foot pain

Do I need Heel Spurs Removed???

Plantar Fasciitis / Heel Spur Syndrome
It is common in practice that I have a patient come to the office with x-rays from their primary care doctor showing heel spurs. Patients always are very anxious about this and think that they need surgery to remove them. It should be known that the majority of the time, heel spurs are not the culprit for heel pain. One of the most common causes of heel pain is plantar fasciitis which is an inflammation of the plantar fascia which is a ligament on the bottom of the foot. With constant pulling of the ligament on the heel bone, a heel spur develops which is just a calcification of bone. Most of the time, plantar fasciitis is treated non surgically with stretching, icing, steroid injection and anti-inflammatories. Once the pain is completely resolved, it is important to address the biomechanics of the foot with custom orthotics to try and decrease the chance for recurrence. In cases when these non surgical options do not work, surgery is an option through a very small incision on the side of the foot. It is always important to see your local podiatrist at the first sign of heel pain. The sooner treatment begins, the better the outcome.
If you or any family members or friends have heel pain or any other foot and ankle issues, contact Quality Foot Care today at 215-230-9707 for an appointment with your local board certified podiatrists.

Hammertoes- How to Treat! Lonnie Kaplan DPM

  • Hammertoe Deformity

As you can see from the above picture, even celebrities have foot and ankle abnormalities. One example of this is a hammertoe. A hammertoe is most easily described as a contracture of the toe causing the top of the toe to be prominent. (usually due to abnormal muscle pull) There are many causes of hammertoes such as flat feet and high arch feet. They can also be seen after trauma. Symptoms can include pain in the top of the toes where they rub against the top of the shoe. Commonly calluses can be formed in the area on the top of the toes which become painful. Hammertoes can also lead to pain in the ball of the feet due to extra pressure in this area from the contracture. Depending on what caused the hammertoes, they tend to progress over time.

New Years Resolution for Weight Loss? Lonnie Kaplan DPM

  • feet weight

It’s that time of the year where everyone is trying to shed a few pounds from their holiday over eating. I tend to be a regular at the gym and in the last few days, as there are at the beginning of every year, there have been a lot of unfamiliar faces. What needs to be realized is that when you go from inactive to working out a lot, there is a high probability of injury to the foot and ankle.

Common injuries include stress fractures, sprains, and strains. A stress fracture is a type of fracture which cannot always be seen on x-ray that tends to occur in people that increase their activity level too quickly. Symptoms of this injury can include pin point tenderness over an area of bone (particularly seen in the metatarsals which are the long bones of the forefoot). Treatment can include special shoe gear as well as immobilization.

Sprains and strains of the foot and ankle are also seen in people who hit the gym after being sedentary for a long time. There are tons of muscles, tendons and ligaments in the foot and ankle that can easily be injured. Stretching before, during and after exercises is a great way to try and decrease the occurrence of these sprains and strains. Common symptoms of these include pain in the foot especially with range of motion (ie moving the toes/ ankle etc) Treatment of these include ice, elevation and possible immobilization of the affected body part. It is always important to have x-rays completed of the affected foot or ankle to rule out fracture or other causes of foot/ankle pain.

If you or anyone you know has any foot or ankle pain, contact Quality Foot Care at 215-230-9707 to schedule an appointment with your local podiatrists today!

Foot Pain after your Holiday Party? Lonnie Kaplan DPM

Now that the holidays are upon us and we are indulging in food and drinks at parties with co-workers, family and friends, the incidence of gout tends to be on the increase. Gout is a type of arthritis that is seen when there is too much uric acid in the blood. It is commonly seen after eating seafood, meats, spinach as well as after drinking beers and other alcohols (all high in purines). Symptoms consist of severe pain in a joint (in the foot most commonly in the big toe joint), redness and swelling of the joint. Some people describe severe pain with something as basic as the sheets touching the affected body part. It is important to know that the above symptoms can be seen in many other disorders including infection and should be evaluated immediately. It is also important to know that you aren’t only affected with a gout flare up if you  had gout as a child. Many adults will have their first flare up in there 50’s or 60’s.

After infection and other diagnoses are ruled out (sometimes by x-ray and/or joint fluid sample), the most common treatment is an anti-inflammatory such as Indomethacin. Colchicine is another medication that can be used during an acute flare. Injection of steroid into the affected joint can also be used as initial treatment. It is important to start taking long term medications as well to decrease the likelihood of flare-ups. Some of these medications include Allopurinol, Febuxostat or Probenecid. It is also important to focus on avoiding foods high in purines and meeting with a dietitian can help you determine this.

