
Wound Care
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
Ingrown Toenails

Ingrown toenails occur when the edges or corners of a toenail grow into the surrounding skin, causing pain, swelling, and sometimes infection. This condition commonly affects the big toe and can result from improper nail trimming, tight shoes, or injury. Symptoms of ingrown toenails include redness, tenderness, swelling, and sometimes a discharge of pus if an infection develops. The pain can range from mild to severe, making it difficult to wear shoes or walk comfortably. A podiatrist can help treat ingrown toenails by removing the affected portion of the nail or, in more severe cases, performing a minor surgical procedure to prevent it from recurring. They can also provide advice on proper nail care and footwear to prevent future issues. If you are dealing with ingrown toenails, it is suggested that you make an appointment with a podiatrist.
Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, 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.
Ingrown Toenails
Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.
Causes
- Improper toenail trimming
- Genetics
- Improper shoe fitting
- Injury from pedicures or nail picking
- Abnormal gait
- Poor hygiene
You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.
Symptoms
Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.
Treatment
Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.
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.
Ingrown Toenail Care
An ingrown toenail is a toenail that grows sideways into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.
Several factors affect whether a person is at risk from an ingrown toenail. The many causes include being overweight, diabetes, participating in sports, having a fungal infection of the toe, and cutting your nails too short. Ingrown toenails also have a genetic predisposition, causing some people to be more prone to receive the condition than others. Other causes include improperly fitting shoes and shoes that keep the feet damp.
Ingrown toenails can be preventable with certain measures. For starters, allowing your toe nails to grow slightly longer in length will help prevent them from becoming ingrown. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help prevent an infection from forming. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is also suggested, as this may help the toenail grow upwards and not into the nail bed. Swelling and redness can be reduced by resting with your feet elevated.
A podiatrist should be seen if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact a podiatrist immediately. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.
An ingrown toenail can be easily treated with a Band-Aid. Simply wrap the affected toe with a Band-Aid to prevent infection and keep the nail from growing out at a painful angle.
In more serious cases, your podiatrist may decide to make a small incision to remove a portion of your toenail. To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day. Afterwards, normal activities can be resumed.
Early Podiatry Visits for Bunion and Hammertoe Correction

Patients undergoing combined bunion and hammertoe surgery often experience more pain and slower recovery than those who have bunion correction alone. Research shows that those individuals with both conditions tend to have more severe foot deformities preoperatively and see less improvement in pain levels post-surgery. Since bunions can contribute to hammertoe formation, early intervention is key. Signs such as the second toe lifting or pain beneath the second metatarsal head may indicate worsening deformity. Addressing bunions before hammertoes develop may help prevent the need for additional surgical correction. If you are noticing changes in your toe alignment or have increased discomfort, it is suggested that you consult a podiatrist for better long-term outcomes and a smoother recovery process.
Hammertoes can be a painful condition to live with. For more information, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will answer any of your foot- and ankle-related questions.
Hammertoe
Hammertoe is a foot deformity that occurs due to an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. It can be caused by the type of shoes you wear, your foot structure, trauma, and certain disease processes.
Symptoms
- Painful and/or difficult toe movement
- Swelling
- Joint stiffness
- Calluses/Corns
- Physical deformity
Risk Factors
- Age – The risk of hammertoe increases with age
- Sex – Women are more likely to have hammertoe compared to men
- Toe Length – You are more likely to develop hammertoe if your second toe is longer than your big toe
- Certain Diseases – Arthritis and diabetes may make you more likely to develop hammertoe
Treatment
If you have hammertoe, you should change into a more comfortable shoe that provides enough room for your toes. Exercises such as picking up marbles may strengthen and stretch your toe muscles. Nevertheless, it is important to seek assistance from a podiatrist in order to determine the severity of your hammertoe and see which treatment option will work best for you.
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.
What Are Hammertoes?
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Causes of Heel Pain in One Foot

