Common Foot Disorders

What is arthritis?     

Arthritis is a disabling disease that affects nearly 40 million Americans. It is characterized by inflammation of the cartilage and the lining of the body's joints. Symptoms include swelling in one or more joints, recurring pain or tenderness in any joint, redness or heat in a joint, limitation in motion of a joint, early morning stiffness, and skin changes including rashes and growths. The three types of arthritis are osteoarthritis, rheumatoid arthritis,and gouty arthritis. Because each foot contains 33 joints and bears a tremendous amount of weight and pressure, feet may be more susceptible to arthritis than other parts of the body.

CAUSES OF ARTHRITIS

• Heredity.
• Age.
• Viral and bacterial infections.
• Excessive weight.
• Prescription and illegal drugs.
• Systemic disease.
• Ill-fitting shoes.
• Trauma.

WHAT CAN YOU DO?

• Wear supportive shoes on a daily basis.
• Begin a program of physical therapy, exercise, or massage.
• Use ice packs or hot packs.
• Soak feet in lukewarm water.
• Wear socks retarding cushioning .

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Prescribe appropriate anti-inflammatory medications.
• Perform appropriate x-rays and joint evaluation
• Recommend custom orthotics.
• If the problem persists, surgery may be necessary.

Source: APMA

What is Athlete's Foot?

What is athlete's foot?

Athlete's foot is a common infection of the skin and nails characterized by itching, scaling, redness, and the formation of small blisters. The most common areas affected are the bottom of the foot and between the toes. The fungus has the potential to spread to the toenails, causing them to become thickened, discolored, and painful. While this infection is common among athletes, keep in mind that it can affect athletes and non-athletes alike.

CAUSES OF ATHLETE'S FOOT

• The feet are vulnerable because shoes commonly create a warm, dark and humid environment that encourages fungal growth.
• Athlete's foot can also be contracted in dressing rooms, hotel and lock room showers, and swimming pool locker rooms where bare feet may come in contact with the fungus.

WHAT CAN YOU DO?

• Keep shoes and socks dry as a preventative measure.
• Practice good foot hygiene, including daily washing of the feet with soap and water; drying feet carefully, especially between the toes; changing shoes regularly; and wearing wicking acrylic or cotton socks.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Prescribe topical medications.
• Prescribe oral anti-fungal medications.

Source: APMA

What are blisters?

Source: APMAat is athlete's foot?

Blisters are painful, fluid-filled lesions, often caused by friction and pressure.

CAUSES OF BLISTERS

• Ill-fitting shoes
• Stiff socks
• Wrinkled socks against the skin
• Excessive moisture
• Foot deformities

WHAT CAN YOU DO?

• Keep your feet dry.
• Always wear socks as a cushion between your feet and shoes.
• Wear properly fitting shoes.
• If a blister does occur, do not pop it.
• Cut a hole in a 1/4" piece of foam or felt, forming a "doughnut" over the blister; tape the foam or felt in place or cover with a soft gel-type dressing.
• Treat an open blister with mild soap and water; cover it with an antiseptic ointment and protective soft get dressing to prevent infection and speed up the healing process.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Remove the blister surface if needed.
• Prescribe appropriate medications, topical or oral.
• Recommend paddings, dressings, and friction-reducing measures.

Source: APMA

What is a bunion?

A bunion is an enlargement at the base of the big toe caused by a misalignment of the joint. It may be swollen, tender, and painful with the wearing of footgear.

STATISTICS

• 8 out of 1000 males have a bunion.
• 38 out of 1000 females have a bunion.
• 55 out of 1000 people ages 65 or older have a bunion.
• 63% of patients with bunions see a podiatrist.
• 1% of entire adult population have a bunion.
• 4% of people over the age of 65 have had a bunion. 

CAUSES OF BUNIONS

• Heredity
• Biomechanical abnormalities
• Neuromuscular disorders
• Inflammatory joint disease (arthritis)
• Trauma
• Congenital deformities

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination of the foot.
• Perform x-ray evaluation.
• Recommend padding or taping.
• Prescribe orthotics as needed.
• Perform surgery as indicated.

Source: APMA

What is a callus/corn?

A callus or corn is a build up of skin that forms at points of pressure or over bony prominences. Calluses form on the bottom side of the foot. Corns form on the top of the foot and between toes.

STATISTICS

• 65 out 0f 1000 people are afflicted with calluses or corns.
• 37 out of 1000 males are afflicted.
• 91 out of 1000 females are afflicted.

