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How to Avoid Common Foot Problems

The feet take tremendous abuse throughout our entire life. As a result, foot pain is not just reserved to people in mobile occupations. Most of us do not bother with sore feet until something goes wrong. Yet, foot pain afflicts four out of five individuals, especially after the age of 50. The common reasons for foot pain include years-long inadequate foot care, foot bone deformities as well as chronic diseases, which often affect the blood circulation, bones, muscles and skin, the crucial components that should work well for a foot to remain healthy.

Problems of the Toenails and Skin

The good news is that many problems related to the toenails and the skin on the feet are only temporary. A common condition is contact dermatitis, a rash that develops from rubbing the skin against something irritating. But some other skin problems, such as eczema and psoriasis, are chronic, returning for years or even for a lifetime.

A typical reason for toenail problems is wearing shoes and socks that are too tight, pressing the nail back into the foot. Other common causes are poor toenail cutting and heavy sweating. The toes are sometimes malformed from birth, causing trouble later. Moreover, being overweight puts excess strain on the toes. The poor circulation and weakened resistance to infection, such as caused by diabetes, can lead to inflammation around the nail bed and a number of other problems.

Contact Dermatitis

Constant irritation and itching are typical signs of contact dermatitis, which gets worse when scratched. Taking oral antihistamines often relieves the itching while applying a corticosteroid ointment or cream heals the skin. In the meantime, it is necessary to identify and eliminate the culprit, such as certain pair of shoes or socks or the detergent used to wash socks or bed sheets.

Ingrown Toenail

An ingrown toenail is most often found in young people under 30 years of age and it happens to be the most common and most painful of all health problems affecting the toenail. Extremely overweight people are also at an increased risk of developing ingrown toenails as their fleshy folds that cover the nail plates can encourage the nails to grow into them. With an ingrown toenail, the right or left edge of the nail cuts through the skin sideways into the soft flesh next to it. Once it becomes painful, it is usually inflamed or infected. An untreated infection in an ingrown toenail can become gangrenous and infection can spread through the bloodstream and, if ignored long enough, can be even fatal. Although the treatment for ingrown toenail is relatively simple, it should be done by a podiatric surgeon who will remove the portion of the toenail that is growing into the skin. Antibiotics may need to be prescribed in order to prevent an infection.

Thick, Distorted Nails

The toenails can become thick and hard to cut as a result of long-term trauma, especially from wearing high heels or tight shoes. Because the nails keep growing, failing to cut them properly leads to yet more trouble. You should see a podiatrist regularly to have the nails cut and excess tissue from the nail removed.

Fungal Infections

The most widespread type of foot fungus is tinea pedis, commonly known as athlete’s foot, because it is easily transmitted on the floors of public bathrooms and changing rooms in gyms, pools, spas and hot tubs, where people go barefoot. It is particularly contagious in hot and humid environment and with sweaty feet. Certain fungal infections of the foot can begin as a rash or blister on the sole and instep. A fungus causes toenails to become dry, crusty and lifted up from the nail bed. In most cases little or no pain is involved, though the area may become itchy. The color of affected nails is a combination of yellow, brown and grey. The fungus can spread from the nails into the spaces between the toes or to other parts of the body such as palms or groin. It is common that, if left untreated, an ignored infection jumps to fingernails that have scratched or cleaned the affected toes or to other people who come into contact with it.

The most basic treatment consists in soaking the feet in warm water with Epsom salts and applying a topical antifungal product such as clotrimazole (Canesten, Lotrimin, Mycelex) or miconazole (Monistat, Desenex and Zeasorb), containing the same drug that is also used for treating vaginal yeast infections. Soaking the affected feet in a 50/50 solution of brown vinegar and warm water should also help. Treatment by a doctor involves removal of the powdery material and prescribing antifungal medications such as ketoconazole (Nizoral), which are applied over and under the infected nails. Oral antifungal drugs, such as itraconazole (Sporanox), may also be prescribed. However, nail fungus often comes back even after the treatment was successful.

