Bunions be Gone!

Bunions—those unsightly bony protrusions that can develop over the first metatarsal bone or big toe joint—remain a bit of a mystery. Aside from their definition, everything else varies, including how and why they develop, who gets them and when, and what symptoms they may cause. But one thing is certain:  Bunions can be hard to ignore, especially when they’re painful.

Fortunately, there are early steps you can take that may help you from ever reaching that stage.

“My best advice is to have an evaluation with a foot specialist when you first see a bunion developing or have any pain in your big toe joint,” says Katherine Raspovic, DPM, a podiatric surgeon at MedStar Washington Hospital Center. “There are a few conservative treatment options that can help improve discomfort.” 

The luck of the draw, genetics, often plays a role in determining who gets bunions. But shoes are another likely culprit, with high heels and shoes with narrow toe areas leading the list of suspects. While many high-heel wearers may never have problems, Dr. Raspovic advises those who do to step away from the stilettos, pointy toes and any other shoe that aggravates the sore joint.   

“One of the best preventative and therapeutic measures for bunions is wearing the right shoe for your foot, especially one that avoids excessive pressure on your toes,” she says. “It can be helpful to go to a good store where you can get your feet accurately measured so you can then find the proper size and fit.”

Beyond a change of footwear, other helpful tactics include using orthotics for arch support, modifying or taking a break from some activities for a time and taking anti-inflammatory medication.

Surgery is only recommended when other approaches have failed and the pain is so severe that daily activities and quality of life are affected. Depending on the type of surgical correction, some patients are completely off their feet for six weeks, followed by a walking boot and physical therapy. Post-surgical swelling—which may quickly subside or last for several months—can affect a patient’s ability to wear regular shoes for 10 to12 weeks after surgery. The recovery can be different for each patient based on what surgical intervention is needed to correct the bunion properly.

But with early detection and specialty medical care, many people can avoid surgery, says Dr. Raspovic.

Tune in to the full podcast interview with Dr. Raspovic.

Our specialists are experts in the diagnosis and treatment bunion and other podiatric conditions. Ready to schedule an appointment? Call us at

202-759-0267

Katherine Raspovic, DPM Bunion

Dr. Katherine Raspovic, DPM

 

 

For an appointment, call 202-759-0267.

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Bothered by Bunions?

Tune in to the full podcast interview with Dr. Raspovic.

Bunions—those unsightly bony protrusions that can develop over the first metatarsal bone or big toe joint—remain a bit of a mystery. Aside from their definition, everything else varies, including how and why they develop, who gets them and when, and what symptoms they may cause. But one thing is certain:  Bunions can be hard to ignore, especially when they’re painful.

Fortunately, there are early steps you can take that may help you from ever reaching that stage.

“My best advice is to have an evaluation with a foot specialist when you first see a bunion developing or have any pain in your big toe joint,” says Katherine Raspovic, DPM, a podiatric surgeon. “There are a few conservative treatment options that can help improve discomfort.” 

The luck of the draw, genetics, often plays a role in determining who gets bunions. But shoes are another likely culprit, with high heels and shoes with narrow toe areas leading the list of suspects. While many high-heel wearers may never have problems, Dr. Raspovic advises those who do to step away from the stilettos, pointy toes and any other shoe that aggravates the sore joint.   

“One of the best preventative and therapeutic measures for bunions is wearing the right shoe for your foot, especially one that avoids excessive pressure on your toes,” she says. “It can be helpful to go to a good store where you can get your feet accurately measured so you can then find the proper size and fit.”

Beyond a change of footwear, other helpful tactics include using orthotics for arch support, modifying or taking a break from some activities for a time and taking anti-inflammatory medication.

Surgery is only recommended when other approaches have failed and the pain is so severe that daily activities and quality of life are affected. Depending on the type of surgical correction, some patients are completely off their feet for six weeks, followed by a walking boot and physical therapy. Post-surgical swelling—which may quickly subside or last for several months—can affect a patient’s ability to wear regular shoes for 10 to12 weeks after surgery. The recovery can be different for each patient based on what surgical intervention is needed to correct the bunion properly.

