Frequently Asked Questions
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What is a foot ulcer?
Why Are Ulcers a Problem for Patients With Diabetes?
Patients with diabetes are not only at increased risk of developing foot ulcers, but they are less likely to heal naturally once a wound has developed. For this reason, many diabetic ulcers become seriously infected before treatment begins, and one in every five infected ulcers results in amputation.
Diabetes is a direct cause of foot ulcers due to:
- Neuropathy. Many people who develop foot ulcers have lost the ability to feel pain or sensations in their feet (diabetic neuropathy). In many cases, patients with neuropathy only realize they have an ulcer when they notice blood or drainage on their socks.
- Impaired circulation. Diabetes narrows the blood vessels in the extremities, making it harder for nutrients to reach the feet. A lack of blood flow to the feet prevents the body from healing any ulcers.
- Dry feet. Diabetes can decrease the body’s oil and sweat production, drying the skin and making it more likely to crack.
- Systemic disease. Patients with vascular disease, kidney problems, or heart disease are at increased risk of skin breakage and slow healing. Patients who use insulin are also more likely to develop a foot ulcer.
- Foot deformities. Ulcers may develop due to prolonged pressure on the same part of the foot (such as the heels or pads of the feet) or friction from shoes rubbing against bones and toes.
- Lifestyle habits. Anyone with diabetes can suffer a foot ulcer, but patients who are overweight or use alcohol and tobacco are at higher risk.
Classifications of Foot Ulcers
Diabetic foot ulcers are generally separated into four stages:
- Stage 1. You have red, irritated, or inflamed areas on your feet. This is common where the skin is thinnest, such as on the ankle bone or toe joint.
- Stage 2. You can see blisters or cracks in the skin. The skin around the wound may begin to peel or flake away.
- Stage 3. The skin is broken, and blood or pus may be draining from the wound. At this point, the layers of skin around the area will start to thin.
- Stage 4. In the final stage of a foot ulcer, the wound has affected the skin, muscles, tendons, and bone tissue. You may have dead tissue (gangrene) or bone infection (osteomyelitis) that requires amputation.
How Are Diabetic Ulcers Treated?
Even a small cut can allow harmful bacteria to enter the body, making tiny puncture wounds or burrowing toenails deadly for a patient. It would help if you got treatment as soon as you notice any redness, swelling, or potential for a break in the skin.
Treatment will depend on the severity of the wound and how far it has progressed, but common interventions include:
- Cleaning the wound thoroughly
- Draining the site if there is a noticeable infection
- Safely removing dead skin or tissue from the area
- Taking the pressure off the area (off-loading)
- Applying sterile dressings (and any necessary topical medications)
- Laser therapy to promote wound healing and increase circulation
- Prescribing antibiotics to treat system-wide infection
In extreme cases, your podiatrist might recommend surgery to remove necrotic tissue and perform skin grafting to save the limb. If the limb cannot be saved, you may need amputation to save your life.
In Our Podiatry Office, Good Wound Care Includes Prevention
Most diabetic foot wounds are preventable, and our wound care procedures always include prevention methods to improve the life and health of the patient. Once the injury is treated, we advise you on how to:
- Change your dressings and help the healing process
- Perform daily foot inspections (particularly on the bottoms of the feet)
- Manage blood glucose and other health problems
- Choose well-fitting diabetic shoes and socks
If you’re concerned about a wound on your foot, we can help. Simply request an appointment online or speak with our team in either Twin Falls or Burley by calling (208) 731-6321.
Is lotion good or bad for diabetic feet?
Dry, Cracked Feet Can Be Deadly for Patients With Diabetes
Patients with diabetes are not only more prone to dry skin on their feet, but they're also at higher risk of suffering wounds due to an inability to feel their feet. Diabetic neuropathy can prevent feet from sweating, which keeps the skin soft and moist. As the skin dries out, it can crack and open the body up to infection.
Diabetes may also cause circulation problems, preventing a patient's feet from getting the blood and nutrients they need to heal. As an open wound can have life-threatening consequences, it's vital for patients to moisturize their feet regularly—and see a podiatrist immediately if they have a sore that won't heal.
What's the Best Foot Cream for Dry and Cracked Feet?
While any lotion is an improvement, some moisturizers are better than others at restoring softness and flexibility to the skin. Thinner lotions for the face and hands may temporarily relieve foot dryness, but thicker lotions like body creams or butters generally last longer.
