Posts for tag: Hackettstown

By Kyle Alessi
December 24, 2014
Category: Injury Prevention


Neuromas, or abnormal growth of cells within a nerve, most commonly form between the third and fourth toe bones. Pain is often elicited as a result of these bones pressing together and irritating a segment of a nerve. This may be caused by wearing tight shoes, or by frequent stress on the foot. Women who wear high heels regularly are prone to neuroma formation.

Symptoms of a neuroma begin slowly, but often become progressive. You may feel a sharp, burning sensation in the ball of the foot, especially when bearing weight. Another common symptom is tingling or numbness between the toes and in the ball of the foot. There may also be pain on palpation at the neuroma site. Your podiatrist can perform a foot exam to determine if you have a neuroma. If needed, imaging studies such as X-rays and ultrasound can be done to confirm this condition and rule out other problems.

Fortunately, there are many treatment options available to reduce painful symptoms, and in most cases, without surgery. For example, your podiatrist may first suggest shoe changes. Shoes with good support, a wide toe box, and thick soles can help avert nerve irritation. Getting a proper fit is important. Avoid wearing high heels. If necessary, custom-made shoe inserts (orthotics) can provide support for your feet and prevent the neuroma from getting worse. Other conservative treatments include padding and taping. This can help take pressure away from the irritated nerve. Your podiatrist may also prescribe anti-inflammatory medications to reduce tissue swelling. Cortisone injections may also be used to relieve the nerve inflammation.

If conservative treatments still do not provide relief, your podiatrist may suggest treating the nerve directly in two different ways: surgery or injections. Surgery may be used to excise the neuroma. Upon removal of the neuroma at your podiatrist’s office or hospital, you can usually go home the same day. You can often return to normal activities within 3 to 6 weeks. Injections of an alcohol solution may be utilized to permanently numb the irritated nerve. Although the injections in your podiatrist’s office take just a few minutes, repeated treatments are usually required.

For more information about treating neuromas, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Kyle Alessi

By Fawaz Nesheiwat
September 24, 2014
Category: Nail Fungus


Naturally, fungi and bacteria are all around us. When a fungus begins to overgrow, however, an infection can occur. Fungal infections can affect any part of the body, from the skin to the eyes.

Onychomycosis, or tinea unguium, is a fungal infection that affects the nails. Fungal nail infections occur over a long period of time, so any abrupt change in nail integrity may be too subtle to notice at first.

There are various causes of onychomycosis. Although many of the causes are preventable, some risk factors expedite the possibility of developing it.  These risk factors include being diabetic, family history, advancing age, have a disease that affects blood vessels, living in a warm climate, swimming in a public swimming pool, compromised immune system, wearing closed-toe shoes thereby blocking airflow, having a nail injury, and poor podiatric hygiene.

A fungal infection of the nail may affect part of the nail, the entire nail, or several nails.

Onychomycosis can be identified by appearance. Visible fungal nail infection signs include scaling under the nail, white or yellow streak on the nail, crumbling corner or tip of the nail, flaking white areas on the nail’s surface, yellow spots at the bottom of the nail, or loss of the nail. Common signs of onychomycosis include a distorted nail, an odor coming from the infected nail, and/or a brittle or thickened nail. If you suspect you might have a fungal nail infection, see your podiatrist to have the infected nail tested. If the tests do come back positive, proper treatment will ensue. By following the basic FootCare guidelines, you more than likely can head off most common foot fungus problems.

Your podiatrist may prescribe an oral antifungal medication. Treatment may not rid your body of the fungal infection completely. In almost half of cases, the fungal nail infection will return. However, it is important to take your medicine as directed, as this is currently the best way to treat toenail fungus. Your podiatrist will also debride your thickened or brittle toenails on a regular basis to ensure your fungal infection is under control and your overall foot health is maintained.

Prevent the fungus from returning by practicing good podiatric hygiene. Wash your feet regularly with a mild soap, taking care to scrub between toes, and dry them completely once you have rinsed off all the soap.

For more information about treating fungal foot infections, be sure to schedule an appointment to further seek professional care from one of our doctors at FootCare Associates in Hackettstown, New Jersey.

By Fawaz Nesheiwat

By Kyle Alessi
May 13, 2014
Category: Pain


Ever wake up abruptly at night by a hot, painful feeling in your big toe or ankle? Does the joint feel painful and appear red and inflamed? These can all be signs of a gout attack. Gout is a form of inflammatory arthritis. Be sure to seek treatment upon onset, otherwise it can lead to painful foot deformity and even kidney problems. Early treatment with medication and a proper diet can relieve the joint pain. In severe cases of foot deformity, surgery may be a required.

Gout is a disorder of uric acid metabolism, leading to increased uric acid (waste product) in the blood. The excess uric acid forms hard crystals in the joints, inducing a gout attack. Perpetual gout attacks lead to large deposits of chalky crystals called tophi.

Men are more predisposed to gout than women, but women are more likely to get affected after menopause. The chances of getting gout are increased if you are overweight and have high cholesterol, drink too much alcohol, and/or eat too much meat and fish that are high in chemicals called purines. Some medications, such as diuretics (“water pills”) can also induce gout.