Heel pain in one foot can result from several conditions that affect the structures supporting the foot. Plantar fasciitis is a common cause, occurring when the band of tissue along the bottom of the foot becomes inflamed due to overuse or strain. Achilles tendinitis can also lead to pain, particularly at the back of the heel, as a result of repetitive stress on the tendon. A heel spur, which is a bony growth on the heel bone, may develop from prolonged tension and pressure. Nerve compression, such as tarsal tunnel syndrome, can cause sharp or tingling sensations in one heel. Wearing unsupportive footwear or standing for extended periods can also contribute to discomfort. If you have heel pain, it is suggested that you promptly consult a podiatrist who can determine what the cause is, and offer appropriate treatment solutions.
Many people suffer from bouts of heel pain. 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.
Causes of Heel Pain
Heel pain is often associated with plantar fasciitis. The plantar fascia is a band of tissues that extends along the bottom of the foot. A rip or tear in this ligament can cause inflammation of the tissue.
Achilles tendonitis is another cause of heel pain. Inflammation of the Achilles tendon will cause pain from fractures and muscle tearing. Lack of flexibility is also another symptom.
Heel spurs are another cause of pain. When the tissues of the plantar fascia undergo a great deal of stress, it can lead to ligament separation from the heel bone, causing heel spurs.
Why Might Heel Pain Occur?
- Wearing ill-fitting shoes
- Wearing non-supportive shoes
- Weight change
- Excessive running
Treatments
Heel pain should be treated as soon as possible for immediate results. Keeping your feet in a stress-free environment will help. If you suffer from Achilles tendonitis or plantar fasciitis, applying ice will reduce the swelling. Stretching before an exercise like running will help the muscles. Using all these tips will help make heel pain a condition of the past.
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.
Heel Pain
Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.
One condition is plantar fasciitis. Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.
There are various options your podiatrist may suggest for heel pain. Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.
Preventing heel pain is possible. If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.
Managing Foot Neuropathy

Foot neuropathy, often linked to conditions like peripheral artery disease, PAD, or deep vein thrombosis, DVT, can cause significant discomfort and complications. PAD occurs when blood flow to the lower limbs is reduced, leading to pain, cramping, or numbness, especially while walking. DVT, on the other hand, involves blood clots in the veins, causing swelling, warmth, and redness, which can affect mobility. Both conditions can lead to nerve damage, resulting in sensations like tingling, burning, or a pins and needles feeling in the feet. The primary causes of these issues include poor circulation, diabetes, and prolonged immobility. A podiatrist can help by diagnosing the root cause through detailed evaluations and diagnostic tests. Treatment options may include medication to improve circulation, targeted exercises, custom orthotics, or lifestyle changes. In more severe cases, surgery may be necessary. If you have foot neuropathy, it is suggested that you schedule an appointment with a podiatrist for proper care and relief.
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.
Neuropathy
Neuropathy is the weakness, numbness, and pain in the hands and feet due to damage to the peripheral nerves. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of your body. Causes of Neuropathy include: traumatic injuries, infections, metabolic problems, exposure to toxins, and diabetes.
Diabetes is the most common cause, with more than half of the diabetic population developing some type of neuropathy. There are several types of neuropathy and they vary based on the damage of the nerves. Mononeuropathy is classified as only one nerve being damaged. When multiple nerves are affected, it is referred as polyneuropathy. One of the types of polyneuropathy is distal symmetric polyneuropathy. It is the most common for people with diabetes and starts when the nerves furthest away from the central nervous begin to malfunction. The symptoms begin with pain and numbness in the feet and then they travel up to the legs. A rarer form of polyneuropathy is acute symmetrical peripheral neuropathy, which is a severe type that affects nerves throughout the body and is highly associated with Guillain-Barre syndrome, an autoimmune disorder that attacks the peripheral nervous system and can be fatal. Although there are many types of neuropathy, most of them share the same symptoms such as pain, extreme sensitivity to touch, lack of coordination, muscle weakness, dizziness, and digestive problems. Since neuropathy affects the nerves, those affected should be careful of burns, infection and falling, as depleted sensations disguise such ailments.
The best way to prevent neuropathy is to manage any medical conditions such as diabetes, alcoholism, or rheumatoid arthritis. Creating and managing a healthy lifestyle can also go a long way. Having a healthy diet full of fruits, vegetables, whole grains and lean protein can keep the nerves healthy. These types of food have the nutrients to prevent neuropathy. Regularly exercising can help as well, but it is best to consult with a doctor about the right amount. In addition to diet and exercise, avoiding risk factors will also prevent neuropathy. This includes repetitive motions, cramped positions, exposure to toxic chemicals, smoking and overindulging on alcohol.