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July 18, 2018
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Rheumatoid Arthritis (RA) is a disease in which certain cells of the immune system malfunction and attack healthy joints. RA causes inflammation in the synovium (lining) of joints, most often in the joints of the hands and feet. The signs of inflammation can include pain, swelling, redness, and a feeling of warmth around affected joints. In some patients, chronic inflammation results in damage to the cartilage and bones in the joint. Serious damage can lead to permanent joint destruction, deformity, and disability.

When joints become inflamed due to RA, the synovium thickens and produces an excess of joint fluid. This overabundance of fluid, along with inflammatory chemicals released by the immune system, cause swelling and damage to the joint’s cartilage and bones. Foot problems caused by RA most commonly occur in the forefoot, although it can also affect other areas of the foot and ankle. Deformities and conditions associated with RA may include: rheumatoid nodules, dislocated toes, hammertoes, bunions, heel pain, Achilles tendonitis, flatfoot, and ankle pain.

RA is usually diagnosed prior to visiting a foot and ankle surgeon; however, a podiatrist may be the first to diagnose RA. It is diagnosed on the basis of a clinical examination as well as blood tests. While the treatment of RA focuses on the medication prescribed by a patient’s rheumatologist, there are various options for treatment plans aimed at relieving the pain of RA-related foot problems. The plan may include one or more of the following options: orthotic devices to give proper support, accommodative shoeing to relieve pressure points, steroid injections to reduce inflammation, and surgery as a last resort to correct any deformities associated with RA.

Click here or call Nashville Podiatry at 615-452-8899 to schedule your appointment today!

July 11, 2018
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Do you have pain in your heel? Is it worse when you first get up in the morning? Or after you have been sitting down for a while and stand back up? Does it seem to subside but then return after spending a long time on your feet?  You may have plantar fasciitis!

Plantar fasciitis is inflammation of the plantar fascia – the ligament that stretches from your heel to your toes.  The ligament can become inflamed at your heel if you have problems with your arches (either overly flat or high-arched), work long hours on hard surfaces, or wear non-supportive footwear. 

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If you are unable to come in to see Dr. Mendoza for a few days, try to avoid going barefoot – no shoes puts more strain on the plantar fascia.  Resting, icing the heel, and stretching the calf and Achilles tendon can also help ease the pain.  Wearing supportive shoes is important; Dr. Mendoza recommends running shoes for everyone (even if you’re only walking in them!).  Other treatment options include:

  • Anti-inflammatory medications

  • Strapping the foot

  • Custom orthotics to support the arch

  • Steroid injections to break the pain cycle

  • Night splints to keep the keep the plantar fascia extended while sleeping

  • Surgical release of the ligament

Call our office at 615-452-8899 to schedule an appointment to treat your heel pain!

June 27, 2018
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If you’ve ever had gout before you know that it can be extremely painful – even arising overnight.  Gout is a disorder caused by the build-up of uric acid, most often in the joint of the big toe. Because uric acid is sensitive to temperature changes it is more likely to crystallize in the joint of the big toe because it is the coolest part of the body. Uric acid is present in the blood and is eliminated in the urine.  It is the result of the breakdown of purines – foods with high levels of purines include red meat, red wine, and beer. Watching your diet to avoid these foods can help control your gout attacks.

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In addition to being inherited, there are other factors that put a person at risk for developing gout: high blood pressure, diabetes, obesity, water pills, and simply being a man aged 40 to 60. It is important for Dr. Mendoza to look at your x-rays and personal and family history to determine if the inflammation is caused by something other than gout. Depending on the severity of your gout attack, he may write you a prescription medication or give you an injection to help relieve the pain.

Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza today!

June 13, 2018
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Just like the big toe can develop a painful bump on the side of the toe, the little toe can too!

A tailor’s bunion, or bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. They are not as common as bunions, but both are similar in symptoms and causes; they can be red, swollen, and painful at the site of enlargement, and can become painful when wearing shoes that rub against it. They are caused by an inherited flexible mechanical structure of the foot. The bony deformity received its name years ago when tailor sat cross-legged all day with the outside edge of their feet rubbing on the ground.


Similar to bunions, tailor’s bunions are progressive - they won’t just go away. Sometimes oral anti-inflammatories, icing, and/or a steroid injection may help.  Wearing wider shoes may help to reduce rubbing and irritation. In some cases, surgery is needed if other non-surgical options are not relieving the ache. 

Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza today!

June 06, 2018
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Melanoma is a cancer that begins in the cells of the skin that produce pigmentation. It spreads to other areas of the body as it grows beneath the surface of the skin. Melanoma that occurs in the foot or ankle often goes unnoticed during its earliest stage, when it would be more easily treated.

Most cases of melanoma are caused by too much exposure to ultraviolet rays from the sun or tanning beds. Anyone can get melanoma, but some factors put a person at greater risk for developing this type of cancer, including:

  • Fair skin, skin that freckles, blond or red hair

  • Blistering sunburns

  • Numerous moles, especially if they appeared at a young age

Melanoma can occur anywhere on the skin, even in areas of the body not exposed to the sun. Melanoma usually looks like a spot on the skin that is predominantly brown, black, or blue – although in some cases it can be red or even white. However, not all areas of discoloration on the skin are melanoma. There are four signs (known as the ABCD’s of melanoma) to look for when self inspecting moles and other spots on the body:


Asymmetry: Melanoma is usually asymmetric, which means one half is different in shape from the other half.

Border: Border irregularity often indicates melanoma. The edge is typically ragged, notched, or blurred.

Color: Melanoma is typically a mix of colors or hues, rather than a single, solid color.

Diameter: Melanoma grows in diameter, whereas moles remain small. A spot that is larger than 5 millimeters (the size of a pencil eraser) is cause for concern.

To diagnose melanoma Dr. Mendoza will ask the patient a few questions, such as: Is the spot new or old? Have you noticed any changes in size or color? If so, how rapidly has this change occurred? He will also examine the spot to determine whether a biopsy is necessary. If a biopsy is performed and it reveals melanoma, Dr. Mendoza will develop a treatment plan with you.

Everyone should practice strategies that can help prevent melanoma – or at least aid in early detection, so that early treatment can be undertaken. Be sure to apply sunscreen on the soles as well as the tops of feet. Inspect all areas of feet daily – including the soles, underneath toenails, and between the toes. If you wear nail polish, remove it occasionally so that you can inspect the skin underneath the toenails.

Remember, early detection is crucial with malignant melanoma. If you see any of the ABCD signs – or if you have discoloration beneath a toenail that is unrelated to trauma – be sure to call our office at 615-452-8899 or click here to schedule your appointment with Dr. Mendoza!