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Foot
Care
Planters Warts
The common wart or planters wart is caused by a
virus that invades the skin and makes skin cells grow
at an abnormal rate. The result is a growth of small,
hard cauliflower shaped lump, usually white or pink in
color. Most common warts present no serious health
threats and are quite painless. Some, however, can
become painful because they are located in areas that
are subject to pressure or constant rubbing. The
unsightly warts can grow on any part of the body,
although the hands, feet and palms are usually the
most susceptible. In many cases, home treatment is
highly successful. Clean the area and try to keep the
wart dry since moisture will encourage it to grow.
Apply an over the counter wart medication. If it does
not disappear, you may wish to consult your physician.
Doctors can surgically remove the wart with extreme
heat or cold, or by scraping it away under local
anesthetic. If you get a wart and are over the age of
45, or if a wart develops in the genital region, see a
doctor immediately for diagnosis and treatment.
Heel Pain
The most common cause of deep pain on the bottom
surface of the heel, is plantar fasciitis -
inflammation of the plantar fascia. The plantar fascia
is a broad band of fibrous tissue which runs along the
bottom surface of the foot, from the heel to the toes.
It helps to secure the arch. Long standing
inflammation causes deposits of calcium at the point
where the inserts into the heel bone. This results in
the appearance of a bony heel spur on x-ray. The spur
itself is not the source of the pain. Symptoms include
sharp pain localized to the bottom and/or inside
margin of the heel, often worse in the morning, and
after rest, aggravated by prolonged weight bearing and
ambulation, may severely limit activities, and is most
common in middle-aged and overweight adults. The
causes of heel pain may be excessive load on the foot
from obesity, excessive flattening of the arch on
weight bearing, tight plantar fascia, over pronation
of the foot rolling motion including outward rotation
of the heel and inward rotation of the ankle. You can
do several things to help heel pain, some things are;
application of ice to the heel area after prolonged
activity, wear supportive shoes with a stiff heal
counter and a have a good arch. A well made running or
walking shoe is a good example. Stretching exercises
for the calf muscles will also help stretch the
plantar fascia. This should not be attempted when the
heel is sore. Over the counter anti-inflammatory
medications containing ibuprofen or aspirin when
tolerated. A doctor may also help ease heel pain by
prescribing doses of anti-inflammatory medication,
inject powerful anti-inflammatory medication to calm
inflammation around the painful area, apply taping and
padding to relieve strain on the plantar fascia,
administer physical therapy such as ultrasound or cold
laser, control foot function with an orthotic,
prescribe special splints to help stretch the fascia,
and surgical removal of the plantar fascia and removal
of the heel spur. Some other causes of heel pain may
be various types of arthritis, trauma to the heel,
inflammation of the tendons around the heel, Heel
Neuroma which are benign tumors of the nerves around
the heel, abnormality in the shape of the heel bone,
foreign body in the heel such as a splinter.
Heel Spurs
A calcaneal spur is a projection of calcium into
and around the muscle and ligaments of the foot where
they attach to the heel bone. The spur grows on the
bone, and within the flesh of the foot. The growth of
the spur may take months, or years to become evident.
Because of its location, the spur is a source of
continuous painful ache in the heel. When you place
weight on the heel, the pain can be severe enough to
immobilize you. The pain of the heel spur is most
evident when first standing on your feet in the
morning. Pain caused by a heel spur is not the
pressure of weight on the point of the spur, but of
the inflammation around muscles where they attach to
the heel bone. The pain doesn't increase as you walk
on the spur, it decreases. The pain may be localized
at first, and there will seem to be one central spot
that is the root of the trouble. Continued walking and
standing will soon cause the entire heel to become
tender and painful. Calcaneal spurs are very painful,
and treatment can give immediate relief from the pain.
However, if you have problems with painful heel spurs,
you should definitely see a professional for
treatment.
