Foot Health Follow-up: Fail or Fit?

1. Plantar fasciitis. This foot condition causes pain on the heel of your foot, which can be intense. It’s one of the most common causes of heel pain. It’s worse when you get up in the morning but improves when you start walking or moving your feet. Inadequate footgear, a jumping injury from landing, and excessive walking or running are frequent causes of plantar fasciitis. Treatment for this condition includes comfortable footwear (a must!), rest, painkillers, and exercises for your feet. For severe cases, a steroid injection may be required to alleviate the pain. If you’re a bit on the heavier side, try to lose some weight to ease the burden on your feet and to prevent plantar fasciitis from developing.
   
   
2. Achilles tendinitis. You may be familiar with Achilles tendinitis if you’re a runner who has abruptly increased the duration or intensity of your runs. It’s an overuse injury (from intense or repetitive strain) of the Achilles tendon, a slim band of tissue that attaches your calf muscles to your heel bones. The pain is located at the back of your leg running down towards your heel and may increase as you continue your activities. The problem may be accompanied by stiffness and tenderness, especially when you wake up in the morning. Try to increase the duration and intensity levels of your training gradually to prevent this condition. Give your lower limbs enough time to recuperate. Stretch the back of your legs and make sure you have the proper shoes for the activity you’re engaged in. If over-the-counter pain medications aren’t enough to alleviate your pain, seek the help of your doctor.
   
   
3. Heel spurs. A heel spur is a bony protrusion or outgrowth on the plantar (underside) surface of your heel bone. They’re usually painless, but can become painful and cause heel pain. The outgrowth is made up of calcium deposits. These deposits are caused by repeated trauma to the covering of the heel bone. Athletes who are involved in jumping and running are particularly vulnerable to developing heel spurs. Heel spurs don’t happen overnight, they develop over time. Ice, pain relievers, and injections of cortisone are the first-line treatments available for heel spurs.
   
   
4. Bunion. Yes, it sounds like onion, and both can make you cry. But this time, you cry from pain brought about by a bunion. It’s a bony deformity at the base of your big toe. Your big toe points inwards and snuggles tightly with your 2nd toe (or even the 3rd toe). Ill-fitting shoes and arthritis usually cause it. If you have a positive family history for bunions, you may recall that a first-degree relative (your sibling or parent) has a similar foot problem. Insoles, bunion pads, and pain medication can offer some relief. Consult your primary healthcare provider if the pain causes you to limp, interfere with your walking, or even cry.
   
   

5. Arthritis. Symptoms of arthritis may include pain and swelling in a joint or joints, decreased range of motion secondary to stiffness, and joint deformity. There are several types of arthritis, but the most common ones that affect your foot are rheumatoid arthritis, osteoarthritis, and post-traumatic arthritis. Seek the help of your primary healthcare provider if you experience symptoms of arthritis.
   
   
6. Athlete’s foot (Tinea pedis). Just so we’re clear, you can still get athlete’s foot even if you’re not an athlete. It’s just a condition commonly seen among athletes. It’s a fungal infection on your feet that causes red, dry, itchy, scaly, flaky, and painful skin. Yes, they can all occur at the same time or one area after another. It starts on the spaces between your toes and can spread to other areas of your foot. Treatment includes the application of antifungal creams, powder or spray. There are also several natural antifungal products you can apply topically including tea tree oil, but make sure you patch test for sensitivity first and mix with a carrier oil if needed. Seek the help of your primary healthcare provider if symptoms don’t improve within a week. Don’t be surprised if the infection comes back after some time. You can prevent athlete’s foot by keeping your feet clean and dry. And, for the sake of your feet and the sensitive noses of the people around you, change socks often, especially if your feet sweat a lot.
   
   
7. Onychomycosis (Tinea unguium). This is one of the nastiest and most resilient foot conditions you can unluckily develop. Onychomycosis is a fungal nail infection that has spread from the skin surrounding your nails. Your nails become distorted, thickened, and change in colour (white, yellow, green, black). The usual treatment is to apply an antifungal nail solution or lacquer. Natural antifungals like tea tree oil may also be helpful. You have to be careful because it’s contagious and can be transmitted through direct contact or contact with materials contaminated with fungal spores like socks, shoes, or walking barefoot. Seek the help of your doctor if the condition isn’t responding to treatment. Pack a ton of patience because treatment of onychomycosis can last up to 12 weeks of taking an oral antifungal drug.
   
