Dr. Lee A Wittenberg, DPM

It sounds like it could be a fungal infection (Athletes Foot), but there could also be other issues causing you to itch or to have bumps. My recommendation would be to try an over-the-counter topical anti-fungal cream (ask your pharmacist) and use it twice a day for 2-3 weeks. It it does not improve, see your local Podiatrist.

Blisters are mechanical in nature. You most likely have a biomechanical issue where your foot may not be functioning optimally. Sometimes Orthotics can help change and improve the mechanics of your feet and resolve theses issues. You should get checked by a local Podiatrist in your area to see if he/she can help you correct the issue

Most women retain fluid when they are having, or just before, menstruation. This is the most likely scenario, but you should see a specialist if it persists and is a problem.

Foot odor can be a bacterial infection, a fungal infection, or could be from the proliferation of bacteria and fungus inside your shoes. It usually comes hand-in-hand with hyperhidrosis (excessive sweating). You can try over the counter high strength antiperspirant like 'Certain Dry,' and you can spray your shoes with Lysol once a week to kill microorganisms living in your shoes. You can also change your socks twice a day. But if it continues, see a specialist

It could be Athlete's Foot/a fungal infection, or it could be something else, but there is no real way to tell without having it evaluated

There is a prescription strength antiperspirant called "Certain Dry" that I recommend to my patients with Hyperhidrosis (excessive sweating) that can be applied to the bottom of the feet and palms of the hands 2x per day. It is over the counter-ask the pharmacist where to find it. Also, I recommend spraying your shoes out with Lysol once a week and letting them dry for at least 24 hours prior to using them again. This will kill bacteria/fungus/mold in the shoes. Also, I recommend changing your socks twice a day.

Almost everyone's arch flattens out to a certain degree when they stand up due to ground reactive forces on the feet. There are different types of flatfoot - flexible and rigid - and different things can cause the foot to be flat, whether it is a congenital abnormality, or weakening of ligaments and tendons over time, to the overall structure of your feet. You should see a Podiatrist and, if your deformity is a flexible one, you should invest in a good pair of orthotics for your shoes (arch supports) with the appropriate accommodations for your particular issues, and you should wear the devices all of the time and may also have to consider changing the type of shoes you wear.

There are several reasons why people get recurrent ingrown toenails. These range from the type and tightness of shoe worn to the genetic shape of the toenail and other reasons, as well. And, YES, there is a permanent removal of ingrown toenails called a Matricectomy that can be performed in the office of a Podiatrist. The toe is numbed, the offending border or borders are removed, and a chemical is placed in the corner of the nail bed to burn the growth cells. You will have to take care of it afterwards for a couple of weeks, but there is minimal pain associated with the procedure after it is performed.

This is particularly difficult to answer without an exam, but there are many reasons that your feet may hurt when you run. It could be your weight. It could also be pronation and Posterior Tibial Tendon Dysfunction (which are elements and symptoms of having a flat foot). You should see a Podiatrist to see exactly what kind of dysfunction you might have with your feet and how best to correct these issues

RICE therapy is the best for an acute injury. Rest, Ice, Elevation, Compression. Sprains can take longer to heal than an actual fracture with some people having pain >6 months after injury. If the pain persists >2 months, your brother should seek medical attention.

"Sprain" means the ligaments have stretched. And that weakens the integrity of the ankle and makes you more prone to recurrent sprains. But you may also have "ruptured" or torn the ligaments, and that results in increased ankle instability. There are very well-trained podiatrists that you should attempt to see (try to see someone with either a 3-year surgical residency or someone with a 2 year residency and a fellowship in reconstructive rearfoot and ankle surgery). There is a simple surgery that can be performed called a 'Modified Brostrom' lateral ankle stabilization, and you should be recovered well enough to perform most activities by the end of 2 months after surgery.

Yes, you should find a well-trained surgical Podiatrist to help you. Foreign bodies, especially things like glass (that does not show up on x-ray) can be difficult to find and remove.