The Diabetic Foot
It is very important to take special care of your
feet when you have diabetes. Poor foot care can lead
to serious problems, such as amputation. Diabetes
affects your feet in two ways; nerve damage and poor
blood flow. Nerve damage causes your feet to lose
feeling. If this happens, a simple cut or sore can go
unnoticed and lead to serious problems. It can also
change the shape of your feet causing annoying
pressure points resulting in blisters, sores, and foot
ulcers. Poor blood flow will cause these injuries and
others to heal more slowly than normal. One of the
most important things you can do is to keep your blood
sugar level as close to normal as possible. Follow
these simple foot care steps: Check your feet
everyday. Look at the tops and bottoms, use a mirror.
Check for scratches cracks, cuts, blisters, ingrown
toenails, corns, calluses, sores, changes in color or
temperature of the foot. Wash your feet everyday with
mild soap and lukewarm water which should be 90 to 95
degrees Fahrenheit. Gently dry your feet and cream
tops and bottoms. Take care of your toenails, cut them
straight across. If they are too thick, have them cut
by a podiatrist. Take care of corns and calluses with
a pumice stone. Protect your feet, do not walk
barefoot. Keep your blood flowing well to your feet by
exercising daily. Don't wear tight socks, garters, or
too tight a shoe. Smoking decreases blood flow to the
feet, try to quit of you smoke. The greatest
complication of diabetes is vascular changes that lead
to peripheral gangrene and diabetic peripheral
neuropathy.
Arch Pain
Arch pain is a very common problem. When we are
born, we inherit from our parents a certain size of
foot and a certain shape of the arch. This arch may be
really flat at all times or you may have a foot which
has an arch when you are not standing, but when you
stand on it, the arch collapses. You may also have a
very normal arch or a very high arch. Arch pain is
actually caused by a foot that does not function
properly and it puts a strain on the muscles. This
chronic strain can cause pain and fatigue in the arch
because these structures are stretched beyond their
normal capacity, and the result is pain. We may also
get arch pain due to degenerative arthritis from many
years of our arch trying to collapse. This type of
arch pain is usually seen in people over the age of
30. When we are younger, our muscles in our legs and
in our feet have a tendency to try to compensate and
hold the foot into a better position. How do we know
if our foot functions improperly? Well, some patient's
feet will cause their shoes to wear out abnormally and
others can see by looking down at their arch and
observing that their arch does not stay in a normal
position. It is easy to tell when a person with a
severe flat foot has a problem because their foot is
continually flat. Most patients find out that their
arch is not functioning properly because they start to
develop arch pain. A new shoe is quite often tried by
people with arch pain and they feel comfortable for
many months but as soon as the shoe starts to
gradually soften up and wear out, their symptoms
reappears. Patients often find out that by wearing a
slightly elevated heel, that their symptoms are also
reduced. If you notice one of your children is wearing
their shoes out abnormally, either on the inside or
outside with abnormal shoe wear, most likely this
child has a foot that is not functioning properly,
although they may be a symptomatic without pain. The
long term effect of letting a child function in an
abnormal position, is that as he/she gets older,
his/her foot will have grown up and developed in an
abnormal position which predisposes him/her to earlier
degenerative arthritis and leg and arch pain. Children
who are pronating at the arch level and have a foot
that is dropping, should be treated with orthotics to
hold the foot in a better position so that these soft
bones can develop in a normal adult position to
prevent long term problems. Adults with problems of
the arch collapsing should also be treated, especially
with those who have symptoms and the treatment of
choice is wearing proper shoes to begin with and an
orthotic device made to hold the foot in a better
position to prevent arch strain. When the foot is held
in a better position, it can function properly and we
can usually walk without pain. Arch pain is a
treatable problem and with proper treatment, your foot
can be free from pain.
