Specialized Care

Your feet, like other specialized structures, require specialized care. A doctor of podiatric medicine can make an important contribution to your total health, whether it is regular preventive care or surgery to correct a deformity.

In order to keep your feet healthy, you should be familiar with the most common ills that affect them. Remember, though, that self-treatment can often turn a minor problem into a major one and is generally not advisable. You should see a podiatric physician when any of the following conditions occur or persist.

Athlete’s foot is a skin disease, usually starting between the toes or on the bottom of the feet, which can spread to other parts of the body. It is caused by a fungus that commonly attacks the feet, because the wearing of shoes and hosiery fosters fungus growth.

The signs of athlete’s foot are dry scaly skin, itching, inflammation, and blisters. You can help prevent infection by washing your feet daily with soap and warm water; drying carefully, especially between the toes; and changing shoes and hose regularly to decrease moisture. Athlete’s foot is not the only infection, fungal or otherwise, which afflicts the foot, and other dry skin/dermatitis conditions can be good reasons to see a doctor of podiatric medicine if a suspicious condition persists.

Blisters are caused by skin friction. Don’t pop them. Apply moleskin or an adhesive bandage over a blister, and leave it on until it falls off naturally in the bath or shower. Keep your feet dry and always wear socks as a cushion between your feet and shoes. If a blister breaks on its own, wash the area, apply an antiseptic, and cover with a sterile bandage.

Bunions are misaligned big toe joints which can become swollen and tender. The deformity causes the first joint of the big toe to slant outward, and the big toe to angle toward the other toes. Bunions tend to run in families, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe. There are conservative and preventive steps that can minimize the discomfort of a bunion, but surgery is frequently recommended to correct the problem.

Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet. The friction and pressure can burn or otherwise be painful an may be relieved by moleskin or padding on the affected areas. Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist’s instructions.

Foot odor results from excessive perspiration from the more than 250,000 sweat glands in the foot. Daily hygiene is essential. Change your shoes daily to let each pair air out, and change your socks, perhaps even more frequently than daily. Foot powders and antiperspirants, and soaking your feet in vinegar and water, can help lessen odor.

Hammertoe is a condition in which any of the toes are bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Although the condition usually stems from muscle imbalance, it is often aggravated by ill-fitting shoes or socks that cramp the toes.

Heel pain can generally be traced to faulty biomechanics which place too much stress on the heel bone, ligaments, or nerves in the area. Stress could result while walking or jumping on hard surfaces, or from poorly made footwear. Overweight is also a major contributing factor. Some general health conditions—arthritis, gout, and circulatory problems, for example—also cause heel pain.

Heel spurs are growths of bone on the underside of the heel bone. They can occur without pain; pain may result when inflammation develops at the point where the spur forms. Both heel pain and heel spurs are often associated with plantar fasciitis, an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Treatments may range from exercise and custom-made orthotics to anti-inflammatory medication or cortisone injections.

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. If the ingrown portion of the nail is painful or infected, your podiatric physician may remove the affected portion; if the condition reoccurs frequently, your podiatrist may permanently remove the nail.

Neuromas are enlarged, benign growths of nerves, most commonly between the third and fourth toes. They are caused by bones and other tissue rubbing against and irritating the nerves. Abnormal bone structure or pressure from ill-fitting shoes also can create the condition, which can result in pain, burning, tingling, or numbness between the toes and in the ball of the foot. Conservative treatment can include padding, taping, orthotic devices, and cortisone injections, but surgical removal of the growth is sometimes necessary.

Warts are caused by a virus, which enters the skin through small cuts and infects the skin. Children, especially teenagers, tend to be more susceptible to warts than adults. Most warts are harmless and benign, even though painful and unsightly.

Diseases, disorders and disabilities of the foot or ankle affect the quality of life and mobility of millions of Americans. However, the general public and even many physicians are unaware of the important relationship between foot health and overall health and well-being. With this in mind, the American Podiatric Medical Association (APMA) offers the following tips to help keep feet healthy.

1. Don’t ignore foot pain—it’s not normal.

If the pain persists, see a podiatric physician.

2. Inspect your feet regularly. Pay attention to changes in color and temperature of your feet. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate athlete’s foot. Any growth on the foot is not considered normal.

3. Wash your feet regularly, especially between the toes, and be sure to dry them completely.

4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. Persons with diabetes, poor circulation, or heart problems should not treat their own feet because they are more prone to infection.

5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest and replace worn out shoes as soon as possible.

6. Select and wear the right shoe for the activity that you are engaged in (i.e., running shoes for running).

7. Alternate shoes—don’t wear the same pair of shoes every day.

8. Avoid walking barefooted—your feet will be more prone to injury and infection. At the beach or when wearing sandals, always use sunblock on your feet just as on the rest of your body.

9. Be cautious when using home remedies for foot ailments; self-treatment can often turn a minor problem into a major one.

10. If you are a person with diabetes, it is vital that you see a podiatric physician at least once a year for a check-up. FSM