Our Services
Ingrown Toenails
Ingrown toenails can be some of the most painful conditions. It is a very common complaint in a podiatrist office. The medical term for an ingrown nail is onychocryptosis. The nail plate may be curved into the skin, or the skin may be enlarged and the folds cut into the normal nail.
Symptoms of an ingrown nail usually first start as a mild pain along the side of a toenail. In time the soft tisse may swell, become red, and with extreme pain to touch. There may be an infection where the toe is warm, with drainage or pus seen if the nail punctures the skin. The reaction of the skin and soft tissue from an ingrown nail is called paronychia. An ingrown nail is more commonly seen on the big toe, but lesser toes may also be ingrown.
Causes of ingrown nails can be actually from a genetic factor. Shoe pressure also plays a role in the formation of an ingrown nail. Some doctors will advise you to trim your nail straight across at the end to prevent an ingrown nail and do not curve towards the skin as this will cause a sharp nail edge. Trauma to the nail may cause permanent damage to the matrix (the cells the nail grows from) causing them to grow in a curved direction. A fungus, called onychomycosis may also deform the nail causing it to grow differently.
Prevention of an ingrown nail can be accomplished sometimes by proper trimming of your nails and avoiding “bathroom surgery”. A proper fitting shoe is always the best approach but may not completely prevent an ingrown nail. The best prevention may be to get advice from your podiatrist at the first sign of a problem.
Podiatric Care of an ingrown nail may include use of antibiotics and soaking the foot to prevent or treat an infection of the toe. If there is an infection you must keep it clean and get proper treatment to avoid worse problems. For a simple ingrown nail sometimes your podiatrist can trim the nail border for you to see if the nail will grow back straight. More often then not, if you have one problem with an ingrown nail, you will probably have a reoccurrence sometime in your life. For recurrent ingrown nails or fairly severe problems the nail border or the entire nail may be removed permanently. This is technically a surgical procedure.
Surgery to correct an ingrown nail is a very frequent procedure. This can frequently be performed with local anesthetic in the doctors office. In certain situations this can be done as well at a hospital or surgery center. The worst part of the procedure is usually the injection to numb your toe. Many patients are in severe pain when they come to the office that the pain after surgery is minimal. As with any procedure everyone tolerates pain differently, typically an aspirin or Tylenol is all that is needed to control post-operative pain. The entire procedure could last less than 10 minutes including the time to numb you toe. The nail is removed where needed and sometimes the part of the nail that it grows from (the matrix) is destroyed. This can be destroyed by surgical cuts, a rasp, or a chemical. Typically a chemical is utilized forming a burn wound that will require time to heal. The day of the procedure a larger bandage is used to avoid excessive bleeding, you may need a larger shoe to wear. Usually the second day you may begin showering and soaking your foot in Epsom Salt Solution to drain any infection or drainage from the burn wound. This usually last 1-2 weeks, sometimes longer if you are a slower healer. A simple bandage to keep things clean with some antibiotic cream is used for a dressing.
Heel Pain and Radio Frequency Treatment
(Topaz Procedure)
What You Need To Know About the TOPAZ® Procedure
What is the TOPAZ® Procedure?
The Radiofrequency (TOPAZ) procedure is a minimally invasive intervention that aims to treat chronic conditions such as plantar fasciitis and Achilles tendinosis. This technique is specifically designed to eliminate scar tissue that impedes the body's natural healing process. Repeated damage, or overuse, of ligaments in the foot leads to the development of excess scar tissue, which eventually leads to chronic pain.
The TOPAZ procedure proves particularly beneficial for individuals who experience persistent heel or Achilles pain despite undergoing non-surgical treatments and/or physical therapy. Plantar fasciitis, which affects people who spend long periods on their feet - like teachers and runners - represents the primary cause of heel pain. Radiofrequency treatment offers a highly effective solution for those whose chronic pain restricts their daily activities significantly.
Why Is the TOPAZ® Procedure Performed?
