Marysville Foot & Ankle Clinic
Telephone: (360) 653-3354
E-mail: tcskiles@marysvillefootclinic.com
9516 State Avenue Suite D
Marysville, WA 98270
Contact Method Preferred:
Information Request Submission Form
Toe & Nail Problems
Many nail problems can be prevented by wearing the right shoes and trimming your nails properly. To help avoid infection, keep your feet clean and dry. If you have diabetes, talk with your podiatrist before doing any foot self-care.
Ingrown Nails
An ingrown nail is the result of a nail growing into the skin that surrounds it. This often occurs at either edge of the big toe. Ingrown nails may be caused by improper trimming, inherited nail deformities, injuries, fungal infections, or pressure.
Symptoms & Evaluation
Ingrown nails may cause pain at the tip of the toe or all the way to the base of the toe. The pain is often worse while walking. An ingrown nail may also lead to infection, inflammation, or a more serious condition. If it's infected, you might see pus or redness.
To determine the extent of your problem, your podiatrist examines and possibly palpates (presses) the painful area. If other problems are suspected, blood tests, cultures, or x-rays may be done as well.
Treatment
If the nail isn't infected, your podiatrist may trim the corner of it to help relieve your symptoms. He or she may need to remove one side of your nail back to the cuticle. The base of the nail is then treated with a chemical to keep the ingrown part from growing back. Severe infections or ingrown nails may require antibiotics and temporary or permanent removal of a portion of the nail. To prevent pain, a local anesthetic may be used in these procedures. This treatment is usually done at your podiatrist's office.
Thickened Nails
Abnormally thick or crumbling nails may be caused by injuries, pressure from shoes, fungal infections, or conditions such as diabetes, psoriasis, or vascular disease. Eventually, the nail may loosen and fall off.
Symptoms & Evaluation
Along with thickening, the nail may appear ridged, brittle, or yellowish. The nail may also feel painful when pressure is put on it.
Since thickened nails may be a symptom of an underlying medical condition, it's important for your podiatrist to look at your medical history or possible related problems. To check for a fungal infection, a culture may be done. The thickness and color of the nail are also examined carefully to determine possible infections or other conditions.
Treatment
If the nail isn't infected, your podiatrist may be able to thin it by trimming, filing, or grinding. If a fungal infection is present, oral or topical antifungal medications may be needed. This can help prevent ulcerations under the nail while keeping the fungus from spreading to other nails. If pain is still present, the entire nail or part of it can be surgically removed. Do not remove the nail by yourself.
Black-And-Blue Nails
A black-and-blue nail is usually caused by sudden or repetitive injury to a toe. This might occur during sports that involve running or stopping quickly. The injury may also result from a heavy object falling on a toe. If your toe is black and blue but not injured, see your doctor immediately.
Symptoms & Evaluation
The big toe is most often affected. Bruised broken blood vessels cause the black-and-blue colors under the nail. If the condition is the result of a sudden injury, pain may be severe.
Your podiatrist talks with you about your symptoms and physical activities. He or she may palpate (press) the area at the end of the toe to determine the extent of the pain. Your toe and foot are examined for any signs of infection. If a fracture or a bone spur is suspected, x-rays may be needed. If small black spots are present under the nail, other problems may need to be ruled out.
Treatment
If pain is severe, the nail may be removed, or a hole may be drilled in the nail to allow drainage, which relieves the pressure. A local anesthetic may be used. Pain may also be relieved with prescription medications, or by soaking or icing the area. If pain is not severe, you may not need treatment. The nail can be thinned or left alone to fall off. A new nail should grow to replace it.
Hammer Toes
In general, the term "hammer toes" describes a buckling of any of the toe joints. Joints at the end or middle of the toe, as well as the joint near the ball of the foot, may be affected. Toe joints usually curl because of a muscle imbalance or tight tendons. Hammer toes vary in severity and in the number of joints and toes involved.
