
Neuropathy
Neuropathy is the weakness, numbness, and pain in the hands and feet due to damage to the peripheral nerves. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of your body. Causes of Neuropathy include: traumatic injuries, infections, metabolic problems, exposure to toxins, and diabetes.
Diabetes is the most common cause, with more than half of the diabetic population developing some type of neuropathy. There are several types of neuropathy and they vary based on the damage of the nerves. Mononeuropathy is classified as only one nerve being damaged. When multiple nerves are affected, it is referred as polyneuropathy. One of the types of polyneuropathy is distal symmetric polyneuropathy. It is the most common for people with diabetes and starts when the nerves furthest away from the central nervous begin to malfunction. The symptoms begin with pain and numbness in the feet and then they travel up to the legs. A rarer form of polyneuropathy is acute symmetrical peripheral neuropathy, which is a severe type that affects nerves throughout the body and is highly associated with Guillain-Barre syndrome, an autoimmune disorder that attacks the peripheral nervous system and can be fatal. Although there are many types of neuropathy, most of them share the same symptoms such as pain, extreme sensitivity to touch, lack of coordination, muscle weakness, dizziness, and digestive problems. Since neuropathy affects the nerves, those affected should be careful of burns, infection and falling, as depleted sensations disguise such ailments.
The best way to prevent neuropathy is to manage any medical conditions such as diabetes, alcoholism, or rheumatoid arthritis. Creating and managing a healthy lifestyle can also go a long way. Having a healthy diet full of fruits, vegetables, whole grains and lean protein can keep the nerves healthy. These types of food have the nutrients to prevent neuropathy. Regularly exercising can help as well, but it is best to consult with a doctor about the right amount. In addition to diet and exercise, avoiding risk factors will also prevent neuropathy. This includes repetitive motions, cramped positions, exposure to toxic chemicals, smoking and overindulging on alcohol.
Bunions and Surgical Treatment Options

A bunion is a bony bump that forms at the base of the big toe due to misalignment of the foot’s bones. This condition causes the tip of the big toe to shift toward the smaller toes, leading to discomfort, swelling, and difficulty walking. When conservative treatments are not effective, bunion surgery may be necessary to relieve pain and correct the deformity. An osteotomy involves cutting and realigning the bone to restore proper positioning. An exostectomy focuses on removing the bony prominence without realigning the joint. An arthrodesis fuses the affected joint to eliminate movement and pain, while a resection arthroplasty removes a portion of the bone to create more space within the joint. Each procedure is chosen based on the severity of the bunion and the patient’s individual needs to improve function and comfort. If you have a bunion that is painful, it is strongly suggested that you consult a podiatrist who can determine if surgery is right for you, and which type you would most benefit from.
Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Nrup Tolat, DPM of Atlanta Total Foot & Ankle Care. Our doctor will assist you with all of your foot and ankle needs.
When Is Surgery Necessary?
Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:
- Removing foot deformities like bunions and bone spurs
- Severe arthritis that has caused bone issues
- Cosmetic reconstruction
What Types of Surgery Are There?
The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:
- Bunionectomy for painful bunions
- Surgical fusion for realignment of bones
- Neuropathy decompression surgery to treat nerve damage
Benefits of Surgery
Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.
Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.
If you have any questions please feel free to contact our offices located in Woodstock and Atlanta, GA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Foot and Ankle Surgery
When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition. A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case. Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery. Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.
Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome. A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications. Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered. Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.
Care post-surgery will depend on the type of surgical procedure performed. Typically, all postoperative care involves rest, ice, compression, and elevation. To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes. He will also determine if and when you can bear weight. A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.
Definition and Causes of a Plantar Fibroma

A plantar fibroma is a benign growth that develops in the plantar fascia, the thick band of tissue along the bottom of the foot. This firm lump is usually found in the arch and may cause discomfort or pain, especially when walking or standing for long periods. Symptoms include a noticeable mass under the skin, tenderness, and pressure-related pain. The exact cause is not always clear, but trauma to the foot, certain medications, and improper footwear may contribute to its development. Some health conditions, including diabetes and liver disease associated with alcoholism, have also been linked to plantar fibromas. Treatment options focus on reducing discomfort through orthotics and stretching, as well as other medical interventions. If you have one or more lumps on the sole of your foot, it is suggested that you promptly contact a podiatrist who can help you to manage this condition.
