fungus usually grows in dark, moist areas and can invade the body through minor cuts, or
after injury or irritation in which the
toenail becomes separated
from the bed. The
fungus can cause the nail to thicken and become discolored, often yellow
or brown. A foul-smelling debris can accumulate under the nail leading to pressure and pain.
After confirming the presence of
fungus infection , It is best to treat the
infection in early stages
nail starts to thicken or becomes discolored.
In the past it used to be that in the early stages, an
oral medication was given which had
some series side effects in the body especailly on the liver if taken for too long. In case
a patient was unable to take the
oral medication or the
infection was to advanced, the
infected nail was surgically removed by administering local
anesthesia in the office.
Now however, Dr. Harounian has incorporated the newest and the most effective
machine in to his practice to get ride of all the
fungal infection with no pain and no
known side effects in only 30 minutes. The procedure is quick and easy and entails
lasering all 10 toes regardless of how many are infected, to minimize the risk of reinfection.
The two most common causes of
heel pain are
heel spurs and
plantar fasciitis. The chief
diagnostic sign of these problems is: pain in the bottom of the heel when first standing,
which gradually improves with walking. This pain may return with continued walking. The
treatment involves correcting the underlying causitive problems.
Causes: Each time we take a step forward, all of our body weight first rests on the heel of
foot. As our weight moves forward, the entire
foot begins to bear the body's weight,
foot flattens and this places a great deal of pressure and
strain on the
plantar fascia. There is very little "give" to the
plantar fascia, so as it stretches only slightly,
it pulls on its attachment to the heel. If the
foot is properly aligned this pull causes no
problems. However, if the
foot is "
foot rolls inward, causing a break down
of the inner side of the shoe), the arch falls excessively, and this causes an abnormal
stretching of the relatively inflexible
plantar fascia, which inturn pulls abnormally hard
on the heel.
pathology occurs with "supination" (the rolling of the
foot outward, causing a
break down of the outer side of the shoe). Supinated feet are relatively inflexible, usually
have a high arch, and a short or tight
plantar fascia. Thus as weight is transferred from
the heel to the remainder of the
foot, the tight
plantar fascia does not stretch at all,
and pulls with great force on its attachment to the heel.
In both cases, the abnormal stress placed on the attachment of the
plantar fascia to the
heel usually causes pain, inflammation, and swelling. If this process continues, the
plantar fascia partially tears away from the heel. The body will fill in this torn area
calcium; eventually it becomes
bone, and a
heel spur results.
Bunions are misaligned big toe
joints that can become swollen and tender, causing the first
joint of the big toe to slant outward, and the second
joint to angle toward the other toes.
Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the
forefoot and toe. Surgery by a
podiatric physician is frequently recommended to correct
for additional information on diagnosis and treatment visit
foot is a highly mechanical apparatus, made of many
bones and other coordinated
foot carries the entire weight of the body and propels us forward when we
stand, walk, and run. Several common
deformities of the toes are
Claw Toe ,
Hammer Toe , and
mallet toe often cause pain and a loss of function in the use of the
foot. Failure to
treat these conditions may contribute to the development of serious and disabling changes
in habitual ways of walking and carrying the body.
Toe deformities are often congenital, occurring for example, in some people with muscular
dystrophy. People with high arches, or those who have a tendency to rotate their
inward while walking are susceptible to
deformities of the toes, as are those with
rheumatoid or osteoarthritis and people with
Proper evaluation is the first step in understanding
toe deformities and the problems they
present. Seeking early evaluation for disorders of the toes and feet is always a good choice,
and can make a significant difference in controlling the condition.
Hammertoe is a structural
deformity in which abnormal biomechanics cause the toe(s) to
contract at one, two or all three of the
joint within that toe. Normally
themselves are not painful, but by wearing shoes,as the prominent knuckle of the toe rubs
against the shoe, it becomes irritated and can lead to what is called a
Temporary relief of painful symptoms can be achieved by having a
podiatrist debride (trim)
corn . However, When the area becomes rigid and nonflexible with increased swelling and
pain, a surgical correction might become necessary to alleviate symptoms.
Corns and callouses are both similar in that the extra skin forms in response to pressure
on the skin. In the case of
corns , the extra skin forms between the toes. In the case of
callouses, the extra skin forms on the outside of the
Corns are usually from the
joints on one toe pressing on the knuckle
joint on the adjacent toe. Usually, a
seed or central nucleus is seen when examining the
Callouses occur due to many causes
but the most common cause is incorrect padding in the shoes,
flat feet, a
bone spur and
hammertoes . In rare instances, the painful
callouses is an abnormal sweat gland that has
become impacted with hard skin and the small nerve going to the sweat gland becomes painful.
The names given to
corns and callouses by doctors are numerous based on where the
occurring and how the skin is forming the
Shin plints: Shin splints are the typical first injury to walkers and runners
fracture pain is likely to be a continuous pain and
restricted to one spot. Do not run. If you have a more diffuse pain or tenderness in the
lower third of the leg on the inside, or along the entire shin, a
fracture is less likely.
