WHY DO I HAVE A

1) BUNION
2) HEEL SPUR / PLANTAR FASCIITIS
3) HAMMER TOE
4) NEUROMA
5) PLANTAR WARTS
6) PAINFUL 5TH TOE CORN

1)  BUNION
DESCRIBES ANY BIOMECHANICAL DEFORMITY OF THE GREAT TOE JOINT. THIS CAN BE THE TYPICAL CROOKED BIG TOE WITH A MEDIAL BULGE OR IT CAN DESCRIBE A PAINFUL LIMITED RANGE OF MOTION DISORDER OF THE GREAT TOE JOINT, USUALLY ASSOCIATED WITH A COLLAR OF BONE ON THE TOP OF THE BIG TOE JOINT.

THE DEFORMITY OCCURS SLOWLY OVER MANY YEARS AND OFTEN IS PAINLESS. EVENTUALLY, THE JOINT BECOMES DISLOCATED TRANSVERSELY LEADING TO LOSS OF CARTILAGE AND PAIN. OR IN THE CASE OF THE LIMITUS DEFORMATION THE RANGE OF MOTION DECREASES SLOWLY OVER TIME, EVENTUALLY LEADING TO LOSS OF THE CARTILAGE AND PAIN.

IT IS IMPORTANT FOR PATIENTS TO UNDERSTAND THAT THE CARTILAGE ON THEIR BONES IS NOURISHED ONLY BY THE FLUID IN THE JOINT.. THEREFORE, MOTION OF THE JOINT LITERALLY FEEDS THE CARTILAGE.. BOTH TYPES OF BUNIONS LEAD TO DECREASED JOINT CARTILAGE COMPRESSION AND THEREFORE THINNING AND EVENTUAL LOSS OF CARTILAGE" LEADING TO PAIN AND POSSIBLE JOINT REPLACEMENT.

2) HEEL SPUR / PLANTAR FASCIITIS

THE 26 BONES IN EACH FOOT HAVE TWO TOTALLY DIFFERENT FUNCTIONS THAT MUST BE PERFORMED WITH EACH STEP YOU TAKE. FIRST THE FOOT MUST COLLAPSE AND ELONGATE LONGITUDINALLY TO ABSORB ONE AND ONE HALF TIMES YOUR WEIGHT COMING DOWN ON THE FOOT. THIS IS TO PROTECT YOUR ANKLE, KNEE AND HIP FROM THE FORCE OF YOUR WEIGHT HITTING THE GROUND 10,000 TIMES PER DAY. THEN WITHIN A SPLIT SECOND THIS FOOT MUST PROPULSE YOU OFF OF THE GROUND TO TAKE A STEP. THIS REQUIRES ALL 26 BONES TO FUNCTION AS ONE IN A RIGID ATTEMPT TO LIFT YOUR BODY OFF OF THE GROUND REQUIRING A PROPULSIVE FORCE OF 150% YOUR BODY WEIGHT TO LIFT OFF AGAINST GRAVITY.

IF THE 26 BONES IN YOUR FOOT, WHICH REPRESENT A COMBINATION OF ALL YOUR ANCESTORS, DON'T WORK AS WELL AS THEY SHOULD THE BOTTOM OF YOUR FOOT WILL BE OVER-STRETCHED. THIS DAMAGES THE "RUBBER BAND" ON THE BOTTOM OF YOUR FOOT CALLED PLANTAR FASCIA, WHICH IS AN ELASTIC BAND RUNNING FROM YOUR 5 TOE JOINTS TO THE BOTTOM/MEDIAL ASPECT OF YOUR HEEL. REPETITIVE DAMAGE RESULTS IN SCARRING, THICKENING AND LOSS OF ELASTICITY RESULTING IN PAIN. COMMONLY THE PATIENT COMPLAINS OF PAIN AFTER PERIODS OF OFF WEIGHT BEARING THE FASCIA TIGHTENS DUE TO YEARS OF ABUSE AND UPON WEIGHT BEARING THE "WALLPAPER" ON THE HEEL BONE IS TORN AWAY AND THIS IS PAINFUL.

MANY TIMES THE PATIENT WILL EXPERIENCE A DECREASE IN PAIN AFTER THE FIRST FEW STEPS DUE TO "WARMING Up" OF THE FASCIA. EVENTUALLY, IF NOT TREATED THE PAIN BECOMES CONSTANT. IF TREATED PROPERLY THIS RARELY REQUIRES SURGERY.
 

