Ingrown Toenail – Snellville Foot and Ankle Doctor, Dr. Joshua Mann, Educates Georgia Patients

Ingrown Toenail – Snellville Foot and Ankle Doctor, Dr. Joshua Mann, Educates Georgia Patients

What causes an ingrown toenail?

Patients often visit the Snellville, Georgia office of Ankle & Foot Centers of Georgia because they have a painful, ingrown toenail.  This can be the result of a bad pedicure, improper home trimmings (not trimming the nail straight across), toenail injury, or improper shoe gear.  Pain develops because the nail edge starts to grow into the adjacent skin.  If allowed to progress, the area can become inflamed and infected.  Even with antibiotics, you will not have relief unless the impinging nail is removed.  Diabetics need to be especially cautious because even a minor infected toenail can quickly cause a severe infection which may lead to an amputation.

What does an ingrown toenail look like?

So what should you look for if you suspect you have an ingrown toenail?  Early signs may include tenderness and swelling of the skin around the nail.  Signs of an infected toenail include pus, drainage, redness, warmth, pain, and increased swelling.  “Bathroom surgery” should not be performed because it typically only makes matters worse.  If you have any of the above symptoms you should see a Podiatrist as soon as possible.

How is this ingrown toenail treated?

A Podiatrist will perform a thorough exam, and based on the clinical findings offer a variety of treatment options.  Sometimes all that is needed is simple trimming of the offending nail border.  However, if the ingrown toenail reoccurs a foot and ankle doctor can perform a permanent partial or total nail removal.  The procedure will be performed in the office.  First, the Podiatrist numbs your toe with local anesthesia.  The offending nail border or total nail is removed along with the root (where the nail grows from).  Applying a chemical to the base of the nail prevents the nail from re-growing.  It is very rare, but the nail portion can re-grow.  A dressing is applied, and your doctor will give after care instructions. Sometimes the doctor will prescribe antibiotics.  Your Podiatrist will see you 1 to 2 weeks after the procedure to make sure adequate healing is taking place.

How do I prevent this type of toenail problem?

To prevent the occurrence of ingrown toenails follow these suggestions: trim your nails straight across, don’t cut them too short (it is very important to tell your pedicurist this as well), wear proper fitting shoes (shoes that are too short or too narrow will only cause more problems), and always maintain proper hygiene.

Dr. Joshua Mann is a Snellville Foot and Ankle Doctor practicing at the Ankle & Foot Centers of Georgia.  The mission of Dr. Mann and the Ankle & Foot Centers of Georgia is to provide the highest level of podiatric care to every patient who enters their practice.

If you have any additional questions or concerns regarding a possible ingrown toenail or any other toenail pain, please schedule an appointment with Dr. Joshua Mann for further evaluation. You can call our Snellville, Georgia office at 678-889-1728 or click HERE to make an appointment now!

Plantar Fasciitis – Snellville, GA Podiatrist Joshua Mann Specializes in Heel Pain Relief

What is Plantar Fasciitis?

Heel pain is a very common problem we see at our Snellville, GA location and a common issue for all foot and ankle doctors.  The good news is that many successful treatments are available to treat this pain conservatively.  A common cause of heel discomfort is Plantar Fasciitis.  Typically, pain will occur in the bottom of the heel during the first few steps of the day, or after sitting for an extended amount of time.  The pain can worsen with prolonged standing and activity. 

What is the Plantar Fascia and how is it related to heel pain?

The plantar fascia is a ligament that connects from your heel bone (calcaneus) to the ball of your foot, and helps support your arch.  Overtime the heel insertion of the plantar fascia becomes irritated and inflamed.  Common causes are tight calf muscles, obesity, a very high/low arch, increased/new activity, repetitive impact, or worn out shoe gear. This is Plantar Fasciitis. Also a formation of a heel spur could occur; this is a reaction of plantar fascia tension and is not necessary the cause of pain.

What is the treatment?