Pain is felt on extending the toes and weight bearing. It hurts if you press the area with
your finger. Physiologically, it's an inflammation of the
tendons or muscle in this area.
Pain eases when you're well warmed up, but resumes at the end of exercise.
Causes - Running with the weight too far forward; striking the ground with the first third
foot; over-striding; shoes too tight around the toes; inflexible shoes; weak arches
may be present; tight calf muscles stress the shin structures;running or walking on hard
overtraining is its trademark; beginners are very susceptible
Compartment Syndrome is a muscle pain due to the muscles growing faster than the
sheath surrounding them. It includes one form of shin splints; it also affects the other
smallish muscles of the lower leg. Ice and anti-inflammatories can help, but surgery may
be required to allow the muscle more room to expand. Some muscles grow so much that they
constrict the blood flow into the sheath...resulting in necrosis (a medical emergency) of
Patients should always check with their
podiatrist for a more precise diagnosis and treatment.
Ankle sprains are caused by a twisting or force on the ankle
bones of the
one or more
ligaments on the outside of the ankle to be stretched or torn.
If this doesnot get properly treated,
ankle sprains could develop into long-term problems.
Fracture (break) of your ankle usually happens due to a fall, an accident or hard blow.
There are different types of
fractures that occur depending upon the severity of the injury.
Spiral, hairline, open and crushed
bones are names used to describe
Dr. Harounian is an expert in
fracture care and will perform x-rays to determine the type
fracture you have. We sometimes need to realign the
bones, this is done through a
process called reduction. Casting of the
fracture , a walking boot, brace or splint are used
to hold the
bone in place during healing.
Neuromas are enlarged benign growths of nerves, most commonly between the third and fourth
toes. They are caused by tissue rubbing against and irritating the nerves. Pressure from
poorly-fitting shoes or abnormal
bone structure can also attribute to this condition as well.
In our family
foot center, Dr. Harounian uses a high technology ultrasound to better see
where the nerve irriation is and through injecting cortisone at the precise location and
wearing special shoes or inserts pain should be relieved. In more advanced cased, sometimes surgical removal of the growth is necessary.
Diabetes is usually associated with poor circulation of blood flow, decrease sensation due to nerve damage, and
slower healing ability to infections or open sores. Therefore, it is very crucial for the
diabetic patients to
podiatrist for a through examination of their lower extremities pulse and sensation, skin,
Ingrown Toenails which are often painful are usually the result of trimming your
too short, particularly on the sides of your big toes.
One should avoid tapering the corners so that the nail curves with the shape of your toe.
In the case of
ingrown toenail , the sides of the nail curls down and digs into your skin. Shoes that are too tight or short may also cause that.
Ingrown toenail start out hard, swollen and tender, and later, may become sore, red and
infected. Your skin may start to grow over the
ingrown toenail . In order to treat it:
Antibiotics are sometimes prescribed if an infection is present.
In case of an acute infection, Part of your
ingrown toenail (partial
nail plate avulsion)
may need to be surgically removed by administering a local anesthesia.
Wart , or verruca, is a pea-size or smaller bump on the skin caused by a virus that infects the top
layer of skin cells. They can be skin-colored, white, or pink.
Wart are believed to be transmitted
through direct or indirect contact (via a gym or shower floor) with a person carrying the virus. This virus,
called human papilloma virus (HPV), is easier to "catch" if there is a cut or an abrasion on the
Plantar warts occur on the bottoms of the feet. They frequently are studded with pinpoint
dark spots, which are tiny, clotted blood vessels. When they occur on portions of the feet
that bear weight, they are flattened by the weight placed on them, and can be quite painful.
They can be confused with
corns ; however,
podiatrist can remove a common
wart by freezing it with liquid nitrogen,
by using laser vaporization, or by surgically removing it in a procedure called curettage
and electrodesiccation. Your doctor should explain that no single treatment is guaranteed
to work, and a given form of treatment may need to be repeated several times. Unfortunately,
wart virus can be very resistant to therapy. Even after an apparent complete cure, it
may pop up again in the same spot years later.
podiatrist is recommended to better evaluate the situation and to prevent the spreading of this virus.
The adult acquired
flatfoot which is four times more common in women than men is a
progressive, symptomatic (painful) deformity resulting from gradual stretch (attenuation) of the tibialis posterior
tendon as well as the
that support the arch of the
flat feet are not painful, particularly those
flat feet seen in children. In
the adult acquired
flatfoot, pain occurs because soft tissues (
The geriatric patients have many of the same
foot problems as the younger patient but their
condition is often complicated by poor circulation, arthritis, bursitis, neuritis or other
Just remember that your feet should not hurt because you are getting older. Many of your
conditions can be alleviated by modern
arthritis and osteoarthritis are two common forms of
arthritis that affect
millions of Americans, especially those over age 45. Rheumatoid
arthritis affects the
entire body whereas osteoarthritis is isolated to the
Surgery to reconstruct the
joint may be needed if arthritis causes chronic problems that
cannot be controlled by medication,
orthotics or physical therapy.
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