By checking the ingredients, you can generally tell which foot cream will be the most beneficial for hardened skin. Look at the label before you buy to see if the lotion contains:
- Parabens. Some lotions contain preservatives called parabens to prevent them from spoiling. Parabens can dry out the skin more quickly, causing skin irritation or even topical rashes. Always do a "patch test" when trying out a new lotion, only applying a small amount and waiting a few hours to see if you have a reaction.
- Moisturizing agents. Emollients (such as petroleum jelly, mineral oils, and shea butter) trap water under the skin by creating an oily layer on the surface. Humectants (such as glycerin, lecithin, and propylene glycol) moisturize by drawing water into the outer layer of the skin.
- Scents and or alcohols. Lotions should be free of any overpowering scents, alcohols, or chemicals that can irritate or dry out the skin.
- Active ingredients. Some lotions contain stimulating agents that can relieve the pain in neuropathic feet, such as arnica, mint, eucalyptus, or capsaicin (hot pepper oil).
- Exfoliants. Ingredients such as urea, lanolin, and alpha hydroxy acids help the dead skin cells on the surface to fall off and reveal the healthier tissue below.
How Often Should I Moisturize My Feet?
It's best to apply lotion twice a day after washing your feet in warm water with mild soap—one that has similar ingredients to the lotion to avoid drying. Once your feet are completely dry between the toes, you should:
- Apply a small amount of lotion to the tops, bottoms, and sides of your feet, allowing each layer to soak in completely.
- Massage moisturizer into your feet using a circular motion to increase blood circulation.
- Prevent lotion from building up between the toes, as this can promote the growth of yeast, fungus, or bacteria.
- Put on a pair of clean cotton socks after moisturizing to prevent feet from drying out too quickly.
- Wear hard-soled, well-fitted shoes both inside and outside the house.
There may be many things you can do to prevent diabetic injuries and promote strong and healthy feet. Our foot and ankle specialists can perform a careful examination, recommend small changes that have big rewards, and ease the pressure on your diabetic feet. Simply request an appointment online or speak with our team in either Twin Falls or Burley by calling (208) 731-6321.
What should I do if I think my toe is broken?
Symptoms of a Broken Toe
Many of the symptoms of a fractured toe could also be applied to a sprained toe. Both involve the immediate onset of pain that continues for several days. Even a podiatrist may be unsure of the exact nature of the injury without performing an imaging test.
Common signs of a broken toe include:
- Inability to bend the toe
- Tingling or numbness
- Inability to walk or put any weight on the affected foot
- Throbbing pain
- Bruising on the skin and under the toenail
- Inability to touch the toe without pain
- A crooked appearance or marked difference from the same toe on the opposite foot
Fortunately, the immediate treatment for both conditions is to stay off the injured toe and elevate the affected foot. If you are still unable to run, walk, or stand the next day—or if the pain seems to be getting worse instead of better—you should see a podiatrist for the most effective care.
Diagnosing and Treating a Toe Fracture
You never want to wait too long before getting a medical opinion on foot pain. A toe injury may seem minor, but delayed treatment can put you at risk of additional injuries and make your recovery more complicated.
In our podiatry offices, we use various diagnostic tools to determine the underlying cause and severity of your condition. Once we have a complete picture of the problem, our staff will devise a treatment plan that may include:
- Conservative treatment. If you have a simple, non-displaced fracture, you may only need to immobilize the toe while it heals naturally. This can include splinting or buddy-taping the affected digit, wearing a walking boot, or wearing a stiff-soled shoe to prevent the ball of your foot from flexing when you walk.
- Rest. You should put as little weight as possible on your foot while it heals. You may need to elevate your foot when sitting and apply ice to the broken digit to decrease inflammation and encourage healing. If you try to get back on your feet too soon, you may risk re-injury that needs more invasive treatment.
- Surgery. If the bones in the toe are displaced or have been broken into several pieces, you may need a surgical procedure to remove bone fragments and realign the damaged bones.
Long-Term Complications of a Broken Toe
You should never try to treat a suspected toe fracture at home, especially if your injury involves the big toe. All toes are necessary for proper mobility, but the big toe bears a great deal of weight and is responsible for jumping, quick movements, and other daily activities.
If not treated properly, a fractured toe could cause long-lasting problems such as:
- Deformities. Bones that do not heal properly may form bumps or cause the toe to bend at a different angle.
- Arthritis. A break near a joint puts you at risk of developing osteoarthritis that causes chronic pain years after the injury has healed.
- Infections. You may need antibiotics to prevent deep-tissue infection if you suffer a displaced fracture or a bone breaks through the skin.