If you have any questions or concerns regarding gout or any other foot and ankle condition, call Quality Foot Care today at 215-230-9707 to make an appointment with Doylestown’s local podiatrists!

Is it More than a Callus on Your Child’s Foot? Lonnie Kaplan DPM

One of the most common conditions we see as podiatrists are plantar warts also known as plantar verruca. These lesions commonly occur in children and parents often misdiagnose them as a callus (thickened skin) Plantar warts are very different than thickened skin and treatment is much different as well. A plantars wart is caused by the Human Papilloma Virus and it commonly affects the outer layer of the skin. It is contagious and commonly acquired by walking barefoot in a public pool, locker room, hotel room etc. Most of the time, children will complain of pain in the area as well as a thickening of skin in the area. If this is experienced, it is important to have your child evaluated by a podiatrist. The longer the delay, the more they can spread and the more warts you can develop.

Your podiatrist will typically trim the thickened tissue (usually not painful), and evaluate the area. It is common to see black dots in the lesion (these are small capillaries). There are multiple treatment options available and your podiatrist will discuss this in detail with you. Unfortunately the Human Papilloma Virus vaccine does not protect against these plantar warts. Treatment usually entails salicylic acid (most podiatry offices use a percentage higher than what you can get in the pharmacy over the counter) as well as trimming the lesion. Another treatment option is a blistering agent that exfoliates the top layer of skin. It is important to remember that warts take a long time to go away but the sooner you treat them the better the outcome. Always also be sure to check everyone in your family as they easily spread to brothers, sisters, and other family members.

Call Quality Foot Care today at 215-230-9707 for an appointment with Doylestown’s community podiatrists. We would be happy to discuss the above with you to keep your entire family on their feet!


Prolonged Standing Can Cause Health Problems

prolonged standing


We all hear about how sitting too much at work is bad for our health. But, what about those who have to stand for many hours at their jobs? Are there health risks associated with standing too long while working?

The answer is yes, standing too long without breaks at your job can cause health problems. In a recent study published in Human Factors, prolonged standing can lead to a myriad of health problems including back problems and joint pain.

The first author Maria Garcia, notes that long-term muscle aches and fatigue resulting from prolonged standing has not received very much research. In the study, it is also proven that both young and old are affected. Those participating in the study were 12 women and 14 men. The age groups were broken into two groups and participants were simulating standing work for 5 hours at an interval.

According to the Canadian Center for Occupational Health and Safety (CCOHS), working in a standing position on a regular basis can lead not only to fatigue and lower back pain but can also cause other health problems such as sore feet, swollen legs, varicose veins and stiffness in the neck and shoulders.

So, what should employers do in a situation where employees have to stand for long periods of time? When the work requires employees to be standing for long periods of time high chairs can be provided to allow the worker to sit for a bit.

In a work place that is trying to be well-balanced, the workers are allowed to be in a number of positions including sitting down and standing. Unfortunately, not all work places are so accommodating and the standing can begin to takes its toll.

Saving Your Feet

For those who have no choice but to stand while working there are things that you can do to help alleviate the foot and muscle aches and pains.

  • Put your feet up while on breaks and this includes your lunch breaks.
  • Wear shoes with good support.
  • Watch your weight as extra weight puts strain on your legs and feet.
  • Exercise regularly to maintain good circulation.
  • Eat a low salt diet to avoid excess swelling.
  • Do not wear tight hosiery or high heels.
  • Change your standing position regularly.

You are not going to last too long as a great employee if you are having issues with your feet. It is very important to take care of yourself and your feet. Long periods of standing do take a toll on your body but following the simple tips above will help alleviate problems that may arise.

When you get home after work and have been standing on your feet for hours, treat them kindly. Put your feet up or give them a nice warm soak in warm water and Epsom salt. Not only will your feet thank you, your whole body will. Taking even just a few minutes to take care of your feet will make a big difference.

For foot problems that just do not seem to get better, be sure to make an appointment with your foot specialist.

Sunburn on Feet……Ouch!

sunburn on feet

Summer is great and warm and this is why many people head for the lakes, oceans and ponds. The thing that many forget is to be careful when exposing the skin to direct sunlight for numerous hours. Yes, there is sunscreen but many people do not think to put it on their feet. It’s easy to remember to put it on your face, arms and legs. Just the thought of having to dress for work with a sunburn is enough to make us remember. The problem is that when the feet get a sunburn we have to learn the hard way how uncomfortable it is to put shoes on over a sunburn. Not only is the sunburn painful you now get to add the agony of being in shoes at work for hours on end.

