There are many reasons for numbness and tingling in the feet.  Sometimes the cause originates in the feet and other times it a systemic cause meaning there is a disease process in the body that manifests in the feet.  The number one cause of burning/numbness/tingling/pins and needles sensation in the foot in the US is diabetes.  Other common causes are alcoholism, vitamin B12 deficiency, hypothyroidism, HIV, and multiple sclerosis.  Occasionally patients have “idiopathic peripheral neuropathy” which means there is no clear cause for the burning, numbness or tingling in their feet.  Systemic causes usually result in burning, tingling or numbness in BOTH feet and often in a symmetric distribution (like the toes, ball of the foot, or entire bottom surface).  A systemic cause of nerve sensations frequently occurs while at rest, especially in the evening and can even wake you from sleep.

Sprained Ankle? Smashed Toe? Sports Injury? Gardening Accident? The list of urgent foot and ankle injuries can be extensive and expensive, but there are options! Instead of rushing over the the E.R. or urgent care, try calling a podiatry office.  There are several advantages of going directly to the podiatrist for any and all foot and ankle problems.  First and best of all:  minimal wait time!  We can always make room for urgent cases.  Secondly, we take digital x-rays in our office that can be immediately processed and evaluated.  This is good for the sake of the doctor because we need certain views (which are often not properly done in other settings) and good for the patient because he/she will not need a second round of x-rays.  We apply splints and casts and dispense fracture shoes or boots on site.  We can numb up a toe and reduce a fracture then splint it.  Another advantage is that we are very savvy with numbing the foot and toes and make the procedure as comfortable as possible.  Sadly, we often see patients who have had nail trauma or fractures and go to other facilities where numbing injections are not frequently given and thus they get stabbed much more than necessary which is very traumatic.

Patients often come into our Thousand Oaks, CA office with pain in their foot and assume that it is gout.  Gout affects approximately 1% of the population so it is not very common.  It occurs more often in men >40 yrs of age, however, women can get gout after menopause.  The incidence of gout in a healthy premenopausal woman is very low.

I recently ran into an acquaintance of my wife at Europa coffee house in Westlake Village, CA. As we did the standard “hello, how are you? How’s the family” exchange, She suddenly said, “Oh I totally forgot you were a foot doctor! I should’ve called you last week because I needed a new pair of orthotics and I didn’t know who to call!” Turns out she asked her chiropractor who made her a pair. She went on and on about how she had a pair that she had made in San Francisco from her podiatrist that she loved, but that was several years ago. She was extremely disappointed in the ones that her chiropractor had made for her and wanted to know if there was a difference in the types of orthotics.

Ignoring broken toes will not make them heal faster!  We often see patients in the office who broke a toe several months ago and are still having pain.  They often think "there is nothing to do for a broken toe" or are even told that by an urgent care, ER or primary care physician.  Because the fracture is not treated appropriately, the toe can be swollen and painful for months and months.   Most toe fractures can be treated with taping and a stiff-soled surgical shoe, however, sometimes a fracture warrants a controlled ankle motion (CAM) boot.  When a fracture is significantly displaced or angled then, the toe is numbed and put back in place (reduced) and then splinted.  If it cannot be reduced in the office then surgery is necessary to realign and hold in place with a pin or screw.  A fracture takes 6-8 weeks to heal when treated properly.  When ignored, it can take months to heal and then sometimes necessitate a bone stimulator or surgery.  It is worth seeing a podiatrist for your broken toe to ensure proper treatment and expeditious healing.

Ingrown toe nails are common, particularly in the adolescent population.  The most common causes are narrow/tight shoes, sweaty feet and trimming the nails too short.  Some people have a genetic predisposition to ingrown toenails because the nail itself is curved on the sides.  Often times, the nail starts to grow in and then the patient tries to “dig it out,” thereby making it worse and/or causing it to get infected. 

Patients with neuroms suffer from one or more of the following:

A bunion is an enlargement of bone at the great toe joint that can cause your great toe to touch, under-ride or over-ride the second toe. This deformity, if left alone, can often lead to debilitating pain and difficulty wearing shoes. Podiatric/Orthopedic Foot & Ankle surgeons have long used the tried and true method of surgical correction by using a bone cut known as an osteotomy to realign the bone to a more straightened position. This cut is then fixated with a screw and done in combination with appropriate soft tissue release to complete the surgical correction. These osteotomies have names to it, such as the common Austin to the Juvara (base wedge osteotomy). Other osteotomies that have been used are the SCARF, Logriscino, and Reverdin. All of these procedures have their own criteria on their use and often are used in conjunction with other procedures to fully correct the bunion. In severe cases, a joint fusion may be needed, which is a procedure called a Lapidus.

With any open procedure, there is some convelescense with it. In most of these procedures, patients can be weight-bearing immediately after with a protected walking boot or surgical shoe. Some will require almost 6 weeks of non-weight bearing with cast immobilization and crutches. As people's lives become busier, patients needing bunionectomies are looking for other alternative procedures to allow them to recover faster and return to work quicker. One company has taken that concept and developed a new device that not only will correct the bunion with minimal dissection, but offer a quicker return to work and activities. This device is known as the Arthrex Mini TightRope.

Here's the overview of the procedure: three small incisions are used. First incision is used in the first interspace to release the tight lateral structures. Second incision is medial right over the bunion and used to resect the medial eminence. Third incision is just lateral to the second metatarsal to allow tightening of the tight-rope. After releasing the lateral structures and resecting the medial eminence, appropriate drill holes into both the first and second metatarsals are prepped for insertion of the tight-rope. The tight-rope is then inserted and tightened to preference through the third incision. All incisions are closed and dressed. Protected weight-bearing for four weeks in a walking boot or stiff-soled surgical shoe. (Click here if you want to watch the video of the Arthrex Mini TightRope procedure.)

Sounds easy enough ... Makes sense to use the tight-rope device to pull the deformity back into the corrected position, right?

Why do women wear high heeled shoes?  According to Smith and Helms, the tendency to wear high heels is motivated by a general psychological mechanism that drives women to engage in cultural practices that make them desirable to men (1).  High heeled shoes make women seemingly more appealing to men by shortening the calf, shortening the stride, lengthening the leg, toning the legs and making the foot appear smaller and thus more feminine.  There are various heights of heels and according to several high fashion shoe designers, a low heel is less than 2.5 inches, a mid heel is 2.5-3.5 inches and anything above 3.5 inches is considered a high heel.