Corns and Calluses
Corns and calluses have two things in common. One,
is that the skin around a corn or callus is just
thickened normal tissue. Two, is that corns and
calluses can be very painful. Corns are usually just a
thickened piece of skin over a top of a toe, between
toes, or at the end of toes. The main reason we have
corn on our toes is that we may be wearing shoes that
are too tight or too short, or we may have hammertoe
deformities which cause our toes to contract back,
rubbing against our shoes excessively. Corns can also
be caused by small bone spurs which are causing
chronic irritation against the skin as the shoe rubs
over the spur, resulting in a thickened piece of skin
or corn. Our shoes and socks do play a very large role
in deformities of the toes, such as hammertoes, spurs,
and corns. This is especially common on women who wear
high heeled pointed tight shoes and pantyhose. Some
people have hereditary problems in which their toes
become contracted and hammered, which predisposes them
to chronic irritation, pain, corns, spurs, and
ulcerations. Most patients should be aware that if we
were wearing more reasonable shoes, we would
consistently have less pain and less corn formation on
our toes. A patient wearing high heels daily with a
very tight pointed toe box area would be much better
off wearing a flatter shoe with a more rounded toe. If
changing the shoes has done very little, then
podiatrists often trim back the corns to give some
temporary relief. In some patients, this can even be
permanent. For those corn that are persistent, a minor
surgical procedure can be performed in the office
which will permanently straighten out a hammertoe
deformity or remove a spur which may be causing a
corn. Calluses, on the other hand, are almost always
seen on the ball of the foot and they are also a
thickened form of skin caused by chronic irritation
from one of two things; either the patient has an
abnormal amount of pressure one side of the foot, or a
bone in the ball of the foot is somewhat out of place
carrying more pounds per square inch than the other
bones in a thickening of the skin and a callus. Most
calluses can be treated very successfully by having
the podiatrist trim them on a regular basis. For those
calluses which are persistent, there is a procedure
where the bone in the ball of the foot that is out of
position, can be re-established to its normal
position. This procedure can usually be performed in
the office but may require the patient to wear a
walking cast for three to four weeks. If you have a
corn or callus, your feet can be free from pain with
the proper treatment program.
Ingrown and Fungal Nails
The two most common forms of nail problems are
ingrown toenails and thick fungal nails. An ingrown
nail is a nail deformity in which the edges of the
nail start to pinch down into the skin located on the
sides of the nail causing pain and in some patients
infection. The nail can simply be painful, but is
considered an ingrown once it has this deformity, but
does not have to be red or infected. Some nails with
this deformity look red and swollen and very tender to
the touch, and quite often patients have to trim out
the edges of the nail every month to reduce any
symptoms they may have. Most ingrown toenails are
caused by our shoes and sock which we wear from a very
early age, while some ingrown toenails are caused by
having injured our toenail and eventually loosing the
nail after this injury. As the new nail tries to grow
back, it will quite often grow back at least as
deformed as it's predecessor and usually takes on a
more severe shape. As a child, our nails are quite
soft and supple, but once we begin to wear shoes and
socks, we change this soft flat nail into one which
begins to curve on the sides digging into the skin at
a very early age. Once we start to have sensitivity at
the edges of our nails, we start cutting back at a
rather sharp angle which just compounds the problem
allowing the skin edges to shrink further and further
up on the nail requiring that every month we begin
much more aggressive with our treatment. Some patients
believe that cutting a notch in the middle of the nail
or by filing the nail down in the middle will give
some relief, but this usually does very little to
change to nail permanently. The treatment of an
ingrown toenail is relatively simple today using
modern chemicals and laser surgery. After the edges of
the nails have been removed, a chemical is placed into
the root structure of the nail to destroy it or laser
is used to prevent any recurrence of this ingrown nail
deformity. There is usually no pain following this
treatment of ingrown nails since the skin is not
actually cut and the nail is not sensitive following
surgery. Most people can return to their normal
activities the following day of the surgery. Fungal
nails come in many sizes, shapes, and colors. A fungal
nail may be slightly discolored, white to yellow,
while others can be green or black. The nail can be
rather thin or it can be up to one-fourth inch thick
with these fungal characteristics. Fungus is found in
almost all parts of the world and in all conditions,
but it thrives where moisture is present. Our feet
happen to sweat more than our hands and for most
people this increase in moisture allows the barrier to
be broken down in and the fungus thrives once it is
established in our skin underneath our nails. Patients
who have fungal nails should work at trying to keep
their feet from sweating to cut back on the amount of
moisture in the area and to treat any fungal disease
of the skin to prevent contamination from the skin to
the nails. The treatment of fungal nails has been
improving over the last ten years because of better
medication both topically and orally. Most fungal nail
deformities can be treated today using modern laser
techniques and new oral and topical medications. A
patient with an ingrown nail deformity can be free
from pain with proper treatment.
