In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.

Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.

Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.

Hammertoes, as its name suggests, may cause the affected toe to bend downward, resembling a hammer-like shape. Typically, this condition can affect the second, third, or fourth toes. Because hammertoes can be painful and cause a great deal of discomfort, it’s important that you seek professional help if you notice your toe’s appearance has become deformed. Common causes for a hammertoe’s development include a muscle imbalance, tightly-fitted footwear, a previous injury, and certain diseases such as arthritis or diabetes. Along with the noticeable change of appearance of the affected toe, some may also experience swelling, redness, a burning sensation, and the development of corns or calluses on the top of the middle joint of the affected toe. For more advice on how to treat a hammertoe, please seek the professional guidance of a podiatrist.

Hammertoe

Hammertoes can be a painful condition to live with. For more information, contact Dr. Howard Horowitz from Bowie Foot & Ankle . Our doctor will answer any of your foot- and ankle-related questions.

Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.

Symptoms

• Pain in the affected toes
• Development of corns or calluses due to friction
• Inflammation
• Redness
• Contracture of the toes

Causes

Genetics – People who are genetically predisposed to hammertoe are often more susceptible

Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur

Trauma – Direct trauma to the toes could potentially lead to hammertoe

Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe

Treatment

Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it

Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used

Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option

If you have any questions please contact our office located in Bowie, MD. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

Gout is a painful, inflammatory form of arthritis. Those affected will typically feel an intense stiffness in the joints of their feet, particularly in the big toe. Schedule a visit to learn about how gout can be managed and treated.

The medical term for a bunion is referred to as hallux valgus. It appears as a bony protrusion that forms on the side of the big toe and may cause wearing shoes to be uncomfortable. The big toe can become misaligned, and may affect the remaining toes. Some of the symptoms that are associated with this condition can include pain, inflammation, and the toe may appear red. If a bunion is left untreated, arthritis may develop, which can cause deeper joint pain. Genetic factors may play a significant role in developing a bunion, in addition to wearing shoes that do not have ample room for the toes to move freely in. If you notice a bump extending from your toe, it is suggested that you consult with a podiatrist who can properly diagnose and treat bunions.

If you are suffering from bunion pain, contact Dr. Howard Horowitz of Bowie Foot & Ankle . Our doctor can provide the care you need to keep you pain-free and on your feet.

What Is a Bunion?

Bunions are painful bony bumps that usually develop on the inside of the foot at the joint of the big toe. As the deformity increases over time, it may become painful to walk and wear shoes. Women are more likely to exacerbate existing bunions since they often wear tight, narrow shoes that shift their toes together. Bunion pain can be relieved by wearing wider shoes with enough room for the toes.

Causes

• Genetics – some people inherit feet that are more prone to bunion development
• Inflammatory Conditions - rheumatoid arthritis and polio may cause bunion development

Symptoms

• Redness and inflammation
• Pain and tenderness
• Callus or corns on the bump
• Restricted motion in the big toe

In order to diagnose your bunion, your podiatrist may ask about your medical history, symptoms, and general health. Your doctor might also order an x-ray to take a closer look at your feet. Nonsurgical treatment options include orthotics, padding, icing, changes in footwear, and medication. If nonsurgical treatments don’t alleviate your bunion pain, surgery may be necessary.

If you have any questions, please feel free to contact our office located in Bowie, MD. We offer the newest diagnostic and treatment technologies for all your foot care needs.

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

The age group of people who are typically affected by Sever’s disease is between ten and fourteen. It impacts the growth plate in the heel and can cause severe pain and discomfort. It can happen as a result of participating in running and jumping activities, which can exert excess pressure on the heel. It is beneficial to perform stretches that can loosen the Achilles tendon which is connected to the heel. Additionally, many patients wear specific types of footwear that can help in the healing process. If you notice your child is limping or complaining of heel pain, it is strongly suggested that you schedule an appointment with a podiatrist who can diagnose and treat Sever’s disease.

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Dr. Howard Horowitz from Bowie Foot & Ankle . Our doctor can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.

If you have any questions, please feel free to contact our office located in Bowie, MD. We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.

Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.

Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.

Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.

Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.

If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.

Some people may experience a condition that is referred to as plantar hyperhidrosis. This ailment causes the feet to sweat excessively and can cause discomfort and embarrassment. It can occur as a result of a thyroid disorder, genetic factors, and obesity. In severe cases, sweaty feet may cause shoes to slip off, and dangerous scenarios may happen while driving if the affected foot slips off the brake. Mild cases of plantar hyperhidrosis may be treated with anti-anxiety medication. For more severe cases, surgery may be considered to clip the nerve, and permanently remove it. If you are afflicted with this condition, it is advised that you seek the counsel of a podiatrist who can properly treat plantar hyperhidrosis.

If you are suffering from hyperhidrosis contact Dr. Howard Horowitz of Bowie Foot & Ankle . Our doctor can provide the care you need to attend to all of your foot and ankle needs.

Hyperhidrosis of the Feet

Hyperhidrosis is a rare disorder that can cause people to have excessive sweating of their feet. This can usually occur all on its own without rigorous activity involved. People who suffer from hyperhidrosis may also experience sweaty palms.

Although it is said that sweating is a healthy process meant to cool down the body temperature and to maintain a proper internal temperature, hyperhidrosis may prove to be a huge hindrance on a person’s everyday life.

Plantar hyperhidrosis is considered to be the main form of hyperhidrosis. Secondary hyperhidrosis can refer to sweating that occurs in areas other than the feet or hands and armpits. Often this may be a sign of it being related to another medical condition such as menopause, hyperthyroidism and even Parkinson’s disease.

In order to alleviate this condition, it is important to see your doctor so that they may prescribe the necessary medications so that you can begin to live a normal life again. If this is left untreated, it is said that it will persist throughout an individual’s life.

A last resort approach would be surgery, but it is best to speak with your doctor to find out what may be the best treatment for you.

If you have any questions please feel free to contact our office located in Bowie, MD. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.