3) HAMMER TOE
THE FUNCTION OF THE LESSER DIGITS, TOES 2, 3, 4, & 5, IS TO GRAB THE GROUND AND PROVIDE STABILITY WHEN WALKING. IF THE 26 BONES INHERITED IN YOUR FOOT ARE NOT AS STABLE AND DON'T WORK TOGETHER AS WELL AS THEY SHOULD THEN THE FOOT WILL DEMONSTRATE INSTABILITY AND THE TOES WILL GRAB THE GROUND LONGER AND HARDER THAN DESIGNED TOO AND BUCKLING WILL OCCUR - OVER TIME THE TENDONS ADJUST AND SHORTEN AND SLOWLY OVER THE YEARS - HAMMERING OCCURS. THIS LEADS TO PAINFUL "CORNS" ON THE TOES, PAINFUL DEEP CALLUSES UNDER THE TOE JOINTS ON THE BOTTOM OF THE FOOT AND GENERALIZED INSTABILITY DUE TO LACK OF TOE PURCHASE ON THE GROUND DURING
PROPULSION PHASE.
 

THIS CAN BE TREATED CONSERVATIVELY EARLY BUT REQUIRES SURGICAL RECONSTRUCTION IF ALLOWED TO PROGRESS.
 

4) NEUROMA
THE NERVE THAT PASSES IN-BETWEEN THE TOE JOINTS TO INNERVATE THE SIDES OF THE TOES HAS TO PASS IN BETWEEN THE HEAD OF THE METATARSAL BONE. IF THE FOREFOOT WIGGLES A LITTLE BIT, 10,000 STEPS PER DAY, THEN THE NERVE BECOMES IRRITATED. THE BODY THICKENS THE NERVE COATING, IN AN ATTEMPT TO PROTECT THE NERVE, AND THIS LEADS TO PAIN ON COMPRESSION OF THE NERVE. SOME PATIENTS EXPERIENCE, SHOOTING PAIN INTO THE TOES, OR ACHING PAIN IN-BETWEEN THE TOE JOINTS. THIS PROBLEM CAN BE TREATED CONSERVATIVELY WITH PAINLESS INJECTION THERAPY INVOLVING NO DISABILITY OR LOSS OF WORK-TIME.

5) PLANTAR WARTS
PAINFUL WARTS ON THE BOTTOM (PLANTAR) OF THE FEET ARE VERY COMMON IN CHILDREN/YOUNG ADULTS AGE 6 TO 26. ALSO PREGNANCY, MENOPAUSE AND STRESSFUL TIMES BRING THEM ON.

PAPILLOMA VIRUS - COMMON AS DIRT AND AS OLD AS DIRT, IS ON ALL OF US ALL OF THE TIME. WHEN OUR IMMUNE SYSTEM IS DIMINISHED, THE VIRUS ESTABLISHES ITSELF IN THE SKIN. PUBERTY, MENOPAUSE, PREGNANCY AND STRESS ALL AFFECT HORMONE LEVELS AND THIS EFFECTS THE IMMUNE SYSTEM DEFENSE ALLOWING THE WART TO ESTABLISH ITSELF.

WARTS LIKE FRICTION AND THEREFORE, APPEAR ON WEIGHT BEARING SURFACES OF THE FOOT. BECAUSE THEY LIKE FRICTION, TOPICAL ACIDS, ETC. OFTEN STIMULATE MORE SPREAD OF THE WART.

LASER HYFERCATION UNDER IV SEDATION IS A SAFE, EFFECTIVE AND PAINLESS . WAY TO ERADICATE THEM.

6) PAINFUL 5TH TOE "CORN" 

PAINFUL CALLUSES "CORNS" ON THE LATERAL SIDE OF THE 5TH TOE ARE VERY COMMON. THEY ARE CAUSED BY A SMALL PROTUBERANCE OF BONE ON THE TOE WHICH PICKS UP ALL THE FRICTION FROM THE SHOE AS WE WALK AND OUR FOOT MOVES FORWARD SLIGHTLY IN THE SHOE WITH EACH STEP.

PADDING IS HELPFUL BUT SURGICAL REMOVAL OF THE BONY PROTUBERANCE AND PLASTIC "SURGICAL" REMOVAL OF THE "CORN" PROVIDES A HIGH PERCENTAGE PERMANENT SOLUTION. THIS CAN BE DONE WITH OUTPATIENT SURGERY UNDER IV SEDATION. RETURN TO NORMAL SHOE GEAR IS OFTEN POSSIBLE WITHIN 4 DAYS. THE PATIENT IS LEFT WITH A PERMANENT CURE TO THE PAINFUL CORN AND ONLY MISSES A FEW DAYS OF WORK, ETC.