Achilles Tendonitis Q & A

What is Achilles tendonitis?

Achilles tendonitis is a painful condition affecting the largest tendon in the body, the Achilles tendon of the leg, which connects the calf muscles to the heels. Both professional and recreational athletes may sustain this common injury.

Symptoms of Achilles tendonitis may include the following:

• Difficulty flexing the leg or extending the toes
• Experiencing pain and stiffness along the tendon upon waking
• Experiencing pain along the tendon or back of the heel that worsens with activity
• Experiencing severe pain the day after exercising
• Experiencing swelling along the tendon
• Having a bone spur
• Hearing a “popping” noise in the heel or calf
• Thickening of the tendon

If you experience any of the above symptoms for an extended period and symptoms do not go away with home care, visit your doctor as soon as possible.

What causes Achilles tendonitis?

Achilles tendonitis is essentially an overuse injury of the Achilles tendon due to repetitive stress. Sometimes, this happens when a person starts a new exercise routine, or increases the intensity of an existing activity too quickly.

Other causes for Achilles tendonitis may include having tight calf muscles that put extra pressure on the tendon, or having a bone spur along the heel that creates friction against the tendon.

How is Achilles tendonitis treated?

At Central Massachusetts Podiatry, Drs. Feldman, Saviet and Pelto focus on implementing rest, offering support to the tendon, and reducing inflammation when treating Achilles tendonitis. Self-care and over-the-counter pain medications are generally sufficient in improving symptoms. However, your doctor may also suggest physical therapy exercises directed at stretching, strengthening, and healing the tendon, and the surrounding structures of the leg and foot.

In some cases, patients may require special orthotic devices to support the tendon as it heals. If the tendon is severely ruptured, surgery may be required. Contact our offices to learn more about Achilles tendonitis treatment.

Heel Pain Q & A

What is plantar fasciitis?

If you are suffering from heel pain, chances are it’s associated with plantar fasciitis. This condition refers to the inflammation and swelling of a tough band of tissue located across the bottom of the foot. The plantar fascia connects the heel bone to the base of the toes.

People with plantar fasciitis experience severe and stabbing pain as soon as they step out of bed in the morning. Pain may also be present when standing after long periods of sitting. Plantar fasciitis is incredibly common in runners. However, being overweight, female, and wearing shoes that lack adequate support also increases your risk of developing this condition.

What causes heel pain (plantar fasciitis)?

The most common cause of heel pain or plantar fasciitis is overuse. In rare cases, this condition may also develop after an injury. The typical purpose of the plantar fascia is to absorb shock and support the foot arch. However, when tension becomes excessive, the fascia suffers very small tears. Constant stretching and tearing lead to pain and inflammation of the fascia.

What are my treatment options for plantar fasciitis?

If heel pain persists for longer than two to three weeks despite at-home treatment, you need to see a doctor. Schedule an appointment immediately if heel pain prevents you from walking or putting weight on your foot, if the pain is very severe and arrive suddenly, or if your heel is red or swollen.

Your doctor will perform a review of your medical history, an interview to learn more about your symptoms, and a physical exam to assess heel pain. X-rays or other imaging tests may also be performed. Once your doctor determines the cause and severity of heel pain, he can work with you to develop a treatment plan. Treatment options may include plantar fascia stretching or physical therapy, anti-inflammatory medications, night splints (i.e. splints that stretch the calves and arches during sleep), and custom-made orthotics or shoe inserts.

If you are searching for help with your plantar fasciitis or heel pain in Worcester, MA, for you or a loved one, you are in the right place at Central Massachusetts Podiatry. Ultimately, you should feel comfortable with your treatment and your podiatrist.

Bunions & Hammertoes Q & A

What is the difference between bunions and hammertoes?

A bunion is a painful deformity of the inner foot bone. In this progressive condition, the bump located behind the big toe enlarges to the point that the toe is forced to deviate and press into the neighboring second toe. One of the primary culprits to bunions is the tapered toe box present in most footwear.

Hammertoes are another type of forefoot abnormality that results in a contracture, or prominence, of the toe. This causes imbalance while walking or running. This prominence may arise at any of the two joints of a toe. Contemporary-style footwear can contribute to hammertoes.

What can I do to prevent bunions and hammertoes?

