The Achilles is the human body’s strongest and thickest tendon and runs down the calf on the backside of the lower leg, connecting the calf muscle to the heel. We use our Achilles tendon whenever we are in motion walking, running, or jumping. The Achilles is tough enough to stand up to forces of 1,000 pounds or greater, but it is the most commonly torn tendon due to athletic injuries.

Achilles tendinitis occurs when the Achilles tendon becomes inflamed due to overuse, stress, injury, or degeneration. Achilles tendinitis and its accompanying pain and swelling can strike anyone, from professional athletes to weekend exercisers and athletes, as well as youth sports enthusiasts.

What Are Some Causes of Achilles Tendinitis?
~ Sudden trauma to the tendon from causing it to stretch too abruptly, such as when sprinting or jumping
~ Overuse
~ Fast increases in walking or running distances or speeds without giving the body the chance to adapt as it normally would by introducing slight increases over time
~ Quickly resuming sports or exercise activities after long periods of inactivity
~ Failure to properly and adequately stretch before exercise or activity
~ Repetitive climbing up stairs or running up hills
~ Inappropriate shoes, sneakers, sandals, or other footwear
~ Excessive foot pronation, or turning the foot down or to the inside when walking or running for longer-than-usual periods of time

What Are Symptoms of Achilles Tendinitis?
~ Mild pain after exercise or activity that gets worse over time
~ Pain, aching, or nagging discomfort along the back of the lower calf, especially after running or exercise utilizing the calf muscles
~ Persistent swelling in the back lower calf area, not only during or after exercise
~ General stiffness, tenderness, or tiredness in the lower calf area, especially after a night’s sleep when the feet first hit the ground for the day

How Is Achilles Tendinitis Treated?
~ Reduce stress and impact to the Achilles area, as well as rest the tendon by choosing non-impact sports or exercises
~ Wear a brace or support bandage to limit the tendon’s motion or a walking boot to further rest the Achilles and avoid additional stress to the area
~ Insert appropriate heel orthotics into shoes and sneakers, or wear heel-supportive footwear to alleviate stress and strain on the tendon
~ Stretch the tendon and surrounding area muscles through physical therapy and/or at-home stretching regimens
~ Take over-the-counter non-steroidal anti-inflammatory medications on a temporary basis to treat pain and swelling (ask your doctor first)
~ Massage and ice the area regularly

If the above treatments do not solve the Achilles tendinitis, surgery may be necessary.

Deposits of cholesterol, known as xanthomas, can accumulate in the Achilles tendon as a result of high cholesterol levels in the body. The tiny lumps can be alleviated by general strategies to lower cholesterol; however, xanthomas may need further treatment, such as a biopsy of the legion that does not rupture the nodule.

Acrocyanosis is a disorder that causes spasms in the arteries responsible for blood flow to the skin on the hands and feet. When the skin is deprived of necessary oxygen due to the constricted blood flow, it takes on a blue color, known as cyanosis. Acrocyanosis is not a common condition, although it afflicts women more than men. In addition to blue-colored skin, the hands and feet may feel moist and cold. Swelling may also be present, but the condition usually does not cause pain.

Since acrocyanosis can worsen with exposure to cold, acrocyanosis of the feet is treated by keeping the feet warm and dry so that the blood circulates as best as possible. Insulated boots and insulated socks can help with this. The condition does not worsen over time. Since acrocyanosis can be present alongside a serious medical condition affecting the cardiovascular system or connective tissue, it is best to seek the advice of a doctor or medical professional.

Alcoholic neuropathy is nerve damage as a result of chronic alcohol abuse. The condition causes numbness, loss of sensation, pain, tingling, and weakness in the hands and feet that worsens over time. Alcoholic neuropathy can also affect other body parts and systems, including the brain. Drinking alcohol excessively can damage nerve tissue as a result of the ethanol found in alcoholic beverages; in addition, the problem may be compounded by a lack of vitamins and the poor diet alcoholics usually consume. The resulting nerve damage can become permanent if it is not properly treated.

To treat alcohol neuropathy, the underlying cause of alcoholism must be addressed so that the damaging alcohol consumption stops. In addition vitamin supplementation, particularly B vitamins, may restore the damaged nerves. Prescription medications are also available to alleviate the pain (always seek the advice of a doctor before taking any medication). In some cases, galvanic stimulation is administered to help improve nerve function. Magnetic therapy is another treatment option.

Amniotic band syndrome, or ABS, is a rare condition that affects the fetus during pregnancy. About 1 in 1,200 babies are impacted by amniotic band syndrome. With ABS, thin, fibrous strands of tissue develop inside the amniotic sac and then entrap the fetus’s limbs, digits, or other fetal body parts.

The fibrous bands can limit tissue growth or cause necrosis, resulting in limb and appendage disfigurement or even amputation inside the womb if they are wound tightly enough to constrict blood flow. ABS can affect the unborn baby’s legs, feet, and toes. For example, if a band wraps around the peroneal nerve in the leg, it can result in clubfoot.

Amniotic band syndrome is also known as Streeter bands, congenital ring constriction, and constriction band syndrome. It is generally considered a random occurrence without genetic influence; however, there is some research indicating that early rupture of the inner membrane of the amniotic sac can cause ABS.

For more information about ABS diagnosis and specific treatments, please contact us.

When the ankle bones twist or receive too much force, the ligaments surrounding the outside of the bones may suffer from over-stretching or tearing, resulting in a painful ankle sprain. There are different levels of severity when it comes to ankle sprains, and if the sprain is not properly diagnosed and treated, it can cause permanent, lasting ankle trouble.

What Are Symptoms of an Ankle Sprain?
~ Swelling after twisting or injuring the ankle area
~ Bruising of the ankle area
~ Pain in the lower leg

How Is an Ankle Sprain Treated?
~ Apply ice to the ankle area and elevate the affected lower leg to lessen swelling
~ Rest the ankle from activity, exercise, and even walking
~ Limit motion and support the injured ankle by wrapping it with compression bandages
~ If the sprain involves severe twisting or tearing of the ligaments, surgery may be necessary to repair the damage and tighten the over-stretched ligaments

How Can Ankle Sprains Be Prevented?
~ Wear properly fitting, supportive footwear and sneakers, especially during exercise and sports
~ Protect weak ankles from sprains and re-injuries with appropriate ankle braces and supports
~ Keep the ankle muscles strong and flexible through regularly exercising and stretching them as well as the surrounding muscles

When the ankle bones twist or receive too much force, the ligaments surrounding the outside of the bones may suffer from over-stretching or tearing, resulting in a painful ankle sprain. There are different levels of severity when it comes to ankle sprains, and if the sprain is not properly diagnosed and treated, it can cause permanent, lasting ankle trouble.

What Are Symptoms of an Ankle Sprain?
~ Swelling after twisting or injuring the ankle area
~ Bruising of the ankle area
~ Pain in the lower leg

How Is an Ankle Sprain Treated?
~ Apply ice to the ankle area and elevate the affected lower leg to lessen swelling
~ Rest the ankle from activity, exercise, and even walking
~ Limit motion and support the injured ankle by wrapping it with compression bandages
~ If the sprain involves severe twisting or tearing of the ligaments, surgery may be necessary to repair the damage and tighten the over-stretched ligaments

How Can Ankle Sprains Be Prevented?
~ Wear properly fitting, supportive footwear and sneakers, especially during exercise and sports
~ Protect weak ankles from sprains and re-injuries with appropriate ankle braces and supports
~ Keep the ankle muscles strong and flexible through regularly exercising and stretching them as well as the surrounding muscles

Arthritis is the inflammation of the joints, a condition that affects over 50 million Americans. Certain types of arthritis can be hereditary, and although the disease becomes more common with age, it affects people at all stages of life. More than 60% of Americans with arthritis are under 65 years of age, but most commonly, the disease strikes people over 50 years of age.

In the feet, arthritis can lead to immobility. Since the human foot is comprised of over 30 joints and the feet bear the impact of the entire body’s weight, the foot is more susceptible to develop arthritis than other body parts. Unfortunately, as it progresses, arthritis can become debilitating and even crippling; however, early diagnosis and proper treatment can limit and slow its advancement.

There are two main forms of arthritis: rheumatoid arthritis (RA) and osteoarthritis. Rheumatoid arthritis diseases cause chronic inflammation that can affect many smaller joints, such as the ankle and toe joints. RA is the most serious form of arthritis. Osteoarthritis is more common and results from degeneration of the joints due to wear and tear over time. As people age, some joints, particularly those that have been overused or under constant pressure, become susceptible to cartilage breakdown. Common symptoms of osteoarthritis are pain and muscle weakness that become progressively worse, as well as sore or stiff joints due to overuse or periods of inactivity.

What Are Symptoms of Arthritis of the Foot and Ankle?
~ On-going joint pain and tenderness
~ Redness, swelling, and stiffness in the joint area
~ Growths, rashes, and other skin changes in the joint area
~ Limited motion and stiffness of the join

How Is Arthritis of the Foot and Ankle Treated?
~ Physical therapy and exercise to increase strength and function
~ Anti-inflammatory medication and steroid injections (do not take any medication without the advice of a doctor)
~ Massages
~ Foot soaks and ice application
~ Orthotics or prescribed footwear

Athlete’s foot is a common foot fungus that spreads easily in public places such as indoor and outdoor swimming pools, locker rooms, and showers, as these are moist conditions where people usually walk barefoot. The symptoms of athlete’s foot are itchy, burning feet with scaling and redness between the toes. Eventually, the inflammation can become painful, and blisters may develop. The fungus can also develop along the soles, arches, and sides of the feet. The condition can be chronic.