   
8. Chilblains are inflamed blood vessels in your skin that occur as a response to repeated exposure to cold air (not freezing air). They occur in small blood vessels and are painful. They’re also known as pernio and can lead to red patches, itching, swelling, and even blistering on your feet. They can also occur on your hands. You can relax because chilblains usually go away as the weather gets warmer. Unfortunately, you can have recurrences during the cold season for years. The best treatment is prevention by keeping yourself warm during the winter months. You can also use various creams to reduce the severity of the symptoms. Chilblains almost never cause permanent damage but can lead to skin infections. The damage may be severe if left untreated. The exact cause of chilblains is still a mystery for medical experts.
   
   

9. Calluses and corns. Corns are small circles of thickened skin on the sides and tops of toes or on the soles of your feet. Calluses are bigger areas of thickened, rough, yellowish skin that are often located on the balls of your feet. Both conditions are caused by too much friction or pressure as a result of poorly fitting footwear. Activities that largely contribute to the development of the corns and calluses include running long distances and walking on hard and rough surfaces without footwear. Treatment includes removal of pressure and the application of creams, pads, corn plasters or salicylic acid products. Patients with diabetes mellitus should NOT use products with salicylic acid for corns and calluses. Consult your doctor if your symptoms persist.
   
   
10. Blisters are fluid-filled pockets that develop within the upper layers of your skin. They’re small and result from wearing poorly fitting or new shoes. They heal naturally within a week. Resist the temptation to burst the blister. Consult a general practitioner if it becomes infected. Blisters, particularly in new shoes, may be prevented by wearing second skin type blister pads over the most likely affected areas.
    
    

11. Ingrown toenail. Your toenails can grow into the skin at the borders of the nail bed, causing inflammation, redness, and ultimately infection. The number one cause of an ingrown toenail is poorly trimmed nails. Other causes include moist skin, nail trauma, and poorly fitting shoes. We would advise against pedicurists cutting your toenails because they do not cut across the nail and they cut aggressively deep into the corners. To prevent the appearance of ingrown toenails, keep your feet clean and cut your nails straight across. If there is pus, bleeding, or swelling, seek the help of your primary healthcare provider. Surgery may be required to remove the toenail, the ingrown part, not the entire toenail.
    
    
12. Warts or verrucas are areas of rough, flat skin with a cluster of dark dots towards the centre. Their sizes range from 1 to 10mm in diameter and can occur in groups or pairs. HPV or human papillomavirus causes warts. The virus is found on contaminated surfaces and can be transmitted through direct contact to a susceptible host. They enter your feet through breaks and tiny cuts. People who have weakened immune systems are particularly vulnerable. Creams with salicylic acid can hasten the healing process. Don’t be surprised if warts disappear spontaneously after torturing your foot for several years. A qualified health professional should be consulted if they cause too much pain, or if you want them removed for cosmetic reasons.
    
    
13. Gout is a particular type of arthritis that can cause swelling, severe pain, and stiffness in one or more joints. The skin overlying the joint is usually shiny and red. Gout is caused by a build-up of uric acid in the blood. The most common joint affected is the large joint at the base of your big toe. Other joints commonly affected include ankles, elbows, knees, wrists and fingers. The pain is most severe during the first 4 to 12 hours after onset. According to self-reported data, 4.5 percent of Australians had gout in 2017-2018. Over 5 percent of New Zealanders were identified as having gout in 2018. The majority of people who have gout are males and over the age of 65. Treatment for an acute attack of gout includes non-steroidal anti-inflammatory drugs, corticosteroids, and colchicine.
    
    Proven risk factors for acute attacks of gout are listed below:
    
    
    • Excess alcohol. Don’t make excuses; all types of alcohol are considered a risk factor.
      
      
    • Intake of high-purine foods (meats like turkey, veal, bacon, and organ meats like liver; seafood like anchovies, herring, sardines, mussels, scallops, codfish, haddock, and trout).
      
      
    • Cold weather.
      
      
    Excess consumption of sugary drinks, especially soft drinks can also contribute to the onset of gout.
    
