Common Foot Conditions in Glenview & Gurnee, IL

Unlike the heel spurs that occur in adults, heel pain is very unusual in children. For the children who do get heel pain, the most common cause is an irregularity to the growing area at the back of the heel bone where the large achilles tendon attaches to it. This is called Calcaneal Apophysitis (an inflammation of the growth plate). It occurs most often to children between the ages of 10 to 14.

Symptoms of Heel Pain For Children

In severe cases, the child will be limping. The back and side of the heel bone will have discomfort. Also, there may be pain at the bottom of the heel. The pain usually stops when the child is not active and becomes painful with physical activity. Pinching the sides of the heel bone is often painful. Running, jumping make the symptoms worse. One or both heels may be affected.

Treatments

• Minimize physical activities - don't stop, just reduce the amount until symptoms improve
• Do not go barefoot
• Use a soft cushioned heel raise
• Stretch the calf muscles provided the stretch does not cause pain
• Ice the area for 20 minutes after the activity, can be done 2 to 3 times a day

There are many forms of arthritis and related conditions that affect muscles, joints, and bones in our feet that cause problems like pain, swelling, and stiffness. There are other conditions that cause additional problems like tingling, numbness, painful ulcers, thick skin, or pitted nails. Here is a list of arthritis conditions that affect our feet:

Rheumatoid Arthritis Symptoms are different from person to person and can closely resemble other inflammatory joint conditions, often making the diagnosis challenging. How can you know if the symptoms are rheumatoid arthritis? One of easiest, stand out features of the disease is that it invades the little joints; for example, of the feet or the hands. And the pain is symmetrical — if it affects the first toe on the left foot, it usually will affect the same toe on the right foot.

Ankle Fractures

A fracture is a major or small break in a bone. Fractures of the ankle vary from minor avulsion injuries (tiny sections of bone that have chipped off) to serious obliteration breaks of the fibula, tibia or both.

(Also called tinea pedis) is a fungal infection of the skin (in the feet) that causes flaking, scaling and itching, usually between the toes. Blisters and cracked skin may also be present, leading to raw tissue, pain, swelling and inflammation. It is caused by fungi in the genus Trichophyton and is typically found in warm, moist areas where people walk barefoot, such as showers or pools. It is caused by a fungus that grows and multiplies quickly and causes an infection. Although the condition typically affects the feet, it can spread to other areas of your body. Your risks for catching Athlete's foot increases if you:

• Wear Plastic Shoes, Especially Closed Toe
• Have Sweaty Feet
• Leave Your Feet in Water for a Long Period of Time
• Acquire a Nail or Skin Injury

Athlete's foot can usually be diagnosed by your podiatrists visual inspection of the feet, but where the diagnosis is unsure direct microscopy of a potassium hydroxide preparation (known as a KOH test) may help rule out other possible causes, such as eczema or psoriasis. A KOH preparation is performed on skin samples from the affected area. The KOH preparation has almost 100% positive predictive value, but once in a while false negative results may be obtained, especially if treatment with an anti-fungal medication has already started.

Millions of us are overweight. This causes health issues like: diabetes, high blood pressure, heart disease, arthritis, varicose veins and more. If you are not sure whether or not you are overweight or underweight the BMI calculator is an efficient and quick way to check. 

The BMI for this example is healthy at 21.18. You should be between 18.5 and 25.0 for a good Body Mass Index. If you are below you are underweight and if you are above you are overweight. Be aware that the BMI range for children is different than adults. If you are cognizant of your BMI and you know you need to lose weight you should consult with your primary care physician and work together to come up with a weight loss plan. Your physician will know what to advise you to do. Same goes for the underweight. Talk to your doctor and get the best advice possible and follow it. Maintain a healthy weight. This will lower your risk for chronic diseases. You will feel good and you will have a better, more enjoyable lifestyle. Here are the (3) steps you will need to figure out your BMI:

• Weigh yourself and multiply it by 703. (Ex. 165 x 703=115,995)
• Divide this number by your height in inches. (115,995/74=1,567.5)
• Divide the new number by the height in inches again. (1,567.5/74=21.18)

An excess misaligned bony protrusion at the base of the big toe, a bunion causes that toe to slant toward the others. Knocking foot bones out of alignment and making the characteristic bump at the joint's base, a bunion can be very painful due to pressure or arthritis, and may also lead to corns. Pain relievers, padding to cushion the bunion, custom molded orthotic shoe inserts, or surgery may help, as will wearing shoes that are the correct size and style and avoiding high heels.