Corns and Calluses

Corns and calluses are areas of hard and thickened skin on the foot, especially on the sole and the top of the toes, that develop to protect the skin from excessive pressure and friction. They can be painful. Follow this link for information on treating and removing corns and calluses.

Warts

Warts can be confused with other skin growths, especially calluses. A small sample of the wart may need to be examined under a microscope to confirm the diagnosis. The most common treatment at home is to use non-prescription products containing salicylic acid that gradually peel away layers of the wart or to use cryotherapy products (freezing the wart with liquid nitrogen). These simple over-the-counter treatments are suitable only for small warts and should not be used on plantar warts. For larger warts it is recommended to seek professional help. The doctor may shave the surface of the growth and apply an acid-based solution with bichloracetic or trichloroacetic acid to kill off what remains of the wart. Several sessions may be needed, depending on the size of the wart and its age. Electric needles and lasers are used to remove larger warts. Moreover, since warts are caused by an infection with viruses, they can be treated with immunotherapy that will stimulate your immune system to prevent infection.

Plantar warts (verrucas) are stubborn, annoying skin warts on the sole of the foot. Plantar simply means pertaining to the sole of the foot. They hurt because of the pressure they are subjected to when you walk. For that reason they take some time to cure. Plantar warts first look like a round callus but feel more intense. If untreated, they tend to keep growing. You should not try to treat them with over-the-counter medications. Plantar warts should be treated in the doctor’s office using the same techniques as for most other warts. Vaccine with human papillomavirus, the cause of plantar warts, is also available. Because plantar warts are caused by a virus, they can be easily transmitted to others. Therefore, avoid walking barefoot in public places.

Foot Ulcers

Ulcers are open sores on the foot, causing the tissue around and beneath them to become infected. They are mostly a result of reduced blood supply to the cells in certain area caused by constant pressure, poor circulation, abnormality in the bones or diabetes. Unless treated, foot ulcers can progress to gangrene and require amputation of a toe. Therefore, prompt treatment is crucial.

To treat a foot ulcer, the doctor removes the dead tissue and applies special dressings and medications. Antibiotics are prescribed to fight and/or prevent infection. Exposure to extreme cold or hot must be avoided. The foot should be allowed to rest as much as possible while the ulcer heals. Roomy, well-cushioned orthopedic footwear may be prescribed by your doctor to help prevent recurrence. Foot ulcers that do not respond to medical therapy may need to be removed surgically.

Rough Heels

Scaly areas on the heels are mostly due to dry skin. Other potential causes include contact dermatitis, fungal infections as well as heredity. The heels may finally crack and start bleeding. In order to prevent and treat this condition it is necessary to protect the heels and keep their skin moist and acid. Vinegar foot soaks followed up with moisturizing cream will help to keep the skin soft and flexible. Wearing solid shoes and socks will protect the heels.

Inside the Foot

Various conditions, such as bunions, hammertoes, heel pain, metatarsalgia or nerve disorders, can occur when the complex interrelationship of ligaments, bones, veins and nerves within the foot is disturbed in any way.

Flat Feet

Flat feet are a major cause of numerous foot problems, including pain on the outside of the ankles, swollen ankles, poor shock absorption, pain in the knees and/or back, strained arch ligaments on the inside of the foot and shin splints. Bunions can form as a result of flat feet and cause problems with tendons, nerves and ankle ligaments. Soaking your feet regularly and applying ice to ease discomfort often offers good relief. Regular exercise should also help minimize the pain. A custom-made orthotic device as well as over-the-counter foot pads and arch supports can provide long-term relief. When these simple remedies do not help, the doctor may prescribe a steroid cream.

Bunions

A bunion is an inflamed joint, most often at the base of the big toe. The leading cause is a deformity that pushes the joint out to the side. Bunions often run in families since foot shape is inherited and the problem gets further exacerbated by long-term use of tight shoes. Irritation, swelling and pain are the most common symptoms. The worst thing to do is to wear narrow shoes, especially with high heels. Other risk factors include rheumatoid arthritis, flat feet, gout and nerve damage in the feet.