Your doctor will examine all your toes, testing whether or not buckled joints can be moved. Your feet will also be checked for any skin changes. Corns (a buildup of dead skin cells) often form between curled toes or on top of buckled joints where shoes rub. If irritated, corns may turn into open wounds and become infected.
Types Of Hammer Toes
Hammer toes may be flexible or rigid, depending on the joint's ability to move. A flexible joint may become more rigid as you age.
A Flexible Joint - You can straighten a flexible hammer toe with your fingers. Although they look painful, flexible hammer toes may not hurt.
A Rigid Joint - A rigid hammer toe cannot be moved, even with the fingers. Rigid joints may cause pain and distort foot movements. This may put extra stress on the ball of the foot, causing a callus (a corn on the bottom of the foot).
Treating Hammer Toes
If your symptoms are mild, changing shoes may be all the treatment you need. Using a splint or pad to hold your toes straight also may help. Or try cushioning corns and calluses with felt padding. If your symptoms are severe, surgery may be needed. The type of procedure often depends on whether your toe joints are flexible or rigid.
Rigid Joints - A piece of bone may be removed to help straighten a rigid toe. Two surgical examples are shown below. With either surgery, a pin may be used to hold the remaining bone in position during healing.
Flexible Joints - To release a buckled joint, the tight tendon (often the bottom one) is cut and repositioned.
Bunions
Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrected foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis or an injury produces a bunion. And some people are born with the tendency to develop bunions. If you're at risk for developing a bunion, wearing high-heeled or poorly fitting shoes makes the problem worse.
Types Of Bunions
Positional (mild) bunions arise from the growth of new bone. Structural (severe) bunions result when the joint at the base of the toe shifts position. Many bunions are a combination of both types.
Positional Bunions - As new bone grows, the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe father out of alignment.
Structural Bunions - When the angle between the bones of the first and second toes is greater than normal, the big toe slants toward the smaller ones. In severe cases, this may also cause the second and third toes to buckle.
How Are Bunions Treated?
If a bunion is not painful or severe, your doctor may recommend that you wear a different style of shoes. Or you may be prescribed custom-made shoe inserts (orthoses) to control incorrect foot mechanics. For painful or severe bunions, outpatient surgery may be recommended. After surgery, you'll soon be on your way home and ready for recovery.
Removing Bone - If a structural bunion is severe, a piece of bone is removed from the first metatarsal (the long bone behind the big toe joint). Once repositioned, this bone may be held in place with a pin or a screw. Any new bone that makes up a bunion is shaved away.
Shifting Soft Tissue - To realign the affected joint, any tight tendons on the inside of the toe are released (cut). New bone that makes up the bunion is shaved away.
Shifting Bone - The most common bunion surgery reduces the angle between the first and second toes. Bones in the big toe joint are realigned and the bunion is shaved away. Ligaments and tendons around the joint may be tightened to hold it properly in place.
Information Request Submission Form
Contact Method Preferred:
Marysville Foot & Ankle Clinic
Telephone: (360) 653-3354
E-mail: tcskiles@marysvillefootclinic.com
9516 State Avenue Suite D
Marysville, WA 98270
Phone: (360) 653-3354
Thickened Nails
Abnormally thick or crumbling nails may be caused by injuries, pressure from shoes, fungal infections, or conditions such as diabetes, psoriasis, or vascular disease. Eventually, the nail may loosen and fall off.
Symptoms & Evaluation
Along with thickening, the nail may appear ridged, brittle, or yellowish. The nail may also feel painful when pressure is put on it.
Since thickened nails may be a symptom of an underlying medical condition, it's important for your podiatrist to look at your medical history or possible related problems. To check for a fungal infection, a culture may be done. The thickness and color of the nail are also examined carefully to determine possible infections or other conditions.
Treatment
If the nail isn't infected, your podiatrist may be able to thin it by trimming, filing, or grinding. If a fungal infection is present, oral or topical antifungal medications may be needed. This can help prevent ulcerations under the nail while keeping the fungus from spreading to other nails. If pain is still present, the entire nail or part of it can be surgically removed. Do not remove the nail by yourself.