Children often exhibit structural and functional disorders of the foot and leg that can be effectively treated by the podiatrist. The pediatric examination involves a complete history and orthopedic evaluation of the lower extremity. Children need proper care and treatment of their feet beginning in early childhood. Many children walk excessively bowlegged, flat footed or pigeon toed. Although these conditions are not painful for the child, they are damaging to their feet.

Almost all babies start life with their toes pointing slightly out. However, if the unborn baby lies with its feet pressed against the mother's womb in the wrong direction, it can be born with its feet turned inward. This ailment can make learning to walk very difficult. If your baby trips, it may be one of the first signs of toeing in. Podiatrists can teach parents easy exercises that can help straighten out the infant's feet. These exercises will only take a few minutes each day until the condition is corrected.

Most babies appear flatfooted. Generally, this will disappear as the baby stands and walks. Children with low arches, or flat feet, may not be able to stay up with other children because of the additional strain on their feet and legs. Custom Made Orthotics can be used to stabilize proper foot alignment and provide extra support. Children must be refitted as they grow.

Diabetes mellitus represents several diseases in which high blood glucose levels over a period of time can destroy nerves, kidneys, eyes, and blood vessels. Diabetes can also bring down the body's ability to protect itself against infection. When diabetes is not well maintained, by diet, exercise and proper foot wear, destruction to the organs and impairment of the immune system is likely. Foot problems commonly develop in people with diabetes and can quickly become serious.     

• With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly, due to reduced sensation. Pressure and friction on the skin, bones, and joints of the foot during walking can lead to breakdown of the skin of the foot. Ulcers, corns and calluses may develop.       
• Poor circulation and restrictions of the immune system from diabetes make it difficult to heal these wounds. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Most often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the blood-stream, this process can be life-threatening. Infection of the skin, connective tissues, muscles, and bones can then be present.     

10 Important Steps for Patients with Diabetes     

1. Check your feet. Look for redness, swelling, broken skin, sores.       
2. Keep your feet clean. Wash your feet with soap and warm water every day! Make sure the water is only warm, not hot.       
3. Go soft on your skin. Apply moisturizer to your feet every day. Damaged skin leads to more problems.       
4. Where your feet are concerned, avoid the heat. Do not use a heating pad or hot water bottle on your feet for any reason.       
5. Listen to your doctor. Be sure to stay in contact with your podiatrist. Never use any medication on your feet unless you talk to your doctor first.       
6. Let your clothes stay loose. Stay away from girdles, garters, or other tight clothing that may restrict blood flow to your feet.       
7. Be careful with sharp instruments. Do not cut corns or calluses off your feet! This invites infection. Cut your toenails straight across and fairly short to avoid ingrown toenails.       
8. Maintain a proper diet. Lose weight if you need to as it will put less pressure on your feet and help you control your diabetes.       
9. Be kind to your feet. Before putting on your shoes, examine them to make sure there are no pebbles or rough surfaces inside. Also, check your socks.       
10. Kick the smoking habit. Smoking makes your blood circulation worse. Quitting may be the best health choice you ever make.       

What is a Ganglion Cyst?

A ganglion cyst is a swollen fluid filled sac that starts from a tendon sheath or joint capsule. “Ganglion” means “knot” and describes the knot-like bump that forms just under the surface of the skin. Ganglion cysts most often occur on the top of the foot and on the ankle as well. Ganglion cysts change in size, and usually grow very slowly and may get smaller and larger, and could possibly even vanish altogether, only to show up again later.

What Causes a Ganglion Cyst?

Repeated irritation may weaken the lining of a tendon or joint. People who wear boots are at a higher risk.

Symptoms

Most often a ganglion cyst forms without any symptoms. If the Ganglion puts pressure on the nerves you may have a tingling sensation, pain or loss of feeling. The weather change may also have an affect on your ganglion cyst.

Treatment

Ganglions are sometimes hard to treat without having surgery but there are some alternative measures you can take. You can ease the pressure and the friction by placing pads around the area. Change your footwear. You can have your podiatrist aspirate the ganglion, however they may come back. Try icing the area. If you do have a lot of inflammation your podiatrist may order you a prescription.

