"After my athletic injury, I had met with several doctors in the Northern Virginia area… many were quick to diagnose, quick to jump into surgery, and quick to misdiagnose. Dr. Pontell not only examined my foot via MRI, Xray, Ultrasound and in person – he explained EVERYTHING to me... After completely healing, at 38 years old I can run longer, and run faster than I ever had been able to run before – even before my injury. I’m in the best shape of my life. I tell everyone all the time that I am able to do what I do because of him - my foot he reconstructed is a million times stronger than my uninjured foot." -A.D.
"I went to Dr. Hallivis based on his reputation and his extensive experience. He definitely stood up to his reputation. He was professional, friendly, approachable and knew everything there was to know about my problem. He treated me and my pain resolved in 2 days. His office ran on time and his staff was warm and helpful. I would recommend him to anyone with a foot problem.” - M.H.
Acrocyanosis is a painless disorder that affects the arteries supplying blood to the skin of the hands and feet. These small arteries carry oxygen and nutrients through the blood to the skin of the extremities. Spasms in the arteries block blood flow in people with this condition. Without adequate blood supply, the skin lacks oxygen, which changes the skin color to a dark blue to purple color. This characteristic color is called cyanosis.
Acrocyanosis is generally a benign condition but can be indicative of a serious medical illness elsewhere in the body, such as cardiovascular or connective tissue disease. It occurs more frequently in women than in men. Symptoms include feet that are persistently cold in temperature, blue skin discoloration, sweaty or moist skin, and swelling.
Treatment focuses on keeping the foot warm and the blood circulating normally. It may include wearing insulated boots, thin polypropylene liner socks to wick the moisture away from the skin, and/or use of an insulated sock to maintain normal skin temperature. The disorder itself cannot be remedied but does not worsen over time.
Alcoholic peripheral neuropathy is a nerve loss condition in the foot caused by the prolonged use of alcoholic beverages. Ethanol, the alcoholic component of these beverages, is toxic to nerve tissue. Over time, the nerves in the feet and hands can become damaged resulting in the same loss of sensation as that seen in diabetic peripheral neuropathy. The damage to these nerves is permanent. A person with this condition is at the same risk and should take the same precautions as people with diabetic peripheral neuropathy. Another form of peripheral neuropathy is caused by exposure to toxins, such as pesticides and heavy metals, and is equally detrimental to health.
Treatment for alcoholic peripheral neuropathy may include Vitamin B-12 injections, certain oral medications to ease any burning pain, topical ointments, magnetic therapy, and galvanic stimulation (which is the therapeutic use of electric current, particularly for stimulation of nerves and muscle). Note: Please consult your physician before taking any medications.
Chilblains (Cold Feet)
Chilblains are caused by the skin’s abnormal reaction to cold. Circulation is a determining factor for chilblains; people with poor circulation in the feet are more susceptible.
Chilblains are characterized by small itchy, red swellings on the skin, which become increasingly painful, swell, and dry out, leaving cracks in the skin and exposing the foot to the risk of infection. They occur on the extremities—the toes (particularly the smaller ones), fingers, the face (especially the nose), and the ear lobes. They can also occur on areas of the feet exposed to pressure, such as on a bunion or where the second toe is squeezed by tight shoes. Symptoms include burning and itching, swelling or redness, breaks in the skin, and ulcers.
Treatment includes keeping the body, legs, and feet warm, especially for individuals who have poor circulation and/or limited mobility.
Calamine lotion will take away most of the skin discomfort. If chilblains become ulcerated, application of an antiseptic dressing is the recommended form of treatment.
Erythromelalgia is a rare disorder that results from enlarged blood vessels in the feet. Because the blood vessels are open or dilated, oxygen and heat from the blood is discharged into the tissues, making the feet turn red and feel hot all the time. Prescription medications that restrict the opening of the blood vessels is the typical treatment. Note: Please consult your physician before taking any medications.
Ischemic foot refers to a lack of adequate arterial blood flow from the heart to the foot. There are a wide variety of possible causes, including arterial blockage from cholesterol deposits, arterial blood clots, arterial spasms, or arterial injury. With ischemic foot, the person suffers from an inadequate blood supply reaching the foot to provide the oxygen and nutrient needs required for the cells to continue to function.
Symptoms typically include cold feet, discoloration in the toes, muscle cramping, and, over time, ulcers and pain.
Treatment includes walking exercises to increase blood flow, wearing protective shoes, and medications. Note: Please consult with your physician before taking any medication.
A neuroma is an enlarged, benign growth of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from poorly fitting shoes or an abnormal bone structure can also lead to this condition. Symptoms may include sensations of thickness, burning, numbness, tingling, or pain in the ball of the foot. Treatments generally include wearing corrective shoes or orthotics and/or receiving cortisone injections. In severe cases, surgical removal of the growth may be necessary.
Morton’s neuroma is a thickening of tissues around the nerve that leads to the toes. Morton’s neuroma usually develops between the third and fourth toes in response to irritation, such as that caused by wearing high-heeled or narrow shoes, or from trauma. Symptoms may include a burning pain that radiates from the ball of the foot to the toes or numbness in the toes. Conservative treatments usually resolve the pain or progressions of the condition, and range from wearing roomier, lower-heeled footwear or using orthotics to reduce the pressure on the nerve, to injections of corticosteroid medication to reduce swelling and inflammation.
Spasms are contractions of the hands, thumbs, feet, or toes and are sometimes seen with muscle cramps, twitching, and convulsions. The contractions of the muscles can be violent.
Carpopedal spasms, or spasms in the feet or toes, are usually accompanied by numbness, tingling, or a “pins-and-needles” feeling; muscle weakness; fatigue; cramping; twitching; and uncontrolled, purposeless, rapid motions.
Common causes of spasms include:
- Vitamin D deficiency.
- Hyperventilation (calcium becomes temporarily unavailable to the body during hyperventilation).
- Muscle cramps, usually caused by sports or occupational muscle injury.
- Parkinson’s disease and other neuromuscular conditions.
Spasms of the hands or feet can be an important early warning sign of other serious health problems, so it is important to seek medical attention. Treatments may include calcium and Vitamin D supplements (if you have a deficiency).
Venous stasis is a loss of proper function in the leg veins that normally carry blood back toward the heart. This may occur following injury to the veins, which may lead to blood clots in the superficial veins (known as superficial phlebitis) or blood clots in the deep veins (known as deep venous thrombosis).
Individuals with this condition usually exhibit swelling of the legs and ankles. The superficial veins in the legs may be varicose, causing the veins to be enlarged and appear as a cord or a bunch of grapes. Patients often complain of a feeling of fullness, aching, or tiredness in their legs. These symptoms worsen with standing, and are relieved when the legs are elevated. As the condition progresses the blood continues to collect in the feet, ankles, and legs.
Rest, elevation, and compression stockings are the most common forms of treatment.