Younger people may be able to minimize their chances of developing these forefoot deformities. This can be done by carefully selecting footwear, not based on fashion or trendiness, but on function and support. Footwear should be wide enough in the toe box so that the toes can splay out in their natural form. Your podiatrist can consult with you on how to appropriately select footwear that supports the natural form of your foot and toes.

How are bunions and hammertoes treated?

Drs. Feldman and Pelto may consider many options in treating bunions and hammertoes. Patients may be able to perform a certain range of motion exercises that helps reverse these deformities and strengthen the muscles located near them. Other treatment options may involve gait analysis, orthotics, and shoes that feature pads or splints. In severe cases of chronic deformities, surgical intervention may be required to relocate these deformities into the correct position and restore normal functioning to the foot.

If you are suffering from bunions or hammertoes, you should call our clinic to schedule an appointment today. Being treated by an experienced podiatrist can help you find relief from these often painful conditions.

Ingrown Nails Q & A

What is an ingrown nail?

An ingrown nail is a fingernail or toenail that grows beneath the surrounding skin rather than over it. Ingrown toenails are most common and the big toe is usually the victim. When the corner or side of the toenail wedges into the soft flesh it can cause pain, swell, or even drain pus. When these toenails are not treated, they can develop an infection. When the pain involved with ingrown toenail becomes too severe or seems to spread or worsen, you should visit the doctors at Central Massachusetts Podiatry.

How do ingrown nails form?

There are a number of explanations that describe why ingrown nails form. One of the main culprits is trimming or filing toenails too short or attempting to round out the edges. When this happens, the skin around the nail starts to grow over it.

Another potential cause for ingrown toenails is wearing ill-fitting shoes. If shoes are too little, the toe can grow into the skin after constant pressure. Injury can also cause ingrown nails. If you bump your toe against a hard surface, this can trigger the nail to grow inwardly. Repetitive activities like kicking a soccer ball can also cause this condition.

What can the podiatrist do to treat ingrown nails?

If ingrown nails are troubling you, you should see a professional like Dr. Feldman, Dr Saviet or Dr. Pelto who can effectively treat the problem without causing more pain or discomfort. Treating an ingrown toenail at home can sometimes complicate rather than relieve the issue.

Wearing comfortable and proper-fitting shoes, taking over-the-counter pain relievers, and soaking the feet several times a day may relieve ingrown nails before an infection develops. Once nails are infected, you need to see a doctor right away. Surgical intervention may be required to remove a section of your nail, the nail bed, or the surrounding soft tissues.

Child Foot Disorders Q & A

What are child foot disorders?

Child foot disorders include a host of congenital and acquired conditions affecting the foot, ankle, or toes. Our competent team of podiatric health care providers is able to diagnose and treat such conditions in toddler, small children, and teens.

While the most common reasons children often show up in our offices is for treatment of flat feet, warts, and ingrown toenails, there are many other child foot disorders that may affect your child’s comfort, functioning, growth, and development.

Common disorders may involve the foot, such as hooked foot or Haglund’s deformity (a heel bone condition), the toe, such as missing toes, polydactyl (an extra toe), or Apert’s syndrome (fusion of the toes), in addition to combination disorders that involve various structures of the foot, like muscle imbalance deformities.

How do I know if my child has a foot disorder?

Having awareness about child foot disorders is a great starting point for recognizing an issue in your child and getting help. All children are not prone to complaining about pain and therefore, you may not be able to rely on them telling you. What’s more, toddlers and smaller children may not even have the appropriate command of words to intelligently explain a foot problem.

Watching your child while he or she is walking, running, playing and resting can help you determine if there is an issue with pain or ambulation. Does your child favor one foot over another? Get tired quickly? Or, never want to participate while others are playing? These all may be indications of a problem.

How are child foot disorders diagnosed and treated?

Our mission is to provide comprehensive diagnostic and treatment services for child foot disorders. Patients at Central Massachusetts Podiatry have the access to three highly skilled podiatrists with many years’ experience treating all sorts of foot conditions. In addition, our offices feature x-ray services and special gait analysis software to detect child foot disorders.

Treatment of these disorders depends on the type of disorder and its severity. Many pediatric foot conditions may resolve themselves over time while others require medical intervention to prevent further damage and restore function. Contact our clinic to learn more.

