Some say it feels like a stone in your shoe, others a marble, others a bunched up sock, but all have the sensation of something that doesn’t belong there irritating your foot. There are a couple of possible causes for this.

The first is a neuroma. This is a benign thickening of a nerve that causes feelings of numbness or pain. It usually occurs when a nerve between a couple of smaller toes is pinched by bones or tendons that have moved out of position.

Another possibility is capsulitis or bursitis—both inflammatory conditions—in the second metatarsalphalangeal joint where the bones of the second toe and metatarsal (foot bone) meet.

Both have similar symptoms—numbness and/or pain in the toes or ball of the foot—but a good podiatrist won’t jump to conclusions too quickly. At Sierra Foot & Ankle we take the time to ask questions and examine your foot to pinpoint the exact reason for the feelings you describe. Then we will try conservative remedies, and most of the time they will be successful.

Next time you have these symptoms, call our office at (775) 783-8037 for an appointment.

The recovery and rehabilitation time for a torn Achilles tendon, also called an Achilles tendon rupture, can vary based on factors such as the severity of the initial injury, the treatment procedure selected, and how well you follow your doctor’s guidelines for rehabilitation.

For many Achilles ruptures, you have a choice to make between conservative treatment (immobilization via a cast or walking boot, allowing the tendon to heal on its own) or surgical tendon repair. The recovery time can be similar for both treatments, although full rehabilitation may be faster with surgery.

In either case, you’ll probably need to wear a cast or walking boot for about 6-8 weeks while the tendon injury heals. After that, you’ll gradually return to more weight-bearing activity and perform rehabilitation exercises. The average time for a full return to your previous sports or level of activity is around 6 months, although it can vary quite a bit (4-12 months).

Achilles ruptures are serious injuries that need immediate attention in order to get you the best long-term outcome. To make an appointment with Dr. Victoria Melhuish please call (775) 783-8037 or use the website contact page

Typically ankles curve in because your arches are too low or have fallen. Without the arch in the proper position, the ankle angles inward, adding stress to the foot. Sometimes naturally flat feet don’t have any painful symptoms. Often though, the strain on the midfoot and the ankles can bring pain along the arch and in the heel. Adult acquired flatfoot is a more serious problem. Part of the bone structure in your foot suffers damage and allows the arch to collapse. Usually you are left with discomfort along the posterior tibial tendon, the outside of the ankle joint, or in the midfoot.

If your ankles curve or angle in, have our expert staff examine your feet, even if you aren’t experiencing pain yet. This condition is easiest to treat when it is caught early. Don’t wait until discomfort keeps you sitting down—contact Sierra Foot & Ankle, for an appointment or more information by calling (775) 783-8037 or using the website contact page.

Ingrown toenails happen when the edge of the nail grows into the skin surrounding it. They can be visually unappealing, but more than that, they can cause discomfort and pain. In some cases, they can lead to bleeding, swelling of the skin, and infection. When conservative treatments are unsuccessful, surgery may have to be considered. Is ingrown toenail surgery painful? You won’t feel a thing! During surgery, a local anesthetic is usually injected into the area around your toe. This will numb your foot and prevent you from feeling the procedure as it occurs. The nail will be freed from the skin and removed if needed. After the operation, be sure to keep your foot raised and rested. You might receive over-the-counter or prescription painkillers to relieve any soreness you’re feeling. To stop ingrown toenails from returning, and to remove any harmful pressure on the foot, be sure to wear comfortable shoes and avoid overly trimming your toenails. Surgery is a successful way to stop your ingrown nails from hurting, and to keep ingrown toenails from coming back!

Dr. Victoria Melhuish can explain more about ingrown toenails and how to take care of your feet. Contact us at Sierra Foot and Ankle by calling (775) 783-8037, or visit our office in Carson City today!

Swift therapy is a revolutionary new therapy proven to effectively remove plantar warts that have formed on the bottom of a patient’s feet. These warts can be painless or they can cause considerable discomfort. Most patients elect to have them removed rather than wait for them to go away on their own, which can take months or years. 