This could happen for a number of reasons. It might help to know your age, your past medical history, etc. But in the absence of that information, Neuromuscular diseases (such as Neuropathy, Muscular Dystrophy, Stroke, Lupus, and other disease processes) can cause muscle weakness and even loss of function. I would highly recommend seeing a Neurologist or Podiatrist and have a full examination

I tell my patients all the time that the biggest thing for them is their comfort. Whether I feel something actually has clinical/therapeutic effects or not, if my patients are getting relief from a device, I am all for it. So, they will not hurt you, even in the long-term use. And if they make you feel better or give you relief, that's all the better.

Soaking in Epsom Salts is good really for only 1 thing-helping to dilute and drain an infection (for example: if you had an ingrown toenail that was infected). Otherwise, the heat from the water can help with the pain, but this is really "Plantar Fasciitis," and has nothing to do with the spurs. I have answered a plantar fasciitis question in the past in very strong detail, so look for that article/response on my page. Really, for inflammatory problems, such as this, it is better to ice to decrease inflammation than to use heat/hot water. Soaking regularly in Epsom Salts and water will dry your skin out and help you little

If there is pus, it could be serious. You should immediately seek attention by a dermatologist or a Podiatrist. But it could be a minor issue. If it is itchy, it could be simple athletes foot/fungal infection.

You most likely have plantar fasciitis.

My Heel Hurts! Could I have Plantar Fasciitis???

The most common cause of heel pain that I see in my practice is caused by a pathology called ‘Plantar Fasciitis.’ People usually come in complaining of pain at the inside of their heel or along the bottom of the arch that came on suddenly. Symptoms usually consist of pain that starts with the first step out of bed in the morning, after getting up out of a seated position, and pain that may extend around the back of the heel and up the back of the leg as the disease progresses.
What is Plantar Fasciitis? The plantar fascia is a ligament that runs from the bottom of the heel to the ball of the foot. A ligament is a thick, fibrous structure that attaches one bone to another bone, and is present for structural support. The Plantar Fascia is one of the major supports for holding up the medial arch of the foot.
The reason that the plantar fascia gets irritated is usually from a combination of causes. It often occurs if a patient has recently had a gain in weight, or sometimes when there has been a recent change in activity level. Often, a patient will have recently started a new exercise regimen, which causes increased stress on the ligament and along the arch. Also, peoples’ arches often begin to fall, or flatten as they get older, and this may also cause stress to the plantar fascia. This causes an inflammatory process along the course of the ligament, or at its insertion on the heel, which causes pain.
The reason the ligament hurts after periods of rest is simple. When a patient is not standing, there is no stress along the arch or on the ligament. The ligament then has a chance to begin healing. The moment the foot hits the ground, all of the healing that may have been done, gets undone, and the inflammatory response begins all over again. This becomes a repetitive cycle, and the pain may become worse and worse as the pathology progresses.
So, how do we treat Plantar Fasciitis? There is a standard regimen that I use for my patients experiencing this problem. The fastest way to get rid of the inflammatory response is to give the patient a cortisone injection. Though unpleasant, most patients are happy to try to get rid of the pain swiftly. The foot is then strapped to support the arch so the ligament does not tighten up with weight bearing and activity. A strict course of icing and stretching is instated for the patient. Further injections may be given, but a patient should generally never have more than 3 injections in the same area more than 3 times in a 12 month period. Doing so may weaken the soft tissues.
Orthotics are also very effective in preventing the problem from recurring, and help the patient with over-all function and balance. In fact, orthotics not only help to support the medial arch, but they help to balance out the knees, hips and low back, and help to prevent muscle fatigue.
Surgery is rarely indicated for Plantar Fasciitis. In fact, the current literature states that unless a patient has had this problem for a minimum of 9 months, and has been compliant with all of his physical therapy and conservative therapy, surgery should not be performed. Surgical correction of this problem involves cutting the ligament, and this will eventually lead to an over-all weakening of the medial arch, and weaken the structure of the foot, in general.
I have a great deal of success treating Plantar Fasciitis with my patients, and usually am able to make a patient pain free within 2 weeks to 2 months, in extreme cases. The longer the pain is present, the harder it is to get rid of. So, if you are experiencing heel pain, be sure to see your local foot and ankle specialist as soon as possible for the best results!