Flat Feet Q & A

What are the symptoms of flat feet?

A typical adult foot has a clear curve in the middle that goes inward towards the foot. This is known as the foot’s arch. Flat feet basically describes a condition in which the whole bottoms of your feet are pressed against the floor when you stand. Frequently, people report having no symptoms with flat feet. However, other people may experience severe pain in their heels or arches that seems to worsen with increased activity. You may also experience swelling along the inside of your ankle due to flat feet or arch problems.

What causes flat feet or arch problems?

A range of issues may contribute to flat feet or arch problems. The most common and simple explanation is that an arch never developed throughout childhood. Flat feet are actually quite normal in babies and small children.

Another potential cause of flat feet is damage or inflammation to the tendon that connects the lower leg to the foot arch. Tendons may be stretched or torn. Bones may be dislocated or broken and cause this condition. In addition, nerve problems and common medical conditions like rheumatoid arthritis may also result in flat feet or arch problems.

How can I be treated for flat feet or arch problems?

All flat feet do not necessarily require medical attention. Most of the time, this condition can be painless and not cause the individual any trouble. However, in some cases, flat feet or arch problems may evolve into a more serious complication in the foot and/or ankle. Your doctor can diagnose flat feet or arch problems by examining your feet as you stand or walk.

If flat feet do not cause pain or gait issues in children or adults, then no treatment may be recommended. If pain is present, your podiatrist may recommend orthotics and special shoes to better support your feet. In more severe cases, surgery may be required to repair a tendon, cut and shift bones or fuse the joints back into their proper position.

Foot & Ankle Surgery Q & A

Why would I need foot surgery?

Podiatric surgery involves the invasive, surgical treatment of conditions relating to the foot, ankle, and associated structures of the leg. Drs. Feldman, Saviet and Pelto have many years of combined experience performing podiatric surgery in the Central Massachusetts area.

If your podiatrist has recommended that you undergo surgery, it is likely that you have tried a range of non-invasive treatments with little to no success. Many conditions of the foot and ankle simply do not respond to more conservative treatments, requiring more aggressive treatment in order to reduce pain, realign structural issues, or remove deformities.

What kinds of podiatric surgery do you offer?

At Central Massachusetts Podiatry, our podiatrists are competent at conducting a selection of podiatric surgeries, including:

• Bunion surgery: An incision is made at the top or side of the big toe. Bone and soft tissue are removed in order to realign the joint and return it to normal function.
• Hammertoe surgery: Surgical intervention may require that a portion of the bone be removed or that that the toe joint be fused.
• Heel surgery: Bone spur is removed, or the fascia is released from the heel bone to ease discomfort.
• Fractures: Broken bones in the foot are reset or realigned in order to prevent long-term problems due to delayed healing or severe injuries.
• Diabetic foot surgery: Foot deformities are corrected in the diabetic patient in order to prevent neuropathy, vascular or circulatory disease. Ulcerations or bone infections may also be treated surgically.
• Arthritis: Surgery dependent on the type of arthritic condition, severity, and affected joint(s). Joints may be reconstructed, fused, or completely replaced, if necessary.
• Nail surgery: Toenail deformities, such as ingrown toenails, are treated by remodeling the toenail to fight infection and relieve pain.
• Skin lesions: Surgery is usually performed to remove lesions associated with skin cancer.
• Arthroscopy: small incisions are made to allow instruments and cameras to be used to perform surgery within joints
• Flatfoot surgery: Surgical interventions are sometimes required to correct severely flat feet with bone cuts/grafting, joint fusions and soft tissue procedures.

How do I prepare for podiatric surgery?

Before you undergo podiatric surgery, your doctor will conduct an array of tests or examinations to determine the extent of the problem and to verify the necessity of surgical intervention. You will want to discuss any preexisting medical conditions, allergies, and relevant family history with your doctor to ensure positive outcomes of surgery. Call the office if you have any questions pertaining to preoperative podiatry surgery care.

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Warts Q & A

What is a wart?

