Advanced Foot and Ankle Center Blog
May 31, 2019
Category: Foot Care
Tags: Diabetic Feet  

Diabetic feet need special care because of decreased circulation, neuropathy, joint deterioration, and more. While your primary care physician may guide you on blood sugar control, medications, a healthy diet, and active lifestyle, your podiatrist assesses and treats how your feet and ankles function everyday and for the long term. Enlist their help in the health maintenance of your diabetic feet.

Keeping ahead of neuropathy and avoiding amputation

Those are two key goals of diabetic foot care. Your podiatrist will want to see you regularly to assess the color, temperature, sensation, function, and shape of your feet and ankles, noting any developing problems. Early detection of circulation issues, nerve degeneration (neuropathy), and deformities, such as hammertoes, bunions, and Charcot Foot, are key.

Your podiatric foot examination will include an eye-on inspection of your skin (color, temperature, texture, and integrity). Your foot doctor also may perform gait analysis to watch for changes in how you walk. Sometimes a podiatrist orders X-ray imaging or an MRI to view the internal structure of the foot and/or ankle.

Remember, that foot ulcers are the primary threat to the overall health and well-being of the diabetic, says the National Center for Biotechnology Information (NCBI). Untreated, they may lead to complications so severe amputation is the only option.

What can you do to treat your diabetic feet?

  1. Be proactive. Inspect your feet daily, looking redness or skin breakdown.
  2. Wash and dry your feet daily.
  3. Trim your toenails carefully using a clean clippers. Trim straight across and not too short to avoid ingrown toenails.
  4. Wear shoes at all times--even indoors--to avoid injury.
  5. Wear clean, well-fitting, moisture-wicking socks.
  6. Keep your weight and blood sugars within normal range.
  7. Get in-office treatment of calluses and corns, says the American College of Foot and Ankle Surgeons.
  8. Avoid all forms of tobacco.
  9. Report any changes to your foot doctor as soon as possible.
  10. See your podiatrist every six months or as he or she directs.

Healthy feet and a healthy you

Podiatric health is so important, but especially to the diabetic. So stay in touch with your foot doctor, and be routinized in your foot care for better long-term health.

By Advanced Foot and Ankle Center
May 30, 2019
Category: Foot Conditions
Tags: Neuroma  

What Are Neuromas?

You might be walking along and feel pain near the ball of your foot, like there’s a rock inside your shoe. If the ache stays with you, a condition called neuroma might be the cause. A neuroma is a growth of nerve tissue frequently found between the third and fourth toes. Led by Dr. Silvers, Dr. Witt, and Dr. Lloyd, Advanced Foot and Ankle Center (offices in Prosper and McKinney, TX) offers treatments for neuromas. Here's all you need to know about neuromas.

Causes of Neuromas: Neuromas can have numerous causes. Some common causes of neuromas include: genetics, ill-fitting shoes, rheumatoid arthritis or gout, repetitive trauma, and pregnancy. Neuromas can also be caused by biomechanical problems, such as a bunion or foot pronation.

Symptoms of Neuromas: Normally, there are no outward signs, such as a lump, because a neuroma is not really a tumor. A neuroma is a painful condition. There may be a sharp, burning pain or numbness in your toes or ball of your foot.

Diagnosis of Neuromas: At your appointment, your podiatrist in McKinney will perform a physical examination. Your podiatrist will order x-rays or other imaging tests to confirm a diagnosis. X-rays may be required to rule out a fracture or arthritis of the joints that join the toes to the foot. X-rays alone will not show whether or not a neuroma is present, so an ultrasound or magnetic resonance imaging test may be done to confirm a diagnosis.

Treatment of Neuromas: People with neuromas may need to take painkillers, change their footwear, or get steroid injections. Prescription orthotics can help reduce pressure on the nerve and relieve your pain. In some cases, surgery may be required to remove the affected nerve or release the pressure on it. Surgery is an effective treatment for neuromas.

Save yourself from pain! Don't delay- call Advanced Foot and Ankle Center at (972) 542-2155 right now to schedule a consultation with one of our podiatrists in Prosper or McKinney, TX. Get your life back on track by receiving the best neuroma treatment available. We will help you cure your pain fast!

A lot of people come into our office due to a painful condition.  One of the most common causes for pain in the lower extremity is due to inflammation along a major tendon in the lower leg called the Posterior Tibial Tendon.  This tendon courses from just below the knee, down the inside of your leg, behind your ankle and inserts into the inside/bottom of your arch. Its main function is to maintain your arch during gait.  This tendon will most likely be inflamed because of your biomechanics. If you have a flat foot, your arch collapses more than usual which will cause an abnormal strain or pull of the tendon. Eventually, the tendon will become inflamed which causes swelling and pain at the site.   As this tendon becomes weaker, your arch will become flatter which causes more pulling of the tendon. Because of this, the issue usually doesn’t go away on its own.