Children and Foot Problems
Fortunately, very few children are actually born
with any type of severe foot disability, with the club
foot deformity being the most common. While rare, club
foot is an easily recognizable foot problem and with
modern techniques, is correctable today. One thing to
be aware of is that children inherit their parents
feet. In the first three to four years, the most
common complaint in children is that their legs hurt
after they've been playing all day. This is caused by
a foot that does not function properly, which puts a
strain on the muscles in the leg which are trying to
make this foot function better. After playing all day,
the muscles at night can go into spasm or feel
extremely fatigued and the child often wakes up at
night complaining of leg pain. By simply putting this
child in a special orthotic to hold it in a better
position, these symptoms will improve. As the child
gets older, they start to develop other symptoms, and
one of the most common one in children is heel pain.
This heel pain usually is seen following strenuous
activities, such as soccer, football, baseball, and
goes away after 12 to 14 hours of rest. The number one
factor is the foot doesn't function properly. The
second factor is the growth center for the heel is
being strained by the activity plus the fact that the
foot does not function properly. This problem is also
easily treatable and controlled and will give a
considerable amount of relief with a simple orthotic
device. In early adolescent years, we start to see
more young people with arch pain especially those that
have a foot which is very flexible and seems to be
flattening out or in those children who are showing a
lot of unusual shoe wear. You can have a foot that
does not function properly in a child and the foot can
have a rather high arch. or a normal arch, or a foot
that has no arch. Putting an orthotic device
underneath the arch and holding the foot up will not
only reduce their symptoms, but reduce the abnormal
shoe wear that their shoes are showing. Children who
have an arch that is abnormally flat or it looks as
though it is collapsing on the inside, should be
treated. The treatment is simply an orthotic device to
hold the foot in a better position and allow the soft
bones of the child to grow up in a better alignment to
each other which will prevent severe degenerative
changes in the adult. These feet should be treated
even if the patient has no symptoms. Another problem
seen in children not related to foot function, is one
in which they start to develop warts at a very early
age. By going around barefooted, they allow small
viruses to penetrate the skin through thorns and cuts
which slowly develop into a thickened callus type
tissue. Treatment of planter warts today is highly
effective and should be done to prevent enlargement of
the wart of development of other warts on the foot.
Warts
Warts on the foot are almost always caused by a
virus that is able to penetrate our skin, and after
penetration, develops into a very sensitive thickened
skin lesion. Most of the warts are actually seen on
the bottom of the foot, although, we do see some on
the top of the foot. The reason there are much fewer
warts on the top of the foot is because we do have a
tendency to go around barefoot at times. It is very
easy to step on a small thorn, bark dust, a piece of
glass, or a nail, which allows the entrance of this
virus into our skin. It is much more difficult to get
these same type pf skin penetration on the top of the
foot. Sometimes warts are very difficult to diagnose
since they can look like corns or calluses. It takes a
trained physician to tell the difference on the bottom
of the foot. Those warts that are on the bottom of the
foot appear to be flat, enlarged, thickened pieces of
skin which are very tender to the touch or very
sensitive to being pinched. Those on the top of the
foot seem to be more elevated and thickened like some
skin moles and have the same appearance as the warts
that we see on our fingers. Most warts are seen on
either the foot or the hand and we will rarely see
warts on our chest, back, or face. After we get a
wart, several things can happen. The wart can start to
grow in size becoming more sensitive or remaining
relatively pain free. Sometimes we start to develop
satellite warts around the main wart and instead of
having just one wart, after four to five months, you
can have 10 to 15 warts within one inch of the
original wart. Warts can also spread in other ways.
Occasionally, patients will have warts between the
toes and by the toe with the wart on it rubbing
against the next toe, over a period of months it will
actually spread over to the other toe. Generally
speaking, warts are not contagious to other people,
but it is somewhat contagious to the patient with the
wart.
Ingrown
Toenail |