There are many different types of fungi that cause athlete’s foot, so the type of medicine used to successfully treat athlete’s foot depends on properly identifying the fungus responsible for the outbreak. A doctor should be seen to properly diagnose athlete’s foot. There are several over-the-counter creams, sprays, and powders available to treat athlete’s foot. Medications of any kind should not be used without first consulting a healthcare professional or doctor. A doctor can also prescribe topical or oral medications to treat severe cases.

Fungal infections such as athlete’s foot can be prevented by the following suggestions:
~ Wash and dry feet thoroughly, taking extra care to dry between the toes.
~ Use powder to keep the feet dry.
~ Keep socks and footwear clean and dry; socks can be changed several times daily.
~ Wear footwear made of breathable materials that allow air to circulate around the feet; constricting footwear, stockings, and socks can trap moisture and perspiration on the feet.
~ Never share socks or footwear.
~ Do not walk barefoot in public areas such as showers, pools, and locker rooms; instead, wear plastic flip-flops, slides, or shower shoes.

Black toenails (subungual hematomas) are bruised toenails that result from blood collecting under the nail. They can be caused by crushing, impact, or injury to the toe, such as dropping something heavy on or stubbing the toe. Runners frequently suffer from black toenails due to the big toe rubbing against the tip of an ill-fitting sneaker. Although black toenails can be painful and tender, treatment is usually not necessary unless there is bone or tissue damage, too.

Blisters are fluid-filled bubbles that form on the skin of the foot or other parts of the body due to friction or a burn. On the foot, they commonly occur on the heel and toes, areas subjected to friction and rubbing against footwear. Most blisters are filled with clear fluid and do not usually require medical attention; however, larger, more serious, painful blisters may require a visit to the doctor, as they can be filled with pus or blood.

A blister provides a protective barrier so that new skin can form in a clean, sterile environment unexposed to dirt and germs while the skin heals. Since blisters are body’s natural response to protecting the skin, most blisters should not be and do not need to be punctured to release the fluid. To prevent pain and infection, blisters can be covered loosely with an adhesive bandage or special, donut-shaped pad.

If a blister pops or opens, wash it with soap and water only; other solutions could burn and irritate the new skin forming underneath. The protective skin of the blister should never be torn off, even if the blister breaks, as doing so could lead to infection. Apply an antibiotic ointment and adhesive bandage to keep the new skin clean and sterile. If white or yellow fluid oozes from the blister, it is a sign of an infection that needs to be treated by a doctor.

Prevent blisters by wearing properly-fitting socks and footwear. Make sure socks have heels and do not bunch up on the foot. If a shoe causes friction or rubbing in a particular spot, cover the area with an adhesive bandage or petroleum jelly before a blister forms. Break in new shoes slowly over time.

A broken ankle occurs when one or more of the three bones that make up the ankle is fractured. Aside from a broken bone, a patient diagnosed with a broken ankle might also suffer from injuries to the connecting tissues or ligaments in the ankle, as well as the two ankle joints. Since ankle sprains and other ankle injuries have causes and symptoms similar to those of a broken ankle, it is important to seek medical attention for proper diagnosis and treatment of an ankle injury.

What Are Some Causes of a Broken Ankle?
~ Sports-related injury to the ankle
~ Falls and trips
~ Sudden twisting or rolling of the ankle
~ Car accident

What Are Symptoms of a Broken Ankle?
~ Swelling
~ Bruising of the ankle area
~ Acute, severe pain immediately at the onset of the injury
~ Tenderness and sensitivity to touch, along with an inability to endure weight on the ankle
~ Ankle deformity if the injury involves dislocation

How Is a Broken Ankle Treated?
~ Apply ice to the ankle area and elevate the affected lower leg to lessen swelling
~ Wear a leg cast or brace if the ankle is stable and no bones are out of place
~ Undergo surgery if the ankle is unstable, has torn ligaments,is dislocated, or has fragmented, loose bone
~ Healing is monitored by X-rays to check progress and to avoid complications
~ After the bone repairs, physical therapy, braces, and supports are part of continued treatment until the ankle is fully healed

A bunion is a deformity of the big toe joint that results from bone misalignment or repositioning at the joint. Although bunions occur most frequently at the base of the big toe, they can also arise on the outside of the foot at the base of the small toe.

When the joint at the base of the big toe becomes enlarged, friction and pressure are created as it painfully rubs against footwear. Eventually, the big toe may press inward against the smaller toes, even overlapping as far as the third toe in some cases, a condition called hallux valgus. With some bunions, the big toe also rotates or twists inward, which is called hallux abducto valgus.

What Are Risk Factors that Can Cause Bunions?
~ Overpronation, flat feet, or other neuromuscular problems that affect the feet
~ Tight-fitting, narrow-toed, or high-heeled footwear
~ Recurring stress to the foot
~ Previous foot injuries
~ Congenital defects
~ Arthritis

What Are Symptoms of Bunions?
~ Chronic pain and discomfort when walking, especially as the bunion becomes larger and rubs against footwear
~ Swelling, redness, and tenderness at the site
~ Thickened skin on the bottom of the affected area

How Are Bunions Treated?
~ Apply ice
~ Rest the area and avoid motions that apply pressure to the affected joint
~ Wear loose-fitting, non-constricting footwear that does not put pressure on the bunion
~ Insert orthotics into footwear to provide stability and correct positioning
~ Take over-the-counter anti-inflammatory medications on a temporary basis for pain and inflammation (ask your doctor first)
~ Stretch the area with specific exercises to keep the joint mobile
~ Splint the area during sleep to encourage proper joint alignment, which is preferred for younger people suffering from bunions because their bones are still developing
~ Receive a cortisone injection to reduce joint inflammation
~ Remove corns or calluses
~ Have a bunionectomy, or surgery to remove the bunion and realign the toe, if necessary

Untreated bunions can also lead to other toe deformities, such as hammertoe. Arthritis and bursitis may also develop in the joint area.

How Can Bunions Be Prevented?
~ Wear properly fitting, supportive footwear or custom orthotics
~ Seek early, correct diagnosis and treatment to slow or stop bunion development

At the end of a long day, especially one with a lot of standing and walking, it is not uncommon for the feet to feel tired, ache, and burn. This condition of burning feet can become more common after the age of 50. However, if burning feet turns into a chronic and recurring experience, it can indicate a serious underlying health issue, such as diabetes, thyroid dysfunction, or nerve problems. Because of this, it is important to contact a podiatrist if burning feet persists or becomes a regular occurrence. Burning feet can also result from obesity or alcohol abuse.

To help with burning feet, wear properly-fitting, supportive footwear in a breathable material, along with cotton socks; cushioned inserts can also provide more comfort while standing. Custom orthotics can correct foot imbalances that may lead to the sensation of burning feet. Rest the feet from time to time when standing for long stretches. Foot baths can soothe hot, sweaty feet.

Calluses, or thickened skin, result from on-going friction or pressure on a particular area of skin. On the foot, calluses (hyperkeratosis) commonly occur on areas subjected to pressure and impact: the heels, balls of the foot, and the big toe. Calluses cause irritation and pain as the thickened skin continues to be exposed to pressure or rub against footwear. Although the skin is affected, the bone beneath it is what actually causes the problem. Corns and blisters can also result from friction and pressure on the feet and toes.

Some calluses are painful and sore; the nerves are inflamed and fluid-filled sacs form underneath the callused area. Orthotic inserts and properly fitting footwear can prevent and alleviate calluses. Cortisone injections can provide rapid pain relief of inflammation and pain. For cases of heel callus formation resulting from a metatarsal bone deformity, surgery may be necessary to correct the bone and lessen the pressure.

To reduce calluses, soak affected feet in warm, soapy water, then rub the skin with a pumice or appropriate foot file; apply a thick moisturizing cream afterward to keep the skin soft. There are over-the-counter callus removers (always check with a doctor before using any medication; these particular treatments contain chemicals and can cause burns). Podiatrists also have methods for reducing calluses.

Capsulitis occurs when a toe joint ligament in the foot becomes inflamed due to over-stretching. These ligaments connect the toe and metatarsal bones. Capsulitis usually results from extending too much pressure to the forefoot as a result of trauma, overuse, or ill-fitting footwear.