Plantar warts are caused by the human papillomavirus virus (HPV). The virus thrives in warm, moist environments and usually enters the body through a cut, abrasion, or small tear in the skin. This virus can be highly contagious either through skin contact or contact with something that someone else’s wart has touched.

Swift therapy was developed in the United Kingdom and has received FDA approval. Swift is a type of immunotherapy, which means that its purpose is to trigger a response from the patient’s immune system. By targeting the underlying cause of plantar warts—the virus itself—the immune system receives a signal to begin fighting it off. In turn, the warts also start to disappear. The eradication of the viral infection prevents not only the warts from returning but also new warts from forming. 

Swift involves the use of a specialized probe designed to release precise doses of microwave energy. The microwave energy is applied to the affected areas on the feet. Some patients may experience minor pain or discomfort when the second or third doses are delivered, but it quickly subsides. This makes Swift ideal for those with low pain tolerance, as well as for people of all ages, including children. 

What makes this treatment especially appealing to patients and podiatrists alike is that it is non-invasive. Unlike conventional plantar wart removal methods, such as cutting, burning, and freezing, Swift’s state-of-the-art method does not break the surface of the skin. As a result, patients can resume their normal activities after their treatment session has concluded.

On average, patients should expect to undergo two to four treatment sessions total. A severe outbreak, however, may necessitate additional sessions. Sessions are typically spread out across two-week intervals to give the patient’s immune system an adequate amount of time to respond and for favorable results to appear. 

If you are interested in learning more about Swift or would like to utilize this amazing therapy, contact Sierra Foot & Ankle by calling (775) 783-8037 for an appointment or contact us online.

A bunion is a painful, bony bump on the joint of the big toe. It results from an unstable joint that allows a bone in your toe to move out of alignment.

People who get bunions tend to share common risk factors. Your shoes contribute to your bunions. People who wear high heels, pointy-toes, poorly fitting shoes, or tight, narrow shoes, and unsupportive footwear, are more likely to have bunions.

Given that a bunion is related to your foot structure and an unsteady joint, there is a genetic factor in developing bunions. You are more likely to develop a bunion if your family has a history of them. Stress on the foot, injuries, or deformities of the foot also play a part.

People with rheumatoid arthritis (RA), an inflammatory condition, also have a greater risk of developing bunions.

We offer both conservative and surgical treatment options. It is always best to make an appointment with our doctor to discuss your individual situation and what treatment would be best for you. Sierra Foot & Ankle is excited to offer Lapiplasty, an advanced procedure that does more than remove the painful bump – it also corrects the root cause of the problem. Lapiplasty completely and permanently corrects and stabilizes the misaligned joint that is the source of your painful bunion. With the joint stabilized and the bone back in its correct place, your toe remains correctly aligned. No more bunions! And, unlike traditional surgery that keeps you off your feet for weeks, Lapiplasty allows you to recover in a walking boot starting days after surgery. You don’t have to live with the pain of bunions. Sierra Foot & Ankle can fix them at the source and get you back on your feet before you know it. Call (775) 783-8037 for an appointment or contact us online.

A bunion is a common foot deformity that affects people of all ages, especially women. This abnormal growth usually appears on the outside of one or both big toes.

Bunions are hard, bony bumps that protrude outward, which can cause pain and discomfort. Some bunions are small and unobtrusive, while others can grow to be quite large. When left untreated, bunions worsen over time and cause the big toe to begin pointing toward the other toes and/or trigger other foot issues, such as the development of hammertoes, corns, and calluses.

Symptoms of Bunions

A visible bump on the outside of your big toe is the most common symptom of a bunion. This type of bump can also develop on the outside of your little toe; this is called a bunionette.

Symptoms of a bunion include pain and tenderness near the sight of the bump, as well as redness and inflammation. If the bump is particularly large, you may lose range of motion within your big toe and notice that it feels stiff. You may also have a difficult time finding shoes that fit comfortably. Some people develop corns and calluses on the bunion.

Contact Us for Bunion Treatment

At Sierra Foot & Ankle, we are passionate about helping patients with bunions receive the care and treatment they need to address the deformity and alleviate the pain. If it is time for you to seek treatment for your bunion, please contact us. We are proud to offer numerous treatment methods at our practice, including an advanced, reliable bunion removal surgery called lapiplasty.