CAUSES OF CALLUSES/CORNS

• Repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe.
• Heredity disorders.

WHAT CAN YOU DO?

• Wear supportive shoes with a wide toe box and a low heel.
• Use over-the-counter creams, avoiding any acid preparations.
• Use pumice stone or file to treat if not diabetic.
• WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?
• Perform a physical examination.
• Perform x-ray evaluation if needed.
• Perform trimming or padding of the lesions.
• Perform surgery as indicated.

Source: APMA

What is a diabetic ulcer?

A diabetic ulcer is a breakdown of the skin on an area of the foot. An ulcer can develop quickly and may be painful and difficult to heal. Infection is a common complication. It is important to have an x-ray to determine whether there is any bone involvement when an ulcer is present.

CAUSES OF DIABETIC ULCERS

• Uncontrolled diabetes mellitus
• Lack of sensation
• Vascular insufficiency
• Ill-fitting shoes
• Trauma
• Heredity

WHAT CAN YOU DO?

• Consult a podiatric physician immediately.
• Alert the doctor's office that you are a diabetic with a foot sore.
• Self-treatment is not recommended for this serious condition.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Perform x-ray evaluation.
• Perform debridement and wound care.
• Conduct laboratory tests.
• Initiate total medical team approach, which may include your family practice doctor, endocrinologist, internist, vascular surgeon, and infectious disease specialist.

Source: APMA

What is a flat foot?

A flat foot is a structural deformity resulting in the lowering of the arch of the foot. This is sometimes referred to as fallen arches. A person with a flat foot or a highly arched foot that is fairly painful is in need of treatment. People with flat feet may have ankle, knee, or low back pain.

CAUSES OF FLAT FEET

• Heredity
• Arthritis
• Trauma
• Musculoskeletal disorders.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination and gait analysis.
• Perform x-rays.
• Prescribe custom orthotics.
• Perform surgery as indicated.

WHAT CAN YOU DO?

• Wear supportive shoes.

Source: APMA

A fungal nail is an infection characterized by a change in the toenail's color, thickness, and quality. It may cause pain and difficulty in walking. Studies estimate that fungal nail infections affect three to five percent of the population. However, podiatric physicians believe that because so many cases go unreported, the incidence is much higher.

CAUSES OF FUNGAL NAILS

• Often, the infection starts in the skin as athlete's foot, which may spread to the nails.
• Shoes and socks create a warm, dark, and humid environment which encourages fungal growth.
• Trauma
• Heredity

WHAT CAN YOU DO?

• Keep shoes and socks dry as a preventative measure.
• Practice good foot hygiene, including daily washing of the feet with soap and water; drying feet carefully, especially between the toes; changing shoes regularly; and wearing wicking acrylic or cotton socks.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Culture the infected nail.
• Prescribe appropriate medications.
• Perform debridement or removal of the nail as indicated.

Source: APMA

What is a hammertoe?

A hammertoe is a contraction deformity, resulting in bony prominences on the toes.

CAUSES OF HAMMERTOES

• Heredity
• Ill-fitting shoes
• Muscle imbalance
• Arthritis

 WHAT CAN YOU DO?

• Wear a supportive shoe with a deep toe box.
• Apply cold compresses.
• Soak the foot in lukewarm water to relieve pain.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

 Perform a physical examination.

• Perform an x-ray evaluation.
• Perform trimming and padding.
• Perform surgery as indicated.

 Source: APMA

What is plantar fasciitis/heel spur syndrome?

Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Heel spur syndrome is a bony overgrowth on the heel bone. Plantar fasciitis and heel spur syndrome affect women more than men. They can cause the bottom of the heel and arch to become painful.

STATISTICS

• Plantar fasciitis and heel spur syndrome are the most common causes of plantar heel pain.
• 73% of patients with heel pain are diagnosed with either plantar fasciitis or heel spur syndrome.
• 15% of patients who see a podiatrist complain of heel pain.
• 90% of those who suffer from plantar fasciistis or heel spur syndrome respond to nonsurgical care.
• 83.5% of patients with plantar fasciitis or heel spur syndrome experience pain with first steps in the morning.
• Plantar fasciitis can occur with or without a heel spur present.

CAUSES OF PLANTAR FASCIITIS

• Stretching the long band of tissue that connects the heel and the ball of the foot.
• Muscle imbalance.
• Bone deformity.
• Obesity.
• Trauma.
• Tightness of the muscles on the back of the leg.