What Are Some Causes of Capsulitis?
~ Sudden trauma or too much stress on the forefoot and toes
~ High heels, ill-fitting footwear, unsupportive footwear, or footwear inappropriate for the activity at hand
~ Activities that involve recurring bending of the toes, such as ladder climbing, gardening, or working on the floor or ground
~ Other medical conditions or deformities that render the foot and toe joints susceptible to inflammation, such as arthritis

What Are Symptoms of Capsulitis?
~ Pain and stiffness in the forefront and ball area of the foot
~ Swelling and tenderness of the toe joints
~ Sharp aches and pains in the toe joints
~ Difficulty walking
~ Since capsulitis often mimics other serious foot conditions, such as Morton’s neuroma, it is best to see a doctor for accurate diagnosis

How Is Capsulitis Treated?
~ Wear properly fitting footwear with low heels and plenty of support, along with cushioned orthotics to alleviate stress to the forefoot area
~ Refrain from the activity that caused the initial inflammation and rest intermittently during activities that involve recurring toe bending
~ Apply ice to the affected area
~ Take over-the-counter anti-inflammatory medications on a temporary basis (ask your doctor first)
~ Receive cortisone injections from your doctor

Charcot foot occurs when the foot bones weaken due to conditions such as arthritis and nerve damage. Diabetics who have neuropathy can suffer from Charcot foot. The weakened bones become susceptible to fractures in the feet or ankles, which can cause bone deformities that alter the shape and form of the foot. Fallen arches and collapsed joints result in changes in foot shape; this can lead to wounds and ulcers as pressure causes friction on the misshapen areas. Charcot foot can affect one or both feet as well as the ankles. The onset of Charcot foot occurs at the average age of 40.

Charcot foot can be treated through rest, elevation, and immobilization to halt pain and allow the fractures and wounds to heal. However, many cases require surgery to correct the deformities and fix the fractures, particularly in patients that have chronic or significant deformity alongside instability, extreme pressure, and/ or severe ulcers.

Charcot foot is a serious disease that leads to deformities and eventual disability. In extreme cases, amputation may be necessary, which is why diabetics and others with neuropathy must seek immediate care when any changes in the foot or ankle occur.

Chilblains, an atypical response to cold temperatures, causes the formation of small, red bumps on the toes, fingers, nose, and/ or ears, the areas most susceptible to cold. Chilblains can also develop on other areas of the foot that are subjected to constant pressure. The bumps can swell and get worse, causing the affected skin to dry out and crack. The damaged skin can become blistered, ulcerated, and even infected. Those with poor circulation are more prone to chilblains. Chilblains can be chronic or acute.

Chilblains can be treated by keeping the body warm, particularly the areas usually affected by the condition. Skin with chilblains can be treated with antiseptic lotions to prevent infection, lanolin creams to maintain skin moisture, and calamine lotion to alleviate itching and discomfort (always consult a doctor before taking any type of medication). A doctor can properly diagnose the condition and treat any infections that develop.

Chronic lateral ankle pain often results from a prior ankle sprain or injury and involves pain along the outer ankle area.

What Causes Chronic Lateral Ankle Pain?
~ Repetitive ankle sprains and post-sprain formation of scar tissue
~ Fractures in the ankle joint bones
~ Arthritis of the ankle joint, or inflammation of the ankle joint, tendons, or joint lining
~ Ankle-area nerve damage, including stretching, tearing, or pinching of ankle nerves

What Are Symptoms of Chronic Lateral Ankle Pain?
~ Outer ankle and lower leg pain
~ Stiff, tender ankle
~ Swelling of the ankle area
~ Unstable ankle and trouble maintaining balance on bumpy, unlevel ground or while wearing high-heeled shoes

How Is Chronic Lateral Ankle Pain Treated?
~ Take anti-inflammatory or prescription steroidal medications on a temporary basis to decrease swelling (ask your doctor first)
~ Do physical therapy, including exercises that strengthen and improve the range of motion for ankle muscles
~ Wear ankle braces and ankle supports
~ Immobilize the area to allow bone healing after fractures

Claw toe, also called claw foot, is a deformity that causes toes to bend upward or downward from a joint. The bottom part of the toe bends up from the joints at the ball of the foot, whereas the top part or tip of the toe bends down from the middle joints, taking on the resemblance of an animal’s claw.

Claw toe can be congenital, or it can result from nerve damage due to injuries or diseases such as alcoholism, diabetes, or strokes. It can also happen from arthritis or cerebral palsy. Corns or calluses may develop if footwear rubs against the protruding parts of the bent toes.

Claw toe is best treated when symptoms first arise and the toes are still flexible. Treatment can involve stretching and using the affected toes to keep them limber, as well as splinting or taping the toes in proper position. If you suspect you have claw toe, see your doctor right away.

Club foot is a condition where one or both feet are positioned rotating inward or downward in a mild or severe manner. The affected foot may also be smaller than usual, particularly in the heel area. It is usually congenital and may even be visible in an in-utero ultrasound. Clubfoot does not cause pain and can be corrected with proper treatment early on.

Clubfoot affects about one in 1,000 babies, making it one of the most commonly-occurring, non-deadly major birth defects. Almost 50% of clubfoot babies have two clubbed feet, and two-thirds of clubfoot babies are males. The condition can occur due to the in-utero positioning of a forming baby or a combination of environmental and genetic factors. If a family member has clubfoot, it increases an infant’s odds of having it.

Treatment of clubfoot should begin immediately to avoid growth problems as well as subsequent discomfort and disability. If treated before a baby walks, function and stability can be greatly improved. Serial casting is a common treatment for clubfoot that gradually shifts the bones into proper alignment. Over several months, the doctor intermittently stretches the foot toward the proper position, then casts it to hold the new position in place. X-rays show progress.

After successful serial casting, the child will need to wear special shoes or braces for several years to maintain proper foot positioning. Frequently, the muscles will try to return to the pre-treatment position until about mid-childhood. If serial casting is not successful, the joints, ligaments, and tendons can be surgically shifted.

Corns form on the toes due to friction or pressure from rubbing against footwear or even other toes. The friction and pressure thickens the skin and inflames underlying tissue. Corns can be soft; these are open sores between the toes. Hard corns develop on top of the toes or on the outside of the little toe. Ill-fitting footwear and toe deformities can cause corns.

Treat corns by soaking the foot in warm, soapy water, then rubbing the skin with a pumice or appropriate foot file. Donut-shaped foam pads can reduce friction and pressure on the corn. Podiatrists also have methods for reducing corns.

Cysts can develop on any part of the body. On the foot, they usually develop under the skin; however, they can also emerge more deeply in the bones, joints, or ligaments. Cysts are fluid-filled and can cause pain and discomfort, especially if they are located in an area susceptible to footwear pressure or infringe upon a nerve. Cysts can develop from something as simple as improperly-fitting footwear; they can also result from foot injuries.

There are several types of cysts that can impact the feet. One of the most common is ganglion cysts that form on a tendon or joint. These cysts are filled with a jelly-like fluid and form a knot or mass underneath the skin that’s size can vary over time. Synovial cysts also form in tendons or joints. Doctors can use diagnostic tests such as X-rays, CT scans, ultrasounds, and MRIs to view and diagnose cysts.

Cysts on the feet can be treated with orthotics that alleviate pressure. Doctors may monitor cysts over time to detect changes in size or composition; they may also remove fluid from a cyst. Sometimes, after extracting fluid, treatment may involve a steroid injection into the cyst. It is not uncommon for cysts to return.

Diabetes, or hyperglycemia, is high blood glucose. If blood sugar levels are not normalized in a diabetic, the body may have trouble fending off infections due to decreased functioning of the immune system. This can affect the feet in particular due to peripheral artery disease (lack of circulation) and peripheral neuropathy (loss of feeling).

As a result of diabetes, the feet may become susceptible to a slew of problems, such as ulcers and wounds that do not heal properly, fungal infections, ingrown or brittle toenails, corns, calluses, hammertoes, athlete’s foot, and cracked or dry skin. Gangrene, or dead tissue, can develop, causing bacterial infections that may result in amputation of the affected areas. Even every day activities such as walking can cause issues in the feet of a diabetic, as the bones, joints, and skin are affected by the condition.

For the diabetic, proper and thorough foot care is imperative. Diabetics should check their feet daily for early detection of foot problems or injuries.

Here are proper foot care suggestions for diabetics to follow:
~ Keep feet clean, warm, and dry (thoroughly dry between toes)
~ Wear comfortable shoes and do not wear the same pair every day (look for roomy toe boxes, leather uppers, and shoes that do not pinch, rub, or cause pressure; avoid stiff shoes and gradually break-in new footwear)
~ Always wear clean, dry socks without tears or irritating seams (thin cotton is absorbent and helps keep feet dry)
~ Do not leave feet exposed or unprotected (sleep in loose socks; do not wear flip flops or sandals; do not go barefoot)
~ Never expose feet to heat or high water temperatures (burns can occur due to loss of feeling)
~ Maintain better foot circulation (do not smoke; avoid stockings or socks with tight elastic bands; do not cross feet or legs when sitting)
~ Treat the feet gently (pat dry; avoid cutting or tearing the skin)
~ Carefully shape toenails straight across with an emery board (avoid ingrown toenails)
~ Do not use over-the-counter foot products such as antiseptic solutions, plasters, tapes, or anything sticky (they can damage the skin and lead to wounds)
~ Use moisturizer to keep skin supple (except between toes)
~ Do not treat corns or calluses at home; see a doctor for care

It is important that diabetics seek podiatric care on a regular basis to prevent foot problems that can easily get out of control. A podiatrist will ensure proper foot care, from maintenance to the treatment of any developing problems. Any foot problem should be immediately addressed in a diabetic to avoid serious complications.

Dysplasia is abnormal cell growth. In the foot, dysplasia results in cartilage overgrowth at the tips of the carpal or tarsal bones that affects the adjacent bone joints. It usually occurs in one limb, not both, which can result in uneven lengths in corresponding limbs. Dysplasia can affect other bones of the leg and hip as well.