A plantar fibroma may disrupt your daily activities. If you have any concerns, contact Nrup Tolat, DPM of Atlanta Total Foot & Ankle Care. Our doctor can provide the care you need to keep you pain-free and on your feet.
Plantar Fibroma
A plantar fibroma is a fibrous knot in the arch of the foot. It is embedded in the plantar fascia which is a band of tissue that extends from the heel to the toes along the bottom of the foot. There can be multiple plantar fibromas in the feet at the same time. There are no known causes for this condition. If you have a plantar fibroma, there will be a bump in the arch of your foot that cannot be missed. Any associated pain is most often due to a shoe rubbing against the nodule. Non-surgical options, such as steroid injections, physical therapy, and orthotics should be tried first. Surgery is a last resort and is the only thing that will remove a plantar fibroma entirely. Consult with a podiatrist for a proper diagnosis and to determine the treatment regimen that is right for you.
What Causes a Plantar Fibroma?
While there are no specific causes identified, a plantar fibroma can possibly come from genetic predisposition or the formation of scar tissue that forms from healing the tears in the plantar fascia.
What Are the Symptoms of a Plantar Fibroma?
There will be a noticeable lump in the arch of the foot that may or may not cause pain. If pain is felt, it is typically because a shoe is rubbing up against the lump or when walking or standing barefoot.
Treatment and Prevention
A plantar fibroma will not disappear without treatment, but it can get smaller and be a non-issue. If pain persists, a podiatrist examines the foot and when the arch of the foot is pressed, pain can be felt down to the toes. An MRI or biopsy might be performed to help diagnose or evaluate the plantar fibroma. The following non-surgical options are generally enough to reduce the size and pain of these nodules:
- Steroid injections
- Orthotics
- Physical therapy to help apply anti-inflammatory creams on the bump
Surgery is considered if the mass increases in size and the patient continues to feel pain after non-surgical methods are tried.
If you have any questions please feel free to contact our offices located in Woodstock and Atlanta, GA . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Plantar Fibroma
A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas. Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.
What Your Feet Can Reveal About Your Health

The condition of your feet can provide important clues about your overall health. Cold feet may indicate poor circulation, which can be a sign of conditions like peripheral artery disease or diabetes. Persistent foot pain that does not improve with rest may suggest arthritis, nerve damage, or an underlying structural issue. Changes in the nails, including discoloration, thickening, or brittleness, can be linked to fungal infections, nutritional deficiencies, or even thyroid disorders. Additionally, burning foot pain may be a symptom of nerve damage, often associated with diabetes or vitamin B deficiency. Paying attention to these signs and seeking medical advice when necessary can help detect health issues early. If you have any type of foot pain, it is suggested that you consult a podiatrist who can treat various foot conditions, and determine if it is an indicator of additional health issues.
When dealing with systemic disease of the feet, it is extremely important to check the affected areas routinely so that any additional problems are caught quickly. If you have any concerns about your feet and ankles contact Nrup Tolat, DPM from Atlanta Total Foot & Ankle Care. Our doctor will assist you with all of your podiatric needs.
Systemic Diseases of the Feet
Systemic diseases affect the whole body, and symptoms usually are displayed in the feet. This condition can make a patient’s ability to walk unbearable. Systemic diseases include gout, diabetes mellitus, neurological disorders, and arthritis.
Gout – is caused by an excess of uric acid in the body. Common symptoms include pain, inflammation, and redness at the metatarsal/phalangeal joint of the base big toe. Gout can be treated by NSAIDs to relieve pain and inflammation, and other drugs that lower the acid levels in the body.