WHAT CAN YOU DO?

• Warm up and stretch properly before exercise.
• Wear appropriate shoe gear.
• RICE - rest, ice, compression, and evaluation.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Perform x-ray evaluation.
• Recommend taping
• Prescribe orthotic devices.
• Prescribe appropriate medications.
• Administer injections.
• Perform surgery if needed.

 Source: APMA

What is an ingrown toenail?

An ingrown toenail is a painful condition characterized by the nail digging into the surrounding skin, leading to inflammation and possible infection of the toe. This is a serious condition for people with impaired circulation, diabetes, or other systemic diseases.

CAUSES OF INGROWN TOENAILS

• Heredity
• Improper nail trimming
• Trauma
• Shoe pressure
• Poor foot structure

 WHAT CAN YOU DO?

• Trim toenails straight across as a preventative measure.
• Select the proper shoe style and size.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Perform x-ray evaluation when necessary.
• Remove the ingrown portion of the nail.
• Culture the nail.
• Prescribe appropriate medications, such as antibiotics.
• Perform surgical correction of the nail when indicated.

Source: APMA

What is a neuroma?

A neuroma is a painful condition often referred to as a pinched nerve, swollen nerve, or nerve tumor. It is defined more specifically as a benign growth or nerve tissue frequently found between the third and fourth toes. This may result in pain, burning, tingling, or numbness between the toes and in the ball of the foot.

CAUSES OF NEUROMAS

• Heredity
• Improper or ill-fitting shoes
• High heeled shoes
• Trauma

WHAT CAN YOU DO?

• Change to shoes with lower heels.
• Wear supportive shoes with a roomy toe box.
• Soak and ice.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Perform x-ray evaluation to rule out other causes.
• Recommend padding and taping.
• Prescribe custom orthotics.
• Prescribe anti-inflammatory medication.
• Administer cortisone injections.
• Perform surgery when indicated.

Source: APMA

What is plantar fasciitis/heel spur syndrome?

Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Heel spur syndrome is a bony overgrowth on the heel bone. Plantar fasciitis and heel spur syndrome affect women more than men. They can cause the bottom of the heel and arch to become painful.

STATISTICS

• Plantar fasciitis and heel spur syndrome are the most common causes of plantar heel pain.
• 73% of patients with heel pain are diagnosed with either plantar fasciitis or heel spur syndrome.
• 15% of patients who see a podiatrist complain of heel pain.
• 90% of those who suffer from plantar fasciistis or heel spur syndrome respond to nonsurgical care.
• 83.5% of patients with plantar fasciitis or heel spur syndrome experience pain with first steps in the morning.
• Plantar fasciitis can occur with or without a heel spur present.

CAUSES OF PLANTAR FASCIITIS

• Stretching the long band of tissue that connects the heel and the ball of the foot.
• Muscle imbalance.
• Bone deformity.
• Obesity.
• Trauma.
• Tightness of the muscles on the back of the leg.

CAUSES OF PLANTAR FASCIITIS

• Warm up and stretch properly before exercise.
• Wear appropriate shoe gear.
• RICE - rest, ice, compression, and evaluation.

CAUSES OF PLANTAR FASCIITIS

• Perform a physical examination.
• Perform x-ray evaluation.
• Recommend taping.
• Prescribe orthotic devices.
• Prescribe appropriate medications.
• Administer injections.
• Perform surgery if needed.

Source: APMA

When a woman is pregnant, the excessive weight gain combined with hormonal release relaxes certain ligaments in the body. As the fetus grows larger, the center of gravity changes from the lower back to the front of the body. In the later stages of pregnancy, the woman tends to turn out her feet for stability. This puts undue stress on the tendons, muscles, and ligaments of the foot, which may cause pain or mechanical problems such as bunions, tendinitis, ingrown toenails, and other inflammatory conditions. A pregnant woman's foot also can swell or enlarge anywhere from one to two sizes, causing discomfort. Other common complications include swelling of the legs, varicose veins, leg fatigue, and cramps.

WHAT CAN YOU DO?

• Wear comfortable, supportive shoes.
• Use over-the-counter arch supports.
• Elevate and rest legs often.
• Stretch.
• Begin a supervised exercise program.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination.
• Prescribe support hose.
• Prescribe orthotic devices.
• Evaluate and treat associated foot problems.

 Source: APMA

What are prescription orthotics?

