My Blog

By Michael Gittleson DPM
July 10, 2019
Category: Podiatry
Tags: Ingrown toenails  

Ingrown toenails are a common but painful problem that occurs when the edge of the toenail grows into the skin. If ingrown toenails are something that you are dealing with rather often then you may want to figure out what’s causing them so you can put a stop to it. From the office of our Chevy Chase, MD, podiatrist Dr. Michael Gittleson, learn more about the causes and treatment options for ingrown toenails.

What causes an ingrown toenail?

There are many reasons why someone may be at an increased risk for developing ingrown toenails. Common causes include.

Wearing high heels or shoes that are too tight: this compresses the toes and puts too much pressure on the toenails

Trimming the nails too short: nails that are rounded over or trimmed at an angle are more likely to become ingrown than nails that are trimmed straight across

Fungal infections: a fungal infection can cause the toenail to widen and thicken, which can increase the likelihood of an ingrown toenail

Injury to the nail: often the result of a sports-related injury

A family history of ingrown toenails: if your parents are prone to ingrown toenails you may be too

Can I treat an ingrown toenail on my own?

If you are a healthy individual then you may be able to handle an ingrown toenail on your own without seeking treatment from our Chevy Chase, MD, foot specialist; however, you should absolutely see a podiatrist for treatment if you suffer from diabetes or if you have nerve damage in your feet, as even small problems like ingrown toenails can lead to more serious complications.

You can treat your ingrown toenail by:

  • Soaking your feet for 15-20 minutes, 3-4 times a day in warm water
  • Placing a piece of cotton under the toenail to help it grow away from the skin
  • Wearing shoes that fit properly and don’t put pressure on the toenail
  • Taking pain relievers to reduce pain and swelling
  • Applying an antibiotic ointment to prevent an infection

When should I see a doctor about my ingrown toenail?

Even if there are no signs of infection you should see a doctor if you haven’t notice an improvement in your symptoms after three days of at-home care, if it’s been more than five years since your last tetanus shot or if you have a condition that slows your body’s ability to heal effectively. Symptoms of an infection include pus or drainage coming from the toenail and red inflamed skin that can be warm to the touch.

If you are having trouble with ingrown toenails, heel pain, ankle instability, or any other problems it’s important that you have a foot specialist you can turn to for help. Call our Chevy Chase, MD, podiatry practice today and let us know how we can help you.

By Michael Gittleson DPM
July 05, 2019
Category: Foot Conditions
Tags: Hammertoes  

A hammertoe is a common foot deformity that affects the middle joint of the smaller toes. As a result, this causes the toes to bend downward. Since this bend causes the joint to stick out this can put more pressure on the affected joints when wearing shoes, which can also make the deformity worse over time. As with most foot deformities a hammertoe will start out minor and continue to progress over time if left untreated.

During the earlier stages you may not notice much pain and discomfort. In fact the only way you may be able to tell that you have a hammertoe is by examining the foot and noticing that the small toes bend downward like a claw. Of course, at this stage the deformed joint is still flexible enough to be straightened out.

However, if the deformity progresses this can cause the joint to become rigid, which won’t respond effectively to simple conservative treatments. As you might imagine, the sooner you see a podiatrist to treat your hammertoe the better. Early intervention is key, as a hammertoe will not get better without the proper care.

Hammertoes are often the result of an imbalance in the muscle or tendon of the foot. Over time, this leads to structural changes in the foot. Genetics may also play a role in whether your feet are at risk for this deformity. A hammertoe can also be made worse by wearing shoes that are too tight and put too much pressure on the toes.

Along with the structural changes that occur with hammertoes it’s also common to experience redness, inflammation or the development of a corn or callus on the toe. If you are noticing symptoms of a hammertoe see your podiatrist for an evaluation. A simple physical exam is usually all that’s needed to diagnose a hammertoe; however, sometimes an x-ray will be performed in order to determine the extent of the deformity.

If you are dealing with a flexible hammertoe, more often than not simple nonsurgical treatment options are all that’s needed. Following simple treatment options and care can prevent the hammertoes from becoming rigid or painful. Some nonsurgical treatment options include:

  • Wearing the appropriate footwear. This means wearing shoes that aren’t pointy or have high heels, which can put more pressure on the toes.
  • Placing custom orthotics into your shoes, which can ease discomfort and prevent pain resulting in a muscular imbalance.
  • Taking over-the-counter pain relievers such as ibuprofen, which can reduce both pain and inflammation.
  • Splinting the toe or toes to keep them straight, which can also reduce stiffness, inflammation and pain.
  • Applying protective non-medicated padding over the top of the toe to prevent a corn or callus from developing.

If your hammertoe is painful or rigid then you may need to discuss whether surgery is the best option for alleviating your symptom and correcting the deformity. If you are dealing with a hammertoe turn to a foot specialist for help.

By Michael Gittleson DPM
June 19, 2019
Category: Foot Care
Tags: Flat Feet  

While there are many people with flat feet, often times they won’t even know it; however, there are others with flat feet that regularly experience pain, soreness, and other problems. While flat feet is rarely considered a serious issue, if you are dealing with problems as a result of your flat feet it’s important that you turn to a podiatrist who can offer up ways to prevent problems.

How to tell if you have flat feet

If the arches of your feet touch the floor when you stand then you have flat feet. The arches of our feet don’t actually develop until around the age of six; however, sometimes flat feet develop due to injury or repeated stress on the feet.

Symptoms of flat feet

The most common symptom of flat feet is foot pain that originates in the heels and arches. You may find that the pain gets worse when standing or moving for long periods of time. Those who are physically active may experience pain more regularly. Sometime swelling on the inside of the foot or ankle may also occur.