- Balance problems. A poorly-mended toe affects your overall balance and stability, potentially causing you to miss out on the activities you love.
Let Us Advise You on the Best Course of Action
Don’t take your toes for granted! If you cannot bear weight on your foot, our Idaho podiatry team can diagnose the cause of the problem and start effective treatment immediately. Simply request an appointment online or speak with our team in Twin Falls or Burley by calling (208) 731-6321.
Will I need surgery for an ingrown toenail?
Early Treatments for Ingrown Toenails
If this is the first time you’ve had an ingrown toenail and it hasn’t progressed very far into the skin, you may be able to correct the condition before it gets worse. A few simple but effective home methods include:
- Lifting. Lifting the nail straightens its curved edge, allowing it to grow out and away from the nail bed. Start by soaking your foot for a few minutes to soften the skin and nails. Pat your foot dry, and gently lift the ingrown away from the skin using clean dental floss. Place a clean piece of cotton under the nail to hold it in position and bandage it with a small amount of antibiotic ointment. Change the cotton and bandage every day, ensuring that your condition is improving.
- Shoe changes. A different pair of shoes can be invaluable in treating ingrown toenails. Roomy clogs or open-toed shoes minimize pressure on the toe, while upgrading to shoes in a larger size prevents other nails from being pushed into the skin.
- Pain relief. Soaking your feet in warm water for 10-20 minutes can help relieve pain, while over-the-counter medications like ibuprofen can help reduce swelling.
Some Patients Are More Likely to Need Toenail Surgery
If the skin has grown over the nail, or the nail is so deep into the skin that it cannot be lifted, you should seek a podiatrist’s help immediately. The longer the condition goes untreated, the more painful and potentially dangerous it becomes.
You may opt for surgical removal of the nail if you have:
- Noticed signs of infection. A nail that feels tender or sore may soon start to swell, turn red, or even begin cracking open and oozing. Swift removal may be needed to prevent the infection from spreading.
- Diabetes. Patients with diabetes may be unable to feel an ingrown toenail until it has progressed significantly, increasing the risk of systemic infection or eventual amputation. When we evaluate your affected nail, we can advise you on footwear choices and trim your remaining nails so they don’t become ingrown.
- A history of ingrown toenails. Patients with foot deformities or irregular foot mechanics may suffer recurring ingrown toenails. Surgery can relieve the current condition, but it can also stop nails from growing inward in the future.
Will I Have to Go to the Hospital to Have a Toenail Removed?
Our investment in the latest technology means that you won’t have to endure a long and frightening procedure under general anesthesia. Dr. Wettstein performs the entire process right in our office using a local anesthetic, so you’ll be awake the whole time and able to walk out the door in about an hour.
Toenail removal surgery may involve:
- Numbing the affected area for 2-4 hours
- Extracting the ingrown portion of the nail
- Cleaning the wound and treating any infection with antibiotics
- Removal of the nail matrix along the edge of the toenail to prevent the nail from growing unnaturally in the future
- Bandaging the foot to protect it from trauma as it heals
- Resting the foot for 24 hours after the procedure
- Allowing the foot to fully recover over the next two or three weeks (you will likely be able to resume normal activities within a day or two of surgery)
The easiest and most effective way to know what your condition requires is to consult with an experienced podiatrist. Our foot and ankle specialists can examine your feet carefully and devise a plan of action that works for you. Simply request an appointment online or speak with our team in either Twin Falls or Burley by calling (208) 731-6321.
Is there anything I can do at home to help my neuropathy?
Home Treatments to Ease Neuropathy Symptoms
No home remedy can take the place of professional medical care, especially if neuropathy has allowed a diabetic wound to set in. However, there are many different things patients can do—or not do—that greatly improve their quality of life.
Patients often report lessened symptoms when they:
- Practice good foot care. Impaired sensation in the skin increases the likelihood of infections, so diabetic feet need constant monitoring whether or not they are causing pain. Wear comfortable shoes, inspect your feet each day for injuries and pressure points, and give yourself a foot massage to encourage healthy blood flow.
- Manage blood sugar levels. Maintaining a normal blood sugar level is the most effective way to improve all complications of diabetes, including nerve pain. Best practices include eating a healthy diet and abstaining from alcoholic beverages.
- Take a bath. Warm water temporarily increases blood circulation, relieving painful sensations throughout the body. It can also relax the muscles and ease the physical stress of chronic pain. Numb feet may burn if the water is too hot, so always test the water temperature with your arm before stepping in.