Gout is a type of arthritis caused by excess uric acid (a waste product made by the body) in the blood. Everyone has uric acid in his or her body. It comes from substances called purines. Most uric acid comes from purines made naturally by the body. The rest comes from purines in your diet. When the amount of uric acid gets too concentrated, sharp spiked crystals form. These crystals collect in the joints and cause swelling and intense pain. Gout attacks usually come on suddenly, without warning and typically last 12 to 24 hours. The most common area for gout to appear is the base of the big toe, but gout attacks can also affect the ankles, knees, hands, and wrists. If left unattended, gout attacks happen more frequently and can eventually cause permanent disfigurement and damage the joints.

What are Symptoms of Gout?

Have you ever experienced a hot, painful feeling in your big toe in the middle of the night? Did the painful area seem swollen and inflamed (red)? This can be a symptom of gout.

Generally speaking, "hammer toe" means a bending of any of the toe joints. Joints in the middle or at the end of the toe, as well as the joint near the ball of the foot, may be involved. Toe joints can curve and buckle because of tight tendons or muscle imbalance. Some hammer toes are severe, depending on how many of the joints are involved. Tight shoes, pantyhose or socks can be the cause of hammertoes.

There are two different kinds of hammertoes, flexible joint or rigid joint. A flexible joint may turn into a rigid joint as you get older.

Flexible Joint - You can straighten this kind of joint out with your fingers. Even though they look painful, they usually are not.

Rigid Joint - This kind of joint is not movable, even with your fingers. Rigid joints can be painful and cause discomfort. They may disable foot bio-mechanics, putting extra pressure and stress on the ball of the foot, causing a callus on the sole of the foot.

Pain that happens immediately after an injury or early in an illness may play a protective role, often warning us about the damage we've suffered. When we sprain an ankle, for example, the pain warns us that the tendons, ligaments and soft tissues may be stretched, frayed and bruised, and that further physical activity may cause added injury. Pain also signals us to seek podiatric medical attention. The signal is of serious importance because of the many ailments that lead to pain in the heel.

A common cause of heel pain is the heel spur, a bony outgrowth at the base of the heel bone near the plantar fascia. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. When there is no indication of bone enlargement, the condition is sometimes referred to as "heel spur syndrome." Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. The pain you feel is not from the spur alone. Your heel hurts because the spur pinches a nerve. If the bursa becomes inflamed, it may tighten the plantar fascia. As with plantar fasciitis, the pain may decrease after standing or walking for a short amount of time. These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.

Both heel pain and heel spurs are frequently associated with an inflammation of the ligament (fascia) running from your heel to the ball of the foot. The inflammation is called plantar fasciitis.

Heel pain can also occur in children, most commonly between ages 8 and 13, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur. When the bones mature, the problems disappear and are not likely to recur. If heel pain occurs in this age group, podiatric care is necessary to protect the growing bone and to provide pain relief. Other good news is that heel spurs do not often develop in children.

Hyperkeratosis is one of the most common conditions a podiatrist treats. Hyperkeratosis is another name for corn or callus. They can show up anywhere on the feet and vary in seriousness from a small callus under the foot, to an infected ulcer that can appear under a corn on a toe. Basically, the skin has hardened due to repeated friction and pressure. It is the body's way of protecting itself. Hyperkeratosis usually refers to a more scattered thickening of the skin (generally on the toes, but can show up on the metatarsal of the foot) whereas a corn is a thicker more centered area (more common on tops of the toes).

Treatment

Your podiatrist will ask you some questions about how long you have had the hyperkeratosis and where does it hurt. The podiatrist will probably examine your shoes for the proper fit. He or she may advise you to use orthotics to relieve some of the pressure. He or she will set up a regular schedule for the trimming and or cutting of the hyperkeratosis. You may require surgery.

Morton's neuroma is a sharp, stabbing, painful condition that affects the ball of your foot, most commonly between your 3rd and 4th toes.

Usually, the pain decreases when you stop ambulating and massage the area. This condition is benign and fixable. It may feel like you are standing on a small rock.

A neuroma is a thickening of the tissue around the nerves between the metatarsals that extend to adjacent toes. This may cause burning, numbness and stinging. Improper footwear or traumas are the main reasons this condition develops. They cause compression and injury to the nerve. Eventually, if the compression continues, the nerve regenerates itself with thick fibrous tissue that causes the swollen inflamed nerve.