Lee Wittenberg, DPM
Apache Foot & Ankle Specialists
9710 W. Tropicana Ave, Ste 115
Las Vegas, NV 89147
(702) 362-2622

Your problem is most likely due to Venous insufficiency.

Venous Insufficiency: Why are my ankles and feet swollen?
People often ask me, ‘why are my ankles, legs and feet swollen?’ The most common reason for ankle and foot swelling is Venous Insufficiency. What is venous insufficiency? It is a problem of pooling of fluid or retention of fluid in the legs, feet and ankles resulting from poor venous return of blood to the heart.
As we get older, or sometimes secondary to certain medical conditions, the veins are not as ‘competent’ and cannot return the blood back to our heart as efficiently as it should. The result is the over-filling of the veins in the legs and feet. When the veins get too full, the veins become distended, or stretched out. When this happens, the veins can no longer contain the excess blood and the fluid begins to leak from the veins into the surrounding tissues. This causes swelling in the legs and ankles.
Veins, as opposed to arteries that carry blood away from the heart and to the surrounding tissues, have no internal muscle and they do not ‘pump’ like arteries do. The Veins rely on our skeletal muscles, the muscles that move our bodies, to squeeze them to push the blood back toward the heart for re-oxygenation. There are little valves, or cup like structures, that are meant to catch the blood as the skeletal muscles relax to try to prevent the blood from falling back down to the lower segments, and so the blood continues to travel toward the heart. But as the veins become incompetent, the valves are no longer effective, or can break down. Then the blood goes toward the heart, but just falls back down to the feet and ankles secondary to gravity.
People with venous insufficiency may notice that the ankles and feet are not as swollen in the morning as they are in the afternoon. That is because when you are lying flat at night, the blood can more easily travel back to the heart, and the swelling goes down. But as you stand and walk all day, gravity takes over and pulls the blood toward the feet and ankles, and it stays there.
People suffering from venous insufficiency may notice that they have spider veins around the ankles and legs. Patients may also have larger varicose veins in the thighs, legs, or ankles. Also, as the problem progresses, there may be a dark discoloration of the skin in the legs. This is secondary to Hemosiderin deposition; a break down product of the pigments in the blood cells that might die within the tissues as the fluid leaks out of the veins. This will be a brown or reddish-brown discoloration. It may never go away.
There are several ways to treat Venous insufficiency. Conservatively, you can wear compression stockings to increase the efficiency of the broken veins. Secondly, you may take diuretics, or water pills, that will help the body to rid itself of excess fluid. Thirdly, you can see a vein specialist. There are procedures that may be done to improve the efficiency of the more viable veins in the legs and ankles.
Swelling in the legs may also result from a more serious problem, Congestive Heart Failure (CHF). This may be a life-threatening issue, and if you are short of breath or are having difficulty breathing, or if you cannot walk very far without becoming winded and needing to rest, you should go immediately to your physician or local Emergency Room.

Lee Wittenberg, DPM

Hammer toes are generally NOT genetic, but rather result from ill-fitting shoe gear, high heels, and mechanical issues related to the foot and ankle.


Lee Wittenberg, DPM

Apache Foot & Ankle Specialists
4840 S. Fort Apache Rd, Ste 101
Las Vegas, NV 89147
702-362-2622

2980 St. Rose Pkwy, Ste 140
Henderson, NV 89052
702-722-6633

The likelihood is that you may have had fungus introduced into the toenail, possibly from the surgery, or from healing after the surgery. Go to your local Podiatrist, have a nail biopsy, and see if you can take the oral medication Lamisil to eliminate the fungus in the nail. Though the treatment is only for 3 months, it takes a minimum of 9 months to clear the fungus in the nail after you start taking the medication