Dr. Lee A Wittenberg, DPM

The cause of bunions is a combination of genetics, shoe gear, and biomechanics. There is usually, in my experience, a mechanical issue with the function of a patient's foot that causes bunions. Just because your shoes are 'comfortable,' does not mean they are good for your feet or giving your feet the mechanical and structural support they need.

A number of things could cause this type of problem; anything from excessive swelling in the foot, leg and ankle, to neurologic issues to tendonitis. You need to have this examined more thoroughly to find out what is wrong

In my practice, it is rare to perform surgery for the most common type of heel pain, Plantar Fasciitis. 99% of the time I am able to resolve the problem conservatively if this is the diagnosis. However, there are other diagnoses that could cause heel pain. Your Diabetes may or may not come into play. But being Diabetic, you should never hesitate to see your Podiatrist about the pain, as there could be something more serious happening. The worst thing would be for you to end up having an amputation because you ignored the problem. Make an appointment with your Podiatrist immediately

Frequent ankle sprains may be a result of stretching or even rupture of the lateral ankle ligaments. This can be diagnosed through MRI imaging and through a clinical exam by your Podiatrist. The more often you sprain the ankle, the less likely the ligaments are to return to their natural state of tension and support, and the more likely that they will eventually rupture. There are very good surgical procedures to help correct this problem, and the recovery is not too long. My patients who get lateral ankle stabilization procedures are usually very happy with the results and return to full activity without having more sprains and with a feeling of increased security and stability with activity.

Most over the counter treatments are not effective in treating warts, and I have seen several patients get infections from using the over the counter treatments inappropriately or too frequently. I recommend going to see your local Podiatrist. There are several ways to treat the wart, such as freezing, acids, other topical treatments, Bleomycin injections, surgical treatment with excision and/or lasers or cautery. However, there are other foot pathologies that look like warts, and may not be. Warts are caused by the Human Papilloma Virus, and there are other skin lesions that can be acquired that are not from an infectious process. It's best to see a professional for treatment.

This is a very vague question. It really depends on what your risks are, what your comorbidities are, and what your foot dysfunction might be. Often times, you can help your foot function with proper, custom made orthotics (the majority of over the counter orthotics are not adequate to help with your foot function/dysfunction)

Blisters can happen for a number of reasons. If you find that it happens with certain shoes, the shoes are not fitting you properly-they are probably sliding on your feet causing friction that is creating the blisters. Your foot function should be examined by a professional-it is possible that orthotics will rectify the abnormal function that might be causing the blistering. Simply changing shoes may rectify the problem.

Pain in the ball of the feet may or may not be from hammer toes. There is no way to straighten a hammer toe without surgical intervention. But there are several causes of pain at the ball of the feet and many can be treated either with injections or with arch supports, or both. It would be best fro your mother so that she can be more thoroughly evaluated by a specialist, and treatment will be given, if necessary.

You may have a heel spur, or you may not and may still have significant pain from a problem with a ligament on the bottom of your foot. The problem is called 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

Cramping in the foot might be caused by mechanical issues related to the joints and tendons in your foot. This might arise from muscle fatigue or stress, possibly even related to having a flat foot, or other deformities or functional issues that are occurring during ambulation and activities. Your muscles may be working harder to compensate for some of these issues. Your best resolution to the problem would be to visit your local Podiatrist and have your feet examined. Good orthotics from an expert (not the kind from the pharmacy, Walmart, or rip off places like the Good Feet Store or Foot solutions) might help you resolve the problems without any type of injections or surgery.

The heat from warm water may make your feet feel better, but you are actually drying the skin out. Most pathologies do better when you ice them to decrease inflammation. Soaking in warm water or using hot compresses will increase inflammation and can increase pain

There could be actually swelling in your feet (venous insufficiency, a joint or nerve pain/entrapment, or trauma). Or you could have a problem with your nervous system creating a sensation of swelling that might not be there. It is difficulty to discern without examining you or knowing your medical history. You might want to visit a physician to have an examination.

As I tell my patients, you can try whatever you would like, and who knows? For some people weird, gimmicky things like Acupuncture Shoes my make you feel better. But, honestly, I do not think so. The key to treating heel pain, which is usually caused by Plantar Fasciitis, is supporting the medial arch (orthotics or flip flops/shoes with build in arch support), Stretching and icing, and anti-inflammatory treatments.

It really depends on where your pain is. The foot and ankle are very complex with many bones, joints, tendons, ligaments, nerves and blood vessels. The location of the pain may be a little more telling. And the fact that you are overweight will most definitely put more stress on your feet and ankles and all of the structures related to them.

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.