Foot Ailments

Jul 1, 2011
2011 / July 2011

A recent American Podiatric Medical Association survey revealed travelers spend the majority of their vacation walking. Those who admitted to wearing improper footwear experienced the most foot ailments, including bunions, plantar fasciitis, hammertoe and Morton’s neuroma, all of which can easily be avoided by taking proper precautions.

A bunion is an abnormal bump that forms at the joint at the base of your big toe, caused when the big toe pushes against the others, forcing your big toe in the opposite direction. Bunions are more common in women (wearing narrow-toed heels may lead to bunion development) and sometimes run in families. The condition becomes painful as extra bone and a fluid sac grow at the base of the big toe. Symptoms include red, calloused skin along the inside edge of the big toe, a bony bump and pain over the joint aggravated by tight shoes.

If a bunion develops, take good care of your feet and wear wide-toed shoes. It may help to wear foam pads or “spacers,” available at the drugstore, to protect the bunion and separate the first and second toes at night. Try cutting a pair of old, comfortable shoes to wear around the house. If the bunion gets worse, causing severe deformity and pain, you may need surgery.

Plantar fasciitis is a painful, long-term foot condition caused by inflammation of the thick bands of tissue (plantar fascia) running across the bottom of the feet. It is one of the most common causes of heel pain and the most common orthopedic complaint.

The pain in the bottom of the heel is worse in the morning and may improve throughout the day, returning after long periods of standing and sitting. By the end of the day, the pain is a dull ache that improves with rest. Plantar fasciitis typically affects active men and women between the ages of 40 and 70. Risk factors include foot arch problems (flat feet or high arches), sudden weight gain or obesity, repetitive pounding of the feet from long-distance running, a tight Achilles tendon or shoes with poor arch support or soft soles.

Conservative treatment and time are usually successful in the care of plantar fasciitis. It may take several months and up to two years before symptoms improve. Initial treatment consists of anti-inflammatory medications (over-the-counter NSAIDs), heel stretches and rest. To relieve pain, apply ice to the painful area twice a day for 15 minutes and rest as much as possible. Wear properly fitted shoes, felt pads to cushion the heel or orthotics to off-load the pressure and pain. Consider wearing splints at night to stretch the injured fascia and allow it to heal. Some physicians offer steroid injections or creams. Physical therapy can be effective, and if needed, surgery is a last option.

Hammertoes are a deformity in which the end of the toe bends downward. It usually affects the second toe, but it can affect all toes. Hammertoe is likely to occur in women who wear shoes that do not fit well or have high heels and children who wear shoes they have outgrown. The condition may be congenital or develop over time. Eventually, patients will no longer be able to move the toe. A corn usually forms on the top of the toe, and a callus is found on the sole of the foot.

In children, mild hammertoe can be treated by splinting the affected toe. Podiatrists can make foot devices called hammertoe regulators, or you can buy them at the pharmacy. Exercises may be helpful. For severe hammertoe, surgery is needed.

Morton’s neuroma is a painful condition that affects the ball of the foot, especially the area between the third and fourth toes. There is a thickening of the nerve tissue between these toes. Morton’s neuroma is more common in women than men, and the exact cause is unknown.

Symptoms include tingling in the space between the toes; toe cramping; and sharp, shooting or burning pains in the ball of your foot. The pain gets worse over time. Nonsurgical treatment is tried first. Your podiatrist or orthopedist can recommend any of the following: padding or taping the toe area, shoe inserts, changes in footwear, NSAIDs by mouth or injected into the toe area, or injectable nerve-blocking medication. Surgery involves either the removal of the nerve, which could cause numbness in the area, or cutting nearby nerve structures such as the ligament that binds together some of the bones in the front of the foot.

Each foot has 26 bones; 33 joints; and more than 100 tendons, muscles and ligaments and is a window to our state of health. Joint stiffness in feet could be a sign of arthritis; tingling or numbness of the feet can signal diabetes; and swelling of the feet could signal heart disease, high blood pressure or kidney disease. Regular foot checks are an important part of health care. If you have a foot problem, be sure to see a podiatrist or orthopedist.

For more information, visit www.apma.org.

 


The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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