Central Ohio Podiatry Group Central Ohio Podiatry Group
Central Ohio Podiatry Group  
Central Ohio Podiatry Group  
Central Ohio Podiatry Group
Central Ohio Podiatry Group
Prompt Appointments

614-890-7224


Convenient Locations

Westerville
550 S. Clevela
nd Ave.
Suite B

Dublin
5060 Bradenton Ave.
Suite A



New Patient Forms



Our Doctors

Dr. Jack Buchan

Dr. David Buchan

Dr. Randall Contento

Board Certified Foot & Ankle Surgery


Fellow, American College of Foot and Ankle Surgeons



The doctors at Central Ohio Podiatry Group treat a variety of problems with your feet and ankles. Our training and experience will allow you to return to an active, pain-free lifestyle.

Below are brief discussions of conditions commonly treated by the doctors at Central Ohio Podiatry Group. These are only a short description of various ailments; an early evaluation and diagnosis by the doctor is imperative for proper treatment and positive results. Self diagnosis and treatment is not recommended!

  • Skin and Nail Conditions: infections, ingrown toenails, skin growths, plantar warts, fungus nails, rashes, athlete’s foot
  • Structural Foot Conditions: heel pain, plantar fasciitis, fractures, tarsal tunnel condition, flat or high-arched feet, ankle sprains, neuromas, achilles tendon pain
  • Bone Related Problems: bunions, bone spurs, hammertoes, arthritis, joint pain, corns
  • Diabetic or Circulatory Problems: ulcerations, infections, wounds, neuropathy, Medicare Diabetic Shoe Program
  • Foot/Ankle Support: orthotics, orthopedic bracing

    We provide expert diagnosis and treatment of:

    • Achilles Tendonitis
    • Accidental Injury
    • Ankle Sprains and Injuries
    • Arch Pain
    • Arthritis
    • Athlete’s Foot or Rashes
    • Bunions
    • Corns and Calluses
    • Diabetic Foot Infections or Problems
    • Flexible Flat Feet
    • Fractures of Toes and
    • Metatarsals
    • Fungus Toenails
    • General Foot Pain
    • Gout
    • Hammertoes
    • Heel Pain and Spurs
    • Infections
    • Ingrown or Sore Toenails
    • Metatarsalgia
    • Nail Disorders
    • Neuromas
    • Orthotics
    • Painful Joints
    • Pediatric Heel Pain
    • Plantar Fasciitis
    • Tarsal Tunnel
    • Tendonitis
    • Tumors
    • Warts
    • Wounds

    Ankle Sprains and Injuries

    Ankle twists or sprains are a very common foot/ankle injury many times ignored, tolerated and/or mistreated. Most common of the sprains is the inversion sprain, when the foot goes down and in toward your other foot. Many of the sprains are mild and only result in stretching of the ankle ligaments. This can be treated with the usual Rest, Ice, Elevation and Compression, known as RICE and recovery should be less than a week. If, however, your ankle sprain is more severe with swelling, bruising or inability to bear weight, your evaluation and treatment must be more in-depth. An x-ray of the foot will be needed to rule out a possible fracture of a metatarsal, the most common being the fifth metatarsal on the outside of your foot. MRI examination is beneficial to evaluate the integrity of the ankle joint and its ligaments and tendons. Clinically an assessment for range of motion as well as ligament stability will need to be done. If a non-displaced fracture is noted, immobilization is needed for 6 to 8 weeks. If a displaced fracture is noted, surgical repair may be warranted with up to a 3 month recovery to get back to pre-injury activity levels. If ligament damage is noted, immobilization and “RICE” is required for about 3 weeks. Continued ligament healing then requires use of an ankle-support device and possibly physical therapy until the tissues completely recover. This is a slow process as ligaments can take up to 18 weeks to heal and at the end of the healing cycle the ligament may be prone to re-injury. If recurrent ankle sprains are a problem or excessive ankle motion is noted post-injury, an MRI exam and surgical consultation is needed to evaluate if surgical intervention is need to reestablish ankle stability and integrity.


    Arthritis

    Joint stiffness, pain or tenderness, swelling and/or redness that persists for more than two weeks—all may signal arthritis. There are many forms of arthritis that damage our bodies, especially the joints, gradually wearing away protective cartilage where the bones meet to make a joint. The force our body weight generates on the toe and ankle joints makes them particularly susceptible to arthritis. Your feet will carry you the equivalent of five times around the world during your lifetime!

