I think I sprained my ankle. Do I need to see a doctor?
Ankle sprains are among the most common injuries seen by foot and ankle specialists. An inability to walk on the affected foot and/or severe swelling and bruising warrants medical evaluation. Most ankle sprains improve with rest, ice, compression, and elevation, but an inability to walk after the injury could indicate a more worrisome injury such as a broken bone of the ankle or foot. Many foot and ankle fractures don’t require surgery, but accurate diagnosis is important in initiating the most effective treatment plan. Early appropriate treatment of a severe sprain can also decrease the risk of developing a chronically unstable ankle that could require a surgical stabilization procedure. Achilles tendon ruptures can also present as an “ankle sprain.” Any sensation of an acute pop during running and/or jumping activities should undergo a medical evaluation to be assessed for this possibility. A missed Achilles tendon rupture is difficult to treat, but a rupture seen early and treated appropriately most often leads to an uneventful recovery. Not all Achilles tendon ruptures require surgery, but early diagnosis and treatment gives the patient the best chance for a successful recovery.
Why am I losing the arch of my foot?
A foot that becomes flatter over time, warrants medical evaluation. An important structure called the posterior tibial tendon is vital in supporting the arch of the foot. If the tendon develops degenerative tearing, the function of the tendon deteriorates over time, and the arch will flatten, and this can also be associated with swelling and pain on the inside of the ankle. If caught early, conservative treatment with physical therapy, activity modification, and bracing can be successful in treatment of this problems. Surgery is often required with failure of conservative treatment. Arthritis of the midfoot can also be associated with flattening of the arch. Pain in this condition is on the top of the foot rather than along the inside of the ankle. This type of arthritic pain can be controlled with appropriate shoe wear and injections in most cases. Surgical treatment of this condition is undertaken only after conservative measures have failed.
Should I have my bunion corrected?
A bunion, also known as hallux valgus, occurs when the big toe deviates toward the second toe and a large bump develops on the side of the foot. This large bump may or may not be painful. Genetics play the biggest role in the development of a bunion. Bunions that are not painful should generally be left alone from a surgical standpoint. Painful bunions are first treated with shoe wear modification so that the shoe does not rub the bunion. Orthotics(arch supports) and night splints do very little, if anything, to successfully treat bunion pain. There are many options for bunion surgery, so it is important for the patient to see a doctor who has experience with multiple surgical options.
Why is my big toe stiff?
If you are developing stiffness in your big toe joint, you are likely developing arthritis in the joint that allows your big toe to move. This condition can become painful. Shoe wear modifications can help decrease your pain. If shoe wear modifications fail, the condition may warrant surgical intervention by removing bone spurs or even fusing the joint. Newer options to maintain joint motion are also becoming a possible way to treat this problem.
Problems of the foot and ankle frequently interfere with maintaining an active lifestyle. At Raleigh Orthopaedic Clinic, we emphasize conservative treatment first. If surgery is the best treatment for a given condition, we have the expertise and training to accomplish the goal of returning the patient back to an active lifestyle.
David W. Boone, MD
Orthopaedic Foot and Ankle Specialist
Raleigh Orthopaedic Clinic
Dr Boone is fellowship trained in Foot and Ankle Surgery and is board certified by the American Board of Orthopaedic Surgery. He also has a subspecialty certificate in Orthopaedic Sports Medicine. He has been practicing at Raleigh Orthopaedic Clinic since 1994 and is currently president of the group.