- Have good sleep habits. Nerve pain at night can disrupt the length and quality of sleep, making it more challenging to cope with daily symptoms. If your neuropathy worsens at night, try limiting caffeine intake past 2 p.m., only get into bed when it's time to sleep, and wear an eye mask to block light.
- Use topical pain relief. There are many different pain creams and ointments aimed at treating nerve pain. One of the most common is lidocaine, an anesthetic available in prescription and over-the-counter products. Some patients use capsaicin cream made from hot chili peppers to create a warming sensation in their feet. These solutions are temporary but can give a patient time to relax or fall asleep.
- Exercise regularly. Exercise is highly beneficial for patients with diabetes because it improves both the symptoms and the root cause of the discomfort. Firstly, it releases natural pain-blockers called endorphins, easing symptoms while exercise continues. It also promotes blood flow, improving circulation in the legs and feet and expanding narrowed blood vessels in the feet. Before starting a new regimen, patients should discuss low-impact exercise options (such as walking and yoga) with their doctors.
- Practice mindfulness. Meditation, biofeedback, hypnosis, and other alternative therapies may benefit patients suffering from chronic pain. Cognitive-behavioral therapy or guided imagery can also help patients cope with the mental and emotional strain of living with neuropathy.
- Don't smoke. Smoking constricts your blood vessels, making circulation worse and intensifying neuropathy symptoms. If you smoke, start working on ways to quit.
When Should I See a Podiatrist About Neuropathy?
Prevention is better than a cure, but prevention isn't always 100% effective. Modern medicine has made significant improvements in clinical treatment for nerve pain in the feet and legs. Medications, conservative solutions, and other therapies can prevent nerve pain from getting worse and, in some cases, reverse the effects of nerve damage.
The most common reasons diabetes patients visit us is because natural remedies aren't helping their nerve pain or because they've suffered a wound or injury on their foot. These are serious complaints, and early treatment is the best option for both. If a diabetic foot condition is preventing you from doing the things you love, we can help. Simply request an appointment online or speak with our team in either Twin Falls or Burley by calling (208) 731-6321.
What are the benefits of MLS laser therapy?
What Conditions Does MLS Laser Therapy Treat?
Since laser therapy works by stimulating your body's natural healing response, it's effective on many injuries and disorders. We have successfully used MLS therapy for a variety of conditions, including acute conditions and long-term chronic pain.
Laser therapy can be used to improve healing in patients who have:
- Arthritis. MLS therapy is renowned for its anti-inflammatory effect. It stimulates damaged tissue on a cellular level, accelerating cell production to promote faster recovery. Patients with arthritis or tendonitis who undergo laser treatment usually see reduced swelling and improved range of motion.
- Soft tissue injuries. Reducing inflammation allows blood to flow more freely to the injury site, allowing strains, sprains, plantar fasciitis, and other soft tissue injuries to heal more quickly.
- Repetitive stress injuries. Laser therapy is invaluable for athletes. It reduces recovery times after strain injuries or sudden trauma and promotes healthy tissue growth to prevent deformities during healing.
- Diabetes. Patients with diabetes may suffer from poor blood circulation in their feet, making superficial wounds or foot ulcers potentially life-threatening. MLS laser therapy floods the feet with the oxygen and nutrients necessary for tissue repair, encouraging reactions in unresponsive cells. Laser therapy has also been shown to help patients with neuropathy by easing nerve pain symptoms and promoting nerve regeneration.
- Undergone surgery. When foot or ankle surgery is necessary, MLS laser therapy sessions can be highly effective in reducing post-surgical recovery times. In addition to promoting cellular healing, laser therapy stimulates collagen production to reduce the formation of scar tissue.
What Are the Advantages of MLS Laser Therapy?
MLS Laser Therapy involves two lasers, each one tuned to a specific wavelength of light. One laser is set to reduce swelling at the injury site, while the other focuses on pain relief, offering a combination treatment that gets you back on your feet as quickly as possible.
Patients often choose MLS laser therapy because it's:
- Painless. The MLS laser does not cause any pain during or after treatment. Most patients see improvement after the first session and feel even better with each progressive appointment.
- Fast. Laser therapy sessions typically last between 10-15 minutes. Acute injuries may resolve after four or five sessions, while chronic conditions may require ten or more sessions.
- Long-lasting. Treatments such as cortisone injections or medications mask pain in the short term but don't treat the underlying cause. MLS laser therapy provides rapid pain relief and aids in the healing process, helping you to feel better while your condition improves.