    As cartilage erodes and bone rubs against bone, the joint becomes painful. Movement may become limited as bone ends erode or thicken, sometimes developing painful outgrowths, or spurs. This is very common in the great toe joint, where motion upon walking becomes limited and eventually painful. This is referred to as “turf toe” and is quite common after injury to the joint. If left untreated, damage to cartilage can seriously weaken the joint, often leading to altered gait and limited activities due to pain.

    Rheumatoid arthritis and osteoarthritis are two common forms of arthritis that affect millions of Americans, especially those over age 45. Rheumatoid arthritis is a “systemic” disease that can affect the entire body. Osteoarthritis, sometimes called degenerative arthritis, or referred to as joint “wear and tear,” is isolated to the joints. Pain and stiffness caused by cartilage destruction develop slowly as a result of years of everyday living and pounding.

    Arthritis of the feet is very common since 25% of the bones of your body are in your feet. Add to that the many miles that you travel daily and have traveled over your life, and you can see that feet can easily show the affect of the abuse. Many times the symptoms of foot arthritis can be controlled by medications, orthotics and physical therapy. In early stages, orthotics are beneficial in treating “turf toe.”

    In more resistant cases, reconstructive surgery is needed to give improvement in joint motion and the benefit of reduced pain. The goals of surgery are different for each individual and will need to be discussed with us. While surgical care will not cure arthritis or completely restore the joint to its natural health, it will ease pain and make daily activities more manageable. Early recognition is key!


    Bunions

    A bunion, from the latin “bunio” meaning enlargement, is a protuberance of bone or tissue around a joint. This enlargement occurs either at the base of the great toe or on the outside of the foot, at the base of the little toe where it is called a “bunionette” or “tailor’s bunion.”

    Bunions at the base of the great toe usually begin when the big toe starts moving toward the smaller toes and this crowding puts pressure on the join, pushing it outward. Both men and women can develop bunions, although it appears that bunions are more commonly seen on women’s feet. Bunions develop from a weakness in the bone structure of your foot. Because of the instability of the bones and ligaments which form the various joints and arches in your foot, the joints have a tendency to move out of proper alignment. The deformity runs in families and people with flat feet or low arches are more prone to develop the problem. Bunions also maybe associated with various forms of arthritis. Bunions are a progressive deformity, getting worse with time, and as bunions become more severe, the joint moves further out of proper alignment and eventually arthritis will damage the joint space.

    As bunion deformities progress, they do become quite symptomatic and bothersome. The skin and deeper tissues around the bunion also may become swollen or inflamed from increased pressure of footwear. The other toes can be affected by a bunion, as a result of pressure from the great toe pushing inward toward the lesser toes. Shoes which used to fit gradually become too tight and walking and everyday activities become uncomfortable. Inactivity becomes the exercise of choice!

    Treatment initially is to relieve pressure on the bunion and smaller toes with larger shoes and restriction of painful activities. Eventually, given the progressive nature of the bunion, surgical correction of the bunion is required. Due to the structural nature of the problem, the metatarsal bone needs to be cut and realigned to re-establish its normal alignment. In addition, the surrounding tendons and ligaments may need to be repositioned to help realign the joint in a straight position. This procedure is performed in an out-patient hospital setting with anesthesia so that you won’t feel, see or hear anything. You can generally go home within a couple hours of completing the surgery.

    Pain and deformity are significantly reduced in the great majority of patients who undergo bunion surgery. In addition to easing pain, the purpose of bunion surgery is to remove the enlargement and realign the join to restore normal function. This means that after surgery, the foot can carry the body’s weight properly, and that special shoes are no longer needed. As with most conditions, early diagnosis and treatment is essential before structural joint damage occurs. So that that you can return to your activities without lasting complications, make an appointment today and see what is causing your discomfort and what can be done so that your everyday pain may be reduced.


    Fungus Infections (Skin and Nails)

    The fungal problems seen most often are athlete’s foot and fungus nails. A fungus is common mold that thrives the three D’s: dark, damp and dirty. On the feet, it can grow on and between the toes, as well as soles and toenails. Chronic fungal infections are most common in adults, while acute fungal infections are seen more in children.

    The risk is low, but athlete’s foot is a mildly contagious infection. This fungus can make your feet itch, burn, and the skin on the bottom of your feet crack, blister, or peel. Athletes aren’t the only one who can get this as anyone who has feet that perspire heavily or if your work shoe creates a most environment, may get a fungal infection. Most environments are perfect place for fungi to thrive. You don’t hear of athlete’s hands!