Diabetes mellitus – is an increase in the level of blood sugar that the body cannot counteract with its own insulin. Failure to produce enough insulin is a factor in Diabetes.
Diabetes of the Feet
Diabetic Neuropathy – may lead to damaged nerves and affect the feet through numbness and loss of sensation.
Peripheral Vascular Disease – can restrict the blood flow to the feet, and often times lead to amputation of the feet.
If you have any questions please feel free to contact our offices located in Woodstock and Atlanta, GA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Systemic Diseases of the Foot
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
Bunions Worsen With Age and Are More Common in Women

Bunions tend to worsen over time and are more prevalent in women due to a combination of genetic, structural, and footwear-related factors. Aging weakens connective tissues, leading to joint instability and increased toe misalignment. Women are particularly at risk because of shoes with narrow toe boxes and high heels, which place excessive pressure on the forefoot and push the big toe out of alignment. Hormonal changes may also contribute by affecting ligament flexibility. As bunions progress, they can cause pain, swelling, and difficulty walking. Choosing supportive, wide-toe shoes and avoiding prolonged use of restrictive footwear can help slow progression. Strengthening foot muscles with targeted exercises may also provide relief. For persistent discomfort or severe deformity, it is suggested that you see a podiatrist who can offer personalized solutions, including orthotics, padding, or surgical options to improve comfort and function as the condition advances.
If you are suffering from bunion pain, contact Nrup Tolat, DPM of Atlanta Total Foot & Ankle Care. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is a Bunion?
Bunions are painful bony bumps that usually develop on the inside of the foot at the joint of the big toe. As the deformity increases over time, it may become painful to walk and wear shoes. Women are more likely to exacerbate existing bunions since they often wear tight, narrow shoes that shift their toes together. Bunion pain can be relieved by wearing wider shoes with enough room for the toes.
Causes
- Genetics – some people inherit feet that are more prone to bunion development
- Inflammatory Conditions - rheumatoid arthritis and polio may cause bunion development
Symptoms
- Redness and inflammation
- Pain and tenderness
- Callus or corns on the bump
- Restricted motion in the big toe
In order to diagnose your bunion, your podiatrist may ask about your medical history, symptoms, and general health. Your doctor might also order an x-ray to take a closer look at your feet. Nonsurgical treatment options include orthotics, padding, icing, changes in footwear, and medication. If nonsurgical treatments don’t alleviate your bunion pain, surgery may be necessary.
If you have any questions, please feel free to contact our offices located in Woodstock and Atlanta, GA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
What Are Bunions?
Bunions are large bony bumps at the base of the big toe. Medically known as hallux valgus, a bunion is a misalignment of the metatarsophalangeal joint, or big toe joint. The misalignment will generally worsen with time if left untreated.
The exact cause of bunions is unknown, with genetics seen as a potential cause. High heels and poorly-fitted footwear, rheumatoid arthritis, and heredity all seem to be potential factors behind the exacerbation of bunions. Women have been found to be more likely to develop bunions in comparison to men.
Bunions do not always produce symptoms. The best way to tell is if the big toe is pushing up against the next toe and there is a large protrusion at the base of the big toe. You may or may not feel pain. Redness, swelling, and restricted movement of the big toe may be present as well.
Podiatrists use a variety of methods to diagnose bunions. If there are symptoms present, podiatrists will first consider that it is a bunion. If not, a physical examination will be conducted to check function of the big toe. Finally, an X-ray may be taken to view the extent of the bunion and confirm it is a bunion.
Typically, nonsurgical methods are used to treat bunions, unless the bunion has become too misaligned. Orthotics, icing and resting the foot, roomier and better fitted shoes, taping the foot, and pain medication are usually utilized first. If the bunion doesn’t go away or causes extreme pain, surgery may be required. Surgeons will either remove part of the swollen tissue or bone to straighten the toe out.
If you have a bunion, it is recommended to see a podiatrist. The longer it is left untreated, the worse it may get. Podiatrists can properly diagnose and treat a bunion before it gets worse.