Dr Mark Nelson
Foot & Ankle
Clinic Home Page
Foot Medical Information
Foot Health & Common Problems
A biological masterpiece, but subject to many ills
The human foot is a biological masterpiece. Its strong,
flexible, and functional design enables it to do its job well and without
complaint — if you take care of it and don’t take it for granted.
The foot can be compared to a finely tuned race car, or a space shuttle,
vehicles whose function dictates their design and structure. And like them,
the human foot is complex, containing within its relatively small size 26
bones (the two feet contain a quarter of all the bones in the body), 33
joints, and a network of more than 100 tendons, muscles, and ligaments, to
say nothing of blood vessels and nerves.
Tons of Pressure
The components of your feet work together, sharing the tremendous pressures
of daily living. An average day of walking, for example, brings a force
equal to several hundred tons to bear on the feet. This helps explain why
your feet are more subject to injury than any other part of your body.
Foot ailments are among the most common of our health problems. Although
some can be traced to heredity, many stem from the cumulative impact of a
lifetime of abuse and neglect. Studies show that 75 percent of Americans
experience foot problems of a greater or lesser degree of seriousness at
some time in their lives; nowhere near that many seek medical treatment,
apparently because they mistakenly believe that discomfort and pain are
normal and expectable.
There are a number of systemic diseases that are sometimes first detected in
the feet, such as diabetes, circulatory disorders, anemia, and kidney
problems. Arthritis, including gout, often attacks foot joints first.
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
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 and 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 and 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
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 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. Avoid pressure on the toes as much as possible. Surgery
may be necessary to realign the toes to their proper position.
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 painful or
infected, your podiatric physician may remove the ingrown portion of the
nail; 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. Warts often come from walking barefooted on
dirty surfaces or littered ground. There are several simple procedures which
your podiatric physician might use to remove warts.
Reprinted with permission from the American Podiatric Medical Association
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