Foot and Ankle Information

Foot and Ankle Pain

The foot and ankle are two of the most versatile and complex areas of your body. One foot alone contains 26 bones supported by a network of muscles, tendons, and ligaments. When everything is working well, you hardly give them a thought. But when a problem arises, it’s often impossible to ignore.

More than 11 million visits were made to physicians’ offices in 2003 because of foot and ankle problems, including more than 2 million visits for ankle sprains and strains and more than 800,000 visits for ankle fractures.* Some conditions that may affect your foot and/or ankle could be:

Your Treatment Options for Foot and Ankle Pain

Fortunately, most cases of foot and ankle pain respond well to treatments like rest, ice, orthotics (shoe inserts), prescribed exercises, and anti-inflammatory medications. Local cortisone injections can also provide pain relief.

However, when these medical treatments fail to provide adequate pain relief, surgery may be an option. Often foot and ankle surgery is performed on an outpatient basis using minimally invasive techniques. These techniques may mean less pain and less risk, as well as a faster recovery time.

Understanding Diabetic Foot Disorders

Preserving Life and Limb

Diabetes is a worldwide epidemic. Although the cause of diabetes is still unknown, we are learning more and more every day about this disease and the health problems it can create when not managed properly. According to the American Diabetes Association, nearly 7% of Americans have diabetes — that’s 20 million people. Many don’t even know they have it.

To understand diabetes is to understand a complex system of causes and effects — a lot like a row of dominoes standing on end. A person with diabetes cannot properly process food into energy. Their bodies just don’t produce enough of the hormone insulin to convert sugar into energy. This results in high blood sugar levels that can compromise the body’s intricate system of veins and arteries. The resulting poor circulation causes a host of serious conditions including the potential for blindness, kidney failure, heart disease and nerve damage, especially in the feet. Nerve damage desensitizes feet, leaving room for problems that go undetected so long that they cannot heal. In severe cases, the only option for some foot infections and other diabetic foot disorders is amputation.

How Can You Prevent the Domino Effect?

This website will answer some of the questions you may have about how diabetes may affect your feet and how you can help to protect yourself from serious foot problems. It also will help you better understand what to expect if you do develop foot disorders.

Why Focus on the Foot?

Normal, healthy feet will show wear and tear as we age. Our feet change over time, losing some of the padding that once cushioned our steps. For those with diabetes, there really is no such thing as normal wear and tear. If you or a loved one has been diagnosed with diabetes, you should be aware of potential problems and how to avoid them. Together, we can minimize the chances of a diabetic foot disorder from getting a “toehold” in your life.

What Are the Most Common Diabetic Foot Disorders?

Peripheral Neuropathy

Diabetes damages the nerves that help you detect sensations like pain. This nerve damage, or neuropathy, often affects peripheral body tissue first. Peripheral neuropathy may first appear as tingling or numbness in your fingers and toes. Over time, the nerve damage causes a lack of feeling in the toes and feet. The lack of feeling in the foot opens the door for many problems — ulcers of the foot tissue, infections, and, in severe cases, amputations of the toes, feet and legs.

As part of your diabetes management, be sure to have your physician carefully examine your feet every year. For some patients, feeling in the feet can be restored through new surgical techniques that alleviate pressure on compressed nerves.

Foot Ulcers

Diabetic ulcers are sores that develop in the soft tissue of the foot usually as a result of minor skin trauma or cumulative trauma in patients with loss of sensation in the foot. The lack of normal feeling in the foot means that these sores can exist without your feeling them. Ulcers are a leading cause of diabetic infections that if unresolved can lead to amputation of the affected limb. These ulcers will not heal on their own. If left untreated, the resulting infection may progress and can lead to increasingly extensive amputation the longer it goes untreated. Unfortunately, in many patients an amputation on one leg is followed within just a few years by amputation of the other.

Early detection of these ulcers can be critical in helping to prevent these amputations. By regularly visiting your foot and ankle specialist, frequently checking yourself, and seeking quick treatment for ulcers, you will be helping to prevent foot ulcers from compromising your mobility and your quality of life.

Understanding Foot and Ankle Arthritis

What Is Arthritis and Who Develops It?

Simply put, arthritis is inflammation of a joint. But there’s nothing simple about the pain or loss of mobility that can be associated with it. In fact, arthritis is the leading cause of disability in the United States. Although it can affect anyone, arthritis is mainly found in adults.


The most common form of arthritis, osteoarthritis (OA) typically affects older people. The cartilage that normally cushions and protects the bones of the joint breaks down over time. Eventually, bone rubs against bone, opening the door to inflammation and other mechanical problems like bone spurs.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disease process that may affect the entire body. The body’s immune response attacks the soft tissue in the joints causing inflammation and pain. Over time, the inflammation leads to compromises in the joint’s cartilage and bone.

Arthritis Caused by Injury

When cartilage in the joints is damaged by a trauma like a fracture or dislocation, arthritis may develop. Even properly treated injured joints are much more likely to develop arthritis than joints that have not been injured.

What Are the Symptoms of Arthritis?

Depending on which of the joints is affected, symptoms of arthritis vary. Typically, symptoms include pain, tenderness, swelling and difficulty moving the joint. Arthritis in the foot or ankle may make walking difficult and painful, reducing your activity level.

In order to diagnose you properly, your doctor will consider your symptoms, examine your feet, and take X-rays, a CT scan or MRI to get a clear view of the alignment of your toes and the condition of the joints in your feet.

Understanding Bunions

What Is a Bunion and Who Develops Them?

When you have a bunion, it looks like the joint at the base of the big toe has bulged out along the side of the foot. In that characteristic “bump,” you are actually seeing the effect of additional bone formation in the joint and a mechanical mis-alignment of the big toe (also called the great toe). A bunion causes the big toe to angle toward the smaller toes. This abnormal, and often painful, position is referred to as hallux valgus or hallux abducto valgus.

Although bunions affect women much more often than men, tight-fitting and high-heeled shoes are not the sole cause of bunions. Ill-fitting shoes may add to the problem, but some inherited factors may predispose certain people to the formation of bunions, including congenital abnormalities in bone formation, rheumatoid arthritis, nerve conditions and injury.

What Are the Symptoms of a Bunion?

Sometimes bunions cause no symptoms whatsoever, but most bunions cause intermittent (comes and goes) or chronic (persistent) pain at the base of the big toe. The pain may be worse when walking or wearing shoes, and it may feel better when resting. Very painful bunions may appear red and swollen, and feel tender to the touch.

In order to diagnose you properly, your doctor will consider your symptoms, examine your feet, and take X-rays to get a clear view of the alignment of your toes and the condition of the joints in your feet.

Pin Tract Care With External Fixation

What is External Fixation?

We’re all acquainted with the non-surgical approaches that help a broken bone heal: the doctor applies a cast, brace or splint around a fracture or a corrected bone deformity to provide support during the healing process. In some cases, however, particularly more severe injuries, today’s best orthopaedic treatment includes securing the fracture externally with a device called a fixator that is connected to the affected bone with special bone screws, often referred to as pins. The device remains outside the body (external) and the pins pass through the skin and muscle to secure the bone in proper alignment.

External fixation helps to maintain alignment of the fractured bone when a cast may be inadvisable. However, these devices do require that you take care of them and the pin sites to help prevent infection. Among other complications, an infection may create the need to remove the device and may compromise the proper healing of your fracture or repair.