Treatment options would include:

• Shoes with a wide toe box and low to no heel.
• Activity Adaption: Rest the foot by using less pressure exercises like swimming.
• Met Pads: To take the pressure off of the nerve. They will help rise and spread the met heads.
• Ice and taping
• Orthotics: help cushion and support the foot.
• Alcohol injections, xylocaine.
• Surgery

There are many types of Nail Problems. You should visit your podiatrist for the following:

• Fungus Nails
• Ingrown Nails
• Thick and Painful Nails

Fungus Nails

Fungal infections are very common on both fingernail and toenails. It is a living organism that thrives in dark, damp environments such as under and around nails. Toes are more likely to be affected by fungus since it is attracted to a dark and damp environment which is more common on the foot than on the hand.

What is an Ingrown Toenail?

When a toenail is ingrown, it is curved and pushes into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, creating pain, inflammation, swelling, and warmth in the toe.

Thick Toenails

Injury to the root of the nail can disfigure it temporarily, while severe or repeated injury can permanently distort a nail. People who take part in sports such as soccer can experience this kind of damage.

Plantar fasciitis involves pain and inflammation of a thick, ligament-like band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes. This band pulls on the heel bone, raising the arch of your foot as it pushes off the ground. If your foot moves incorrectly, the plantar fascia could become strained. The fascia may swell and its tiny fibers may begin to fray causing plantar fasciitis.

Treatment

Your podiatrist may ask you about your symptoms first. Where does it hurt? When and how often? Next, he or she may examine your foot and feel for damaged ligaments, displaced bones or joints and inflamed tendons. Your podiatrist may also watch you walk to see if your symptoms are caused by improper bio-mechanics. X-rays may be taken to see if there is a stress fracture of the heel bone or a heel spur. To relieve mild symptoms try aspirin, ibuprofen, or other medications as directed. Rubbing ice on the affected area may also help. If your pain is due to poor foot mechanics, custom molded orthotics, shoe inserts, may help. To reduce severe pain and swelling, your podiatrist may prescribe injections or pills. Physical therapy, such as stretching or ultrasound may also be advised. To reduce symptoms caused by irregular foot bio-mechanics, your podiatrist may tape them or use strappings that will support the arch and temporarily controls movement. Night splints may also be used. It may also help to avoid running on hard or uneven ground, wear house slippers that support your arch and lose excess weight.

Surgery

Your podiatrist may want to do a procedure if all other treatments don't control the pain. In surgery, the plantar fascia is partially cut to release tension. As you get better, fibrous tissues fill in the space between the heel bone and the plantar fascia.

A Plantar Fibroma is a non-malignant nodule usually found on the central and medial portions of the Plantar Fascia. It is slow growing and measures less than an inch in size. At first, where the nodules grow along the Plantar Fascia the disease is minor, could be uncomfortable and cause pain. However, after a period of time the cords thicken, the toes get rigid and bent and walking is decreased due to pain. There may be several nodules present. Similar condition may appear on the hands.

Treatment

• Avoid putting pressure on the area
• Use inserts for your shoes with soft padding or use custom made orthotics
• Topical medications
• Shock Wave Therapy may reduce pain and help with walking
• Cortisone Injections may also help slow down the Plantar Fibroma, although studies are not complete
• Surgery (as a last resort)

Do you get leg cramps or leg pain when you climb stairs or walk? When you stop and rest, the pain may go away. But usually returns when you start to walk again. This is a pain cycle called intermittent claudication. It can also be a symptom of Peripheral Vascular Disease, or PVD (also called “poor circulation”). With PVD, the vessels that carry blood to your lower extremities become blocked or narrowed. This makes it more difficult for the blood to reach your lower body. If PVD is left untreated, leg and foot tissue may perish. This is called black foot or gangrene and may lead to amputation. You can avoid these conditions by working with your podiatrist.

Treatment

Your podiatrist will first ask you questions about where and when you feel pain and the duration. Your pulse and blood pressure will be taken at your legs and arms to check your blood circulation. Your podiatrist will also check your feet for cracks, fissures, infections and discoloration. Your podiatrist will order some tests to pinpoint the blockage. A Doppler Exam uses sound waves to produce an image of your blood vessels. It is harmless and non-invasive. The podiatrist may examine the entire leg. An Arteriogram uses a dye that is injected into your blood vessels. Then a variety of x-rays are taken. The dye helps the blood vessels show up on the x-rays.

