I am 65 years old and have suffered from heel pain for several years and took early retirement because of it. I was afraid that surgery was the only solution for my foot and so put off going to the doctor. My daughter eventually took me to see Dr. LeBeau at his Foot and Ankle clinic. Now I wished I had come sooner.
St. Augustine Foot and Ankle
1 St. Johns Medical Park Drive
St. Augustine, FL 32086
Below are the most common foot and ankle conditions with a brief description. If you are having foot or ankle problems please call our office and schedule an appointment or use our online Request an Appoinment form.
Achilles Tendon Rupture: The Achilles Tendon is the heel cord in the back of the heel. Achilles tendons can rupture for many reasons, including age, sex (males are more susceptible), and sports. However, the Achilles Tendon may also rupture secondary to medical negligence – e.g., giving cortisone injections into the Achilles Tendon.
Arthritis: Artho means joint and itis means inflammation. There are approximately 38 causes of arthritis and most of these conditions affect the human foot. The most common of these conditions is osteoarthritis. This is the simple wearing and tearing away of the cartilage of the joints. Age, excessive weight, ill-fitting shoes and trauma (injury) are the basic causes of osteoarthritis. Fortunately, this condition is very treatable.
Athlete’s Foot: Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus usually attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth.
The warmth and dampness of areas around swimming pools, showers, and locker rooms, are also breeding grounds for fungi. Not all fungus conditions lead to Athlete's foot, however. Other conditions, such as malfunctions of the sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, also may mimic Athlete's foot.
Black toenails can result from a variety of things. Athletes will often encounter a problem with their toenails turning dark. Darkened nails often occur from the toe hitting the end or the top of the shoe toe area. The darkened nail is essentially a bruised nail. Sometimes, the bruise can lead to a fungal nail infection. If you are a diabetic, any change in the color of your toenail should be evaluated.
Blood Clot/ Deep Vein Thrombophebitis (DVT): Deep Vein Thrombosis (also called DVT) is a blood clot that develops in the leg. This is a serious condition, because it can move to the lungs (pulmonary embolus) and cause death. It can also cause permanent damage in the leg called Post-Phlebitic Syndrome
Bunion: A bunion is a common term for a medical condition known as Hallux Valgus. Hallux Valgus if the tilting of the toe away from the mid-line of the body. It is usually characterized by a lump or bump that is red, swollen and/or painful on the inside of the foot in and around the big toe joint. There are many causes of bunions, but the primary one is tight, ill-fitting shoes, shoes that constrict the forefoot over a long period of time. High heels and constricting forefoot shoe gear are the primary causes of Hallux Valgus.
Charcot foot: Charcot (pronounced “sharko”) foot is a debilitating and limb-threatening condition characterized by multiple fractures and dislocations. Early signs of Charcot foot disease include foot or ankle swelling, redness and warmth. Sometimes this early stage can mimic diabetic infection, thrombophlebitis and gout. Timely diagnosis and treatment is essential and often helps prevent catastrophic complications.
Claw Toe: Claw toe most frequently develops in older women. It causes the joint at the base of the toe to bend upward and the other joints on the toe to bend downward in the shape of a claw. Claw toe may be related to underlying medical conditions or caused from wearing poor fitting shoes. It is important to diagnose and treat claw toe early because the condition tends to become worse over time.
Complex Regional Pain Syndrome: see Reflex Sympathetic Dystrophy.
Corns, Calluses, IPK: Corns and calluses are the most common conditions on the skin of the foot. A corn which is a thickening of the outer layer of skin usually occurs on the tops of the toes. Calluses which are the same condition on the bottom of the feet are caused by sheering pressures. A severe form of callus is considered an IPK (Intractable Plantar Keratosis). These conditions are usually painful and can respond to conservative care.
Diabetes: Diabetes is probably the most damaging disease that a patient can encounter with regards to their feet. Diabetes comes in two basic types; type 1 and type 2. Type 1 is usually associated with juvenile diabetes and is usually a hereditary type of disease. Type 2, commonly referred to as adult onset diabetes, is usually characterized by elevated blood sugars by people who are overweight and have not attended to their diet as they should.
Diabetic Neuropathy: Diabetic nerve damage can decrease one’s ability to feel pain, heat and cold. Loss of feeling means patients may not even feel a foot injury. They might not notice a foot injury until the skin breaks down and becomes infected. Nerve damage can also lead to changes in the shape of the feet and toes. We are experts in performing leading-edge surgery to help relieve the pain of neuropathy. We also provide special therapeutic shoes rather than forcing deformed feet and toes into regular shoes.
Dry Cracked Heels: Dry cracking heels (xeorosis) is a condition of thickening and fissuring (cracking of the bottom part of the heels). In most people this is a nuisance and a cosmetic problem. But when the problem persists, especially in diabetes or people with impaired vascular sufficiency, this can lead to a serious medical problem.