    Fungal infections usually start underneath the tip of your toenail, and then spread back toward the cuticle and to other nails. Your nail may thicken and become so brittle that trimming crumbles the nail. It can become brown, green, and black or may fall off. The fungal nail also becomes thick and so may become painful as it hits your shoe. The nail may also grown curved and become ingrown. As the fungus grows, foul smelling, moist debris can be seen.

    Treatment is best begun at early stages of infection. Both skin and nail infections can be treated with oral and topical medications. Dependent on the extent and state of your infection, the safest, most effective treatment will be started. Fungal infections don’t happen overnight and consequently aren’t cured overnight. Effective nail treatment requires the good healthy nail toe “push” the infected fungal nail as it grows out, which may take 8 to 10 months. Medications may or may not completely eliminate the fungus, but early treatment is imperative for good results.


    Hammertoes and Corns

    A hammertoe deformity usually refers to an abnormal toe position where one or more small toes buckle or bend-under, out of their normal straight position. Many disorders can affect the joints of the toes, causing pain and preventing the foot from function as it should. People of all ages can have toe problems, from infants born with deformities, to older adults with acquired deformities. Over time, these deformities develop from being a flexible tendon deformity to one that affects the bone and therefore is rigid and non-bending.

    Hammertoes are most commonly found on the second (next to the big toe) and fifth (or small) toes. Because of this abnormal toe position, the joint of the toe becomes prominent on top of the buckled toe. The tendons and ligaments then begin to contract and accelerate the problem. Skin irritation (inflamed skin areas) or even corns – (an accumulation of hard dead skin cells) may form on top of these prominent, contracted joints where shoes are likely to rub. This usually will lead to pain and inability to wear most types of shoes comfortably, especially if the pressure or corn is on the small toe. Many people feel the corn is causing the pain and are disappointed when trimming of the corn does not give good long-term relief. In reality, the corn is nature’s protection or “band aid” between the shoe and bone. This pressure will soon lead to inflammation or bursitis and the inability to wear a lot of your shoes. A bone spur, which is an overgrowth of bone, will occur within the toe joint if outside pressure continues to irritate the bone.

    Any toe problem that causes pain or discomfort while walking should be evaluated. Ignoring the symptoms can aggravate the condition, and over time may lead to an infection, a breakdown of tissue or ulceration. For people with poor circulation or an underlying medical problem, prompt attention is a must.

    Treatment of hammertoe pain is directly dependent on the extent of development of the deformity. Early recognition and modification of shoe gear can give good relief. However, if structural changes have occurred in the toe and the deformity is painful or permanent, surgical correction is recommended to relieve pain, correct the problem and provide a stable, functional toe. The type of surgery performed will depend on a thorough evaluation of the toe, the factors causing the deformity and which treatment is likely to be the most successful. Dependent on the number of toes affected, the surgical correction can many times be done in the surgical suite of our office with local anesthesia. Generally, the patient can return to activities in a few days wearing a cut-out surgical shoe while the toe heals.

    If there are pressure calluses or corns that are causing pain in your everyday activities, it is imperative that early diagnosis be obtained and your options discussed.


    Heel Pain and Spurs

    The heel bone bears all of the body’s weight with each step and sharp pain, stiffness or aching on the bottom of your foot or in your heel is a very common ailment. The pain is often at its worst upon awakening in the morning or after resting, causing limping for a few minutes before your foot “loosens up.” As you continue your daily activities, the pain may return and not go away with activity.

    Heel pain originates deep within the foot, directly on the heel bone or within the foot’s connective tissues, called the “plantar fascia.” This fibrous band extends from the heel bone, supports the arch and reaches across to the toes. Pain can result when these tissues become irritated or inflamed, eventually causing boney spurs to develop on the heel bone.
    Most cases of heel pain are characterized by inflammation. First, the fascia begins to pull on the bone and the tissues become irritated, then inflamed. This inflammation is called plantar fasciitis.

    A projection or growth of bone may form on the heel bone when the fascia pulls over an extended period of time. While some heel spurs are painless, others that are determined to be the cause of chronic heel pain may require medical treatment. Not all heel spurs hurt: it is the inflammation of the structures that causes the pain and thus treatment is aimed at reducing stress on the foot and decreasing inflammation. Injury, overuse or mechanical causes can bring on discomfort in the heel. A correct evaluation and diagnosis is imperative for successful treatment as most heel pain can be relieved without surgery.