The TOPAZ procedure presents an optimal solution for individuals afflicted by chronic plantar fasciitis or Achilles tendinosis. These conditions are often characterized by the accumulation of scar tissue and persistent pain. In the case of plantar fasciitis, which affects people with both high and low arches, the plantar fascia ligament responsible for supporting the foot's arch can become inflamed and thickened. Similarly, intense running or hill climbing can cause inflammation and scarring in the Achilles tendon, which connects the calf muscle to the heel bone, causing Achilles tendinosis.
By breaking down this scar tissue, the TOPAZ procedure stimulates the body's natural healing processes while providing relief from pain and improving mobility limitations.
How to Prepare for the TOPAZ® Procedure
In order to achieve the best outcomes and facilitate a seamless recovery, there are several essential steps and precautions that must be taken before undergoing the TOPAZ® procedure.
Consultation with Your Resurgens Physician: Prior to the procedure, you will consult with your physician. They will carefully review a pre-operative checklist and assess whether TOPAZ is the appropriate treatment for your specific condition. It is important that your condition has a chronic nature, lasting 3-6 months or longer.
Preoperative Imaging: Before proceeding with TOPAZ, you will need to undergo imaging tests such as X-rays, MRI scans, CT scans, or ultrasound examinations. These tests are necessary in order to confirm which tissues are causing discomfort and requiring attention.
Review of Medical History: Your physician will thoroughly evaluate your medical history during this process. They will pay particular attention to any past foot or ankle issues you may have experienced in order to ensure comprehensive care.
Medication Management:
- Discontinue the usage of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen for a period of three days before the procedure.
- Cease taking medications that contain steroids, such as cortisone or medrol, at least two weeks prior.
- If applicable, halt the use of blood thinners like aspirin, Plavix, or Coumadin at least seven days before the surgery. However, it is crucial to seek approval from your cardiologist and/or primary care physician beforehand.
Transportation Arrangements: Make arrangements for someone to drive you to and from the location where the procedure will take place. The administration of light sedation can impair your ability to drive.
By diligently adhering to these guidelines, you are laying a solid foundation for a successful TOPAZ procedure and facilitating a swift recovery process.
What Happens During the TOPAZ® Procedure?
The process of the TOPAZ® Procedure is simple and efficient. The entire procedure lasts approximately 20 minutes and utilizes intravenous sedation, which ensures that you remain relaxed while still maintaining independent breathing.
Here's what you can anticipate from beginning to end:
Preparation: You will be comfortably positioned, and local anesthesia will be administered to numb the affected area. A grid pattern will be marked on your foot or ankle to delineate the specific regions that will undergo treatment.
Procedure (Coblation): The TOPAZ® device, which resembles a specialized sewing needle, is carefully inserted at each point on the grid. Once activated, it emits radiofrequency waves that effectively break down inflamed scar tissue without causing harm to surrounding areas. This deliberate "micro-trauma" stimulates your body's natural healing process by enhancing blood flow.
Post-Procedure Care: Immediately after the procedure, your foot or ankle will be bandaged. Weight-bearing restrictions vary depending on individual circumstances; some individuals may require a cast or splint for 2-4 weeks, while others may resume walking right away. This minimally invasive procedure offers a fast and efficient method for treating persistent and painful conditions such as plantar fasciitis and Achilles tendinosis, promoting effective healing.
Are there Risks Associated with the TOPAZ® Procedure?
Although the success rate of the TOPAZ® Procedure is high, it is important to understand that all medical procedures carry potential risks and side effects. Here is what you should know:
Delayed Relief: Immediate relief from pain cannot be guaranteed. In fact, there may be a slight increase in discomfort before improvement begins. However, post-procedure physical therapy and rehabilitation typically leads to a significant reduction in pain.
Risk of Rupture: If your fascia has partial tears, undergoing the procedure might raise the risk of a complete rupture.
Complications Due to Pre-existing Conditions: Individuals with certain bone or joint conditions, ligament disorders, or neurogenic diseases may not be suitable candidates for this procedure. Additionally, if you have previously undergone specific types of surgeries, it may not be advisable.
Unsuccessful Outcome: It is estimated that approximately 5-10% of patients may not experience improvement and might need to explore alternative treatments for pain relief.