Extracorporal Shock Wave Therapy (ESWT): ESWT is an emerging new therapy for the treatment of chronic heel pain.
Flat Feet: Flat feet of themselves are not necessarily a problem. But people with a flat foot or the opposite condition, a highly arched foot, that are painful, are certainly in need of treatment. Flat feet and high arches that are associated with ankle, knee or low back pain are also in need of treatment.
Foot Ulcers: Foot ulcers are generally a breakdown of the skin on the plantar aspect (bottom) of the foot. They have many causes, but the most common are diabetes, and vascular insufficiency. Diabetes or vascular insufficiency should be taken very seriously as a good warning sign of impending loss of limb.
Fracture: A fracture is a break in a bone. Fractures are divided into Traumatic Fractures (those fractures that occur as a result of an injury) and Stress Fracture (those fractures that occur as a result of repeated micro-trauma). Fractures take several weeks to heal properly and in some cases, fractures can fail to heal (they develop a "non-union").
Fungal nail: Fungal nail infections can persist for years without ever causing pain. The disease, characterized by a change in a toenail's color, is often considered nothing more than a mere blemish, but it can present serious problems if left untreated. Also referred to as Onychomycosis, fungal nail infections are an infection underneath the surface of the nail, which can also penetrate the nail. In addition to causing difficulty and pain when walking or running, fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate.
Ganglion cysts: Ganglion cysts are a common condition that can develop on the top or bottom of the foot. They are not harmful or cancerous, although they may cause discomfort. Ganglion cysts that are painful or interfere with walking are treated first with non-surgical methods, or surgical removal, if needed.
Gout: Gout (hyperuricemia or elevated uric acid) is generally thought to be a hereditary disease, but there are many causes: increased purine intake (*see diet), sudden weight loss due to dieting, and/or diuretics can cause elevated uric acid and mimic the symptoms of gout. In rare cases, leukemia's and/or blood dyscrasias can cause elevated uric acid. Gout can be a serious disease and needs medical intervention, generally by an Internist.
Haglund's Deformity: Haglund's Deformity is a condition of pain and discomfort on the posterior (back) aspect of the heel at the area of the insertion of the Achilles tendon.
Hallux rigidus: People with degenerative arthritis may develop a condition called hallux rigidus, meaning a “stiff big toe.” Hallux rigidus occurs when the joint at the base of the big toe wears down and makes movement difficult. Hallux rigidus is a progressive condition, and over time, the toe may become very stiff.
Hallux Varus: Hallux varus is a surgical over-correction of a bunion. The big toe splays away from the second toe and the foot can look like a “monkey’s foot.”
Hammertoes / Bone Spurs: Hammertoes, exostosis (bone spurs) could also be grouped under arthritis. Hammertoes, bone spurs, and exostosis are all a result of an imbalance of the muscle structures of the toes, when the toes become crooked, bent, or buckle under causing joints to protrude. These are all descriptions of a biomechanical imbalance.Hammertoe most commonly affects the second toe on the foot. It causes the middle joint to bend. Hammertoe is most frequently caused by structural problems in the toe or from wearing poor fitting shoes. It is important to diagnose and treat hammertoe early because the condition tends to become worse over time.
Heel Spur / Plantar Fascitis: Heel spur / plantar fascitis affects men and women equally. It is a condition in which the bottom of the heel is extremely painful. A heel spur is a bony overgrowth on the bottom of your heel bone. The heel spur is usually a result of an inflamed ligament (plantar fascia) on the bottom of the foot that attaches to the heel bone. Constant abnormal pulling of this ligament irritates the heel bone and the body lays down a bone spur as a protective mechanism.
Ingrown toenail is a condition in which the nail is cutting into the flesh. This condition is usually very painful and is usually associated with infection of the toe. A nail is ingrown when one or both corners or sides of the nail grow into the skin of the toe. Irritation, redness, uncomfortable sensation of warmth, as well as swelling, pain and infection can result from an ingrown toenail.
Malignant Melanoma: Malignant Melanoma is a dangerous type of skin cancer.
Metatarsal Problems / Callus / IPK: In severe cases of calluses, which usually occur on the plantar aspect (bottom) of the foot, an IPK can develop. An IPK is, in medical terminology, an Intractable, meaning that it will not go away, Plantar, meaning bottom of the foot, Keretosis, meaning a deep seated painful callus that usually occurs under a weight bearing metatarsal (long bone of the foot).
Neuroma: A neuroma is an irritated, swollen nerve in the ball of the foot, classically described as a pain in the ball of the foot located between the base of the third and fourth toes. The involved nerve is sometimes squeezed and irritated by these adjacent metatarsal heads causing the painful neuroma to develop. Many people with this condition report feeling a painful catching sensation while walking, and many report sharp pains that radiate out to the two toes where the nerve ends. You may actually be able to feel a swelling between the toes, or a feeling similar to a rock in the shoe. This can feel like electric shocks, similar to hitting your funny bone on the elbow. Current research with Reflex Sympathetic Dystrophy (RSD) has shown a potential relationship between neuroma surgery and RSD.