Enchondromas develop in the bone underneath the toenail and are small, benign growths composed of cartilage. The tumors are composed of cartilage that forms in the bone and are usually painless, which is why they often go undiagnosed unless they are revealed during X-rays or screenings done for other diagnoses. Enchondromas that form at the end of the toe feel similar to the pain of an ingrown toenail.

Enchondromas are the most commonly occurring bone tumors of the hands and feet. Enchondromatosis, or Ollier’s Disease, involves the growth of multiple enchondromas in the phalanges and metatarsals, or the small and long bones in the hands and feet. In the case of Maffucci’s Syndrome, enchondromas form benign soft tissue tumors, or hemangiomas, anywhere in the body. Hemangiomas involve the blood vessels and are more prone to becoming malignant than the enchondromas of Ollier’s Disease.

Enchondromas can be present in large areas of the bones, which thins the bone’s cortex, making it susceptible to breaks. Enchondromas usually require no treatment; however, if they grow enough to destroy bone tissue, they can be treated or surgically removed.

Erythromelalgia, a rare condition, is enlarged blood vessels in the feet; it also can occur in the hands, but not as commonly. Symptoms include redness, intense warmth, burning sensation, and pain. The onset of erythromelalgia can be acute or gradual, and the condition can occur on its own or in relation to another disease. In some cases, erythromelalgia results from a genetic mutation.

For relief, affected areas can be cooled and elevated. Ice and water soaks are not recommended due to potential damage to the skin. Certain prescription medications can help alleviate erythromelalgia; it is important to see a doctor for proper diagnosis and treatment (no medication should be taken without the advice of a doctor).

Flatfoot is a foot deformity involving the arch of the foot, where the entire foot rests on the ground when standing, rather than the foot having a normal mid-foot rise. Flatfoot may result from the foot’s arch failing to develop properly during childhood, when standing and walking begin. It can also result from the foot’s arch collapsing over time or due to an injury or other condition.

What Are Some Causes of Flatfoot?
~ Abnormal childhood development of the foot arch, once standing and walking begin
~ Heredity (parents have flatfoot)
~ Injury or trauma
~ Foot arch that has gradually collapsed over time as a result of aging, weight gain due to pregnancy or obesity, or conditions such as arthritis

What Are Symptoms of Flatfoot?
Commonly, the condition of flatfoot causes no symptoms or pain, but the following indications may develop over time:
~ Pain in the foot, ankle, and/ or lower leg area, particularly in the middle of the foot
~ Lack of foot flexibility
~ Localized swelling

How Is Flatfoot Treated?
Since most cases of flatfoot do not result in pain, treatment may not be necessary; however, if pain and stiffness occur, the following treatments may be advised:
~ Rest and stretch the area
~ Participate in physical therapy
~ Wear arch supports, foot braces, and/or supportive tape
~ Ice the area
~ Take over-the-counter anti-inflammatory medications on a temporary basis (ask your doctor first)

In some people, flatfoot can create an inclination to suffer from painful progressive flatfoot, or tibialis posterior tendinitis. This occurs when the tendon of the tibialis posterior is injured, causing inflammation, overstretching, or tearing. This condition, also called adult-acquired flatfoot, can cause chronic pain and may become disabling if not properly treated.

There are many bones in the human foot, some of which are very small. In fact, almost 25% of the body’s bones are housed in the feet. Thankfully, a fractured, or broken toe or forefoot bone is usually not serious or disabling. However, foot bone fractures are still painful and require proper diagnoses and treatment.

Bones are susceptible to two kinds of fractures: stress and general. Stress fractures are small fissures or cracks in the surface of the bone and usually occur in the forefoot, or the area from the mid-foot extending to the toes. General fractures travel into the bone beyond its surface and can be stable or displaced, as well as closed or open. Displaced fractures occur when bone ends no longer stay in proper alignment with one another. With an open fracture, the broken bone pierces through the skin.

The fifth metatarsal, or pinky toe, is vulnerable to several types of different fractures. Ankle-twisting injuries can cause avulsion fractures; with this, the tendon that attaches to the fifth metatarsal bone tears, pulling away a tiny piece of the bone. A Jones fracture is a more serious injury occurring at the base of the fifth metatarsal, which can restrict blood flow in this area that already receives less blood flow due to its location on the foot.

What Are Some Causes of Fractures?
~ Stress fractures from sudden exercise increases or overuse
~ Jarring jumps or falls
~ Accidents causing hard blows or impacts to the foot
~ Falling objects that crush bones in the foot
~ Twisting hard enough to cause the bones to snap or break

What Are Symptoms of a Fracture?
~ Swelling
~ Bruising of the injured area
~ Pain
~ Tenderness and sensitivity to touch
~ Difficulty walking or putting weight on the foot

How Is a Fracture Treated?
~ Apply ice to the area and elevate the affected lower leg to lessen swelling
~ Wear a compression wrap, stiff orthopedic shoe, or walking boot to immobilize and protect the foot
~ Keep weight off the foot and rest it as much as possible

Freiberg’s disease is a rare disorder of the foot’s metatarsal joints. The metatarsal bones run from the toes to the arch of the foot. With Freiberg’s disease, the joint surfaces disintegrate and/ or collapse and abnormal tissue forms in the joint. It can be the result of foot injury or trauma or the occurrence of longer-than-normal metatarsal bones. At its onset, the disease can cause pain or stiffness in the forefoot, which can become chronic; however, some cases are asymptomatic in the early stages. Although anyone can become susceptible to Freiberg’s disease, females are three times more likely to develop it than males, and it usually occurs during adolescence.

Freiberg’s disease may heal without treatment in its earlier stages. Usually, treatment involves resting the affected joint area to alleviate pressure and allow healing, orthotics, and cortisone. Joint surgery or replacement may be necessary in severe cases.

When outdoor temperatures drop to near or below freezing, frostbite can occur after exposure to cold conditions for an extended amount of time. Frostbite can involve damage to the skin, tissue, and even underlying nerves, muscles, tendons, and bones in more severe cases. The body reacts to exposure to cold by constricting its blood vessels, which restricts the flow of blood and oxygen, particularly in the feet, hands, ears, nose, and lips. A lack of circulation can lead to dead skin and tissue.

Frostbite most commonly affects the elderly and diabetics, as they have poorer circulation to these areas. Children are also more susceptible to frostbite because of their smaller extremities. Those who are exposed to cold temperatures for long periods of time, such as outdoor workers and the homeless, are at an increased risk for developing frostbite.

Superficial frostbite affects only the three layers of the skin and can penetrate to the third, or subcutaneous layer. Deep or advanced frostbite is a very serious condition, when the damage has spread to the nerves, muscles, tendons, and even bones. In this case, the skin may turn white, blue, or even black. The frostbitten areas may have gangrene, or dead tissue, which may need to be surgically removed to prevent infection. Although frostbite sufferers can fully recover, they may experience a lasting sensitivity to cold and be more prone to future cases of frostbite.

If frostbite strikes, immediately get medical help and find a warm environment. Rather than warming the skin with too hot of a source, such as sitting close to a portable heater or fireplace, gradually return the skin to a warmer temperature. Thawing the skin and then subjecting it to refreezing is particularly dangerous.

Frostbite can be prevented by avoiding prolonged exposure to freezing temperatures. If you will be outside in frigid temperatures, keep the feet warm and dry by wearing appropriate socks and boots. Go inside frequently to warm up, and be sure to remove any wet clothing, as wet skin is more prone to frostbite. Again, do not thaw and refreeze frostbitten skin.

Fungal infections can develop underneath the toenail surface, often as a result of other fungal foot infections. Fungal nails, or onychomycosis, can be harder to treat than other foot fungi, such as athlete’s foot; they can be accompanied by bacterial and/ or yeast infections that affect the nail plate as a result of the fungal infection, and they may spread to affect other toenails, fingernails, and areas of skin.

Oftentimes, people are unaware that they have a fungal nail problem. Symptoms can be brittle, thickened, discolored nails that may loosen and crumble as the fungal problem advances. White spots on the nail surface can also indicate fungal nails. People with chronic diseases that impact the immune system, such as immune deficiencies, diabetes, and circulatory problems, are more susceptible to fungal nails.

Fungal nails and foot fungal infections can be prevented by the following suggestions:
~ Wash and dry feet thoroughly, taking extra care to dry between the toes
~ Use powder to keep the feet dry
~ Keep socks and footwear clean and dry; socks can be changed several times daily
~ Wear footwear made of breathable materials that allow air to circulate around the feet; constricting footwear, stockings, and socks can trap moisture and perspiration on the feet
~ Never share socks or footwear |
~ Do not walk barefoot in public areas such as showers, pools, and locker rooms; instead, wear plastic flip-flops, slides, or shower shoes
~ Sanitize nail clippers, nail files, and pedicure instruments; never share them with others
~ Avoid injuring the toenails and nail beds, which can eventually develop into an infection

If over-the-counter treatments do not arrest the fungus or if chronic fungal nail is an issue, prescription treatments administered orally or topically may be necessary (always consult a doctor before taking any type of medication). Debridement can remove the infected nail matter. With aggressive fungal nail cases, a doctor may have to permanently remove the toenail.

