Do you have a hard time walking or climbing stairs without foot pain? Is your foot misshapen? Do you wish you could find a pair of shoes that fit? Are all these problems contributed to a bump on the side of your foot below your big toe?

If so, you probably have a bunion.

Although they may develop on the fifth toe, a bunion usually occurs at the base of the first toe (or the big toe). Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond its normal range. In some cases, joint damage caused by arthritis or an injury can produce a bunion. Many simply inherit the traits for forming bunions from their parents or grandparents. If you're at risk for developing a bunion, wearing high-heeled, pointed or improperly fitting shoes makes the problem worse. If you have a bunion already you should call Patrick W. Mullen, D.P.M., a Board Certified podiatrist with seventeen years' experience in correcting bunion deformities.

"Bunions are one of the most common foot deformities seen in our office," states Dr. Mullen. "If not severe, a bunion can be treated non-surgically with wider shoes and custom-made shoe inserts called orthotics that control incorrect foot mechanics." However, for severe bunions he may recommend surgery.

Bunion surgery is usually done on an outpatient basis without the need for general anesthesia. Many patients are able to walk immediately after surgery and need pain medication for only a few days. "It is important to see a foot surgeon who is trained in the many surgical techniques to correct a bunion deformity," says Dr. Mullen. "The type of surgical procedure you undergo depends on the type of bunion you have."

During surgery, Dr. Mullen can shift or remove the offending bone associated with the bunion or he can realign the affected soft tissues (joints, tendons, etc.) surrounding the bunion. Dr. Mullen uses the most advanced treatment procedures available to achieve these goals, such as the absorbable pin. The absorbable pin is a useful device that holds the bone in place after a misalignment is surgically corrected. The pin over time absorbs into the bone, eliminating the need for follow-up surgery.

After surgery, a patient will visit Dr. Mullen weekly for the first three weeks for follow-up visits. During this your foot is examined, bandages changed, X-rays taken and stitches are removed. Most patients are able to return to shoes and full activities by six to eight weeks.

"Bunion surgery is very successful and very liberating," says Dr. Mullen. "My patients are often able to jog, play tennis or simply take a walk in the park again without hobbling or experiencing pain. Their feet look much better after surgery, too."

If you have a bunion, take advantage of the latest procedures to correct the misalignment. For more information and to set up an appointment, call now at (559) 435-0220.

Hammertoe Treatment Help Get Feet Back To Normal

Do you need a "toe" realignment?

Getting one's tires realigned every few months is just one way that millions of individuals properly maintain their car. Ironically, many people also need their toes realigned. This is due to painful, disfiguring condition called hammertoes.

Hammertoes are toes that curl and develop corns and calluses. At times they can be very painful and create problems wearing shoes and even walking. The correction for hammertoes can require something as simple as changing the type of shoes one wears or as complex as surgical intervention. For Peggy Thompson, recent patient of Patrick W. Mullen, D.P.M., surgery was her only option.

"When I first walked into Dr. Mullen's office I could hardly walk," says Peggy. "My toes were crossing and not aligned properly. I couldn't wear any shoes either because my toes were pointing up in the air. I was in total pain."

In addition to the hammertoes, part of the reason for Peggy's pain was due to a prior surgical procedure she had that involved the implantation of metal screws and rods in her feet. This "hardware" was supposed to help in realigning Peggy's problematic feet; however, immediately after surgery all her toes started moving and crossing over. In addition, the screws that were used were too long and ended up coming close to puncturing through the bottom of her feet.

"It felt like I was walking on nails," says Peggy. "I looked in the Yellow Pages and I found Dr. Mullen."

After the first meeting with Peggy, Dr. Mullen immediately noticed all the hardware implanted in Peggy’s feet were not functioning properly. He scheduled a prompt surgical intervention on Memorial Day weekend that took transferred tendons to realign the hammertoes. Dr. Mullen also removed the metal structures. After only a short recovery period, Peggy was walking again.

"I'm walking three miles a day!" says Peggy. "I was limping when I went into his office. He's like my angel."

Dr. Mullen is Board Certified in Foot and Ankle Surgery and is familiar with all the latest invasive and non-invasive methods to correct any imbalances and realign your toes.

Treatment for hammertoes can consist of:

• Trimming and/or padding/corns
• Orthotics (inserts in shoes to correct improper walking)
• Injections to relieve pain and inflammation

Dr. Mullen offers hammertoe surgery only as a last resort to pain. He also offers treatment for all foot problems including bunions, ingrown toenails and neuromas. If you are experiencing any of these foot conditions, please call Dr. Mullen's office today at (559) 435-0220. Most insurance accepted.