Orthotic devices are custom made shoe inserts that are intended to correct an abnormal or irregular walking pattern. Orthotics can make standing, walking, and running more comfortable and efficient by restoring proper foot function and balance. Podiatric physicians prescribe the use of orthotics as a conservative approach to many foot problems. The use of orthotics is a highly successful and practical form of treatment.

DIFFERENT TYPES OF PRESCRIPTION ORTHOTICS

Orthotics fall into three broad categories: rigid, soft, and semirigid. Rigid orthotics is designed to control function. They may be made of a firm material, such as plastic or graphite. Soft orthotics help absorb shock, and take pressure off uncomfortable or sore spots. Semirigid orthotics provides dynamic balance of the foot while walking or participating in sports. Orthotics help guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently.

Source: APMA

Properly Fitting Shoes

Your feet bear the tremendous pressures of daily living. An average day of walking brings a force equal to several hundred tons to bear on your feet. In fact, your feet are subject to more injury than any other part of your body, thus highlighting the need to protect them with proper footwear.

SHOE SHOPPING TIPS

• Have your feet measured while you are standing.
• Always try on both shoes and walk around the store.
• Always buy for the larger foot; feet are seldom precisely the same size.
• Do not buy shoes that need a "break-in" period - they should be comfortable immediately.
• Do not rely on the size of your last pair of shoes when you are purchasing new shoes. Your feet do get larger and there are differences in manufacturing.
• Shop for shoes later in the day. Feet tend to swell during the day, and it is best to be fitted when they are at their largest.
• Be sure that the shoe fits well (front, back, and sides), to distribute weight. Select a shoe with leather upper, still heel counter, appropriate cushioning, and flexibility at the ball of the foot.
• Do not buy shoes that pinch your toes.
• Try on shoes while you are wearing the same type of socks that you expect to wear with the shoes.
• Wear the appropriate shoe for a specific activity, such as running shoes for running.

Improperly fitted shoes can cause pain, deformity, and limitation of activity. See a podiatric physician if foot discomfort persists.

Source: APMA

What is a stress fracture?

A stress fracture is an incomplete crack in the bone caused by overuse. A foot that is not structurally sound is prone to developing stress fractures. Even a normal foot can easily develop a stress fracture from repetitive use. Symptoms may include pain, redness, and swelling.

STATISTICS

• 0.7-15% of athletics injuries are stress fractures.
• Track athletes have the highest amount of stress fractures.
• The first metatarsal accounts for 10% of metatarsal stress fractures.
• The second, third and fourth metatarsals account for 90% of metatarsal injuries.
• There is a decrease in the incidence of stress fractures in men with lean body mass.
• 8.8% of stress fractures occur in the metatarsals.
• 25.3% of stress fractures occur in the tarsal bones.
• 0.9% of stress fractures occur in the sesamoids.
• 28% of stress fractures occur in the calcaneus.

CAUSES OF STRESS FRACTURES

• Overuse or strain of foot.
• Medical conditions such as osteoporosis.
• Medications such as steroids.
• Sudden increased activity level.

WHAT CAN YOU DO?

• Use cold compresses or ice.
• Get complete rest.
• Elevate the feet.
• Stay off your feet.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

•  Perform a physical examination.
• Perform x-ray evaluation and future exams as needed.
• Immobilize or cast the foot/let.
• Prescribe custom orthotics for long term control and prevention.
• Prescribe medications when indicated.

Source: APMA

What is a wart?

A wart is a growth in the skin caused by a viral infection. Warts tend to be hard and flat with elevated, rough surfaces with or without well-defined boundaries. Some have one or more black pinpoints. They are frequently called plantar warts because they appear most often on the plantar surface, or sole of the foot. Children, especially teenagers, tend to be more susceptible to warts than adults. It is possible that a variety of other more serious lesions, including carcinomas and melanomas can be mistakenly identified as warts. Because of those identification problems, it is wise to consult a podiatric physician about any suspicious growth or eruption on the skin of the feet. If warts are left untreated, they can grow and spread into clusters of several warts.

CAUSES OF WARTS

• A virus causes warts, which typically invades the skin through small cuts and abrasions.

WHAT WILL A PODIATRIC PHYSICIAN DO FOR YOU?

• Perform a physical examination and evaluation.
• Initiate treatment, including possible surgical removal.
• Prescribe medication.

WHAT CAN YOU DO?

• Avoid waking barefoot.
• Change shoes daily.
• Keep feet clean and dry.
• Avoid home treatments.

Source: APMA