    Treatment for heel pain is directed at the cause. It usually involves rest, prescription oral non-steroidal anti-inflammatory medications, foot taping, cortisone injections and orthotics. These medications reduce inflammation as does the application of straps of tape which reduce the pull on tissues and help support the bones and joints of the foot. This helps determine if wearing orthotics will improve your condition. Consistent use of shoes with laces, such as running shoes, provides good support and speed up your recovery. Resolution of the pain is gradual and may take several months. Occasionally, a night splint is recommended to help in maintaining the length of the ligament.


    Ingrown or Sore Toenails

    Most often the nail of the big toe is affected. The symptoms occur because the skin around the nail is forced so close against the nail that the nail appears to be “growing” into the skin. Soft skin tissues react to the nail as if it’s a foreign body. Inflammation, pain and infection often result. It is important to seek prompt care especially if you are in a high-risk health group- have diabetes or poor circulation- or if it is infected. Ingrown toenails rarely respond long term to “bathroom surgery.”

    Treatment for a painful ingrown nail consists of removing the ingrown portion of the nail for fast relief of pain and infection. For bad or recurrent problems, we can chemically treat the root of the ingrown nail so that the painful part of the nail should not grow back. This is done in the office, with local anesthesia and you can normally return to your normal activities with very little, if any, discomfort. You will need to bandage the area for several weeks to facilitate healing but you normal activities are encouraged. This procedure usually produces nice long term relief for a very aggravating and recurring problem.


    Neuromas

    A burning, numbness or tingling sensation that radiates at the base of the toes is most likely caused by an inflamed benign nerve tumor or neuroma. The nerve of the toes passes between the metatarsal bones but because of trauma, tight-fitting shoes or other compression, the nerve gets squeezed between the surrounding bones. Over time it subsequently gets enlarged and often quite painful with symptoms radiating toward the tip of the toes or up to the ankle. Most neuromas occur between he third and fourth toes but can occur between any toes. Pain is usually less severe when the foot is not bearing weight.

    Evaluation and correct diagnosis is important so that specific treatment can be started early. X-rays are important to rule out any boney pathology. Eliminating mechanical compression with changing of shoe gear, prescription of anti-inflammatory medication and cortisone injections are first line treatment options to attempt to reduce the swelling of the nerve. If this fails, then a series of injections of a sclerosing agent may be used to try and non-surgically destroy the nerve and receive relief of symptoms. Occasionally, a new treatment called intermetatarsal nerve decompression is available, which releases the ligament between the metatarsal head giving the nerve more room. This allows the nerve swelling to heal without any further irritation from the surrounding bones. Resolution of symptoms occurs about 75 to 80% of the time. Usually the last procedure when all else fails is to resect the painful neuroma leaving residual numbness to the adjacent toes. Early diagnosis and treatment is essential to increase the chance of good results with conservative care.


    Orthotics

    Many foot problems and subsequent pain is due to the misalignment of your foot. Your foot has 26 bones, 20 muscles, 33 complex joints and over 100 ligaments that work to support your body weight as you walk. Unfortunately, with time our feet begin to lose their stability and pain often results. If it is determined that pain is caused by abnormal foot function, then prescription functional orthotics are a good way of attempting to restore normal function to your foot.

    Orthotics limit the position of your heel, therefore by controlling the amount of flattening of the rest of your foot. Weight bearing stress is distributed throughout your foot instead of concentrating in certain areas and the strain on soft tissue and joints is markedly decreased, therefore reducing your pain. Orthotics compensate for incorrect foot movement just like eyeglasses improve vision.

    Prescription orthotics are custom made from a cast impression of your feet. They are usually made of a polypropylene non-breakable material that flexes as your walk but still holds your foot in a corrected position. This medical device maximizes the success of your treatment, versus over-the-counter or store-front arch supports. Many insurance companies reimburse for doctor-prescribed orthotics for certain medical conditions, as prescription orthotics have been shown to be quite effective for pain relief. Orthotics are commonly used for heel pain, (fasciitis and spurs), tendonitis, bursitis and painful joint problems.


    Plantar Warts

    A wart is an infection caused by a virus most commonly seen in children, teenagers and young adults. The virus invades the skin through small cuts or breaks. Because they are commonly on the bottom, or plantar portion of your foot, the wart grows into or deep into your foot, making walking painful.

    The virus can be picked up anywhere and just like colds, which are caused by viruses, warts can be “caught” by contact with other people who have warts. This is espceiall6y true in public places like showers, gyms and locker rooms where you go barefoot.