Potential complications of flat feet

Since flat feet can be responsible for misalignments, this can lead to ankle and knee problems. If you are noticing foot, ankle, knee, hip, or lower back pain then you will want to schedule an appointment with a podiatrist to find out what’s going on.

Treating flat feet

If you aren’t experiencing pain or other issues then you won’t require any treatment for your flat feet. While we can’t fix flat feet our podiatrist can provide you with simple solutions to reduce pain and discomfort associated with faulty biomechanics within the feet. Common ways to prevent flat foot-related pain include:

  • Using arch supports in your shoes, which can take pressure off the arches and provide cushioning and support when standing or moving.
  • Performing certain stretching exercises prescribed by a podiatrist. There are specific exercises designed to stretch the Achilles tendon to alleviate and prevent foot pain.
  • Wearing the appropriate footwear that provides further arch support. Shoes that are old and worn, as well as certain styles such as sandals or flip-flops won’t provide your feet with the proper support they need.
  • Undergoing physical therapy if you are dealing with foot pain due to overuse injuries, which is common among athletes. Physical therapy can help strengthen certain ligaments, tendons and muscles of the feet and ankles to prevent excessive wear and tear, as well as pain and soreness in the arches and heels.

If you are dealing with pain due to flat feet and can’t seem to get your discomfort under control then you will want to talk with a podiatrist who can recommend certain exercises, proper footwear, and custom orthotics to improve the health of your feet. Talk to a podiatrist today.

By Michael Gittleson DPM
June 03, 2019
Category: Foot Care
Tags: Diabetic Feet  

Diabetic feet need special care because of decreased circulation, neuropathy, joint deterioration, and more. While your primary care physician may guide you on blood sugar control, medications, a healthy diet, and active lifestyle, your podiatrist assesses and treats how your feet and ankles function everyday and for the long term. Enlist their help in the health maintenance of your diabetic feet.

Keeping ahead of neuropathy and avoiding amputation

Those are two key goals of diabetic foot care. Your podiatrist will want to see you regularly to assess the color, temperature, sensation, function, and shape of your feet and ankles, noting any developing problems. Early detection of circulation issues, nerve degeneration (neuropathy), and deformities, such as hammertoes, bunions, and Charcot Foot, are key.

Your podiatric foot examination will include an eye-on inspection of your skin (color, temperature, texture, and integrity). Your foot doctor also may perform gait analysis to watch for changes in how you walk. Sometimes a podiatrist orders X-ray imaging or an MRI to view the internal structure of the foot and/or ankle.

Remember, that foot ulcers are the primary threat to the overall health and well-being of the diabetic, says the National Center for Biotechnology Information (NCBI). Untreated, they may lead to complications so severe amputation is the only option.

What can you do to treat your diabetic feet?

  1. Be proactive. Inspect your feet daily, looking redness or skin breakdown.
  2. Wash and dry your feet daily.
  3. Trim your toenails carefully using a clean clippers. Trim straight across and not too short to avoid ingrown toenails.
  4. Wear shoes at all times--even indoors--to avoid injury.
  5. Wear clean, well-fitting, moisture-wicking socks.
  6. Keep your weight and blood sugars within normal range.
  7. Get in-office treatment of calluses and corns, says the American College of Foot and Ankle Surgeons.
  8. Avoid all forms of tobacco.
  9. Report any changes to your foot doctor as soon as possible.
  10. See your podiatrist every six months or as he or she directs.

Healthy feet and a healthy you

Podiatric health is so important, but especially to the diabetic. So stay in touch with your foot doctor, and be routinized in your foot care for better long-term health.

By Michael Gittleson DPM
May 15, 2019
Category: Foot Conditions
Tags: Neuroma  

Are you dealing with pain, burning, tingling or numbness between your toes or in the ball of the foot? If you said “yes” then you could be dealing with a neuroma, a pinched nerve or benign tumor of the nerve that is often found between the third and fourth toes.

The classic symptom of a neuroma is pain, particularly when walking—a factor that leads many people to liken the condition to feeling like a pebble is in their shoe. You may find that the pain eases up whenever you aren’t walking or when you rub the pained area with your hands. While neuromas can happen to anyone, they are most commonly found in women.

Neuroma Causes

While the causes of a neuroma are still not clear, there are factors that can increase the likelihood of developing one, such as:

  • Extremely high arches
  • Flat feet
  • Trauma that leads to nerve damage in the feet
  • Improper footwear (high heels over two-inches tall; pointed toes)
  • Repeated stress placed on the foot

Treating a Neuroma

A neuroma will not go away on its own, so it’s important to see a podiatrist if you are experiencing any of the condition's symptoms. The type of treatment or treatments recommended to you will depend on the severity of the neuroma.

Those with minor neuromas may be able to lessen symptoms by wearing shoes that provide ample room for the toes and offer thick soles that provide more support and cushioning for the toes and balls of the feet. Sometimes a podiatrist may recommend custom orthotics to place inside the shoes, as well.

Your podiatrist may also recommend padding or taping the ball of the foot to improve faulty biomechanics and reduce discomfort. While medication will not eliminate the problem, it can temporarily alleviate symptoms. Over-the-counter anti-inflammatories can often briefly reduce pain and swelling, but for those dealing with more severe pain, steroid injections may be necessary to ease symptoms.

Surgery for a Neuroma

Surgery only becomes necessary when conservative treatment options have failed to provide relief, or when the neuroma has progressed enough that conservative care won’t be enough. During surgery, the inflamed nerve is removed through a simple outpatient procedure. Afterward, there is a short recovery period of a couple of weeks before patients are able to move about pain-free once again!

Give us a Call!

If you are dealing with new or worsening foot pain it’s important that you turn to a podiatrist that can help give you the answers you need. Schedule an appointment today.





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