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Peripheral neuropathy develops when nerves outside the brain and spinal cord become damaged. These nerves carry messages between the brain, feet, and the rest of the body. When the nerves do not work correctly, they can send the wrong signals or fail to send signals at all. This problem frequently affects the feet first because the longest nerves travel to the toes. Symptoms include numbness, burning pain, or sharp discomfort. Some patients also notice weakness or a reduced ability to feel heat, cold, or pressure. Balance can become less steady because the feet cannot sense the ground as well while walking. Among the leading causes of peripheral neuropathy is high blood sugar from diabetes. 

A podiatrist plays an important role in diagnosing peripheral neuropathy and preserving foot health. Diagnosis begins with a medical history and a careful foot examination. The podiatrist checks sensation, strength, and circulation. Additional testing can help measure how well the nerves are working or identify another condition causing the symptoms. Regular foot evaluations help detect skin changes, pressure areas, and small injuries before they become more serious. Early diagnosis also helps reduce the risk of infections and other complications that can threaten foot health. Patients with reduced feeling benefit from professional monitoring because even minor foot problems can become more difficult to manage when sensation is limited.

Treatment focuses on the cause of the nerve damage and protecting the feet from further problems. A podiatrist provides routine foot care and treats wounds. This foot doctor also recommends custom orthotics or shoes that provide proper support while reducing pressure on sensitive areas. Additionally, the podiatrist monitors changes in sensation and foot structure while helping lower the risk of ulcers and other complications. Consistent podiatric care supports comfort, mobility, and safer movement while walking. If you have symptoms of peripheral neuropathy, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and appropriate treatment.

Neuropathy

Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.

What Is Neuropathy?

Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.

Symptoms of Neuropathy Include:

• Numbness
• Sensation loss
• Prickling and tingling sensations
• Throbbing, freezing, burning pains
• Muscle weakness

Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.

Treatment

To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.

Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Golf places repeated stress on the feet and ankles because each swing requires twisting, pivoting, and shifting body weight. A long round means steps on grass, hills, and uneven ground. These movements can lead to heel pain, ball-of-foot pain, or soreness under the big toe joint. Heel pain can feel sharp with the first steps in the morning. Pain in the ball of the foot can feel like burning or aching beneath the toes. Pain under the big toe can make it hard to push off during the golf swing or while walking.

Golf can also irritate the back of the heel, the toes, and the side of the ankle. Pain behind the heel can come from strain on the strong tendon that connects the calf to the heel. This pain can worsen when walking uphill or standing for long periods. Some golfers feel sharp pain, tingling, or numbness between the toes when pressure irritates a nerve. Existing bunions can also become more painful from the sideways force of the swing. An ankle sprain can occur when the foot slips, rolls, or twists on uneven ground.

A podiatrist can examine the foot and ankle to find the cause of pain. X-rays and other imaging can help show whether a bone, joint, or soft tissue is injured. Treatment options include supportive shoes, custom orthotics, and bracing to reduce pressure on painful areas. A walking boot can help protect against serious injuries while healing takes place. Anti-inflammatory care can reduce swelling and soreness. A podiatrist can recommend stretching and strengthening exercises to improve balance and foot control. Early treatment can help golfers return to the course with less pain. If you have foot pain after playing golf, it is suggested that you make an appointment with a podiatrist for an exam and treatment options.

Sports related foot and ankle injuries require proper treatment before players can go back to their regular routines. For more information, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are a common occurrence when it comes to athletes of any sport. While many athletes dismiss the initial aches and pains, the truth is that ignoring potential foot and ankle injuries can lead to serious problems. As athletes continue to place pressure and strain the area further, a mild injury can turn into something as serious as a rupture and may lead to a permanent disability. There are many factors that contribute to sports related foot and ankle injuries, which include failure to warm up properly, not providing support or wearing bad footwear. Common injuries and conditions athletes face, including:

• Plantar Fasciitis
• Achilles Tendinitis
• Achilles Tendon Rupture
• Ankle Sprains

Sports related injuries are commonly treated using the RICE method. This includes rest, applying ice to the injured area, compression and elevating the ankle. More serious sprains and injuries may require surgery, which could include arthroscopic and reconstructive surgery. Rehabilitation and therapy may also be required in order to get any recovering athlete to become fully functional again. Any unusual aches and pains an athlete sustains must be evaluated by a licensed, reputable medical professional.