Recurrent Issues: While generally successful when post-procedure guidelines are followed diligently, there is always a chance that problems with ligaments and tendons could recur.
You can stay informed about these possible side effects and complications by speaking with your Resurgens physician before your procedure. They will help you make an educated decision.
Post TOPAZ® Procedure & Recovery
Patients undergoing the TOPAZ® Procedure typically experience a quick recovery, enabling them to switch from casts or walking boots to athletic shoes with orthotics in just 1-2 weeks. Improvement in their condition is often noticeable within days. With its high success rate, this procedure offers most patients substantial pain reduction and enhanced mobility.
To find the optimal treatment for plantar fasciitis or Achilles tendinosis, it is essential to seek assistance from Foot Associates of Central Texas.
Nanoplasty 3D Bunion Correction
At the Foot Associates of Central Texas we like to stay at the cutting edge of all things Podiatry. Whether it is a new innovation, research or daily tips, we want to keep you in the know. Today we are going to talk about a revolutionary new innovation in minimally invasive bunion surgery. The Nanoplasty™ 3D Bunion Correction® System offers a consistent 3D correction for bunions, using a small, concealed incision on the side of the foot for a more aesthetic outcome. Dr. Grimm is one of the first podiatrist in Central Texas to successfully perform a bunion correction using this procedure.
If you want to learn more about this new innovative procedure contact the Foot Associates of Central Texas today. Our specialists Dr. Douglas Grimm will be here to explain the entire process to you and address any of your other foot care needs. Call us at (512) 733-8600 or fill out the form on the contact page.
Lapiplasty Bunion
Bunions are a common foot problem that affects people of all ages. Often, they respond to conservative treatments, but if you regularly experience foot pain, don’t wait to seek professional help, another option we have at the Foot Associates of Central Texas is to fix it with the Lapiplasty 3D bunion correction.
At Foot Associates of Central Texas, Scott Pattison, DPM, FACFAS is specifically trained in the innovative Lapiplasty 3D correction system. To make an appointment at the office with Dr. Pattison in Georgetown, Texas give us a call at (512) 930-3338 or fill out the form on the contact page.
Orthotics
Orthotics are devices you wear to relieve pain associated with various foot and ankle conditions. They include everything from shoe inserts and ankle braces to custom devices. Your foot and ankle specialist (podiatrist) may recommend you try an over-the-counter orthotic device if you have mild symptoms related to your condition. If symptoms persist or worsen, they may prescribe a more advanced option, like custom orthotics. Orthotics can help prevent or delay the need for more invasive treatment, like surgery.
What foot problems require orthotics?
Your foot and ankle specialist may recommend orthotics for any of the following foot and ankle conditions:
- Bunions (hallux valgus).
- Corns and calluses.
- High arch feet.
- Flat feet.
- Foot tendonitis.
- Forefoot pain (metatarsalgia).
- Hammertoes.
- Morton’s neuroma.
- Plantar fasciitis.
- Patellofemoral pain syndrome (runner’s knee).
- Sprained ankle.
- Stiff big toe (hallux rigidus).
What are signs you need orthotics?
- You have foot pain and swelling during and after everyday usual activities, like walking and standing.
- You have sharp heel pain, especially first thing in the morning, which may indicate plantar fasciitis.
- You have flat feet or high arches that cause foot pain or inward rolling of your foot (overpronation).
- You have balance issues or falls due to collapsed arches.
- The wear and tear on your shoes is uneven.
- You’ve had a recent lower leg injury that affects the way you walk (gait abnormalities).
- You have foot complications from diabetes.
Diabetic Shoe Program
Diabetes affects your body’s ability to heal and can even affect your ability to feel pain in your extremities. Therefore, it is vital that diabetic patients examine their feet on a daily basis and have an examination by a podiatrist at least once a year. Shoe gear is also very important; diabetics should wear shoes at all times to protect their feet. Shoes should be well-fitting, made of stretchable, breathable materials, and with supportive foot beds or insoles.