Warts that occur on the feet are known as plantar warts. Signs and symptoms of these types of warts generally include a small lesion on the bottom or the foot. The lesion may feel rough and fleshy to the touch. Sometimes, calluses develop over warts. You may be able to spot very small black pinpoints, called wart seeds, which are really clotted blood vessels. Warts on the foot may cause pain, bleed, and make it difficult for you to walk or stand.

What causes plantar warts?

Warts are caused by a virus that thrives in environments where there are moisture and warmth. Children or adults may contract warts by walking on dirty surfaces without shoes or socks. The virus responsible for plantar warts is HPV, or human papillomavirus. There are dozens of types of HPV viruses. However, only a handful may cause plantar warts.

Everyone that comes into contact with this virus may not get warts. Some people’s immune systems are more resistant to certain viruses than others. Plantar warts aren’t as easily transmitted from skin-to-skin contact. Instead, people get them by exposing skin that is cracked, cut, or scraped to moist environments like the floor in a locker room.

Do I need treatment for plantar warts?

Plantar warts will typically dissolve on their own after a period of time. Still, you should see a doctor if the wart is particularly painful or if it changes in appearance. Other reasons to see a doctor for warts is if you have a weakened immune system, if you have diabetes, if you aren’t sure whether the lesion is a wart, and if the wart prevents you from engaging in daily living activities.

Warts may be removed by freezing them off, using laser or surgical techniques, or by administering special drugs that enhance the immune system. Even after treatment, warts can reappear.

Neuroma Q & A

What is a neuroma?

Often referred to as Morton’s neuroma, a neuroma is basically a benign growth of nerve tissue usually located between the third and fourth toes. Many sufferers describe the condition as feeling like they are walking on a stone. Neuromas are more common in women.

Symptoms of neuromas may include swelling between your toes, pain in the upper part of the foot between the toes, tingling or numbness in the ball of the foot, and pain when weight is placed on the ball of the foot.

What caused my neuroma?

Doctors are unable to pinpoint the exact cause behind the formation of a neuroma. However, there are some recurring characteristics associated with this condition. These include:

Having instability in the forefoot due to a high-arched foot or flat foot
Experiencing trauma in the nerve of the foot
Wearing improper footwear, such as high heels taller than two inches
Experiencing repetitive stress in the forefoot
Patients should visit the podiatrist as soon as they suspect signs of a neuroma. This condition can progressively worsen if left untreated.

How is a neuroma diagnosed and treated?

When you come to Central Massachusetts Podiatry for treatment of a neuroma, our doctors are able to provide the most comprehensive diagnostic evaluations. Our in-house radiology services allow our health care providers to conveniently order x-rays to determine the cause of your foot pain. Your doctor will also conduct a physical examination, and may order additional testing as needed.

Treatment for your neuroma will depend on the likely cause of your symptoms and their severity. Your doctor will generally start with conservative treatment options, such as arch supports and foot pads that help relieve pressure on the nerve. In more serious cases, steroid injections may be required for pain management. Surgical options may include decompression or removal of the nerve.

Sports Injuries Q & A

What are sports injuries?

In a nutshell, sports injuries are any sort of injury that occurs when you are playing sports or engaged in physical activity. These types of injuries may happen by accident or due to improper training, mechanics, or equipment.

If you sustain a sports injury, you need to stop the activity right away to prevent further harm to yourself. Contact the friendly and knowledgeable professionals at Central Massachusetts Podiatry for step-by-step advice on how to care for sports injuries until you can come in to see the podiatrist.

How are the most common sports injuries sustained?

The most common sports injuries include Achilles tendon injuries, dislocations, fractures, knee injuries, pain associated with the shin bone, sprains and strains, and swollen muscles.

Sports injuries may be acute or chronic in nature. Acute sports injuries are those that happen all of a sudden. These injuries may involve loss of movement in the joint, sudden and severe pain, a bone knocked out of place, swelling or tenderness in the joint, and not being able to put weight on the body part in question.

Chronic sports injuries happen after playing a sport or exercising over a period of time. You might notice a chronic injury due to experiencing a dull ache while resting, experiencing pain when playing or exercising, and swelling at the joint or muscle.

What can my podiatrist do to treat sports injuries?

If you sustain a sports injury, you should immediately stop playing or engaging in that activity. Home care typically involves applying the RICE method, which refers to resting the injured body part, applying ice, compressing it to minimize further damage, and elevating it.