- Site-based. Unlike medications that circulate throughout your body, MLS laser therapy delivers a localized pulse of energy directly to the injury site. This allows your condition to heal naturally without the risk of systemic complications or drug interactions.
- Noninvasive. Laser therapy sessions don't require incisions, injections, or physical manipulation of a painful injury. In some cases, MLS laser therapy's ability to encourage healing in damaged tissues could allow a patient to avoid surgery.
- Customizable. The length and number of treatment sessions can be adapted to suit each individual patient and their ailment, allowing you to tailor your treatment program for the best possible results.
- Safe. MLS laser therapy is FDA-approved, supported by independent studies, and has no reported side effects.
Are You Looking for Expert Foot Care in Twin Falls, ID?
Can You Run with a Broken Toe?
We get the temptation. You have stubbed your toe something fierce, but don’t want it to interfere with your running. Is it safe to run with a broken toe, or a toe that has been injured in some other way?
If you suspect your toe may be broken, you will not want to perform any exercise that involves moving it until you have the opportunity to get it seen by a professional. Fractured bones in a toe, as with anywhere else in the body, can further shift and cause damage if they are moved or have additional forces placed on them.
This does not necessarily mean you must be laid up for the entirety of recovery, however. You can still initially perform some activities that do not place stress on your toe, and we will help you determine what kinds of exercises will be the best for you to perform as your toe heals. As your toe grows stronger, you may begin to gradually ease back into running—and it will also be important to perform stretches and specific exercises to further strengthen and stabilize your toe.
If you feel your toe is broken, you have no benefit in waiting. Give Advanced Foot and Ankle a Call at (208) 731-6321. Our offices in Twin Falls and Burley will help you get back to action as quickly and safely as possible.
Are You Looking for Expert Foot Care in Twin Falls, ID?
What are the different types of foot arches?
Our feet are remarkably complex structures. Containing over one-quarter of all the bones in your body and more than 100 different muscles, tendons, and ligaments, there is certainly a lot of room for variance. Whereas the inherent foot structure is similar for most people, one of those areas of variance can be found in the height of your foot arches.
Before jumping into structural differences, it should be noted that we often refer to the “foot arch” in a fairly general sense, but there are actually three different arches—medial, lateral, and transverse—in each foot. When patients ask about the different types of foot arches, though, they are often looking to learn more about flat feet or cavus foot.
There are essentially three different types of varying foot arches – low, moderate, and high. Knowing these types, which kind you have, and how they affect the way your feet move are all important for both understanding common medical conditions and choosing shoes that are appropriate for the feet you have.
Moderate arches – This type of arch is the most biomechanically efficient, but individuals with moderate arches can still potentially develop common foot conditions like heel pain or ball-of-foot issues.
Low arches –These foot arches can be either flexible or rigid in nature, and they often cause overpronation. This biomechanical abnormality places feet at greater risk for bunions, plantar fasciitis, and other sources of heel pain.
High arches –Also known as cavus foot, this arch style is typically more rigid than the other types. With this particular structure, almost all of the force loads that come from walking, running, and jumping are absorbed by the forefoot and heel areas, instead of being distributed equitably across the foot.
For additional information on your feet and structural features—or to request an appointment for professional podiatric services—simply give us a call at (208) 731-6321 to connect with our Twin Falls office or (208) 312-4646 to reach our Burley office.
Are You Looking for Expert Foot Care in Twin Falls, ID?
How can I exercise with arthritis?
It might seem to be a daunting task to perform exercise and physical activity when you live with an arthritic condition, but we can walk you through how to exercise with arthritis.
The first step is to consult with Dr. Wettstein or your primary physician. We can help you create an exercise plan that works best for you. A solid plan will have exercises that strengthen muscles, promote range-of-motion, work the cardiovascular system, and improve flexibility.
Key points to protect your joints include:
- Use low-impact activities.
- Apply heat (warm towel, shower) before you exercise.
- Move gently and use slow, easy motions.
- Take a break if you feel pain.
- Ice after you are done.
Given the tremendous benefits that can come with physical activity, you may find that an even better question is “how can I afford not to exercise with arthritis?” Let Advanced Foot and Ankle help you create an exercise program that is centered on the right kinds of activities and starts with low-to-moderate levels that will allow your body to properly adjust. Schedule an appointment online with either our Twin Falls or Burley, ID offices or simply call us at (208) 731-6321 for any assistance you might need.
Are You Looking for Expert Foot Care in Twin Falls, ID?