Lapiplasty is a newer type of bunion correction surgery specifically developed to address all three dimensions of a bunion deformity. 

A bunion is a painful bump that forms on your foot due to an unstable joint. The bump grows over time as the bones in your foot move out of place in three ways — they lean sideways, elevate upwards, and rotate out of alignment. If left untreated, bunions can cause significant joint pain and stiffness, arthritis, and hammertoes. 

Most current or traditional bunion correction surgeries are Metatarsal Osteotomies, which do not treat the root cause of the bunion deformity. Instead, osteotomies treat only the symptoms of your pain and the cosmetic issues — the visible bump. The bone will likely continue to move by leaving the unstable joint untreated, and the bunion will return, along with the pain. 

Lapiplasty bunion correction is a patented procedure that addresses the root cause of the bone deformity. During the procedure, your toe bone is realigned in all three dimensions, restoring it to normal alignment and removing the large bump. The toe joint is then secured using titanium plates, preventing the bone joints from moving and the bunion from reforming. 

Lapiplasty is a permanent fix to the cause of your bunion, with long-lasting results that prevent the need for future surgeries. With your joints correctly aligned and stabilized, you will have the full range of motion in your foot. 

Lapiplasty has a quicker recovery time than other types of bunion removal procedures. After undergoing the Lapiplasty procedure, you can be up and walking again within days and resume other normal activities within six weeks.

We would welcome the chance to help you learn more about how lapiplasty can benefit you. To talk with us and schedule an appointment, contact us online or call (775) 783-8037.

The risk factors for flat feet are plentiful. However, that fact is not necessarily something that should create alarm. Some people don’t experience any painful symptoms or problems from a flattened arch, which means that they don’t need treatment. On the other hand, some people do experience pain and need help. It’s best to know the risk factors so you can quickly act on your pain, if it happens.

Obesity puts a lot of weight on the tendons in your foot, which may cause them to stretch out. This is one the reasons that arches collapse. High blood pressure and diabetes also put you more at risk for developing this foot structure.

A traumatic injury to the muscles, tendons, and joints in the foot might cause the onset of flat feet. Conditions associated with aging, including osteoarthritis and rheumatoid arthritis, might cause your arches to fall over time.

If you have any pain from your flat feet, call Sierra Foot & Ankle at (775) 783-8037. 

You can develop a black toenail for several different reasons. The most common culprit is trauma. This could be small, repetitive bumps to the ends of the toes over time—like hitting the insides of your shoes over and over again while running. It could also be the result of suddenly stubbing your toe or dropping something heavy on it. In either case, the trauma causes an injury in the nail bed, which leaks blood. This stains the underside of the keratin, causing that dark color.

Occasionally a black toenail is caused by something else. It might be a side-effect of a fungal infection, particularly if there’s a buildup of debris under the nail. A large dark patch, or a dark streak instead of a splotch, may actually be signs of cancer. Malignant melanoma, the most deadly of skin cancers, can sometimes grow underneath a toenail and make it appear black. If the dark splotch doesn’t seem to be growing out with your hard keratin, have it checked right away. Contact Dr. Victoria Melhuish at Sierra Foot & Ankle in Carson City to discover what caused your nail problem. Call (775) 783-8037 to make an appointment.

A returning ingrown toenail is a surprisingly common problem. It has to do with how your nail grows. Your toenail becomes ingrown when it grows sideways and outward into the skin around it, pinching or piercing the soft tissue. If your footwear squeezes your toes, it can influence the nail to curl. Sometimes changing your shoes may be enough to relieve the pressure on your toes so that the nail grows straight. However, a nail growth abnormality may mean your nail is unable to grow correctly. In that case, you may need a procedure to permanently remove the offending portion of the nail so it isn’t able to grow inward again.

If you’re struggling with a painful, returning ingrown toenail, you do need to change something for long-term relief. Contact Sierra Foot & Ankle for an appointment or more information about taking care of your toenails. You can reach our Carson City, NV office by calling (775) 783-8037 or filling out the online contact form.

