Common Foot Problems
Are your feet killing you? Well then, you may be all too familiar with ailments such as athlete’s foot, calluses and corns, hammer toes, ingrown toenails and bunions. Sometimes home remedies can soothe sore feet, but if problems persist, don’t continue to “doctor” yourself. Often self-treatment may turn a minor problem into a major one. Here are some of the common conditions that we treat.
Athlete’s Foot is a fungal infection that usually starts between the toes or on the bottom of the feet. The fungus can, however, spread to other parts of the body. Signs of athlete’s foot include itchy, scaly skin, and thick, white nails. Ward off infection by washing your feet daily with soap and warm water; drying carefully, especially between the toes; and changing shoes and socks regularly to decrease moisture. A podiatrist will discuss treatment and may prescribe medications.
Blisters are caused by skin friction. Don’t break them because you may create an opening for bacteria. Instead, apply a moleskin pad for protection, keep your feet as dry as possible and wear thick socks for extra padding. When the blister pops, leave the broken skin in place, but keep the area clean and apply an antibiotic cream. Cover it with a sterile bandage. A podiatrist may drain the blisters in a sterile manner therefore reducing infection.
Bunions are misaligned big toe joints that can become swollen and tender. The deformity causes the big toe to slant inward and a bump deformity on the outside. Bunions tend to run in families, but the tendency can be aggravated by ill-fitting shoes that are too narrow in the forefoot and toe area. Wearing wide shoes and protective pads can ease the pressure, but surgery is often required to correct the problem.
Corns and Calluses
Corns and calluses are caused by underlying bone problems that cause excessive irritation. Where shoes repeatedly rub, dead skin cells pile up, creating calluses on the bottom of the foot and corns on the toes. You should never attempt to cut or dissolve corns or calluses at home because it can lead to infection. Your podiatrist can trim or protect them if they become painful, but they usually grow back unless the underlying problem is corrected surgically.
Foot Odor results from excessive perspiration from the more than 250,000 sweat glands in the foot. Daily hygiene is essential to keep feet clean. Air out shoes daily to evaporate moisture, and change your socks a couple of times a day. Foot powders, antiperspirants, and soaking in vinegar and water can help lessen odor too.
Hammertoes buckle into a claw-like position and corns form at the bent joint when these toes rub against the tops of shoes. Claw toes are the result of an inherited muscle imbalance, too-small shoes or a bunion-bearing big toe that slants inward. Usually, the second toe bends into this unnatural shape, but any of the other three smaller toes can be affected as well. Square, open-toed, or prescription shoes may increase comfort. Surgical correction may be required.
Ingrown nails result when the corners or sides of nails dig painfully into the skin. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Use toenail clippers to trim nails with a slightly rounded edge. Leave nails slightly longer than the end of the toe and don’t cut into the corners. Often these become infected and become quite painful. A quick office procedure can alleviate this problem quickly. Recurrent ingrown nails can be treated permanently.
Neuroma is a condition that occurs when two metatarsal bones — most frequently the third and fourth ones — rub together and irritate a nerve. The resulting enlargement of the nerve can produce pain, burning, tingling, or numbness between the toes and in the ball of the foot. Conservative treatment includes orthotic devices (shoe inserts that help realign the foot and distribute body weight evenly) and cortisone or sclerosing alcohol injections, but surgical removal of the growth is sometimes necessary.
Warts are caused by a virus that enters the skin through small cuts. Children, especially teenagers, tend to be more susceptible to warts than adults. Most warts are harmless and benign, though they are unsightly and may be painful. Warts often come from walking barefoot on dirty surface. A podiatrist can dissolve warts painlessly with topical acid treatments or remove them surgically.
Heel Pain/Heel Spurs
Heel pain/Heel Spurs is usually caused by a walking stride that exerts excessive stress on the heel bone. Discomfort can also result from poorly made shoes, obesity, a stress fracture of the heel bone, bruises of the fat pad under the heel, or a disease such as rheumatism or gout. Heel spurs refer to heel pain due to bone irritation. A ligament or muscle may be pulled from the heel. To ease heel pain try wearing well-fitted shoes with soft, shock-absorbent soles. Orthotic devices may absorb some of the impact on the heels. A doctor may also prescribe nonsteroidal antiinflammatory drugs, exercises, cortisone injections, and/or suggest applying heat and/or cold to the heel. Newer techniques include crythotherapy and shockwave therapy. Surgery may be necessary as a last resort if heel pain is severe. However, today heel pain can usually be treated endoscopically.
Diabetes and Neuropathy
Diabetes and Neuropathy is a painful condition related to damaged peripheral nerves. Peripheral nerves are the nerves that branch out from the spinal cord and connect the brain to all parts of the body. Peripheral nerves are fragile and can be easily damaged by many factors such as systemic illness, infections, alcoholism, autoimmune diseases, exposure to toxins and injuries or fractures. Neuropathy affects more than 2 million Americans at any given time. Diabetes is one of the most common causes of neuropathy. Over time, diabetic neuropathy may occur in up to 50% of diabetics, despite controlling blood sugar. Once it occurs, it almost always gets worse.
No matter what caused the neuropathy, the symptoms are the same. Neuropathy initially manifests itself as a tingling in the toes which gradually spreads up the feet or hands and worsens into a burning pain. The sensations, whether tingling or pain, can be either constant or periodic. A person with neuropathy can also experience muscle weakness or numbness.
Diabetic neuropathy usually affects the feet first and then the hands. It starts with sensory changes such as numbness or tingling in the toes. At first these symptoms come and go, but then they become constant. Over a long period of time, the person may experience such a loss of sensation that he might not feel how tight his shoes are, know whether the bath water is hot or cold, or whether or not he has injured himself.
Changes in muscle strength also occur, possibly causing the diabetic to fall or the arches of his feet to collapse. Diabetic neuropathy is the leading cause of ulcerations and infections in the feet, and in advanced cases, amputation.
New testing and treatment has revolutionized care for diabetic neuropathy. The main methods of treatment, until now, have been rigorous control of blood sugar levels, meticulous care of the feet and the use of nerve medication. Nerve conduction velocity tests are helpful in the diagnosis. Diabetics may be eligible for diabetic foot care and shoes.
Flatfoot and In Toe
To help with flatfeet, special shoes or custom-made shoe inserts may be prescribed. To correct mild intoeing, your toddler may need to sit in a different position while playing or watching TV. If you child’s feet turn in or out frequently, corrective shoes, splints, or night braces may be prescribed.
The foot’s bone structure is well-formed by the time your child reaches age 7 or 8, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With a doctor’s care, however, the risk of future bone problems is reduced.
Remember to check your child’s shoe size often. Make sure there is space between the toes and the end of the shoe, Make sure their shoes are roomy enough to allow the toes to move freely. Don’t let your child wear hand-me-downs.
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. Most feet are flexible and an arch appears when the person stands on his or her toes. The arch develops in childhood, and by adulthood most people have developed normal arches.
Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated.
Painful progressive flatfoot, otherwise known as Tibialis Posterior Tendonitis, is caused by inflammation of the tendon of the tibialis posterior. The tendon then becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are predisposed to this condition if they have flatfeet or an abnormal attachment of the tendon to the bones in the midfoot.
Nonsteroidal anti-inflammatory medications, ice, physical therapy, supportive taping and bracing, or orthotic devices are the common ways of treating painful progressive flatfoot. Contact your physician before taking any medication. In some cases, a surgical operation may need to be performed to repair the torn or damaged tendon and restore normal function. To prevent reinjury, orthotic devices may be recommended. In severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.