Fungal problems can cause foot odor and smelly feet. Since the feet are frequently exposed to moisture due to sweating and wet weather conditions, fungal infections are common. Chronic foot odor can signal an infection or heavy perspiration or sweating of the feet.

Fungal infections like athlete’s foot can be prevented by the following suggestions:
~ Wash and dry feet thoroughly, taking extra care to dry between the toes.
~ Use powder to keep the feet dry.
~ Keep socks and footwear clean and dry; socks can be changed several times daily.
~ Wear footwear made of breathable materials that allow air to circulate around the feet; constricting footwear, stockings, and socks can trap moisture and perspiration on the feet.
~ Never share socks or footwear.
~ Do not use someone else’s foot hygiene instruments, such as emery boards, nail clippers, or foot files
~ Do not walk barefoot in public areas such as showers, pools, and locker rooms; instead, wear plastic flip-flops, slides, or shower shoes.

Sweaty feet can be treated with a black tea foot soak: Using two tea bags per pint of water, brew strong black tea by boiling it for 15 minutes; add two quarts of cold water; and soak the feet for half an hour daily for seven days in a row. The black tea contains bacteria-destroying acids and also shrinks pores, which can help keep perspiration at bay. Vinegar foot soaks are also effective: Mix one part vinegar with two parts cool water and soak.

A podiatrist can prescribe ointments to apply to the feet at bedtime. There are also medical treatments such as iontophoresis and surgical procedures that can control extremely sweaty feet.

Gangrene, or dead body tissue, occurs when blood flow and oxygen are cut off or severely restricted. Gangrene can result from bacterial infections deep frostbite, or open sores that do not heal properly. Those with weakened circulatory systems and nerve damage, such as diabetics, are more prone to foot gangrene.

Gangrene is characterized by acute, sudden pain or numbness in a lower extremity, which may be accompanied by skin that feels cold and looks darker than usual. Wet gangrene shows signs of tissue decay; redness, oozing, swelling, and foul odor at the site may be present.

It is important that gangrene areas are removed surgically to prevent infection that can move quickly throughout the body and cause death. If gangrene is suspected, seek immediate medical help.

Gordon syndrome is a rare, inherited genetic disorder where affected joints remain permanently curved or flexed, restricting normal movement. Gordon syndrome is a distal arthrogryposis, a classification of disorders that involves stiffness and impeded mobility of lower extremity joints in the distal extremities, or knees, ankles, elbows, and wrists. Gordon syndrome can cause the foot to atypically bend inward. The degree of the disorder, joint deformity, and related symptoms varies from individual to individual.

Gout, a complex type of arthritis, results from an accumulation of uric acid in the joints. The big toe joint is often affected by gout, probably due to the pressure it is subjected to during walking and standing. Gout causes pain, extreme tenderness, throbbing, and a burning sensation in the joint, with localized redness and swelling. An attack of gout lasts for several hours before it usually subsides, but it more than likely returns to the same area within months. Gout, also known as gouty arthritis, more frequently affects men, but women can also suffer from it.

Since gout can be triggered by diet, it is recommended that gout sufferers avoid alcohol; limit high levels of proteins,red meat, shellfish, and rich sauces; and drink plenty of water or fluids. Medications are effective in treating the disease’s onset, symptoms, and complications.

Haglund’s deformity, or “pump bump,” is a hard, bony enlargement on the back of the heel. Also called retrocalcaneal bursitis, Haglund’s deformity causes pain when footwear rubs against the protruding bone growth, irritating and inflaming the surrounding soft tissue. Bursitis can develop as a result of Haglund’s deformity and irritation to the area. Rigid-backed footwear, including workboots, high-heeled shoes, dress shoes, and even ice skates can irritate the area, resulting in swelling, redness, and discomfort. Women are more prone to this deformity than men due to the stiff contour of pumps and dress shoes.

Treatment for Haglund’s deformity includes inserting heel pads or lifts into shoes to reduce rubbing and pressure to the area, wearing shoes with soft or no backs, icing the area to reduce swelling, and taking over-the-counter anti-inflammatory medications on a temporary basis to reduce pain, inflammation, and swelling (ask your doctor first).

Hallux limitus, an arthritic condition of the hallux, or big toe, involves stiffness in the joint at the base of the big toe. Abnormal alignment of the first metatarsal bone is usually the cause of the condition that restricts motion. Injury, overuse, and genetics are other reasons for the development of hallux limitus.

Symptoms include sudden sharp pain, or the gradual development of discomfort and pain over time, as well as swelling and inflammation that are aggravated by pressure from footwear. Hallux limitus can lead to wider spread joint problems, such as hallux rigidus, as well as calluses, bone spurs on top of the joint, and diabetic foot ulcers, if left untreated. Hallux limitus can be treated with orthotic inserts to stabilize and support the area, ice, rest, over-the-counter anti-inflammatory medications (ask your doctor first), and cortisone injections at the site.

Hallux rigidus is a degenerative arthritis affecting the joint of the big toe that eventually causes the toe to become rigid, or unmovable. Over time, the toe’s motion decreases due to wear-and-tear that deteriorates the articular cartilage, making it difficult to walk, run, or climb stairs, all of which involve pushing off of the big toe. In time, standing or putting weight on the affected area can become painful. Hallux rigidus starts with hallux limitus, which involves stiffness and a limited range of motion of the big toe joint.

As a result of hallux rigidus, bunions, calluses, and bone spurs can develop on top of the bone. There is also pain and swelling around the affected joint. Treatment for hallux rigidus involves the use of ice, rest, over-the-counter anti-inflammatory medications (ask your doctor first), and cortisone injections at the site. Stiff-soled or rocker-bottom footwear and orthotic inserts may alleviate pressure to the area, and shoes with a larger toe box area may also help. Surgery can become necessary in advanced or painful cases.

Hallux varus is a deformity of the big toe joint that results in the big toe pointing outward, or away from the other toes, whereas a bunion would cause the big toe to lean inward. Hallux varus can be congenital, or it can occur from overcorrective bunion surgery, a tight or short abductor hallucis tendon, or injury.

Aside from the direction of the toe pointing outward, symptoms of hallux varus are pain, redness, and blisters on the toe from it rubbing against footwear. An ingrown nail on the big toe may also develop from pressure. The condition can be treated by stretching and splinting the abductor hallucis tendon. For more severe cases, surgery can straighten the toe.

Hammertoe occurs when the second, third, or fourth toe bends at the middle joint, often as a result of wearing ill-fitting shoes. Genetics, arthritis, and muscle imbalance can also cause hammertoe. The affected toe resembles a hammer, which is where the deformity it gets its name. With hammertoe, the toe bends downward, rather than pointing straight forward. Corns or calluses frequently develop at the top of the affected joint or at the toe’s tip from pressure. Hammertoe can cause pain and can lead to loss of flexibility in the toe.

To treat hammertoe, wear comfortable shoes with large toe boxes, as it commonly develops from shoes that are too small, narrow, or high-heeled. It can also result from injury, arthritis, or a high foot arch. Shoe inserts can help when a high arch is the cause. Over-the-counter treatments are available to alleviate the related corns and calluses. Toe stretches can help restore the toe’s correct position, as well as lessen the pain.

Calluses, or thickened skin, result from on-going friction or pressure on a particular area of skin. Heel or plantar calluses cause irritation and pain as the thickened skin continues to be exposed to pressure or rub against footwear. Orthotic inserts and properly fitting footwear can prevent and alleviate calluses.

For cases of heel callus resulting from metatarsal bone deformity, surgery may be necessary to correct the bone and lessen the pressure. Less severe calluses can be reduced by soaking the foot in warm, soapy water, then rubbing the skin with a pumice or appropriate foot file; apply a thick moisturizing cream afterward to keep the skin soft. There are over-the-counter callus removers (always check with a doctor before using any medication; some of these treatments can cause chemical burns). Podiatrists also have methods for reducing calluses and treating the pain that can accompany them.

Heel fissures, or cracks in the skin of the heel, occur due to the area being subjected to constant pressure and friction. The heel is also susceptible to dry skin and calluses. Superficial cracks that do not penetrate deeply into the skin’s surface can be treated with thick creams to provide moisture. Deeper heel fissures that expose layers of skin tissue or blood are more serious, as infections can develop if bacteria enter the fissures.

Heel fissures can be prevented by wearing properly-fitting, supportive, cushioned footwear, as well as heel inserts, both of which protect the heel’s fat pad from wearing down. Avoid wearing sandals and open-heeled footwear that expose the heel and provide less support to the area. Keep the heel’s skin moisturized and soft; uses pumice stones or foot files to get rid of calluses so fissures don’t form in the thickened, dry skin. Podiatrists have treatments for heel fissures and calluses. Always see a doctor for deeper heel fissures that can lead to infection.

Spurs are outgrowths of bone. In the feet, they most commonly occur in the heel. The spurs usually develop in areas subjected to constant pressure. Bone spurs can become problematic when pain and other foot problems crop up as a result of footwear pressing and rubbing against the affected area, causing irritation, redness, swelling, and inflammation. As the bone spur irritates and inflames the surrounding soft tissue, acute pain and/ or a dull ache are experienced.