In order to help diabetics obtain correct shoe gear and prevent or reduce the number of ulcerations, injuries, and amputations, Medicare, Medicare replacement plans, and some private insurances will assist their diabetic patients in paying for diabetic shoes. For qualifying patients, these insurance plans will pay up to 80% of the cost of the shoes and inserts, each calendar year. In order to qualify, certain conditions must be present and an exact process must take place:The patient’s primary care provider (or the doctor that manages the patient’s diabetes) must first examine the patient and document in their medical records the patient’s current plan for management of diabetes, such as diagnostics (blood glucose test or A1C), diet, exercise regimen, and/or medications. They must also document the patient’s foot deformities or conditions, including but not limited to: bunions, hammertoes, neuropathy (loss of protective sensation in the feet), ulcerations, or amputation.
- The patient sees one of our podiatrists for a podiatric foot examination. At that visit, the patient’s feet are thoroughly examined, their shoe gear is evaluated, foot measurements (both length and width) are obtained, and the patient and podiatrist agree on the proper shoe style to fit the patient’s needs and preferences.
- The podiatrist’s office sends the podiatrist’s medical records and paperwork fully documenting the foot examination visit to the patient’s primary care doctor (or the doctor who manages the patient’s diabetes), who signs the medical records agreeing with the podiatrist’s prescription for diabetic shoes.
- Once the podiatrist’s office has the signed medical records from the primary care doctor’s visit, as well as the podiatrist’s visit, they place the order for the shoes in the style, size, and color decided upon at the podiatric exam visit, as well as any inserts for the shoes.
- Once the shoes arrive, the patient returns to the podiatrist’s office to ensure the shoes fit well and are to the patient’s liking. If not, the shoes can be returned and a different style, color, or fit can be ordered. Once the correct shoes and inserts are obtained, both the shoes and insoles are dispensed to the patient. The podiatrist’s office will follow up with the patient if any problems arise with the shoe gear.
The value of a good pair of shoes is immeasurable for any patient, but can mean life or death in diabetic patients. Take advantage of this beneficial program today!!
LINK to Dr. Comfort Shoes (drcomfort.com)
LINK to Anodyne Shoes (anodyneshoes.com)
Peripheral Neuropathy Treatments
Peripheral neuropathy refers to any condition that affects the nerves outside your brain or spinal cord. This can happen for several reasons, from trauma to infections to inherited conditions. There are also many possible symptoms. Many causes, forms or symptoms of this condition are treatable, but this can vary widely from person to person. Come in and talk to us about your condition and how innovative treatment with Nanobubbles may help.
Personalized Care
Experience personalized foot and ankle care at Foot Associates of Central Texas, where our attentive team is dedicated to meeting your unique needs.
Expert Foot Surgery
Trust our expert team for advanced foot surgery, ensuring effective treatment and swift recovery tailored to your individual condition.
Comprehensive Management
Benefit from comprehensive foot and ankle management, taking a holistic approach to maintain your mobility and overall well-being.
Patient-Centered Service
Enjoy patient-centered service in a welcoming environment, with amenities and accessible facilities designed for your comfort and convenience.
Today I met with Dr. Grimm, who was extremely professional, but very kind. He gave me a lot of insight on bunion surgery and the procedure of it. This was my first time that I saw him and I definitely feel that he is a genuine person who cares a lot about his work and his patients. I would highly...
Laurel
Very grateful. I was able to obtain a same day appointment. Upon arrival I was met by friendly people. Dr Grimm was straightforward and very informative as he proceeded with the treatment. I highly recommended him to anyone having foot issues. .
Reynaldo Gonzalez
I can always count on Dr. Grimm. I'm so thankful for him getting glass out of my foot that has been there for almost three weeks. In and out and ALWAYS a great visit. He has helped me and my husband take better care of our feet as we age ..what a blessing to trust and love your doctor.
Holly Eller
Ready to work together?
Experience exceptional foot and ankle care at Foot Associates of Central Texas, where Dr. Grimm and our skilled team provide personalized, comprehensive treatment in a welcoming and accessible environment. Trust us for urgent concerns or ongoing foot health management, with patient satisfaction and comfort as our top priorities in Round Rock, TX.