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Neuropathy
Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.
The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.
Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.
Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.
If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.
Flatfoot
Flatfoot is a foot disorder that is not as straightforward as many people believe. Various types of flatfoot exist, each with their own varying deformities and symptoms. The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot. Other signs of flatfoot include:
- “Toe drift,” or the pointing outward of the toes and the front part of the foot
- The tilting outward of the heel and the tilting inward of the ankle
- The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
- Hammertoes
- Bunions
One of the most common types of flatfoot is flexible flatfoot. This variation usually starts in childhood and progresses as one ages into adulthood. Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing. When not standing, the arch returns. Symptoms of flexible flatfoot include:
- Pain located in the heel, arch, ankle, or along the outside of the foot
- Overpronation, or an ankle that rolls in
- Shin splint, or pain along the shin bone
- General foot aches or fatigue
- Pain located in the lower back, hip, or knee
Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit. X-rays may be taken to define the severity and help determine the treatment option best for your condition. Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices. If nonsurgical methods prove ineffective, surgery may be considered. Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.
Toe Pain
Toe pain can originate from corns, calluses, hammertoes, and bunions, as well as ingrown toenails, sprains, fractures, and dislocations. Corns develop as the toe rubs against the inside of a shoe which causes the skin to thicken as a form of protection. A corn is typically cone-shaped and has a small, hardened spot that points inward. When a corn is pressed into the skin, the toe becomes painful. Corns usually form on the top or side of the toe. A callus is also a thickened patch of skin that generally forms on the bottom of the foot. Calluses are the result of friction from the toe rubbing against the inside of a shoe. They may also occur by walking barefoot or having flat feet. A hammertoe is a bump on the knuckle of the second toe that is produced by wearing shoes that are too short for your feet. The bony protrusion rubs against the top of the shoe causing pain and irritation. A bunion is a malformation of the big toe. The base of the big toe pushes away from the smaller toes, forcing the top of the big toe to press toward the other toes. Bunions can be hereditary, or they can result from injury to the toe joint or from wearing high heels with a narrow toe box. The toe becomes inflamed, and a bump may develop at the end of the misplaced bone. Ingrown toenails typically affect the big toe and its surrounding skin. The nail will dig into the skin and become painful. Wearing tight or narrow shoes that compress the big toe causes the nail to grow into the fleshy part of the toe. Cutting toenails incorrectly can also add to the development of an ingrown toenail. A toe sprain originates from a torn or stretched ligament. Strapping the injured toe to the toe next to it for stabilization is common. A broken or fractured toe usually occurs from trauma like dropping a heavy object on it or bumping into something extremely hard and rigid. Osteoporosis, a thinning of the bones, can also bring about toe fractures.
Any of the conditions mentioned can lead to pain and irritation. While some are more serious than others, seeking an examination and diagnosis from a podiatrist is a good idea. A podiatrist can treat each ailment and get you back on your feet again without pain.
Working on Your Feet
Foot care is important regardless of your profession, but those who work on their feet must pay special attention. Bunions, calluses, blisters, and plantar warts are just a few of the many conditions that can arise after standing all day. While painful at their worst, these conditions can easily be avoided with the right foot care. This includes both appropriate footwear and proper posture—important elements that affect the health of your feet.
Choosing appropriate footwear means choosing a shoe that has a negative heel. This means that the heel is slightly lower than the ball of your foot, which places less of a strain. If you have a profession that requires you to be on your feet all day, investing in a pair of high-quality shoes is pertinent. High-quality shoes can be purchased from a respected manufacturer that emphasizes foot care and foot health.
Despite the regularity of wearing shoes, the feet are naturally not designed to be enclosed. Regular “barefoot” time for your feet can be beneficial for foot health. Among other methods, allowing your feet to breathe can help alleviate the pain and pressure your feet may be experiencing from being on your feet all day.
Simple foot exercises and yoga positions can help improve both the health and function of your feet. Active foot exercises that create movement will stimulate your foot’s blood flow and circulation, and yoga positions that place your feet flat onto the floor will stretch out their muscles. Yoga is particularly beneficial for your Achilles tendon and calf muscles, which are areas that can become especially problematic if not taken care of. Foot exercises and yoga positions can be easily performed every day at virtually any location and any time; whether it is at the office, at the gym, or at home right before you go to bed. Simple stretching can increase your foot health by miles.
The foot pain you experience after lengthy hours working on your feet may seem inevitable and unavoidable; in reality, however, that is not the case. Wearing proper footwear and performing simple foot exercises and stretches can help ease foot pain and allow you to truly avoid frustrating foot problems.
Your feet can easily be kept healthy with some education and a little effort. Pain that begins at the feet can eventually affect the whole body. Begin taking care of your feet now!
Various Causes of Ankle Pain
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
Foot Care for Pregnant Women
The natural weight that pregnant women gain causes their center of gravity to be completely altered. This causes them to have a new weight-bearing stance which adds pressure to the knees and feet. As a result, pregnant women often experience severe foot pain. The two most common foot issues experienced by women in their pregnancies are edema and over-pronation. It is important for all pregnant women to learn more about how to take care of their feet so they are more comfortable during their pregnancy.
Over-pronation, which is commonly referred to as flat feet, is caused when a person’s arch flattens out upon weight bearing. This causes the person’s feet to roll inward while walking. Pregnant women often experience this due to the sudden weight they gain.
Edema, also referred as swelling in the feet, typically occurs in the later part of the pregnancy. It is the result of the extra blood accumulated in the pregnant woman’s body. The enlarged uterus puts more pressure on the blood vessels in the pelvis which causes leg circulation to slow down. This causes blood to pool in the lower extremities.
Fortunately, there are ways to treat both edema and over-pronation. Edema can be treated by elevating the foot as often as possible. Wearing proper fitting footwear will also be helpful for those with edema. A treatment method for over-pronation could be orthotics. Orthotic inserts should be designed with appropriate arch support and medial rear foot for your foot.
It is best for pregnant women to buy new shoes during the day, because this is the time where swelling is at its peak. Pregnant women also shouldn’t rush when buying shoes. It is always advised that you make sure your shoes fit properly but this is especially important during pregnancy.
If you are a pregnant woman, you should consult with a podiatrist in order to make sure your feet are healthy throughout the entirety of your pregnancy.
Wound Care
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
Corns: What Are They, and How Do You Get Rid of Them
Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.
Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.
Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should instead consult their doctor immediately.
According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn white after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can lead to infection. If your corn gets infected, and is not treated immediately, a visit to the doctor will be necessary.
Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes. This fixes the way you walk. This will lower your chances of getting corns, and eliminate current corns by reducing rubbing from friction.
Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.
To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.
Ankle Foot Orthotics for Athletes
Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.
Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.
The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.
Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.
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.
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Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
Diabetic Foot Conditions
According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans. Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases. Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.
Complications of the disease may lead to several foot and ankle-related conditions. The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat. Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.
To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure. Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation. The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.
Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding. These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form. Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet. The resulting deformity is a foot that is flattened and wider in appearance.
To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes. Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces. In more serious cases, surgery may be considered to treat more developed deformities. Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.
Athlete’s Foot
Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection. The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives. Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth.
Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering. Sometimes, blisters can evolve into the cracks or breaks in the skin. The exposed tissue can then create pain, swelling, and discharge. The spread of infection can cause itching and burning as well.
While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet. Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched. Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.
Proper foot hygiene is essential in preventing athlete’s foot. You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected. Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.
While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks. Any treatment used can be supplemented by frequently bathing the feet and drying the toes. If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist. He will determine if the underlying cause of your condition is truly a fungus. If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.
Foot Pain
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