Heel spurs, or bone spurs in the heel, occur on the bottom of the heel bone as a result of calcium deposits forming over time. They frequently accompany the condition plantar fasciitis. They are quite common and often develop in athletes who frequently run and jump, high-impact activities that cause repeated pressure on the area; they are also common in individuals who stand on hard surfaces for long periods of time. People with high foot arches, diabetes, and excess weight can also be prone to heel spurs. Heel spurs can be prevented through stretches and foot exercises, wearing supportive, well-fitted footwear, and properly warming up before impact activities, all of which reduce tension and stress to the area.

Heel spurs can be associated with plantar fasciitis, a condition when the plantar fascia, or band of fibrous tissue that connects the heel bone to the ball of the foot, becomes inflamed.

How do you treat heel spurs?
~ orthotics,
~ supportive and properly fitting footwear
~ anti-inflammatory medications (ask a doctor before taking any medication)
~ cortisone injections
~ surgery if the condition worsens

Ingrown toenails, known as onychocryptosis, most commonly occur on the big toe and are caused by pressure that drives the edge of the nail into the surrounding skin. Ingrown toenails can result from improper nail trimming, injuries, fungal infections, and toe deformities; they can also be inherited. The condition causes pain, redness, inflammation, swelling, and sometimes, infection. The condition is common in athletes and runners and can be caused by ill-fitting footwear in the toe area.

Although ingrown toenails can go away on their own, warm foot soaks with Epsom salts, elevation, and anti-inflammatory medications may help with healing and reducing pain (always seek medical advice from a doctor before taking any medication). Ingrown toenails that are chronic, persistent or get worse should be treated by a doctor who can prescribe antibiotics or even perform surgery, if necessary, to alleviate the condition. To prevent ingrown toenails, trim the toenails straight across and avoid clipping the nails too short or in a curved fashion.

In-toeing is when the feet turn inward instead of pointing straight ahead when walking or running. Out-toeing is when the feet point outward instead of straight ahead when walking or running. The conditions are generally painless. Concerns from mispositioning of the feet when walking are an unsteady gait that can lead to tripping, stumbling, and falling

Although many children have in-toeing or out-toeing, most cases resolve themselves by two years old without any intervention at all beyond a simple reminder to the child to properly position the feet. In cases that do not rectify themselves over time, foot supports or special shoes can alleviate abnormal pressures on the foot caused by the mispositioning, preserving foot structure from damage and limited function later on.

Ischemic foot is inadequate arterial blood flow from the heart to the foot that can occur from arterial blockages, arterial spasms, and injury to the artery. Since blood flow is restricted to the foot, symptoms include cold feet, purplish or discolored toes, muscle cramping, and pain. Ulcers and gangrene can result from the lack of blood to the area. Treatment for ischemic foot involves exercises that increase blood flow to the feet, such as walking; orthotics and protective shoes can protect the affected skin from damage caused by rubbing or irritation. Medications may be prescribed to improve blood flow (always consult with a doctor before taking any medication).

Jackson-Weiss syndrome is a rare, genetic disorder that affects males and females alike. The disorder causes foot and skull abnormalities due to over-stimulated bone cell growth. On the feet, Jackson-Weiss syndrome impacts the toes, resulting in unusually large, stubby big toes that point inward, fused toe bones, and webbed skin between the second and third toes. Corrective surgery is usually performed on affected infants.

Kohler’s disease occurs in young children. Usually caused by abnormal foot artery growth, it disrupts blood supply to the foot and weakens the bone. The disease usually heals over time on its own; however, treatment may involve restricted activity and orthotics and braces to support the bone while it strengthens and heals.

A skin lesion is a variation on the skin’s surface, where the affected area is a different color or texture from the surrounding skin. Skin lesions can appear on any part of the body, including the legs and feet, and may be present at birth or develop over time due to conditions such as acne, injuries, diseases, aging, sun damage, allergies, and cancer. Skin lesions can be small or large and can vary in number. Some examples of common skin lesions are freckles, moles, warts, birthmarks, acne, rashes, and boils.

Although most skin lesions are benign, any change or difference in skin tone or texture should be observed, as changes may indicate that a harmless skin lesion has become malignant. Diabetics and those suffering from weakened immune systems may have skin lesions as a result of the disease. Areas subjected to sun exposure, such as the tops of the feet, can be sites where cancerous skin lesions develop, such as malignant melanoma and actinic keratosis. AIDS or HIV-positive people may have Kaposi’s sarcoma lesions appear on the soles of the feet. These cancerous skin lesions are purplish in color, irregularly shaped, and spread out on the skin’s surface.

If you have a skin lesion that has changed in size, shape, or color, be sure to have it immediately checked by a medical professional. A podiatrist can assist you with skin lesions on the feet and legs. Suspicious or malignant skin lesions must be removed by a doctor.

Maffucci’s syndrome is a very rare congenital disease, wherein multiple enchondromas develop on the bones, along with hemangiomas, or soft tissue tumors that involve entangled, abnormal blood vessels. The benign, non-cancerous cartilage growths form in the cartilage at the end of bones, where bone growth occurs. They most frequently develop in the hands and feet, although they can form anywhere in the body, and can result in severe bone deformities, fractures, underdeveloped muscles, shortened limbs, and shorter stature. Enchondromas halt formation when growing stops. The growths can become malignant, or cancerous. Surgical treatment is necessary if the growths damage bone tissue, at which point they should be removed.

Mallet toe happens when the joint at the tip of the toe remains bent and unable to straighten. The condition, caused by arthritis and bone and muscle imbalances, can be painful due to the toe’s down-turned tip rubbing against footwear, which creates pressure on the toe. Formation of corns on top of the affected toe is common from the friction caused as the toe presses or rubs against the top of the shoe.

High heels and any ill-fitting footwear that puts pressure on the toes can lead to or worsen mallet toe. The condition can also be aggravated by an active lifestyle, sports, and exercise. Mallet toe treatment includes wearing comfortable shoes with a roomy toe box to accommodate the deformity and reduce friction. Supportive gel inserts for the toe area can also relieve irritation, pain, and discomfort.

Metatarsalgia is characterized by acute pain in the ball of the upper foot region, or the area between the foot’s arch and toes. There are five metatarsal bones running down the middle of the foot from the toes to the ankle; when one of the nerves between the metatarsals becomes inflamed, metatarsalgia and its accompanying pain result.

What Are Some Causes of Metatarsalgia?
Metatarsalgia can occur when uneven or too much pressure is applied to the foot’s metatarsals due to the following conditions:
~ Foot injuries
~ Weight-bearing sports and exercises, such as running
~ Ill-fitting or rigid footwear
~ Prolonged standing on hard floors or ground
~ Overpronation, or rolling in of the feet when walking or running which causes uneven weight distribution on the feet
~ Foot deformities
~ Morton’s neuroma
~ Arthritis
~ Aging (degenerates foot bones and pads)
~ Weight gain

What Are Symptoms of Metatarsalgia?
~ Sudden or increasing pain in the toe and forefoot area, especially during activity or walking barefoot
~ Callus formation under the inflicted joint due to pressure

How Is Metatarsalgia Treated?
~ Rest the area and restrict sports and physical activity
~ Apply ice
~ Take over-the-counter anti-inflammatory medications on a temporary basis (ask your doctor first)
~ Wear properly-fitting, supportive, and appropriate footwear and orthotics such as arch supports, metatarsal lifts, and inserts
~ Eliminate overpronation with appropriate footwear and orthotics
~ Lose weight to reduce pressure and stress on the feet

Neuromas are benign growths of nerve tissue, or nerve tumors, that form when the nerves are irritated by surrounding tissue rubbing against them. Improper footwear that creates pressure on the foot, as well as foot structure abnormalities and injury to the nerves can cause or worsen neuromas. Symptoms of a neuroma include intense pain, swelling, tingling, numbness, and/ or a burning sensation in the toes and forefoot area. The pain usually intensifies when walking.

Neuromas most frequently develop between the third and fourth toes. Morton’s neuroma is a condition where the tissue surrounding the nerves thickens due to constant irritation or pressure, such as from wearing high-heeled or constricting shoes.

Treatment for a neuroma may include wearing properly fitting shoes with a roomy toe box, as well as cushioned shoe inserts or pads that alleviate pressure. The foot can be rested, elevated, and iced to relieve discomfort, swelling, and irritation. High heels or narrow-toed shoes that put pressure on the forefoot should be avoided. Since neuromas can worsen, consult a doctor for proper treatment, which may involve cortisone injections and even surgery in more severe cases to remove the neuroma.

Ollier’s disease, or enchondromatosis, is a rare congenital disease of abnormal bone development due to cartilage overgrowth in the form of enchondromas, or benign, non-cancerous tumors. The limbs’ long bones and joint cartilage are affected by the disease, and the small bones and metatarsals of the hands and feet are common sites for the enchondromas to develop. The masses can also grow elsewhere in the body.

It is possible but not common for the tumors to become malignant, or cancerous. Most cases of Ollier’s disease remain benign and do not require treatment, unless bone tissue is destroyed by quick-growing tumors. Then, the growths can be surgically removed.

Osteochondritis is stiffness, swelling, and pain in the ankle joint due to lesions or fractures that form on the joint surface as a result of previous twisted-ankle injuries. Osteochondritis can affect persons of any age.

Symptoms of osteochondritis resemble those of an ankle sprain, such as swelling, pain, and a difficult time putting weight on the affected area.