There are multiple approaches to treating Achilles tendinitis, depending on the ultimate underlying cause of your pain and extent of tendon injury. Fortunately, the vast majority of cases will resolve with conservative care. Some common approaches include:

RICE therapy. That means rest (avoiding vigorous activity while you heal), followed with ice, compression, and elevation to combat swelling and pain. Physical therapy. Stretching and strengthening exercises for calves and ankles relieve tightness and pain, as well as build resistance to re-injury.

Supportive Taping or Bracing. Support is very important even with normal daily walking activities to allow rest and prevent further injury while the tendon is inflamed.

Custom orthotics. Quite often structural biomechanics is an issue. Interestingly both flat feet and well-arched feet develop tendinitis issues because of alignment deviations to the heel bone.  A custom orthotic will align the heel bone thus supporting and relieving strain on the Achilles tendon. Our office is unique with an onsite lab enabling precise fitting and individual customization of orthotics on site.

Don’t let Achilles tendinitis keep you from enjoying your activities—or just getting though your day without pain. Achilles tendinitis if left untreated, not improving or getting worse, can weakening the achilles Tendon and lead to tears or rupture. If the back of your heel or lower Achilles tendon is hurting and hasn’t improved after a few days, make an appointment with Dr. Victoria Melhuish at Sierra Foot & Ankle in Carson City, NV. Reach us at (775) 783-8037.

​​Plantar warts are often difficult to detect because they grow inward. You won’t see a large growth sticking out of the skin because the hard points that cause pain are inside the foot. What you will see on the surface often starts as a small, circular spot that crosses through the natural grooves in the bottom of your foot. 

You may think you have a callus developing at first, but with time, internal growth can lead to mild or moderate pain when you put weight down on the foot. This discomfort and pain is what leads many people to seek help for plantar warts. 

When you look closely at plantar warts, you will notice they are different from a callus. Some things you might notice include the following: 

• Rough or grainy surface skin
• Thick, callused skin
• Small black dots
• Pain when the spot is pressed

Those small black dots may look like tiny seeds. They’re small blood vessels that clot and develop as part of the wart. The surface of the wart typically remains flat, but you can often see the small black dots and grainy, rough nature of the skin. 

The development of pain and discomfort is often the final determination that you’re dealing with plantar warts rather than a harmless callus. 

Most warts are skin growths caused by a strain of the human papillomavirus (HPV) that settles into the weight-bearing pads of your feet, which causes a wart. 

People generally don’t want to live with the discomfort, pain, and limited mobility for any length of time. And warts can spread if not treated properly, so it’s best to come and see our doctor if you believe you have a plantar wart, regardless of pain level. 

You can try many home remedy treatment options to remove the wart, but if the wart becomes painful or doesn’t go away using home remedies, please give our office a call. 

You should see our doctor about warts if you have diabetes, poor circulation or lack of feeling in your feet, signs of infection, or a weakened immune system.

Call our office at (775) 783-8037 for an appointment or contact us online.

A bunion is an enlargement of the joint at the base of your big toe that causes pain and difficulty walking. With less severe bunions, there are non-surgical treatments available.

However, if your bunion is more severe, you may need surgery to correct the alignment problem that is causing the bunion. At Sierra Foot & Ankle, we utilize the lapiplasty surgery technique for correcting bunions and allow for a much better experience overall with a faster recovery time than traditional bunion surgery techniques.

Do All Bunions Need Surgery? Nonsurgical Treatments for Non-Severe Bunions

Not all bunions need surgery. Only a few people with bunions undergo bunion surgery. If your bunion is very mild and has not yet caused you significant pain, there are nonsurgical treatments you can try.

The treatment can be as simple as a corrective orthotic.

Individuals who are the best candidates for surgery tend to have larger and/or more painful bunions where the pain is not relieved with a corrective orthotic. Find out what your options are today! Make an appointment with Dr. Melhuish and have all your questions about your bunions answered.

Lapiplasty Surgical Method for Bunions

Lapiplasty 3D bunion correction is an advanced surgical technique that treats the deformity at the root cause. With this procedure, the bone is not only placed back into its corrective alignment but most importantly the unstable joint is corrected so the bunion deformity will not return.

