful. Squeezing the sides of the wart may also cause pain.
• Tiny black dots. These often appear on the surface of the wart. The dots are actually dried blood contained in the capillaries (tiny blood vessels). Plantar warts grow deep into the skin. Usually, this growth occurs slowly with the wart starting small and becoming larger over time.
The most common cause of yellow discoloration in the toenails is a fungal infection. The fungus often develops underneath the nail, resulting in it becoming thick, raised and yellow in color.
Other potential causes for yellow discoloration of the nail include diabetes mellitus and lymphedema (chronic leg swelling). Yellow staining of the nails can also occur in individuals who use nail polish. A stained nail may take several months to grow out.