Osteochondritis treatment begins with X-rays to check for joint surface fractures and to distinguish the injury from a sprain. The foot and ankle should be immobilized to allow the joint to rest and heal. Surgery may be necessary to treat severe cases to remove cartilage and bone fragments from the ankle joint area, stimulate new blood vessels, and promote scar tissue that will fill in the damaged areas

Osteochondromas occur underneath the toenail when benign bone tumors form in that area, typically after injury. Most common in children and young adults, osteochondromas account for approximately 50% of all benign bone tumors.

Most of the time, osteochondromas do not cause pain; however, discomfort can result if they irritate surrounding tissue. If osteochondromas deform the toenail or cause it to become ingrown, they can be surgically removed. Osteochondromas can become a recurring condition.

Osteomyelitis is a bacterial bone infection that can strike people of any age. In adults, osteomyelitis most frequently strikes the hips, vertebrae, or feet; in children, the ends of the long bones in the arms and legs are the most common site for the disease. Bone infection can occur as a result of an infection in another part of the body that then travels through the bloodstream and settles in the bone. The infection can initiate from a wound from surgery, injury, or an injection, as well as from an internal infection. Due to diabetic foot ulcers, diabetics are more prone to contracting osteomyelitis in their feet.

Symptoms of osteomyelitis include pain, tenderness, stiffness, swelling, and inflammation at the site of the infection, fever, chills, and nausea. The symptoms can appear suddenly or gradually. It is diagnosed with tests and bone images to check for changes in the bone. Further testing of biopsies and cultures may be used to identify the type of bacteria causing the infection so that proper treatment can be administered. Treatment involves antibiotics and pain medication. The affected area may also be immobilized with a splint. If diagnosed early, osteomyelitis can be effectively treated using these measures.

The diagnosis and treatment of severe or chronic bone infections is a specialized field of medicine. In the United States, there are relatively few doctors with expertise with severe or chronic osteomyelitis.

Overlapping and underlapping toes occur when toes are out of position. The conditions can be congenital due to inheritance or the fetus’s in-utero position, or they can develop over time from ill-fitting footwear that constricts or pressures the toes, keeping them bunched rather than flat. It can also stem from a bunion.

An overlapping toe lies across the top of an adjacent toe rather than staying in its straight position. This is most common with the fifth toe. An underlapping toe lies behind another toe; this most commonly affects the fourth and fifth toes. Congenital curly toe is a condition where the toes curl and point to the outside of the foot. It is usually congenital and can be worsened by ill-fitting footwear. As a result of toe overlapping or underlapping, blisters, irritation, corns, and calluses may form as the toes rub against one another and footwear.

Treatment for overlapping and underlapping toes involves stretching and taping the toes, which is usually how the condition is treated in infants. However, the mispositioning usually returns. Surgery to release the tendons and soft tissues at the toe joint at the base of the toe may be necessary, and in severe cases, a pin can be temporarily inserted in the toe to correct its position. With underlapping toes that are inflexible and fixed in position, surgery can remove bone in the toe to improve flexibility.

Peroneal tendons are also known as stirrup tendons because they run parallel along the outer ankle bone, attaching to the inside and outside of the foot near the arch. Their function is to stabilize the ankle and foot.

Injury to the peroneal tendons can occur suddenly during sports such as football, basketball, and soccer, or they can develop over time. The tendons can tear, become inflamed (tendonitis), or suffer from subluxation (moving from normal position). Signs to look for are swelling, pain, instability of the ankle, and feeling as if the tendon has snapped. The area may also be warm when touched. The pain may be constant or intermittent, and it can be greater at the back of the ankle bone where the tendons run.

Immediate and proper treatment is necessary to avoid tearing or further damage. The injured area must be immobilized, and crutches may be used to keep weight off of the affected ankle. Anti-inflammatory medications and ice can decrease swelling (consult your doctor before taking any medication). In some cases, surgery may be necessary to repair the tendons. Physical therapy can help restore motion and strength after the injury is healed.

Plantar fasciitis is inflammation of the plantar fascia, the fibrous tissue that runs along the arch of the foot to connect the heel bone and ball of the forefoot. Heel spurs are not the same as plantar fasciitis; however, the two conditions are associated. Since the plantar fascia is subjected to great amounts of impact and pressure while supporting the foot’s arch, it can become inflamed and irritated. In some cases, it begins to deteriorate.

Standing, running, and walking can cause and encourage the pain and inflammation associated with plantar fasciitis. Treatment for plantar fasciitis is the same plan of attack to alleviate heel spurs: rest, ice application, orthotic inserts, exercises and stretches to alleviate tightness and pressure, and anti-inflammatory medications (always check with a doctor before taking any medication). Splinting the foot at night can also help stretch the plantar fascia. Surgery is necessary in some cases.

Plantar fasciitis can be prevented by wearing supportive, properly-fitting footwear, orthotics, heel pads or cushions, and stretching to keep the foot flexible.

Plantar fibromas occur when benign tumors develop deep inside the plantar fascia, the dense fibrous ligaments that run along the bottom of the foot. The lumps or growths forming along the foot’s arch result in pain that is often felt in various areas of the foot. Plantar fibromas can lead to a multitude of other foot problems as they cause pressure throughout the foot.

Usually, plantar fibromas are diagnosed through a doctor’s examination and x-rays. Sometimes, MRIs are also necessary for proper diagnoses. Nonsurgical treatment options such as orthotics generally do not alleviate the pain caused by plantar fibromas; however, surgery can lead to nerve damage. Cryosurgery is a new development in the treatment of plantar fibromas. Performed as an out-patient procedure, it freezes and shrinks the growths with little to no post-sugery pain or complications.

The posterior tibial tendon is an important leg tendon that attaches the calf muscle to the inside foot bones, keeping the arch in its position and providing support when walking. The tendon commonly becomes torn or inflamed due to overuse, high-impact sports, and falls, which can result in flatfoot, instability, and decreased arch support over time.

Posterior tibial tendon dysfunction causes symptoms such as pain that increases with activity and generally occurs at the tendon’s location, swelling along the tendon, difficulty bearing weight on the foot and ankle, and outer ankle pain as the foot collapses. Treatment includes rest with no high-impact exercise or sports, ice, anti-inflammatory medication (check with a doctor before taking any medication), immobilization through a cast or walking boot, orthotic shoe inserts that help position the foot and accommodate foot shape changes, braces, physical therapy, and cortisone shots. Surgery may be necessary for reconstruction if the above treatments do not alleviate the symptoms and pain after an extended period of time.

Psoriasis is a skin condition that can appear on the legs and feet, as well as other body parts. It is a chronic disease of the immune system wherein new skin cells surface too rapidly, causing inflamed, flaky, thick patches of skin buildup. Psoriasis is characterized by the appearance of thickened skin patches with white, red, and grayish-silver pigmentation. The areas can be small and localized or larger and more widespread. Psoriasis can cause itching and pain as it progresses.

On the feet and toenails, psoriasis may be mistakenly assumed to be athlete’s foot and other fungal infections. Psoriasis can also affect the joints in the feet and legs, causing arthritis. Psoriasis can be hard to treat, but psoriasis sufferers may gain relief from moisturizing lotions and creams, anti-inflammatory medications (check with a doctor before taking any medication), and prescription medications issued by a doctor.

Raynaud’s disease is when the small arteries that circulate blood in the extremities, such as the hands and feet, become narrow due to vapospasms. Vapospasms are contractions that can occur due to stress or cold temperatures. The result is the affected areas feeling numb and cold as a result of the restricted blood circulation. It most commonly affects women and those living in cold climates. Raynaud’s disease usually does not involve treatment, aside from exercising to maintain good circulation and keeping warm with thick gloves and socks in cold weather. There are medications available to treat the disease if symptoms worsen.

Sesamoids are tiny bones embedded in a tendon that allow the tendon to slide smoothly for ease of mobility. In the foot, there are two sesamoids underneath the top of the foot and near the big toe that allow the big toe to move up and down freely. These help with push-off activities such as walking, running, and climbing.

Since the sesamoids are exposed to excessive force and pressure during weight-bearing activities, sports, and exercises, they are often prone to injury and trauma, as well as stress from overuse or from standing on hard surfaces for prolonged periods. Sesamoids can fracture or become inflamed. Sesamoiditis, a form of tendonitis, occurs when the sesamoids become inflamed, usually due to pressure placed on the balls of the feet.

What Are Some Causes of Sesamoiditis?
~ Weight-bearing sports, such as running, particularly on inclined surfaces or for long durations of time
~ Ballet and playing the position of catcher in baseball, which are activities that put recurring pressure on the balls of the feet
~ Having naturally high-arched feet or wearing high-heeled shoes

What Are Symptoms of Sesamoiditis?
~ Pain in the ball of the foot or under the big toe that worsens during recurring pressure or walking barefoot
~ Localized swelling and bruising
~ Stiffness, pain, and difficulty when bending and moving the big toe

How Is Sesamoiditis Treated?
~ Stop the activity that involves pressure to the area
~ Wear supportive, cushioned, soft-soled, low-heeled footwear
~ Ice the area
~ Take over-the-counter anti-inflammatory medications on a temporary basis (ask your doctor first)
~ Brace the area to allow for healing
~ Receive a steroidal medication injection to alleviate swelling

Sever’s disease, or calcaneal apophysitis, is a common but painful heel injury that affects children. With Sever’s disease, the heel’s growth plate becomes inflamed and sore, usually in kids that are active in sports. It can crop up during periods of rapid growth, especially during the onset of puberty. During this time, the heel bone can grow faster than the leg’s muscles and tendons, causing the heel to lose flexibility and feel tightness and pressure. The condition can be worsened by continuous stress and impact on the feet, as well as wearing cleats during sports such as soccer, baseball, and football. Running and jumping on hard surfaces during sports such as track, basketball, and gymnastics can also cause the inflammation.

