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Rehm Remedies
1553 Grand Avenue
San Marcos, California 92078

760-744-6226
askdoc@drrehmremedies.com





FAQ
FREQUENTLY ASKED QUESTIONS
Dr Rehm has collected this list of commonly asked questions to provide some information to aid you in your daily conditions. This page is intended to provide some clarity for the topic that have been brought up repeatedly by patients.
 
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Why are my toenails thick and discolored?

Thick discolored toenails can sometimes be caused by sluggish circulation. Fungus can find a nice home on the toenails, whether or not the person has poor circulation. Sometimes other problems with the toenails can make them thick and discolored such as psoriasis, skin problems or yeast infection.

Solution: It is necessary to find the culprit of these “uchy” toenails. I would suggest going to a board certified podiatrist (certified by the American Board of Multiple Specialties in Podiatry ABMSP) The first thing the doctor would do is to get a culture to find out if and what organisms are growing to determine if any medications are useful. The second thing the doctor would do is to grind them down so they are really thin and get rid of any debris in the nail corners. This way any topical medications used will penetrate easier. The doctor may want to prescribe oral medications as well. It would be well served to prevent these from happening as prevention is the best medicine.

What causes the scaling and dryness on my feet?

Dry scaly skin can be caused by certain medical situations or even pregnancy (be sure to check with your primary care doctor). Sometimes it is just thick and callused because it is an inherited condition or it may happen because the person feet gets a lot of friction with the ground as in going barefoot, wearing flip-flops or harmful shoe materials that may be causing sweating or an allergy. A good portion of the time fungus starts to grow on the skin and forms an athletes foot condition, that may in fact cause extra irritation to the skin and even become infected.

Solution: If over-the-counter medications for athletes foot conditions do not work, please seek an opinion from your podiatric physician and surgeon who is ABMSP board certified. It is always necessary for treatment and prevention to use the proper soap (see ToeSoaks) for the feet, cleansing pad (see ToesEase) and conditioning cream(Balm Riche for non-diabetics and DiabetiCream for those people who have diabetes.)

Why do my heels and my arches hurt?

Heel pain can be due to too much pounding on the heel bone and it becomes inflamed such as a person who is on their feet all day. Heel spurs can develop when the soft tissue on the bottom of the feet that’s attached to the heel bone stretches too much and becomes inflamed. This is called plantar fasciitis. Heel spurs do not hurt but the muscle-tendon-ligament type of tissue that’s pulling on the heel bone is what causes the pain.

Solution: Whether the person needs shots, oral medication or surgery would be determined by your Podiatric Physician. In any case, an orthotic device and well-fitted shoes are in order. This controls the abnormal motion of the foot causing this problem and may even stop the pain…..before you go to your doctor!

What causes my painful corns and calluses?

Corns are a result of hard calluses skin forming on the outside or in-between the toes. It is always due to some pressure or rubbing; usually the toe bones are rubbing together or the tops of the toes are rubbing on the inside of the shoe.

Solution: For the problems on the toes rubbing on the inside of the shoe, this is usually solved by getting a better fitting shoe. Sometimes part of the reason the toe is hitting the inside of the shoe is because the toe is crooked (called hammertoe, mallet toe or claw toe) and these might need to be addressed by your ABMSP board certified podiatrist either surgically or with palliatively.

Why do I have bunions and my toes are crooked and will they get worse?

A bunion is a bump on the medial side of the foot caused by an enlargement of the bone at the first metatarsal and an irritation of the bursal sac there. This irritation is due to an imbalance occurring when a person walks, called over-pronation. Toes are crooked, and depending on what joints are involved, are called hammertoes, mallet toes or clawtoes. They are caused by the same combination of heredity and imbalance in walking as is the bunion deformity.

Solution: The worsening of the bunion and even the pain involved can be halted by wearing a custom-made orthotic device made by your ABMSP board-certified podiatrist, in combination with a well-fitted shoe. Sometimes surgery by a ABMSP board certified podiatrist is needed. The crooked toes can be alleviated in the same manner as is the bunion problem.

What causes the ball of my foot hurt when I walk?

The most common cause of this is because of pinching and eventual scarring of the nerve tissue in between the metatarsal heads. This is termed a Neuroma or a Morton’s neuroma when it occurs between the 3rd and 4th metatarsal heads. The pinching is usually due to an imbalance occurring when walking. This imbalance is called hyper-pronation and will cause squeezing of the nerves with each step.

Solution: If the imbalance is corrected by custom made orthotic devices, made through the process called biomechanical exam and neutral position casting of the foot the nerve could possibly shrink enough over time such that no further treatment would be required. However, very often, various types of injections are used to augment this process. If these conservative measures are employed in a timely manner, surgery, more often than not, is not needed.

Why do my feet burn?

Burning sensation of the feet can occur from trauma to the bottom of the feet, swelling of the feet and legs, hereditary situations, dietary considerations such as a reaction to a high-sugar diet or even frank diabetes mellitus causing a condition called neuropathy. Burning can also be caused by neck and back problems. It is usually associated with the body having too much inflammatory chemicals going to the nerves, one notable cause is preservatives and high sugar content in a persons diet.

Solution: Finding temporary relief for this problem can be problematic but remember that good fitting shoes and orthotic devices will probably not hurt you, but more likely will help you. In this case, ALWAYS bring this problem to the attention of your primary care provider and your ABMSP board certified podiatrist.

 

Any other questions please email Dr. Rehm at askdoc@drrehmremedies.com