    

14. Diabetic foot ulcer. People with diabetes may complain about an ulcer on their foot. An ulcer is basically a patch of broken-down skin where the underlying tissue is visible. It is caused by fluctuating or high blood glucose levels. Poor circulation and faulty skin repair after a minor injury are also factors that worsen the ulcer. If the person has complications from diabetes (peripheral neuropathy), the injury (which later progresses to an ulcer) may go unnoticed. The management for a diabetic ulcer can be multidisciplinary and go beyond the level of expertise of a general practitioner. Approximately 15 percent of people with diabetes develop foot ulcers.
    
    
15. Injury to your toes, feet, and ankles most commonly happens during recreational or sports activities, projects around the home, and work-related tasks. An acute injury can occur from a penetrating injury, direct blow, fall, twisting, jamming, or bending any part of your foot. Pain is sudden followed by bruising and swelling.
    
    Below are examples of acute injuries:
    
    
    • Puncture wounds.
    • Strains like pulled muscles.
    • Ankle sprain. Intense physical activity can force your ankle joint into an abnormal position. A sprain happens between the tissues that hold two bones together (joint area). In contrast, a strain involves damage to tissue or muscle that attaches to a bone.
    • Fractures and dislocations.
      
      
    Note: If you experience any of the abovementioned injuries, seek the help of a medical professional urgently.
    
    Almost 50% of Australians have experienced foot or heel pain according to an inaugural survey of foot problems (called Healthy Feet Survey) in 2017. Six percent of them wake up to foot pain every day. Pain and other problems related to your feet and ankles are by no means minuscule or negligible. Most foot and ankle conditions develop as a result of wear and tear activities. In general, there are some helpful ways to prevent or delay the appearance of these conditions. There are also numerous ways for how you can take better care of your feet.
    
    Below are some of them:
    
    
    • Wash your feet, especially between your toes. If you usually forget, try cleaning them first before you wash your favourite body parts.
      
      
    • Smooth out rough areas of your feet gently with a foot file or pumice stone. This is best done at the end of your shower or bath as the thick and coarse areas of your feet will be nicely softened.
      
      
    • Moisturise. Use a rich foot cream to soften the rough areas on your heel. Applying socks afterwards can help to allow the cream to soak into your heels rather than being rubbed off on your carpet!
      
      
    • Reach down and cut your toenails. Don’t use your belly as an excuse that you can’t reach them. Well, if you’re really having a hard time reaching them, you can go to a pedicurist. Observe their technique closely, making sure that they cut across your nails. Sloppy trimming can result in ingrown toenails.
      
      
    • Stretching your feet can be beneficial if you have plantar fasciitis.
      
      
    • A note on pedicure. Most nail spas and salons follow disinfection and cleanliness guidelines but don’t hesitate to ask for their credentials and how they clean their tools or if you go regularly, bring your own tools for them to use.
      
      
    • Who doesn’t want a foot massage? A foot massage optimises blood circulation, improves your mood, and of course, relaxes you enough to send you off to sleep.
      
      
    • What’s a podiatrist? Podiatrists are medical specialists. They’re also doctors, but they don’t go to the usual medical school. They have their own standards, schools, and associations. Instead of the typical MD (medical doctor) after their names, they have DPM which stands for doctor of podiatric medicine. You may go see a podiatrist if you experience foot pain, cracks on your skin, scaling on your soles, lesions on your feet, and discoloured, thick toenails. On the other hand (or foot), you can also visit your primary healthcare provider (GP) for your condition.
      
      
    • Orthotics is a field of medicine that focuses on the application and use of artificial devices like braces and splints. A person who specialises in orthotics is called an orthotist. They’re not doctors, but healthcare professionals that work under a doctor’s orders to modify braces or make custom-designed ones. The finished product is called an orthosis. So, if you need a foot brace, you will meet an orthotist after you get your prescription from your doctor.
      
      
    
    
    

Related Articles

Plantar Fasciitis: Holistic Healing For Your Heels

A Pandemic of Diabetic Proportions

Fungal Skin Infections Part 1

Outsmarting Your Arthritis

Related Links

Healing Creams	Tea Tree
Foot Care	Systemic Enzymes

References