Wearing low-heeled, comfortable shoes (e.g. orthopedic shoes) with ample room for your toes helps to prevent bunions from developing. You can also use small foam cushions or pads designed to be placed under the bunion. Over-the-counter nonsteroidal anti-inflammatory drugs can relieve swelling associated with bunions. If deformity is too big, surgery, that will correct the underlying problem, is often the best remedy.

Hammertoes

A hammertoe is a contracted toe that has curled into a hammer or claw-like shape. It is caused by weakened muscles in the foot and resulting shortening of the tendons. The toe that is typically affected is the second toe. Hammertoes can be a result of wearing high heels or tight shoes as well as tight stockings or leotards. Other risk factors include conditions such as diabetes, sciatica, herniated disc, multiple sclerosis and nerve damage. However, some hammertoes are also congenital.

Treatment for hammertoes consists in moving the toe into its proper position, fixing it with a strap. In the meantime, until it regains its original place, you can cushion it from pressure and wear extra-wide and extra-deep shoes. You can also try a toe cap that wraps around the affected toe to bring its tip up to a normal position. If these measures do not help, surgery may be the option for you. It will realign the bones or lengthen the shortened tendon.

Heel Pain

Heel pain may be a result of several disorders. It typically appears during middle age and, if left untreated, it can become debilitating.

Painful heel syndrome. As the layer of fat on the sole of the foot meant to provide protective padding grows thinner with age, pressure on the heels can become painful. Moreover, the nerve endings on the soles of the feet, which are close to the surface, get even closer. The painful heel syndrome can also be a result of frequent walking or running on hard surfaces, standing for long periods of time, diabetes, gout, rheumatoid arthritis, a previous foot injury and excess weight.

Plantar fasciitis is an inflammation of the long tendon that connects the heel bone to the bottoms of the toes. This condition can be caused by excess weight, trauma or a condition that rolls the foot too far inward with each step taken. Common symptoms of plantar fasciitis include severe pain when getting up in the morning or standing up after sitting for a while and forming of heel spurs.

Treatment of Heal Pain. A common home treatment to relieve soreness involves soaking the painful foot in warm water and Epsom salts once a day. Give yourself a foot massage and put your foot up whenever you can. Over-the-counter nonsteroidal anti-inflammatory drugs can be used to relieve the pain and swelling. Wearing supportive shoes and an orthotic insert, foam rubber insoles, orthopaedic heel lift or heel cup prevents future pain. Exercising the feet builds muscle tone. Injections of collagen every six months or so can help fatten the soles again in older adults. If none of these tricks bring relief, steroid injections or surgery may be needed.

Metatarsalgia

The metatarsals are the long bones of the foot. The heads of the metatarsals form the ball of the foot. Excessive pressure at this point can hurt the joints and cause inflammation and resulting pain. Thus the term metatarsalgia means pain in the ball of the foot. A leading cause of this condition is wearing high heels, which shift the full weight of the foot forward to be supported by the balls of the feet. Other possible causes are hammertoes and a short Achilles tendon. Exchanging high heels for flat shoes with thick soles and using cushioned pads placed just behind the ball of the foot should bring relief.

Nerve Disorders

Nerve disorders can be a result of wearing ill-fitting shoes as well as of a serious medical condition such as diabetes, rheumatoid disease or impaired circulation.

Neuroma is a swelling in a nerve that is either inflamed or surrounded by inflamed tissue. The most common areas for a neuroma to occur in the foot are between the toes and under a metatarsal bone.

Morton’s neuroma is an extremely painful condition. It is much more common in women than in men. Dancers and runners are the usual victims. Symptoms include numbness or tingling in the foot or toes, burning, inflammation and swelling and pain in the sole of the foot typically under the pad of the third or fourth toe but sometimes also between the second and third toes. Wearing high heels and tight shoes makes the condition particularly painful. Orthotics and foot pads may provide some relief.

Steroid injections are the most common medical treatment for Morton’s neuroma. If steroid injections do not bring relief, the swollen nerve may need to be removed surgically. This is done in order to release the ligaments that cause the pressure and pain between the toes.

Where to Find More Information:
Foot.com
The College of Podiatry