    Warts may appear hard or spongy with tiny red, brown or black spots. They can grow up to an inch or more across, occurring alone (solitary) or with smaller warts clustered together (mosaic). They can persist for years and recur in the same spot even after successful treatment. It is imperative that a correct diagnosis be made as a wart could actually be something more serious. If left untreated, warts may spread to other parts of the body, especially the hands.

    Treatment for warts is varied dependent on the size, number, location and duration of time the warts have been present. Dr. Jack has been using the new CryoProbe treatment for resistant, painful warts. This method allows precise ablation of the wart with no blistering or pain following treatment. Regular activities, including sports, are resumed the same day as treatment and the patient is seen every two weeks to continue painless eradication of the wart. Length of treatment time is dependent on the depth of the wart, but pain usually decreases after the first treatment. The CryoProbe is the latest advancement in painless cauterization of warts, eliminating surgical anesthesia and disability. It is imperative that the whole wart virus be eradicated to decrease the chance of recurrence and the CryoProbe has become a wonderful tool in treating this stubborn virus. Call today for a consultation with Dr. Jack to see if this modality can help you relieve a painful problem.


    Tarsal Tunnel Syndrome

    An impingement of the posterior tibial nerve as it courses behind the medial ankle bone can result in pain, numbness and radiating stabbing pains in the foot and ankle. This condition must be differentiated from posterior tibial tendonitis and lumbar radiculopathy as treatment will differ. Diagnosis of the condition is usually based on clinical symptoms and by a diagnostic injection of the area which may relieve symptoms almost immediately. Most tarsal tunnel syndrome will get better with oral anti-inflammatory therapy, orthotics for controlling the collapsing of the ankle and injection therapy. For those that do not get the desired relief, a nerve conduction study and/or MRI may be needed for further diagnosis. Surgical release of the tarsal tunnel may occasionally be needed to give relief of symptoms, but it is imperative for good results to get an early diagnosis and appropriate treatment. The surgery is very similar to carpal tunnel release but performed on the foot and ankle.


    Wounds of the Foot- Diabetic and Circulatory

    Non-healing wounds have many reasons or etiologies but it is imperative that they heal quickly and completely. Depending on their etiology, depth of the wound, where the wound is located and length of time the wound has been present, the treatments will differ. Before treatment of a wound or ulcer can progress the patient’s circulation to the wound must be evaluated. If there is little or no blood flow to the wound, no treatment however novel or effective, will work. Circulation must be first be established in order to have other medical treatments be effective, such as antibiotics and other wound dressings. If an abscess or cellulitis is present, rapid treatment is essential to reverse the infection. . The infection must be treated with appropriate antibiotics, either oral or intravenously, so that healing can begin. Rapid, non-controlled infection in the absence of circulation is a recipe for disaster and quick recognition and treatment is necessary. Many times with diabetic and patients with neuropathy, pain is absent and therefore infection can become overwhelming before the patient realizes the severity of their problem.

    Once circulation is found to be adequate, topical or oral antibiotics can be used to their full effectiveness. New topical wound treatments will also be effective at this time. As a podiatrist and wound care specialist, we will select appropriate wound care treatment according to the wound’s appearance, tissue quality and stage of healing. Some of the newer wound preparations can even speed wound healing. Treatment instructions are important and are patient specific, with compliance regarding dressing of the wound, off-weight bearing of the limb and a good dose of patience is required, as these wounds take time to heal.

    One last antidote on wound care is acknowledging strict treatment of the systemic problems associated with these wounds. For diabetics, proper sugar control can do a lot to prevent and speed healing of ulcers. For leg ulcers, addressing venous insufficiency and varicose veins with support hose can help prevent the ulcers from occurring. Those with hypertensive leg ulcers need to be treated for high blood pressure. So just because you have a wound on your foot or leg, don’t overlook the systemic disease that may have caused or influenced the wound, as you will only set your self up for reoccurrence or further complications. Early diagnosis and treatment is essential.


    Medicare Diabetic Shoe Program

    Central Ohio Podiatry Group is an authorized Medicare provider of diabetic shoe gear that will help in the prevention of blisters, ulcerations and amputations. We can evaluate, prescribe and dispense a high-quality shoe with three custom molded inserts that will maximize protection and accommodation of your feet. Many diabetic patients qualify for this benefit and Medicare will pay 80% of the cost for the shoes and insoles and your supplemental insurance should pay the other 20%. One pair can be fitted each calendar year and our office can provide diabetics with the foot wear needed through our Dr. Comfort shoe selection (http://www.drcomfortdpm.com/Mensall.htm).


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