If you have any questions please contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Trench foot, also known as immersion foot, is a non-freezing cold injury that develops when the feet are exposed to wet and cold conditions for an extended period of time. This condition gained recognition during wartime, but remains relevant today in outdoor workers, athletes, and individuals exposed to damp environments. Prolonged moisture weakens the skin barrier and disrupts circulation, leading to tissue damage. Unlike frostbite, trench foot can occur in temperatures above freezing, making awareness essential for prevention and early care. Understanding this condition supports better foot health and reduces the risk of long term complications.

The symptoms of trench foot often begin with tingling, itching, or a burning sensation in the feet. As the condition progresses, the skin may appear pale, wrinkled, or waterlogged. Swelling and pain can develop, along with redness, once circulation begins to return. In more advanced stages, blisters, open sores, and skin breakdown may occur, increasing the risk of infection. Some individuals also experience numbness or heaviness in the affected area. Recognizing these symptoms early is important to prevent further damage and support proper recovery.

Several risk factors increase the likelihood of developing trench foot. Prolonged exposure to wet socks, damp shoes, or standing water is the primary cause. Cold weather conditions combined with poor foot hygiene further contribute to the risk. Wearing tight footwear that restricts circulation can worsen the condition, as can limited mobility or prolonged standing. Individuals with poor circulation or underlying health conditions may be more vulnerable. Understanding these risk factors helps guide preventive strategies and supports overall foot care in challenging environments.

The main cause of trench foot is sustained exposure to moisture and cold, which leads to constricted blood vessels and reduced oxygen supply to the tissues. This combination damages the skin and underlying structures over time. Preventive care includes keeping feet clean and dry, changing socks regularly, and wearing properly fitted water resistant footwear. Early intervention is essential to avoid complications such as infection or tissue damage. If you have symptoms of trench foot, it is suggested you consult a podiatrist for an accurate diagnosis and appropriate treatment.

Foot Pain

Foot pain can be extremely painful and debilitating. If you have a foot pain, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

Causes

Foot pain is a very broad condition that could be caused by one or more ailments. The most common include:

• Bunions
• Hammertoes
• Plantar Fasciitis
• Bone Spurs
• Corns
• Tarsal Tunnel Syndrome
• Ingrown Toenails
• Arthritis (such as Gout, Rheumatoid, and Osteoarthritis)
• Flat Feet
• Injury (from stress fractures, broken toe, foot, ankle, Achilles tendon ruptures, and sprains)
• And more

Diagnosis

To figure out the cause of foot pain, podiatrists utilize several different methods. This can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatment depends upon the cause of the foot pain. Whether it is resting, staying off the foot, or having surgery; podiatrists have a number of treatment options available for foot pain.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Hallux rigidus is a form of arthritis that affects the joint at the base of the big toe, causing pain and stiffness that can make walking uncomfortable. Many people first notice difficulty bending the toe, pain during push-off, or swelling around the joint. Treatment depends on how advanced the condition has become and how much it affects daily life. Early care may include shoe changes, custom orthotics, activity adjustments, and anti-inflammatory treatments to reduce pressure on the joint and improve comfort. Some patients benefit from targeted exercises to help maintain movement. When pain becomes more severe, or motion is greatly limited, procedures may be considered to remove damaged tissue, improve joint movement, or address advanced joint damage. Managing symptoms early may help slow progression and keep you active. If you have big toe pain and stiffness, it is suggested that you visit a podiatrist for appropriate treatment solutions.

Toe pain can disrupt your daily activities. If you have any concerns, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

What Causes Toe Pain?

Most severe toe pain is caused due to a sports injury, trauma from dropping something heavy on the toe, or bumping into something rigid. Other problems can develop over time for various reasons.

Toe pain can be caused by one or more ailments. The most common include:

• Trauma
• Sports injury
• Wearing shoes that are too tight
• Arthritis
• Gout
• Corns and calluses
• Hammertoe
• Bunions
• Blisters
• Ingrown toenails
• Sprains
• Fractures (broken bones)
• Dislocations

When to See a Podiatrist

• Severe pain
• Persistent pain that lasts more than a week
• Signs of infection
• Continued swelling
• Pain that prevents walking

Diagnosis

In many cases the cause of toe pain is obvious, but in others, a podiatrist may want to use more advanced methods to determine the problem. These can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatments for toe pain and injuries vary and may include shoe inserts, padding, taping, medicines, injections, and in some cases, surgery. If you believe that you have broken a toe, please see a podiatrist as soon as possible.

If you have any questions please contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.