Don't Let Heel Pain Stop You

You woke up feeling fine, but as you took your first step from bed, you felt a shot of pain from your heel. Making it to the shower was uncomfortable but the pain subsided.  The hopes that you wouldn't have to go to the doctor were cut short, though, because the pain returned about noon. Strangely enough, it always returned after short periods of rest.

"I waited until the very last minute to finally do something about it," described Doris Mitchell. "The pain was always there, and I tried everything I could to make it stop. My daughter referred me to Patrick Mullen, D.P.M., after four months of suffering from a heel spur. I came to the point where I couldn't wait any longer."

A heel spur is a bony protrusion on the bottom of the heel. It is associated with a band of tissue in the bottom of the foot known as the plantar fascia. The plantar fascia inserts into the heel bone where the heel spur develops and spreads out into the foot. Excessive tension to this band of tissue due to your weight, shoes and even trauma can cause inflammation and pain. The size and pressure of a heel spur does not always correlate with the amount of pain.

Patrick W. Mullen. D.P.M, is a Board-Certified podiatrist and stays up-to-date on the latest non-surgical and surgical treatments of heel pain. Very often a patient can recover after an initial treatment with arch supports, orthotics, different shoes or anti-inflammatory medication.

Doctors may also simply initiate weekly physical therapy or foot taping, stretching and padding. As in Doris' case, if these treatments fail, a relatively new procedure called Endoscopic Plantar Fasciotomy may be the answer. In contrast to traditional types of heel surgery, this new outpatient procedure calls for only a small incision on both sides of the heel large enough to introduce a fiber optic endoscope. Using visualization on a TV monitor, small instruments are used to make small, precise incisions to the ligament and release tension, thus relieving the pain. Since there is little tissue injury, people are usually able to return to shoes in seven to 10 days versus four weeks with the old procedure. Patients also are often able to return to work in seven to 10 days with minimal pain compared to 4 to 6 weeks with the old procedure. "Dr. Mullen was wonderful, I couldn't ask for anything more. I only wish I hadn't waited so long in pain."

The cost of the new endoscopic surgery is comparable to the traditional open heel spur surgery. Actually, when considering the loss of work due to a lengthy recovery time, the new endoscopic surgery may in fact be less costly.

Please call Dr. Mullen at (559) 432-0220 for more information.

Permanently Relieve the Agony of Ingrown Toenails

The discomfort of an ingrown toenail can be so great that even the slightest pressure of bed sheets touching the toe can make sleep almost impossible.

Ingrown toenails are the most common foot ailment treated by Patrick W. Mullen, D.P.M.  They are caused by the nail plate growing into the skin along the sides, or margins, of the nail.  While some ingrown toenails are chronic, others are one-time occurrences.  Very often, an infection accompanies an ingrown toenail.

Dr. Mullen offers the latest techniques in treating ingrown toenails, starting with a list of home remedies that may provide a patient with relief. 

If you have problems with ingrown toenails, call Dr. Mullen at (559) 435-0220 to schedule an appointment.

FOOT PAIN GETTING ON YOUR NERVES?

"I have two toes on my left foot that feel real numb," he said.

Very often while walking around his home he would lift his foot up quickly as if he stepped on a tack or a lamp cord that could give him a shock. The pain definitely was a hindrance.

Neuromas, commonly called Morton’s Neuroma, are enlarged benign growths of nerves, most commonly between the third and fourth toes. (However, it can occur between the second and third toes. This condition is caused by the compression of nerves between two displaced metatarsal bones, which is often due to ill-fitting shoes or abnormal bone movement. Inflammation occurs when the head of one displaced metatarsal presses against another and catches the nerve between them. With each step, the nerve is robbed, pressed and irritated.  Consequently, the nerve becomes enlarged with a sheath of scar tissue that forms to protect the nerve.

The symptoms of a neuroma include a sudden sharp stabbing pain in the toes. The pain may start gradually and build, causing tingling, cramps, numbness and burning as well. The toes, however, are not the source of the pain. Morton’s neuromas is a neuralgia, an inflammation of the nerve. To relieve the pain, many people remove the shoe and massage and bend the toes where the pain seems to be located. Substituting a cold sensation for the pain — by stepping on a cold floor with a bare foot — sometimes helps relieve this pain temporarily as well.

"If you find yourself holding your foot in your hand while trying to balance yourself, you probably have Morton's Neuroma," says Patrick Mullen, D.P.M. "However, it is important to have a physical exam to determine this because diabetes or alcoholism can have symptoms similar to a neuroma."

To make a proper diagnosis and determine the best course of treatment, Dr. Mullen thoroughly examines a patient’s foot and checks his or her medical history. Any past nerve conditions may be indication of Morton’s neuroma. X-rays may also help identify the condition. Once discovered, Dr. Mullen employs various forms of treatment.

If you are experiencing nerve pain in the foot, please call Dr. Mullen’s office today at (559) 435-0220.