Conservative care is very successful in treating plantar fasciitis, but severe cases may require surgery.  Conservative (non-surgical) options are stretching, icing, anti-inflammatory medications, supportive shoes and arch supports, injections, physical therapy, a night splint, or walking boot or casting.  Your foot and ankle doctor should only recommend surgery if conservative care has failed to provide the necessary relief.  Extracorporeal shockwave therapy (ESWT) is a non-invasive procedure that does not require any surgical incision, and involves high-energy shockwave impulses to help stimulate the healing process.  Invasive procedures for Plantar Fasciitis include a gastrocnemius recession (lengthening of the calf muscles), partial plantar fascia release, or removal of the bone spur.  The goal of the gastrocnemius recession is to lengthen the contracted musculature (when stretching hasn’t worked) in the calf region to decrease tension to the heel.  A plantar fascia release is performed when ankle joint range of motion is normal.  This will directly release tension of the plantar fascia.  It is very rare that the bone spur needs to be removed, and is only performed when the spur is extremely enlarged. 

Are there different types of heel pain?

A condition known as Sever’s disease or calcaneal apophysitis causes heel pain in pediatric patients.  This commonly occurs in children who are physically active, and during their growth spurt.   The most common cause is being too active and not allowing enough rest time for recovery.   Treatment includes stretching exercises, limiting physical activity, wearing supportive shoes and arch supports, icing, anti-inflammatory medications, and physical therapy. 

Heel discomfort also can involve the back of the heel at the Achilles tendon insertion.  In Achilles tendonitis the tendon becomes inflamed from an increase in activity, improper shoe gear, uphill running, or calf muscle tightness.  When treated early, the condition is often relieved quickly.  Treatment includes heel lifts, stretching exercises, activity modification, anti-inflammatories, icing, shoe gear modifications, and possible walking boot or casting.

Achilles tendinopathy is a chronic condition that results from the degeneration and micro-tearing of the Achilles tendon, and often occurs in middle aged athletes.  Causes include tight calf muscles, decreased blood supply to the tendon, obesity, increased strain of the tendon due to foot type, improper shoe gear, poor training, and prior injuries.  Conservative treatment consists of supportive shoes, arch supports, activity modifications, heat therapy, physical therapy, and stretching exercises.  Severe cases may require surgery. The purpose of surgery is to remove the degenerative parts of the tendon, and to stimulate the healing process.  It is common for full surgical recovery to take 6 months or longer. 

A retrocalcaneal exostosis is the prominent heel bone (calcaneus) formation at the back of the heel.   High heels or the shoe back can cause irritation and pain with this condition.   This condition can be associated with a tight Achilles tendon, inflammation of the Achilles tendon, or swelling of specialized fluid sacs around the Achilles insertion to the calcaneus.  Treatment is very similar to that of Achilles tendonitis, however if conservative care fails you should consider surgery.  The Achilles tendon will be partially reflected from its’ insertion to the heel bone.  The foot and ankle specialist will then smooth and contour the prominent bone, and will reattach the Achilles tendon to the calcaneus using sutures or bone anchors.  Full recovery can take 6 months or longer after surgery.

Other possible causes of pain in the heel include nerve compression, systemic arthritis, bone tumors, and fractures.  A Podiatrist will perform a thorough clinical exam and take x-rays to determine the cause of the pain.  During your visit to the office, reasons for pain will be discussed, and the best treatment plan will be established.

Author Bio:

Dr. Joshua Mann is a Snellville, GA Podiatrist at the Ankle & Foot Centers of Georgia.  Together, their mission is to provide the highest level of podiatric foot and ankle care to every patient who enters their practice. Through patient-centered care, they put patients first by continuously striving for clinical excellence in everything they do to treat heel discomfort and more. This is accomplished through continued research, education, modern technology and medical information integration.

For more information about heel pain, or to schedule an appointment with Dr. Joshua Mann for further evaluation, please call our Snellville, Georgia office at 678-889-1728. Also, you can click HERE to make an appointment online now!

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