But with early detection and specialty medical care, many people can avoid surgery, says Dr. Raspovic.

Tune in to the full podcast interview with Dr. Raspovic.

Morton’s Neuroma: When Feet Fight Back

What is Morton's Neuroma?

Whether you’re a runner pounding the pavement or a fashionista balancing on sky-high heels, your feet are taking a beating. And when they’ve had enough, they fight back.

Increasingly, their weapon of choice is Morton’s neuroma— an otherwise harmless cyst that causes numbness, shooting or burning pain in the ball of your foot. It’s the result of repeated irritation or compression of a nerve or nearby tissue, usually between the second or third toe.

“Toes that are forced into a tight space for a long time are subjected to extra pressure that then causes swelling and pain,” explains John S. Steinberg, DPM, director of MedStar Washington Hospital Center’s Podiatric Residency Program and a podiatric surgeon. “The same effect happens after repeated high-impact activities, including years of wearing high heels. Unfortunately, even minor pain may cause you to limp or change your gait, which leads to other problems because your natural walking mechanics are all off.”

Treatments for Morton's Neuroma

But the good news is that the pain and discomfort from Morton’s neuroma can go away with proper treatment, including some simple remedies you can try at home:

  • Take over-the-counter (OTC) anti-inflammatories to reduce swelling
  • Soak the sore foot in alternating baths of comfortably hot and cold water
  • Wear full-length, OTC arch supports with a solid shell
  • Give your feet a break from high-impact activities and high heels

If the problem persists, foot specialists typically prescribe injections of cortisone or alcohol solution to reduce swelling; custom orthotics to correct foot mechanics and separate the toes; and/or physical therapy. Surgery—once the standard approach—is reserved for only the most extreme cases, notes Dr. Steinberg.

“Nowadays, foot surgeons or plastic surgeons can perform an external neurolysis, which releases ligaments and tight tissue from around the nerve to create space.”

But as any sports fan knows, the best defense is a good offense. To avoid developing Morton’s neuroma in the first place, Dr. Steinberg offers some commonsense advice.

“Change to shoes that are better fitting, so that toes will have the space and support they need.”

Have any questions?

We are here to help! If you have any questions about Morton's or other podiatric issues Call MedStar Washington Hospital Center at 855-546-1974.

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Quick and Effective Treatment for Foot Pain

New Treatment for Foot Pain

More than 75 percent of all American adults will experience foot or ankle pain at some point in their lives. If you happen to be one of them, you already know how such pain can limit every day life. But by harnessing your body’s own healing abilities, a quick treatment may get you back on your feet in no time.

Because there can be many causes—from acute injuries to chronic conditions—there is a range of treatment for foot pain. The first and most conservative line of defense is almost always rest, often along with some combination of stretching, anti-inflammatory medications and over-the-counter inserts to provide support. More severe problems may require physical therapy, bracing and boots or custom orthotics.

But if the above steps still fail to produce the desired result, physicians now have another low-risk, outpatient treatment available: an injection of your own platelet enriched plasma.

Get Back on Your Feet Quicker

“In most cases, platelet-rich plasma—PRP—can decrease or completely eliminate the pain, contributing to a speedier recovery,” says Caitlin Zarick, MD, a podiatric surgeon at MedStar Washington Hospital Center and proponent of the relatively new approach. “Most patients get back on their feet within a few days and can resume regular activity within a month. As a result, PRP treatment is quickly gaining popularity.”

During the less than 30-minute procedure, some blood is withdrawn from the patient and then placed in a centrifuge to separate out the platelets, the component that helps with clotting, healing and tissue growth. Then the platelet-rich plasma—now containing three to five times more growth factors than normal— is injected into affected area.

This treatment for foot pain may involve one injection or a series of three to five, depending on the injury and its response to PRP. Immediately following the procedure, you may need to limit motion or weight-bearing movement and your doctor may prescribe a boot or brace for short-term use.

Have any questions?

We are here to help! Contact us for more information or to schedule an appointment. Call us at 855-546-1974.

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