Your podiatrist will ask you questions about your symptoms. He or she will ask about your diet, medications, and how much alcohol you consume. This will be followed by a physical examination of your feet for signs of gout, which include inflammation, heat, and redness.

He or she may then perform a joint fluid test by using a needle to draw fluid from your affected joint. This fluid will be analyzed for crystals. Your podiatrist may also take a blood sample to measure the uric acid level in your blood.

Treatment for gout usually requires medication. To relieve the pain and swelling associated with gout, your podiatrist may prescribe a non-steroidal anti-inflammatory (NSAID) to stop an acute attack, followed by a lower daily dose to prevent future attacks. Also, your podiatrist can give you a pill or injection form of corticosteroids to help with the gout symptoms. If complications occur, you can also be prescribed xanthine oxidase inhibitors (which limit the amount of uric acid your body produces) at the discretion of your podiatrist. Based on your past and current medical history, he or she will decide which medications would be best suited for you.

With that said, if you experience pain and discomfort with your gout, be sure to schedule an appointment to further seek professional care from one of our doctors at Foot Care Associates in Hackettstown, New Jersey.


By Kyle Alessi

By Fawaz Nesheiwat
April 24, 2014
Category: Pain


Hallux abducto valgus, commonly known as a bunion, is a deformity characterized by a bony hump at the base of the big toe where it affixes to the foot.

Bunions are the result of uneven weight distribution, placing pressure at certain joints and tendons in your feet. This disproportionality in pressure creates instability at your big toe joint, overtime shaping the parts of the joint into a solid protuberance that extends out past the normal contour of your foot. Bunions can be inherited, caused by foot injuries, wearing high heels, or a deformity present at birth (congenital). In addition, bunions may be linked to inflammatory types of arthritis, such as rheumatoid arthritis.

In order to identify your bunion, your podiatrist can take a physical exam by watching your big toe as you move it up and down. He/she will also look for redness or swelling. After physical examination, an X-ray of your foot will reveal the cause and severity of your bunion.

There are a number of treatment options in both the conservative and non-conservative approach:

Nonsurgical treatment:

  • Changing shoes. Wear comfortable, sizeable shoes that provide room for your toes.
  • Padding and taping or splinting. Your podiatrist can tape and pad your foot in a normal position.
  • To control the pain of a bunion, anti-inflammatories (acetaminophen, ibuprofen, or naproxen) can be given. Cortisone injections can also reduce the pain.
  • Orthotics. This padded shoe insert helps evenly spread pressure on your foot.
  • After a long day on your feet, icing your bunion will alleviate soreness and inflammation.

Surgical treatment:

If conservative treatment fails to provide relief, surgery may be the next best option. The aim of bunion surgery is to reposition your big toe to the normal position. Procedures include:

  • Removing the inflamed tissue surrounding your big toe joint.
  • Straightening your big toe by resecting part of the bone.
  • Straightening your great toe relative to the first metatarsal and adjacent toes.   
  • Permanently affixing the bones of your affected joint.

Prevention of bunions from emerging or worsening overtime include: wear true shoe size, wear shoes with a wide toe box, and wear shoes that don’t press or congest your feet.

Depending on the severity of your bunion, appropriate measures can be taken to treat the underlying cause and symptoms. If you experience pain and discomfort with your bunion, be sure to seek professional care from one of our doctors here at Foot Care Associates in Hackettstown, Landing, and Washington.

By Fawaz Nesheiwat

By Barry Mullen
April 08, 2014
Category: Injury Prevention


Spring's arrival generally signals a warming weather trend that usually motivates people to become more active, especially outdoors. Many high school and college athletes are on the cusp of re-starting their spring sport programs. Often, during the cold winter, our activity level generally reduces somewhat. During the winter, that inactivity, coupled with added food intake, often negatively affects our core. This combination, and our desire to regain that core, along with persistent cooler temperatures in early spring, often lends itself to the formation of overuse injuries of the lower extremities. These include, but are not limited to: muscle, ligament and tendon strains (Achilles, plantar fascia, and shin splints most common), and stress fractures of the metatarsal bones.

Here are some training tips to help reduce the chances of incurring an overuse lower extremity injury. If you were less active in winter, scale back your exercising and early spring outdoor workouts by 25%. Each ensuing 2 weeks, add 25% to your last routine until you reach your original workout regimen. This should take 4-6 weeks. If you have indoor aerobic equipment, utilize it to warm up for 5-10 minutes, then stretch your lower extremity muscles before stepping outside. Stretch again after completing your workout as part of your cool down. Allow adequate training time to slowly increase activity level when readying for a race, or major charitable event that involves aerobic activity.

Should you sustain a foot or lower extremity overuse injury, cross train to low impact activity immediately and consult your local podiatric sports medicine specialist. At FootCare Associates, in Hackettstown, NJ, our doctors are all board certified physicians who are well trained in diagnosing and treating overuse lower extremity injuries. Call us at (908) 852-0229 to learn how you can get the most out of your aerobic workouts, and what steps to utilize when attempting to return from injury.

By Barry Mullen