To diagnose you with this condition, one of our providers will obtain a thorough history and physical.  We will usually obtain X-rays to evaluate your foot structure and sometimes an MRI is needed to assess the integrity of the tendon and check for tears.   This condition usually responds well to conservative treatment options but sometimes the problem is advanced, and the tendon needs surgery to heal. These decisions are based on our exam findings, test outcomes, treatment goals and patient’s activity level.


At Advanced Foot and Ankle Center, our providers treat this condition nearly every day and have the experience needed to get your back on your feet as quick as possible.

If you have questions about this or any other foot/ankle condition, please call us at 972-542-2155.


Have a great day,

Dr. Witt


May 10, 2019
Category: None
Tags: Untagged

Are you dealing with pain, burning, tingling or numbness between your toes or in the ball of the foot? If you said “yes” then you could be dealing with a neuroma, Neuromaa pinched nerve or benign tumor of the nerve that is often found between the third and fourth toes.

The classic symptom of a neuroma is pain, particularly when walking—a factor that leads many people to liken the condition to feeling like a pebble is in their shoe. You may find that the pain eases up whenever you aren’t walking or when you rub the pained area with your hands. While neuromas can happen to anyone, they are most commonly found in women.

Neuroma Causes

While the causes of a neuroma are still not clear, there are factors that can increase the likelihood of developing one, such as:

  • Extremely high arches
  • Flat feet
  • Trauma that leads to nerve damage in the feet
  • Improper footwear (high heels over two-inches tall; pointed toes)
  • Repeated stress placed on the foot

Treating a Neuroma

A neuroma will not go away on its own, so it’s important to see a podiatrist if you are experiencing any of the condition's symptoms. The type of treatment or treatments recommended to you will depend on the severity of the neuroma.

Those with minor neuromas may be able to lessen symptoms by wearing shoes that provide ample room for the toes and offer thick soles that provide more support and cushioning for the toes and balls of the feet. Sometimes a podiatrist may recommend custom orthotics to place inside the shoes, as well.

Your podiatrist may also recommend padding or taping the ball of the foot to improve faulty biomechanics and reduce discomfort. While medication will not eliminate the problem, it can temporarily alleviate symptoms. Over-the-counter anti-inflammatories can often briefly reduce pain and swelling, but for those dealing with more severe pain, steroid injections may be necessary to ease symptoms.

Surgery for a Neuroma

Surgery only becomes necessary when conservative treatment options have failed to provide relief, or when the neuroma has progressed enough that conservative care won’t be enough. During surgery, the inflamed nerve is removed through a simple outpatient procedure. Afterward, there is a short recovery period of a couple of weeks before patients are able to move about pain-free once again!

Give us a Call!

If you are dealing with new or worsening foot pain it’s important that you turn to a podiatrist that can help give you the answers you need. Schedule an appointment today.

At Advanced Foot and Ankle Center, we see patients everyday that are suffering from pain due to inflammation.  Most of our patients are treated with an anti-inflammatory medication either in oral form or by injection with steroid and many people get great results with these types of treatments.  However, there are many patients that we see who cannot take oral anti-inflammatories because they have stomach issues, are taking blood thinners, have kidney or cardiac issues or other various reasons.  Another group of patients cannot receive a steroid injection due to the location of the pain because it could damage nearby anatomy or they have diabetes and it could fluctuate their blood sugars.


Because of this, we are happy to announce a new treatment available for inflammation and pain called Traumeel.  Traumeel is imported from Germany where it has been used by doctors there for years. It is a combination of 12 plant medicines and two mineral extracts.  All 14 of these medicines are micro-dosed and are intended to stimulate your body to resolve its own pain. It works by inhibiting specific chemical messengers which cause swelling, pain and inflammation.  Traumeel can be used as either a topical cream or it can be injected at the site of pain either in a joint or along a tendon. Traumeel can be used without any drug-to-drug interaction with your current medications.  


This is a great option for patients who are unable to take NSAIDs like Ibuprofen and Aleve or for patients who cannot have a steroid injection due to diabetes or location of the injection.   Traumeel’s efficacy and safety has been established in multiple clinical trials that include studies under real-life conditions and published case reports. The medication is not a narcotic and it is not addictive.  It is an excellent treatment option for patients who would like a more natural therapy as well.


If you would like to begin this treatment or have any other foot/ankle questions, please call us at 972-542-2155.  


Have a wonderful day


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