Preventing & Eliminating Fungal Toenails

Also known as onychomycosis, toenail fungus can be painful, irritating and embarrassing. When there is trauma to the nail, the nail bed is lifted allowing fungus to penetrate and invade the nail bed. Without treatment, the fungus can grow and spread in dark, warm, moist environments, such as socks and shoes.

Common signs and symptoms of toenail fungus include:

• Discoloring or yellowing of the nail
• Thickening or crumbling of the nail
• Swelling around the nail
• Disfigured nails
• Streaks or spots down the side of the nail
• Foul-smelling debris under the nail
• Pain and discomfort
• Complete nail loss

Prevention is key

Fungal infections can affect the fingernails as well as the toenails, but toenail fungus is more difficult to treat because toenails grow more slowly. Because removal of the fungus is challenging, prevention plays an important role in treatment.

• Keep nails neatly trimmed
• Practice good foot hygiene, including daily washing with soap and water; drying feet and toes carefully; and changing shoes regularly
• Always wear shoes in public areas, such as showers, locker rooms and pools
• Wear comfortable shoes that aren't too tight
• Avoid nail polish which can seal in fungus

Treatment of toenail fungus

If you do develop toenail fungus, especially if the infection becomes painful, visit Gary Evans, DPM. People with a chronic illness like diabetes should always see a podiatrist if they notice changes in their nails as it may be an indication of more serious problems.

To eliminate the fungus, a podiatrist may remove as much of the infected nail as possible by trimming, filing or dissolving it. Oral or topical antifungal medications may also be prescribed to treat the infection. Only for severe, chronic infections will surgical removal of the nail be recommended. Our New York office can help diagnose the cause of your toenail problems and make the best recommendation for treatment.

Maybe you've heard of carpal tunnel syndrome, a condition in the wrist that occurs when swelling or a change in position of the tissue within the carpal tunnel squeezes and irritates the median nerve. Similar to carpal tunnel syndrome is tarsal tunnel syndrome, an ankle condition that occurs from the compression of a nerve in a confined space.

What is tarsal tunnel syndrome?

The tarsal tunnel is a narrow space located on the inside of the ankle next to the ankle bones. Protected by the tarsal tunnel are many arteries, veins, tendons and nerves, one of which is the posterior tibial nerve- the main focus of tarsal tunnel syndrome.

Tarsal tunnel syndrome is caused from a compression on the posterior tibial nerve. Causes include:

• Injury to the ankle, which may produce swelling near the nerve
• Abnormal blood vessels or cysts that occupy space within the tunnel
• Scar tissue that press against the nerve
• Foot deformities, such as flat feet which increase strain on the nerve
• Systematic diseases, such as diabetes or arthritis

When patients visit us at our New York office with tarsal tunnel syndrome, they often experience one or more symptoms, usually felt on the bottom of the foot or the inside of the ankle. In some cases, the pain may extend to the heel, arch, toes and calf. Symptoms include:

• Pain
• Numbness
• Burning or tingling sensation

Gary Evans, DPM can help

Whenever you experience pain, burning and tingling in your feet or toes, make an appointment with our New York office. Left untreated, tarsal tunnel syndrome could result in permanent nerve damage. Treatment for tarsal tunnel syndrome varies depending on the severity of your condition. Anti-inflammatory medications, cortisone injections, immobilization, rest and modifications in footwear are a few methods used to treat the damaged nerve and reduce the pain. When non-surgical treatments are unsuccessful, surgery may be recommended.

Although a shin splint is commonly used to describe various pains between the ankle and the knee, it actually refers to a specific inflammatory condition of the tibia -- a condition called medial tibial stress syndrome.

A type of "overuse injury" to the legs, the most common causes of shin splints include excessive running, poor conditioning and over-pronation (flattening of the arch). The result is pain in the front or inside of the lower leg that usually gets worse with a sudden increase in distance or intensity of training. Shin splints are a common problem for many runners and athletes. Muscle weakness, non-supportive shoes and overtraining are also contributing factors.