Controlling PVD

High blood pressure, high cholesterol, and diabetes make PVD harder to control. Talk to your podiatrist about managing these problems. Here are a few ways to control PVD:

• Stop smoking. Smoking constricts your blood vessels. It can also raise your blood pressure. Talk to your doctor about non-smoking alternatives.
• Eat right. Avoid fatty, fried and greasy foods, too much fat in your diet can increase your cholesterol and block your blood vessels. Eat lots of fresh vegetables and fresh fruits. Avoid caffeine.
• Control blood sugar. Work with your doctor to control your blood sugar levels, high blood sugar from diabetes can greatly increase the damage to the blood vessels.
• Get active. Talk to your doctor about the right exercise program. Exercise improves your cardiovascular system and increases blood flow. It may even help your blood vessels to increase. With regular activity you will minimize pain.

Raynaud's Phenomenon is a disorder that causes discoloration of the toes and fingers. This condition may also cause your nails to break easily and become brittle with longitudinal ridges. This condition was named for French physician Maurice Raynaud, the phenomenon is believed to be the result of a sudden constriction of a blood vessel that greatly reduces the flow of blood to their respective regions. Stressful situations and cold temperatures are the usual triggers of the condition. In extreme cases, Raynaud's Phenomenon can progress to the premature death of cells and living tissue or the localized death and decomposition of body tissue due to poor circulation in the toes and fingertips. Raynaud's Phenomenon is an amplification of the constriction or dilation of blood vessels responding to very cold conditions or stressful situations.

Symptoms

When you have Raynaud's Phenomenon you may experience some or all of the following:

• Pain
• Discoloration
• Numbness or Cold Sensation

Preparing for Podiatrist Appointment

Your Podiatrist will be able to diagnose Raynaud's based on your signs and symptoms. Although, you may be referred to a rheumatologist (a doctor who specializes in disorders of the joints, bones, and muscles).

• Bring in a list of your symptoms
• Your podiatrist will want to know when the condition started and what triggers its presence.
• Other medical conditions you have
• Your podiatrist will be very interested in your past history. Especially if it includes Scleroderma, Lupus, or Sjogren's Syndrome.
• Bring a list of your prescriptions
• Include all over-the-counter medications you're taking, as well as all vitamins and herbs, too.
• Bring questions!
• Come up with a list of questions ahead of time to make the most of your time with the podiatrist.

When our feet have been mistreated, they are at risk for damage from outside forces or from genetic traits. Problems with the foot and ankle develop from a large variety of causes, many of which can be treated with reconstructive foot and ankle surgery. Reconstructive surgery can help eliminate birth defects, injuries, diseases and other foot and ankle ailments that can greatly benefit patients' medical needs. If conservative treatments fail or are not optional, reconstructive surgery is often a good choice in permanently treating many foot disorders. Reconstructive foot surgery is used to treat the following conditions:

• Arthritis
• Hereditary Deformities
• Infections
• Lesions
• Tumors
• Vascular Diseases
• Trauma

Our podiatrists (foot and ankle surgeons) are board certified and specially trained in performing a variety of reconstructive procedures to restore your foot or ankle back to its original state and allow for full range of motion and functionality.

Smoking continues to be the leading cause of preventable death and disability in the United States. According to the CDC's 2004 report on tobacco, cigarette smoking causes more than 440,000 deaths every year, and more than 8.6 million Americans have at least one serious illness caused by smoking. Since the first Surgeon General's report linking smoking to health problems came out in 1964, more than 12 million people have died from a smoking-related disease. If current trends continue, 6.4 million people who are under the age of 18 today will end up dying long before their time from a disease caused directly by their smoking habit.

Smoking also does a lot of damage to our nonsmoking friends and family. Women who smoke while pregnant, for example, are more likely to have babies who don't weigh enough or who die from sudden infant death syndrome. Young children who live with smokers are more likely to have respiratory problems. And secondhand smoke causes about 3,000 deaths from lung cancer and 35,000 deaths from heart disease among nonsmokers every year.

Take Steps to Stop Smoking

• Set a smoking area outside where you must go to smoke.
• Do not smoking while you are doing anything else.
• Stop all smoking in the car and house.
• Get a quit buddy.
• Do something else during your smoke break.
• If you feel stressed, try taking 10 deep breaths.
• Plan a smoke free day.

Tendons are soft tissues made up of thick fibrous cords that connect the muscles to the bones. When you push a group of muscles too hard, it is likely you will strain your tendons. For awhile the swelling and pain will stay and then leave promptly. If you push this group of muscles again too soon your muscles will not be able to keep up. The pressure will cause the tendon's outer layer to enlarge or the small fibers may even rip apart. If you continue on this way, you will eventually damage the tendons and will have tendinitis. If left untreated the symptoms will decrease your ability to share in physical activities. With the help of your podiatrist your tendinitis can be eliminated.