NSAID - Non-steroidal anti- inflammatory drug. They are called nonsteroidal because they are not steroids, which treat inflammation by suppressing the immune system (inflammation is one of the body's healing responses to trauma). Instead, all NSAIDs treat inflammation in a way similar to the mechanism of aspirin, the most well known and oldest member of the class.
Non-Union: Non-union refers to the failure of a bone to "knit" back together following a fracture or surgery. There are many causes of non- union. Non-unions can develop as a result of medical negligence in some instances, such as allowing the patient to walk on the foot too soon.
Orthotics: Orthotics are devices that are used to control abnormal foot function. When the foot is not functioning correctly, it will produce painful areas. The signs and symptoms of altered biomechanics of the foot are usually registered as pain. An orthotic can relieve that pain by supporting the ligaments and the osseous (bone) structures of the feet. Orthotics are devices that are used to control abnormal foot function. When the foot is not functioning correctly, it will produce painful areas. The signs and symptoms of altered biomechanics of the foot are usually registered as pain. An orthotic can relieve that pain by supporting the ligaments and the osseous (bone) structures of the feet.
Osteomeylitis: Osteomyelitis is an infection involving a bone. The condition is serious because treatment often requires several weeks of intra-venous treatment with potent antibiotics and can involve surgery on the affected bone.
Plantar fasciitis is a painful foot condition. It occurs when connective tissue at the bottom of the foot, called the plantar fascia, is irritated and inflamed. The condition commonly occurs among people who spend a lot of time on their feet. Heel pain that occurs in the morning upon wakening is a hallmark sign of plantar fasciitis.
Poor circulation: Poor circulation can make the foot less able to fight infection and heal. Patients can control some of the things that cause poor blood flow by not smoking, keeping their blood pressure, weight and cholesterol under control and keeping their feet warm by wearing properly fitting shoes and socks.
Reflex Sympathetic Dystrophy: Reflex sympathetic dystrophy is a severe and debilitating condition that occurs when the nerves in the leg "go haywire." A small traumatic injury such as a slip and fall or any other type of foot, ankle, or leg surgery can ignite this complication. Early and aggressive treatment usually results in complete remission of the symptoms. However, if the diagnosis is not promptly made, or if it is not treated in a timely manner, then the reflex sympathetic dystrophy can become severe and debilitating to such a degree that stage III disease can evolve into permanent disability.
Shin Splints: A shin splint is technically the tearing away of the anterior tibial muscle from the bone. Shin splints, or tenosynovitis of the anterior tibial muscle (the muscle that runs from the mid portion of the foot up the front of the leg, just below the knee, on the inside front of the calf) is usually caused by over-use. Beginning runners or other people who engage in sport activities who have not sufficiently allowed their muscle tone to build up over a proper conditioning program, or whose conditioning program is too rigorous in the beginning, develop shin splints. However, people with biomechanical, excessive pronation or supination of the foot also develop shin splints.
Stress Fractures: Stress fractures are usually the result of altered biomechanics, in that the structures of the foot are either mechanically not stable and/or the bones of the foot are subjected to repetitive micro trauma.
Sweaty Feet / Foot Odor: Sweaty feet (hyperhydrosis) and smelly feet (bromohydrosis) are two very common, annoying conditions of the feet. While some cases of excessive smelling or sweating of the feet are systemic (throughout the whole body) in nature, such as anemia (low blood count) or hyperthyroidism (overactive thyroid), these conditions are usually of a local cause.
Synovial Sarcoma: Synovial sarcoma is a malignant soft tissue tumor. This tumor is often misdiagnosed as Plantar Fasciitis.
Tarsal Tunnel Syndrome: Tarsal tunnel syndrome -- tarsal: meaning the lower ankle area of the foot -- is a condition that usually affects the medial (inside) aspect of the ankle. There are many structures that run through this area, including tendons, veins, arteries and nerves. Tarsal Tunnel Syndrome occurs when the posterior tibial nerve, as it courses under the ligament at the ankle, becomes inflamed for a variety of reasons, namely: excessive pronation, arthritic problems such as rheumatoid arthritis, trauma, and even obesity.
Warts: Most foot warts are harmless, even though they may be painful. They are often mistaken for other conditions such as corns or calluses –however,a wart is a viral infection. Over 42 types of viruses are known to cause a wart.
Children, especially teenagers, tend to be more susceptible to warts than adults as the most common times for warts to occur are, puberty, emotional & physical stress, pregnancy and menopause.
Warts can appear anywhere on the skin and those which are located on the sole of the foot are called plantar warts. The virus generally invades the skin through small or invisible cuts and abrasions. When they get large enough they can be quite painful. More serious foot lesions such as malignant (cancer) lesions can sometimes be mistaken as a wart.