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Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.
Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.
To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.
There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.
In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.
It is never normal for a child to experience pain in his or her feet. Foot pain that lasts more than a few days and limits a child’s ability to walk should be examined by a podiatrist. Many adult foot ailments originate in childhood and may be present at birth. Common foot issues that are experienced by children are pediatric flat foot, Sever’s disease, ingrown toenails, and plantar warts.
A child’s foot grows rapidly during the first year, allowing it to reach almost half of their adult foot size. Consequently, foot specialists consider the first year to be the most crucial point in the foot development process. There are ways you can help ensure that your child’s foot develops properly. One way is to carefully look at your baby’s feet. If you notice any deformities, you should immediately seek professional care. You should also loosely cover your child’s foot, since tight coverings may prevent movement and inhibit normal development. Another tip is to change the baby’s positioning throughout the day. If your baby lies down in one spot for too long, it may put an excess amount of strain on the feet and legs.
It is best that you try not to force a child to start walking. Children will begin to walk when they are both physically and emotionally capable to do so. You should also avoid comparing your child’s walking progress with other children because the age range for independent walking may range. When your child’s feet begin to develop, you may need to change both their shoe and sock size every few months to allow room for their feet to grow.
Kids are sometimes prone to splinters, cuts, and severe injuries because they tend to walk around barefoot. This also makes them more susceptible to developing plantar warts which is a condition caused by a virus that invades the sole of the foot through breaks in the skin. These ailments can be avoided by making sure your child wears shoes in unsanitary environments. You should also wash any minor cuts or scrapes on your child’s feet. It is a myth that exposure to fresh air will heal injuries; fresh air will only expose your child’s cuts to germs.
As a parent, you should ensure that your child’s feet are developing properly and are being properly maintained. Consequently, it is important that you perform routine inspections on his or her feet to detect any injuries or deformities in their early stages. Early detection and treatment will help to ensure that your child does not develop any serious foot conditions.
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.
Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.
Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.
Plantar Fasciitis
One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.
Achilles Tendonitis
Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.
Heel Spur
A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.
Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.
The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.
Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.
Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.
If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.
While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain foot conditions. The elderly should therefore be well informed about any problems that may arise and about what they can do to properly avoid or treat them.
Some of the most common foot problems seniors are susceptible to include foot ulcers, ingrown toenails, fallen arches, and fungal nails. A foot ulcer is an open sore on the foot and can be a result of diabetes and decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal nails is a condition that results in deformed and discolored toenails.
In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a podiatrist for diagnosis and information on treatment options.
Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems. If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.
As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier between your bones and the ground. This also aids in giving the skin on the feet a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. Emollients also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders. If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.
Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.
Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.
Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.
Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.
Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should instead consult their doctor immediately.
According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn white after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can lead to infection. If your corn gets infected, and is not treated immediately, a visit to the doctor will be necessary.
Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes. This fixes the way you walk. This will lower your chances of getting corns, and eliminate current corns by reducing rubbing from friction.
Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.
To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.
A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.
Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.
A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.
Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.
For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.
Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.
Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.
Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.
Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.
The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.
Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.
Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.
Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.
If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.
The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three phalanges except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.
Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.
Another type of toe fractures is a stress fracture. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity instead of a single injury. Stress fractures occur when the muscles in the bone become too weak to absorb impact. Consequently, the toe bone becomes vulnerable to any pressure and impact it endures. Symptoms for a stress fracture in the toe include swelling without bruising, tenderness to the touch, pain that goes away with rest, and pain after walking or running.
If you suspect that you have a broken toe, you should make an appointment with your podiatrist. He or she will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more.
Our feet are important in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if feet are cared for and looked after regularly, they will perform without pain or complication.
Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly daily. Remember to get between the toes and keep the toenails trimmed and short. If the feet feel dry or there are signs of dryness or cracking, use a moisturizer designed for the feet.
When using moisturizer on the feet, try to avoid applying between the toes. If cream or lotion sits too long, they can cause fungal and bacterial growth. When moisturizer is used between the toes, it can also cause the skin to soften too much.
Shoes are also an important aspect of foot care. When one is picking out shoes, make sure they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet. Good shoes pad the soles of your feet and support the arches and ankles.
Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture off the feet. Without socks, the build-up of sweat in a closed-toe shoe can cause fungal problems and athlete's foot.
The best thing to remember in every day foot care is that shoes do make a difference. If you spend a lot of time on your feet, make sure that your shoes show no signs of wear. Shoes should offer ample support for the arches and the overall foot. Additionally, try to make foot cleaning and maintenance a daily habit. If you keep these things in mind, your feet will stay healthy and safe.
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