Sunburn on Top of Feet

When you have a sunburn on the top of your feet it can be super painful. No matter what type of shoe you decide to wear it hurts. Sandals and flip-flops have straps and other shoes have ties. Trying to be comfortable with sunburnt feet seems impossible.

Sunburn on Feet Treatment

If your feet are severely swollen and blistered it is time to see your foot doctor. A foot doctor can give you a prescription for medication to help alleviate the pain.  If your feet are sunburnt and just uncomfortable there are a few things you can do at home to try to stay as comfortable as possible.

  • Soak your feet in cool water.
  • Apply Aloe Vera gel. This gel can be purchased over the counter at any pharmacy.
  • When you are home limit sock use. By limiting the time you wear socks it will allow your feet to breathe.
  • Avoid soap on the sunburn.
  • Witch Hazel works on many people’s sunburns.
  • Adding one cup of vinegar in a foot soak also helps.
  • Do not rub or scratch the areas that have the sunburn. Rubbing will increase the damage to the skin.
  • Watch for signs of infection. If you suspect that you may have an infection starting be sure to get in touch with your podiatrist ASAP.

Be Wise and No Sunburnt Feet

Of course, it is wise to remember to put sunscreen on your feet. Another thing to remember is to put sunscreen on your feet even when wearing sandals or flip-flops. For the best protection from the sun begin putting your sunscreen on 30 minutes before going out into the sun.

When choosing sunscreen, look for SPF 30 so that your feet will be safe. Do you know it can take up to 6 months for your skin to return to normal after a sunburn? The new skin under where the burned skin peels is super sensitive, so treat it kindly.

Those Foot Cramps!

Foot Pain Arch

Foot cramps are not only annoying but painful. The thing about foot cramps is that they seem to get you when you least expect it. Having you ever been driving and have a foot cramp happen and your toes begin to curl up? Or, you are sleeping soundly and all of a sudden you wake up and feel like every muscle in your foot is in a tight ball? Foot cramps happen to the best of us and there are things to do to help relieve the discomfort.

Foot cramps mostly take place in the arch of the foot, but people can have these cramps in the toes and the calf muscles. The pain with foot cramps can last from a few minutes to several days.

What Causes These Foot Cramps?

For those who are searching for an exact answer, there may be no obvious cause but here are a few factors that may be causing them.

  1. Dehydration

When we exercise and do not take in enough water the sweating reduces the levels of potassium, magnesium and calcium. Excessive alcohol intake and smoking can also cause dehydration.

  1. Medications

Certain medications that are prescribed can cause cramping as a side effect. Diuretics, also called water pills, can cause an imbalance of potassium and calcium.

  1. Pregnancy

During the third trimester, there may be an increase in foot cramps especially at night when resting. This is caused by the uterus exerting pressure on the veins that bring blood up from the feet and legs.

  1. Bad Fitting Shoes

Shoes that squish your feet such as high heels or shoes that are too tight can cause foot cramps. Pointed shoes can cause foot cramps and damage to the feet.

  1. Fatigue

Muscles that have been overworked and are tired can lead to foot cramps. Just as runners are more prone to calf cramps, dancers and athletes are more prone to foot cramps.

  1. Lack of Minerals and Vitamins

Our bodies need the right amount of or balance of minerals and vitamins. Foot cramps can be caused by imbalances in Vitamin D, Calcium, Vitamin E, Potassium, Magnesium and Vitamin B6. It is important to make sure you are eating a well-balanced diet if you are unsure about taking supplements it is best to consult with your doctor.

  1. Injury

Trauma to the feet or legs can cause muscles to spasm. The reason muscles will spasm is to protect themselves from further damage.

  1. Nocturnal Cramps

These are the cramps that will wake you from a sound sleep. These cramps can develop at night from decreased circulation and dehydration. The cramps will most commonly occur in the calf muscles but can also happen in the feet and toes. Calf muscle cramps can happen when a person sleeps with their knees bent and the toes pointing down that places the calf muscle in a shortened position.

  1. Not Enough Exercise

Lack of exercise can lead to muscle weakness and weight problems. Both lack of exercise and obesity will increase the chance of cramps.

  1. Reduced Blood Circulation

Sitting in the same position for long periods of time can reduce circulation to the feet. The reduced oxygen levels in the muscles can lead to cramping of both the legs and feet.

What to Do For Foot Cramps

Foot Cramps

There are a few things that can be done to help alleviate the pain associated with foot cramps.


  1. Massage

Massaging the area where the cramp is will help the muscle to relax and reduce the pain. The massage will increase the circulation to the muscles which will increase blood flow, nutrient levels and oxygen. Harmful waste such as lactic acid will be pulled away from the area.