To prevent shin splints, warm up and stretch muscles before starting any work out activity and choose supportive footwear. Begin work outs gradually and avoid over-training. All of these methods will go a long way in helping to prevent many lower leg problems. Conservative treatment for most shin splint pain includes rest, ice, compression and elevation. Strengthening exercises, anti-inflammatory agents and custom foot orthotics may also be recommended to reduce symptoms.

Shin pain isn't always indicative of a shin splint. Lower leg pain may actually signal a more serious problem, including a stress fracture, partial muscle tear and tendonitis, all of which require special treatment. Always seek the professional care of a podiatrist if:

• Severe pain in your shin follows an injury
• Your shin is hot and inflamed
• Swelling in your shin increases
• Shin pain persists during rest

Proper diagnosis of the cause of pain is necessary in order to administer the most appropriate treatment. If you suffer from shin pain, visit Gary Evans, DPM for an evaluation and proper treatment.

Looking fabulous in your favorite pair of heels does have a price. In fact, poor fitting shoes are a frequent cause of foot problems and discomfort, including calluses, corns, bunions and blisters, just to name a few.

All footwear eventually shows signs of wear and tear. Inspect the condition of your own shoes, and if they appear stretched out or worn, you probably need a new pair. Creasing of the midsole is also a good indication that your shoes have lost their cushion and support.

Maximize Fit, Minimize Discomfort: How to choose the best shoes for your feet

The following tips can help you avoid purchasing a pair of shoes that may contribute to a long list of foot problems.

• Try on shoes late in the day, when the feet tend to be a bit larger due to natural swelling
• Women should opt for low, stable heels
• Try on both shoes to be sure that they fit comfortably on both feet
• Choose breathable shoe materials, such as leather to prevent excessive sweating and blisters
• Have your feet measured to ensure the best fit
• Avoid pointy-toed shoes which cause bunions and hammertoes
• Walk around the store with both shoes on to make sure the fit is comfortable
• For athletes, choose shoes that are specific to the sport you play
• Choose the right shoe for your foot type (e.g. if you have flat feet, select shoes with good arch support)

Still not ready to part with your favorite pair of sneakers or trendy heels? Not sure if the shoes you currently wear are right for your feet? Visit us at Gary Evans, DPM. A professional podiatrist at our New York office can evaluate the condition of your feet and work with you to find the best pair of shoes for your feet.

During pregnancy, it's not uncommon for women to experience an array of aches and pains all over the body. Among these complaints are tired, swollen, achy feet- a common and painful symptom experienced by mothers-to-be during their nine months of pregnancy.

One of the most common foot problems that occur during pregnancy is swelling, or edema, which results from the extra accumulation of blood. The natural weight gain and enlarging uterus puts pressure on the veins that lead to the legs, causing circulation to slow down and increasing fluid retention. The legs and feet may become swollen, making shoes tight, and in some cases causing pain and discomfort. Slight swelling during pregnancy is normal and usually subsides after giving birth. Women should pay close attention to edema symptoms. Swelling to the face or a sudden onset of swelling could be a sign of a more serious condition called preeclampsia and should be reported immediately.

Another troubling foot problem that can occur during pregnancy is over-pronation (flat feet) which is caused when a person's arch flattens out upon weight bearing causing the feet to turn in abnormally. This condition develops when the dense band of tissue in the arch of the foot called the plantar fascia becomes strained and inflamed due to increased flattening of the feet. Over-pronation is common in pregnancy due to the increased weight gain which stresses the feet and flattens the arches. Walking can become very painful, and women may experience increased discomfort and strain on the feet, calves and back.

There are various remedies available to help minimize and alleviate foot pain during pregnancy.

• Take short breaks during the day and elevate your feet to relieve pressure and swelling.
• Drink plenty of water.
• Wear shoes that are soft, comfortable and give your feet room to move.
• Wear seamless socks that do not constrict circulation.
• Exercise or walk regularly to promote overall health.
• Stretch legs frequently and avoid crossing your legs when sitting.
• To prevent arch pain, stretch daily, avoid going barefoot and wear supportive low-heeled shoes.

When foot pain persists, visit Gary Evans, DPM. We'll work with you to find the best treatments for your foot pain. Pregnancy and pending motherhood should be a pleasant, enjoyable experience. Understanding the causes of foot pain and learning easy home remedies can help women step more comfortably throughout these special nine months.