Dr. Berg's Foot Facts

Posts for tag: telemedicine

By Dr. Rion Berg
May 06, 2020
Category: Heel pain
Tags: telemedicine  

Doctor holding cell phoneDespite current concerns about Covid-19, most of us are getting outside. We’re soaking up the sun while gardening or by walking and running in our neighborhoods. Some of us are also frequenting parks and golf courses, now that those are open as of May 1st.

With more physical activity comes foot pain. You may be wondering if you need to come into the office to get your particular foot condition evaluated and treated. The answer is, not necessarily. Through the wonders of telemedicine I can listen to you describe the pain you’re having, you can show me your feet, and I can watch you walk. Oftentimes these will be sufficient for me to prescribe you a home treatment program and/or write you a prescription you can pick up at your pharmacy.  Sometimes we will have the item you need at the office. You can pay for these over the phone and then pick them at the door.

So what are some of the most common conditions I’m seeing through telemedicine?

  • Heel pain
  • Ingrown toenails
  • Cracked skin
  • Broken toes

Heel Pain

Heel pain is usually either plantar fasciitis (bottom of the heel pain) or Achilles tendonitis (back of the heel pain). These conditions are most often brought on by a combination of the following factors: an increase in exercise (walking and running), going barefoot in the house or outside, overpronation (a tendency to pronate or roll your foot inward during movement) and having tight calf muscles.

I’ve helped many patients resolve their heel pain during a telemedicine call by learning more about their particular issues and by watching them walk.

To resolve your heel pain at home, take the following steps:

  • Wear supportive tennis shoes
  • Don't go barefoot at home, but instead wear support sandals
  • Reduce your inflammation
  • Add over-the-counter inserts
  • Reduce your calf tightness
  • Use a heel lift

To learn more about how to resolve your heel pain at home, review the blog I wrote and the companion video, “6 Self-Care Tips to Resolve Heel Pain During the Covid-19 Pandemic”.  The blog contains links to all the products I recommend.

Ingrown Toenail

If you’ve ever experienced an ingrown toenail you know how painful it can be. Although in most cases I’ll need to see you in the office to do minor surgery, we may be able to resolve your issue through a telemedicine call.

First I’ll ask you about the state of your toe. Is it painful, red, swollen, or is there any pus or drainage? Your responses to these questions will help me understand whether your ingrown toenail is infected. I’ll also view your toe during our telemedicine call. After my assessment I’ll determine whether you can start home treatment or whether you need to come into the office for surgery.

To care for your ingrown nail at home take the following steps:

  • Epsom salt soak - soak your toe in a bucket or other container with warm water and ½ cup of Epsom salt for about 15 minutes twice a day.
  • Apply a wet to dry dressing – wrap your toe with gauze and secure with tape (make sure you don’t tape the gauze to your toe. Saturate the gauze with the Epsom salt soak and let it dry while you wear an open toed shoe. Apply twice daily.
  • Wear sandals - wear sandals or another open toed shoe to avoid pressure on the nail.
  • Prescription medication – if your toenail is infected, I’ll prescribe medication. Use as directed.

Note: If redness, pain, or drainage increase you’ll need to make an in office appointment.

Cracked Heels

Walking around barefoot indoors and outside will often lead to dry and cracked heels due to increased pressure on that part of the foot. If your cracks are minor you won’t need a telemedicine appointment. However, more severe cracks particularly those that are deep and bleeding will require a telemedicine call.

To care for your cracked heels at home, take the following steps:

Mild to Moderately Cracked Heels

More Severe Cracked Heels

  • Put moisturizer on before you go to bed and wrap your feet in Saran wrap.
  • Purchase gel socks and use for two hours during the day only. Adessa Gel Socks can be purchased over the phone from our office and then picked up at the door.

Note: Patients who have cracked heels and diabetes, wounds, or ulcers will need to be seen at the office due to increased risk of infection.

Broken Toes

Broken toes often occur when we walk around barefoot during the night and slam our foot into a piece of furniture.  Most often broken toes won’t require an X-ray so you can easily treat this at home.

To care for your broken toe at home, take the following steps:

  • Use ice, 15 minutes on 15 minutes off.
  • Buddy splint your toes using one inch wide Coflex bandages starting on your baby toe (5th toe), then tape your 4th, and then tape your 3rd.

One Final Note: Covid Toes

Recently we’ve been reading about a new phenomenon some people are calling Covid toes. Mostly younger patients with Covid-19 in their 20s and 30s are experiencing a pinkish-red rash that can also turn purple over time. The toes can appear to be frostbitten with skin sores or bumps. This condition can also cause burning in some people. Most people who get this rash are asymptomatic with it disappearing in two to three weeks.

Because patients are asymptomatic the most important thing about this condition is that people who experience it should get tested and isolate themselves from others who could have a much worse case of Covid-19.

If you think you or your child has this condition, I can diagnose it through a telemedicine appointment.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

By Dr. Rion Berg
June 27, 2013
Category: foot conditions

Last week I got a call from number one son, ensign Alex Berg of the U.S. Coast Guard. He was away from his base in Portsmouth New Hampshire training in San Diego when he had sudden onset of foot pain. Using his iPhone, he sent me a picture of the location of the pain on the bottom of his foot.

He described it as sharp pain brought on by running. He was miserable whenever he had to stand for prolonged periods, a frequent occurrence in his job with the U.S. Coast Guard.  Knowing his lower extremity anatomy fairly well, which is unfortunately similar to mine, I knew that his calf muscles were extremely tight.  He runs duck footed and mostly on his heels. 

My phone/video diagnosis was “Cuboid Syndrome”. The pain with this syndrome is well forward of the heel not quite to the middle of the foot, where there is a bone shaped like a cube.  Because of the location, it is not plantar fasciitis or heel pain.  The lateral side of the foot (side toward the baby toe) has a muscle that comes down from the leg (peroneus longus) dives under this bone in a groove, and travels all the way over to the base of the first metatarsal bone, (long bone behind the great toe connecting to the middle of the foot). 

In Alex’s case his tight calf and flat foot caused the tendon to be overworked and constantly inflamed.  It’s like his foot was saying “Hey it’s time to get out of the barn and on the road to propulsion, and you guys back in the calf won’t let me move forward. I’m going to give you something to remember!”

Thanks to my father and his vintage podiatrist training, he taught us to use a simple pad 1/8 to ¼ inch thick specially placed on the bottom of the foot to push up on the cuboid bone. This relieves the tension on the peroneal tendon and the pain can be reduced almost immediately. My son could only get thin moleskin, some kind of padding and probably duct tape, but with the help of my diagrams, his pain resolved immediately and ensign Berg didn’t have to report to the infirmary.

Amazing what we could do via phone, texting pictures, and web based learning.   Of course I advise caution in treating yourself without consultation, but I do encourage learning about common foot problems before you come in for an evaluation.

Finally, it’s important to keep our country safe and that means keeping our servicemen and women healthy on the job.