  1. Stretching

Stretching will help to alleviate the pain when a cramp does occur. Regular stretching throughout the day will help to prevent cramps from happening. Think of stretching as gentle exercise for your feet and try to do stretching exercises at least once a day.

  1. Eat a Well Balanced Diet

By eating a well-balanced diet, you will be getting the minerals and vitamins needed for healthy bones and muscles.

  1. Well-fitting Footwear

It is important to have well-fitting shoes so that your feet are not squished. Wearing shoes that fit your feet correctly will reduce the chance of cramps.

  1. Supplements

If you are still experiencing foot cramps and have tried all of the recommendations here then you may want to speak to your physician. Your doctor can have blood tests run and if you are lacking in certain vitamins and minerals your doctor may prescribe certain supplements.

If you have tried all of the above tips and are still getting foot cramps it may be time to contact your foot specialist.

Aching Feet- How Can I Get This Pain To Go Away?

Achy feet

Achy feet can cause distress and discomfort.

Do your feet ache? Are there times when you just have to get off your feet because you are in agony? You are not alone. There are many factors that can contribute to sore feet. Let’s have a look at the most common reasons for aching feet.

  1. Wearing shoes that do not fit right. Shoes with a sole that is too thin can cause your feet to hurt and ache because there is no support. If your feet ache then be sure to purchase well fitting shoes with a good sole and arch support.
  2. Being pregnant. Not only will the extra weight make your feet ache, the hormonal change causes ligaments to relax. The ligaments in your feet are relaxing and this will cause feet to ache. You may have to take more breaks and put your feet up if you are pregnant and your feet are hurting.
  3. Being Overweight. Extra weight is causing the joints, ligaments and muscles in your feet to work harder.
  4. Foot injury. The deep bruise that happens with impact injury or stepping on a hard object. This is also known as a stone bruise.
  5. Overworking your feet. This is for those who work 8+ hours standing and those who exercise a lot. If your feet are giving you a problem it may be time to look into the shoes you are wearing and seeing your local foot doctor.

What You Can Do At Home For Achy Feet

There are things that you can do at home to help with those tired feet. Here are a few suggestions.

  1. Get off of your feet and elevate them.
  2. Soak your feet in warm water. Epsom salt can also be added to the warm water. Adding 1-2 tablespoons per gallon of water will also help. Soak feet for 15-20 minutes.
  3. Massage your feet with lotion or oil. Be sure to gently apply pressure to the sore areas of your feet.
  4. Arch supports that can be bought at most stores can often give relief for achy feet.
  5. Invest in a good pair of shoes. If you have recently started exercising it is time to purchase well fitting athletic sneakers.

It is important to note that there are medical conditions that can cause your feet to ache. If you have been diagnosed with diabetes, arthritis or cardiac disease it is important to consult with your doctor for the best treatment.

Everyday Wear and Tear

There will be days when your feet will hurt, it is just a part of life. We all get achy feet and it does not matter if you are young or old. If you know you have been on your feet too long, it is time for a break. If your feet continue to hurt and ache even after resting them, it is time to get quality foot care from a podiatrist.

Shooting Pain Between your Toes: What Does it Mean?

By Dr. Ken Lefkowitz

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If you have toe cramping, sharp, shooting, or burning pain in the ball of your foot, or tingling in the space between your third and fourth toes, you may have a condition known as Morton’s Neuroma. This is an injury in the nerve between the toes (usually the third and fourth ones), which causes pain and thickening. This condition can make walking and any activities that put pressure on the foot extremely difficult. It may even become a challenge to press on the gas pedal to drive a car.

Morton’s neuroma is more common in women than in men, but the exact cause is unknown. Many experts believe contributing factors include: abnormal positioning of the toes, flat feet, high foot arches, bunions, hammertoes, and tight shoes and high heels.

A podiatrist can diagnose Morton’s neuroma by x-raying the foot to rule out bone problems and then possibly ordering an MRI or high-resolution ultrasound. Once you are diagnosed with Morton’s neuroma, non-surgical treatment will be attempted first. These treatments may include: padding and taping the toe area, shoe inserts, anti-inflammatory medicines taken orally or injected into the foot, nerve blocking medicines injected into the toe area, or physical therapy. If none of these methods of treatment are successful, surgery may be necessary to remove the affected tissue. After surgery, numbness in the area will be permanent but shouldn’t be painful, and after a while it will become unnoticeable.

If you are experiencing any of the symptoms of Morton’s neuroma or are in need of any form of foot and ankle care, call Quality Foot Care at 215-230-9707 to make an appointment at our Doylestown office.