Take care of your feet

Try not to over do it when exercising or participating in any kind of physical activities. Stay pain-free. If your podiatrist asks you to wear orthotics or ankle braces, wear them. Make sure you stretch your ankles before and after you exercise. Make sure you are wearing the proper shoes for the activity you are doing. You will need to have extra good arch support and extra cushioning. Try to use a varied routine so you do not overuse just one set of muscles.

Controlling your symptoms

Slow Down Your Activities-Take a rest and let the muscles heal. If possible, stay off your feet for a couple of days. Gradually, get back into your routine. Try different activities such as swimming or biking that will put less pressure on the overused muscles. Ice Prevents inflammation. Try icing the area for 10 minutes at a time. Do this many times during the day. Take Your prescribed medication.

An area of the skin where sores occur because of repeated pressure being applied to it. The pressure against the skin decreases blood supply to that part of your body and the affected tissue is destroyed. This may happen because you stay in one position too long without movement. You are at risk for pressure ulcers if:

• You are unable to move certain parts of your body without assistance.
• You are in a wheelchair.
• You are confined to a bed.
• You have fragile skin.
• You are older.
• You do not get enough nutrition.

How do pressure ulcers happen?

Friction or constant rubbing against the bottom of your foot causes the skin in that area to increase, creating a callus. If the skin continues to thicken, the callus pushes up into the foot. This destroys the healthy tissue and creates discomfort. As the good tissue is killed, an ulcer forms. The ulcer may become a hot spot or blister. The blister can turn into an open sore or a corn (thickened skin on the foot). The open sore may get infected if bacteria enters into the wound. The infection will cause more healthy tissue to get destroyed. The infected ulcer may begin to weep with a white, yellow or green discharge. Some ulcers may have an odor or bleed. If you have any of these symptoms call your podiatrist right away.

Peripheral Arterial Disease (P.A.D.) occurs when there is a build up of cholesterol and plaque in the arteries of the lower extremities, causing decreased blood flow to the legs and feet.

What is an A.B.I. Test?

A.B.I. or Ankle-Brachial Index is a non-invasive, pain-free test. The exam often takes 15-20 minutes, It feels similar to having your blood pressure taken during your regular check-ups. You will lie down on the exam table. Pressure cuffs will be wrapped snugly around your arms, above knees, calves and ankles. The technician will inflate the cuffs, and sensors record the pulse waves. Let the technician know if the pressure from the inflated cuffs is uncomfortable. Your blood pressures will be recorded at your arms and ankles. The ankle-brachial index, known as the ABI, is determined by the ratio between these pressures. PAD is diagnosed if your ankle pressure is lower than your arm pressure. With severe narrowing, the ABI or ankle pressure may be half of your arm pressure. Your doctor may recommend additional diagnostic tests if the ABI is abnormal.

A wart is an infection caused by a virus, which can enter your skin through small breaks or cuts. Warts are one of several soft tissue conditions of the foot that can be quite painful. Over time, the wart develops into a hard, rough growth on the surface of the skin. Technically only those on the bottom of the foot are properly called plantar warts. Children, especially teenagers, tend to be more susceptible to warts than adults; some people seem to be immune.

Identification problems

Warts are generally harmless, even though they may be painful. Many times they are mistaken for corns or calluses—which are layers of dead skin that build up to protect an area which is being continuously rubbed. The wart, however, is a viral infection. If left untreated, warts can spread to other parts of the body, like the hands.

Tips for prevention

• Avoid walking barefoot, except on beaches.
• Change shoes and socks daily.
• Keep feet clean and dry.
• Check children's feet periodically.
• Avoid direct contact with warts.
• Do not ignore growths or changes in your skin.
• Visit your podiatrist.

Professional treatment

It is possible that your podiatric physician will prescribe and supervise your use of a wart-removal preparation. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthetic, may be indicated. Lasers have become a common and effective treatment. A procedure known as CO2 laser cautery is performed under local anesthesia where the wart is vaporized using focused light energy in your podiatrist's office surgical setting. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions.

Tips for individuals with warts

• Avoid over-the-counter preparations.
• Seek professional podiatric evaluation.
• Diabetics should be especially careful. Warts may spread and are catching.