Depending on the location and severity of the injury, Drs. Feldman, Saviet or Pelto will determine what sort of treatment is required. Treatment may include use of over-the-counter pain medications and immobilization with a sling, splint, or cast. In situations when connective tissue has been torn or a bone is out of place, surgery may be necessary to repair or expedite healing of the injury.

Talk to your doctor about how to care for sports injuries and prevent future injuries from happening.

Foot and Ankle Arthritis Q & A

What causes arthritis in the foot and ankle?

There are many causes for arthritis in the foot and ankle, including trauma (such as a car accident), overuse, poor biomechanics, autoimmune diseases (such as rheumatoid arthritis), or infection. In most cases, arthritis is caused by the degeneration of the cartilage in the joints.

What can I do to prevent pain from foot arthritis?

If you are experiencing foot arthritis symptoms, avoid unsupportive shoes, such as high-heels, and aim for shoes that have arch support and provide increased stability. Stretch Achilles tendons can indirectly contribute to foot arthritis prevention.

How is arthritis treated in the foot and ankle?

Non-surgical options to treat arthritis of the foot and ankle include activity modification, bracing and orthotics, and compression. Corticosteroid injection into the joints of the foot and ankle can be helpful.

Orthotics Q & A

What are orthotics?

The term orthotics is used to describe custom made inserts that are designed to improve how you walk or run. These specialized devices may help realign or support the foot or ankle, prevent or correct foot abnormalities, and improve overall functioning of these weight-bearing body parts. Customized orthotic devices are designed just for you, offering you maximum support and correction of any deformities. These devices also last longer than non-custom designs.

How are orthotics different than arch supports?

Custom orthotics control abnormal position and movement of the foot, ensuring that the body works in an ergonomically balanced position. Arch supports merely provide additional support and cushioning. While standing or walking the heel and midfoot orthotics hold the foot in a more stable position, allowing the feet to function more efficiently during weight-bearing and propulsion. This control is often accomplished by limiting abnormal pronation of the foot. Pronation is a complex movement that occurs when the heel and forefoot turn out. There is a corresponding internal turning in of the lower leg, and flattening of the arch. This results in strained ligaments and overtaxed muscles due to the effort needed to pull the foot into a more stable position. Customized orthotics help prevent some of the complications of the chronically unstable foot by controlling abnormal pronation.

Why would I need orthotics or shoes?

Our team of skilled podiatrists and medical providers wants to optimize your performance, whether on the field, track, court, or simply in everyday life. By completing a gait analysis program of yourself running and walking, our doctors can then determine if you require specialized orthotics or shoes depending on your activity level, foot type, and body mechanics.

Each person will have a unique gait and potentially require customized orthotics and shoes to achieve maximum functioning. Are you an athlete who is hoping to enhance performance? Or, are you a normal person who just wants to provide better support to your foot or ankle after an injury? If so, call our clinic to schedule your appointment for gait analysis, orthotics, and shoes today.

Shockwave Therapy Q & A

What is EPAT Shockwave Therapy?

Extracorporeal Pulse Activation Technology (EPAT) Shockwave therapy is a revolutionary, non-surgical treatment approach for acute and chronic musculoskeletal issues. Approved by the FDA, this specialized therapy has offered lasting relief to millions of patients around the globe who experience little to no pain after completing EPAT shockwave therapy treatment. Used to address a wide range of joint, muscle, and tendon problems, this non-invasive treatment can help alleviate pain or discomfort in hard-to-treat injuries when other options fail.

What conditions are treated with EPAT: Shockwave Therapy?

EPAT shockwave therapy is a terrific treatment option that delivers an array of benefits to patients, including the fact that there is no scarring, no required downtime after treatment, no risk of infection, faster recovery, and greater than 80% patient satisfaction.

This treatment has been used to help with a variety of issues, such as:

• Plantar fasciitis
• Achilles tendonitis
• Non-unions of bone
• Neuromas
• Triggerpoints

If you have had difficulty finding long-lasting relief from a joint, muscle, or tendon injuries, EPAT shockwave therapy may be the appropriate choice for you.

What can I expect during treatment?