An added advantage is this procedure allows for much earlier walking in a protective walking boot (days after surgery).

The Bottom Line

While bunions are a complicated deformity, there is no reason to suffer.

Schedule an appointment with Dr. Melhuish at Sierra Foot & Ankle to talk about the options that are best for you.

You may have seen them before – small, callous-like growths on the bottom of your feet. They are known as plantar warts and are caused by the human papillomavirus (HPV).

HPV can enter the skin through tiny cuts, abrasions, and other weak points on the bottom of your feet. 

Plantar warts are contagious and commonly spread from direct contact with a wart or contact with HPV in public spaces like gyms, swimming pools, or other family members.

Those individuals most prone to plantar warts:

• People with weakened immune systems or diabetes.
• People who have cuts or scrapes on their feet.
• Children and teenagers – immunity builds with age.
• People who walk barefoot in public places.
• People who have close contact with someone with plantar warts.

Plantar warts are the MOST difficult warts to treat. Because they are thicker and deeper which makes them significantly more resistant to over-the-counter medications. Plantar warts RARELY go away on  their own. While your warts may or may not cause pain, they can spread on your own feet or to other members of your family. Not treating a wart will allow it to become stronger, bigger, and more difficult to treat.

Because plantar warts are so difficult to treat, Sierra Foot & Ankle offers the latest advanced treatment options designed to get rid of the wart and prevent it from returning. 

There is no reason to suffer or to allow your warts to spread. Contact us by calling (775) 783-8037 to make an appointment today to discuss your best treatment options and start treatment.

Plantar warts, caused by the human papillomavirus (HPV), are a common foot condition that can cause discomfort and inconvenience. While many plantar warts may resolve on their own over time, it is important to know when it is time to seek professional help from our podiatrist, Dr. Melhuish. 

Plantar warts typically appear on the soles of the feet and can range in size from small lesions to larger clusters. They often have a rough, grainy appearance with a center that may contain small black dots, which are tiny blood vessels. While some plantar warts may not cause too much discomfort, others can be very painful, especially when walking or standing. Here are some key indicators that it is time to seek professional care from Dr. Melhuish:

• Persistent Symptoms: If you have tried over-the-counter treatments for plantar warts without success and warts continue to cause pain or discomfort, consult our office. Persistent symptoms may indicate a need for more targeted and effective treatment options.
• Increasing Size or Spreading: If your plantar warts are growing or multiplying and spreading to other areas of the foot, it is important to seek professional help. Dr. Melhuish can assess the severity of the condition, determine the best course of treatment, and help prevent further spread.
• Difficulty Walking or Standing: Plantar warts located on weight-bearing areas of the foot can make walking or standing painful. If your plantar warts are interfering with your daily activities or affecting your mobility, schedule an appointment.
• Recurrent Warts: If you have a history of recurrent plantar warts or have had previous plantar warts that have been successfully treated, but new ones continue to develop, it is time to schedule an appointment. Recurrent warts may require a more comprehensive treatment approach to address underlying factors that contribute to their persistence.
• Diabetes or Circulatory Issues: Individuals with diabetes or circulatory problems should seek prompt podiatric care for any foot condition, including plantar warts. These conditions can increase the risk of complications and delay healing, making early intervention crucial.
• Uncertain Diagnosis: If you are unsure whether the lesion on your foot is a plantar wart or another condition, it is advisable to consult our team for an accurate diagnosis. Proper identification is essential to determine the most appropriate treatment plan.

Remember, early intervention helps prevent the spread of plantar warts and minimize the discomfort they cause. By seeking professional care from our podiatrist, you can receive prompt and effective treatment to address your plantar warts and get back to enjoying the activities and lifestyle that you love.

If you are experiencing plantar warts or have any concerns about your foot health, do not hesitate to contact Sierra Foot & Ankle at (775) 783-8037 or via our online contact form. Our dedicated team is here to provide the highest quality care and guide you through the best treatment options for your specific needs. We are here to help keep you doing the things you love to do!