The advanced technology involved with EPAT shockwave therapy allows your podiatrist to direct low-frequency sound waves to the site of the injury in order to stimulate the metabolic process, increase blood flow, and active the body’s natural healing properties. In as little as 15 minutes in your doctor’s office, you can accelerate healing to the injury and start the process of regenerating cells. At least four separate sessions may be required for optimal results.

If EPAT shockwave therapy sounds like a treatment option that can alleviate the pain and limited mobility caused by your musculoskeletal injury, call our office for an appointment to discuss this approach with the podiatrist.

Amniotic Tissue Allograft Q & A

What is amniotic tissue allograft?

Amniotic tissue allograft is a regenerative medicine and human amniotic membrane supplied in a powder or liquid form. It contains over 57 natural growth factors that can help control inflammation, reduce scar tissue, and improve healing. Growth factors are powerful agents that our bodies produce to signal cells to come to the target site, help the site to heal, and help your own cells regenerate the damaged tissue. All of the amniotic membrane tissue for amniotic tissue allografts are donated by healthy consenting mothers undergoing scheduled Caesarean sections.

When is amniotic tissue allograft used?

Amniotic tissue allograft can be used to treat some common conditions such as Achilles tendonitis, posterior tibialis tendonitis, peroneal tendinitis, bursitis, arthritic joints, ankle sprains, and Plantar fasciitis. Amniotic tissue allografts may be used if other non-surgical treatments (anti-inflammatories, physical therapy, and bracing) have not provided symptomatic relief. Amniotic tissue allografts are also a good alternative for patients wanting a steroid injection or if steroid injections are contraindicated.

How is amniotic tissue allograft used?

The tissue allografts are injected into the injured soft tissue or tendon. The amount of injections needed, will be based on your response to the initial injection. The only side effect of the injection, is a potential for a moderate increase in tenderness and pressure at the treated area, and is normally noticed within 72 hours of treatment. Amniotic tissue allografts are not covered by health insurance.

Lunula Laser

What is toenail fungus?

Also called onychomycosis, fungal infections in your toenails can cause your nails to thicken and become yellow and brittle. Toenail fungus is caused by organisms that grow in receptive environments, such as warm, dark, moist areas of your body, such as your feet. Toenail fungus is more prevalent in older adults, but anyone can get it at any age.

In years past, toenail fungus has mainly been treated with oral and topical medications, but podiatrists now rely on laser toenail fungus treatments for the best results. Today, the Lunula Laser provides a safe, effective, and painless alternative to past methods of treating fungal infections that often proved ineffective.

How does the Lunula laser work?

This FDA-approved toenail fungus treatment is revolutionary. With low-level laser energy, the Lunula Laser uses photochemistry to target the toenail fungus and stimulate blood flow. Photochemistry is the science of light and color.

With red and violet laser lights, the photochemical reaction caused by the laser kills the fungus and stimulates new, clear toenail growth. While the laser aggressively treats the fungus, it does not affect the rest of the toe or foot.

The procedure is quick and painless, and each foot takes about 12 minutes to treat. Most patients have multiple sessions to see optimal results, and sessions are usually spaced out about seven days apart.

How do I prepare, and what happens afterward?

You should arrive with clean feet and trimmed toenails. Furthermore, you should remove all nail polish and any lotions or creams from your toes. Following treatment, you can return to your activities immediately.

There have been no reported adverse reactions to the laser treatment. It is well-tolerated, quick, safe, and painless. You can expect to see results in as few as two sessions.

At home, you should wash all your socks in hot water to kill any lingering fungus. Furthermore, you should treat your shoes with antifungal spray to prevent reinfection.

If you want to have beautiful, healthy feet again, and you’re tired of the embarrassment and pain caused by your infected toenails, book an appointment online or of the phone with Central Massachusetts Podiatry today.

What causes nail fungus?

Nail fungus, also known as onychomycosis, involves the thickening, dulling, distortion, darkening, or crumbling of one or more nails. Nail fungus is usually caused by dermatophyte fungus, or, in some cases, yeasts and molds.

Nail fungus is much more common in toenails because the toes are frequently in environments characterized by moisture, warmth and lack of light—factors that make it easier for fungi to grow. Also, the toes have reduced blood circulation in comparison to the fingers, so the body’s immune system is delayed from identifying and fighting against an infection.