Symptoms are localized pain, swelling, and tenderness in the heel, walking with a limp, and increased discomfort during standing, walking, jumping, or running. Treatments to relieve pain and inflammation are rest, elevation, ice application, anti-inflammatory medications (always consult a doctor before taking any medication), and heel cushion inserts. Exercises that stretch and strengthen the lower leg muscles and tendons are also recommended. Sever’s disease has no permanent effects and goes away when the inflammation stops.

Shin splints, a common condition, happen when the muscles or tendons surrounding the leg bone become inflamed, irritated, and painful, which can result from overuse, a collapsing arch, stress fractures in the lower leg bones, or imbalance between opposite leg muscle groups. They frequently occur in runners and dancers.

Shin splints can be treated with rest, ice, and over-the-counter anti-inflammatory medications (ask your doctor first).

Shin splints can be prevented by properly stretching prior to and after exercise, sports, or activity. Corrective shoes or corrective orthotics can also be used to prevent shin splints.

Although they usually do not last long, spasms, or sudden, intense muscle contractions, can be extremely painful. Spasms can occur in the feet, toes, hands, and thumbs, causing numbness, muscle weakness, tingling, and uncontrollable twitching. Foot and toe spasms are referred to as carpopedal spasms. Some causes of spasms are neuromuscular diseases, vitamin deficiencies, abnormal electrolyte or mineral levels, dehydration, and damage or injury to the nerves that connect to muscles.

Some spasms can be avoided or alleviated with proper hydration, vitamin or mineral supplements, and light activities that relax the muscles (never take any medication or supplement without first consulting a doctor). Since spasms may indicate an underlying medical condition, those suffering from any type of muscle spasm should immediately contact a doctor or healthcare professional.

Spurs are outgrowths of bone. In the feet, they most commonly occur in the heel, but they can also grow near the toes and on the joint of the big toe. The spurs usually develop in areas subjected to constant pressure. Bone spurs can become problematic when pain and other foot problems crop up as a result of footwear pressing and rubbing against the affected area, causing irritation, redness, swelling, and inflammation. As the bone spur irritates and inflames the surrounding soft tissue, acute pain and/ or a dull ache are experienced.

Heel spurs, or bone spurs in the heel, occur on the bottom of the heel bone as a result of calcium deposits forming over time. They are quite common and often develop in athletes who frequently run and jump, high-impact activities that cause repeated pressure on the area; they are also common in individuals who stand on hard surfaces for long periods of time. People with high foot arches, diabetes, and excess weight can also be prone to heel spurs. Heel spurs can be prevented through stretches and foot exercises, wearing supportive, well-fitted footwear, and properly warming up before impact activities, all of which reduce tension and stress to the area.

Heel spurs can lead to plantar fasciitis, a condition when the plantar fascia, or band of fibrous tissue that connects the heel bone to the ball of the foot, becomes inflamed.

Treatment for heel spurs includes orthotics, supportive and properly fitting footwear, anti-inflammatory medications (ask a doctor before taking any medication), cortisone injections, and surgery if the condition worsens.

Subungal exotosis is a bony projection, or bone spur, that forms underneath the big toenail. It usually occurs on the big toe as a result of injury or trauma such as crushing the toe. Subungal extoses are painful because the affected area on the outside of the big toe is subjected to pressure from walking and footwear. Surgical removal of the projection is usually recommended and necessary. Enchondromas also develop in the bone underneath the toenail; these are small, benign growths composed of cartilage.

Tarsal coalition develops between the tarsal bones found in the back of the foot due to an abnormal connection between two of the tarsal bones. Tarsal bones include the heel bone, the talus and navicular bones above the heel bone, the cuboid in front of the heel bone, and the cuneiform bones that sit in front of the navicular bone and on top of the cuboid bone. Tarsal coalition can occur in one or both feet, resulting in pain and limited mobility. It most commonly results from bone malformation in-utero, but it does not usually cause problems for the affected individual until late childhood or the teenage years. It can also stem from infection, injury, or joint problems such as arthritis.

Symptoms include stiffness, pain, muscle spasms, and fatigue in the legs. Flatfoot can also arise from tarsal coalition. Treatments include orthotics, immobilization, anti-inflammatory medication (ask a doctor before taking any medication), cortisone and/ or anesthetic injections, physical therapy, and surgery if the above treatments are unsuccessful in alleviating pain and other symptoms.

Turf toe is a sprained joint in the big toe due to excessive upward bending. It is usually a sports injury that occurs as a result of jamming the toe suddenly or pushing off repetitively while running or jumping. Athletes who play sports on turf surfaces, such as football and soccer, are prone to turf toe, which is what gave the condition its name. However, gymnasts, basketball players, dancers, and wrestlers can also suffer from turf toe due to the movements involved in their sports.

Turf toe causes pain, swelling, and restricted movement, as does any other sprain. The sprain can happen over time with gradually worsening symptoms or suddenly with acute pain and an immediate onset of symptoms. X-rays can be taken to rule out bone injury and fractures. Treatments include rest, ice, and elevation. Compression and anti-inflammatory medications may also help (check with a doctor before taking any medication).

Ulcers are persistent wounds or sores that do not heal properly or become chronic. Ulcers on the feet occur mainly due to reduced nerve sensation, poor circulation, vein dysfunction, and constant pressure to a particular spot. Diabetics are prone to foot ulcers. Ulcers may or may not cause pain and can be accompanied by swelling, discomfort, redness, itching, burning, and irritation.

Foot ulcers can crop up due to metatarsal deformities that impact the bottom of the foot, exposing particular spots to constant pressure that causes the skin to callus, separate, and possibly become infected. For bed-ridden patients, foot ulcers can form on the backs of the heels due to constant pressure on the skin from the bed.

Ulcers have four stages of severity that are based on how deeply the wound or sore penetrates through the skin:

The first stage of ulcers involves redness and irritation that occur where bones protrude or constant pressure is applied. The affected area’s skin may stay red even after pressure to the spot is alleviated. There may be accompanying discomfort and pain.

The second stage of ulcers involves the top two layers of skin. Blistering, peeling, and cracking skin are signs of stage two ulcers. Tenderness and pain are felt in the area of the ulcer.

The third stage of ulcers involves deeper penetration in skin breakdown. The tissue between the skin and muscle are affected, and broken, bleeding skin appears. At this point, pain may diminish because of more severe tissue damage.

The fourth stage of ulcers involves even deeper penetration of damaged tissue, pervading all the way to the muscle, tendon, and bone. It can result in bone or blood infections. Again, the damaged tissue may not generate pain or discomfort.

Ulcers should be treated by a doctor who can properly evaluate, diagnose, and treat any underlying medical conditions, as well as properly care for the wound to prevent infection.

Veins carry blood back to the heart, whereas arteries carry blood from the heart. Venous stasis occurs when normal blood flow from the legs back to the heart is restricted. Improper vein function can result from superficial phlebitis, where superficial vein blood clots develop as a result of injury, or deep venous thrombosis, where blood clots form in the deep veins of the leg.

Venous stasis can cause pain, cramping, and swelling (edema) in the legs and ankles, as well as legs that feel tired, achy, throbbing, itchy, and/ or tight. The skin may thicken and darken, and ulcers may develop on the lower legs as a result of the blood pooling there. With varicose veins, the veins become enlarged and visible through the skin, taking on a ropy, bumpy appearance.

Treatment for venous stasis can include resting and elevating the legs, wearing compression stockings, and exercising to improve circulation. In some cases, doctors will prescribe medications or perform surgery on the veins (never take any medication without first consulting a doctor).

Warts are caused by a virus that penetrates the skin, forming a raised, fleshy bump. They can crop up on any part of the skin, including the feet. Some warts go away on their own without treatment; others recur, grow in size, or spread to form clusters of warts. In general, warts are not harmful and do not cause pain or discomfort; however, they are contagious because they stem from a virus.

On the foot, warts can grow on the sole and toes, as well as any other part. Plantar warts occur on the sole of the foot and are flatter and less fleshy than most other warts. They can result from walking barefoot on dirty, germy surfaces that harbor the virus. Viruses prefer a warm, moist environment, so public areas with wet floors, such as swimming pools and showers are perfect breeding grounds for plantar warts. Plantar warts on the heel or ball of the foot can be painful and sensitive due to the pressure placed on these areas of the foot.

To avoid plantar warts, wear plastic or rubber shower shoes, slides, or flip-flops rather than walking barefoot on damp floors or ground, especially in public areas. Remember, warts are contagious and will spread person-to-person or to other parts of the body. Maintain proper foot care, keeping feet and footwear clean and dry.

There are over-the-counter wart treatments; however, warts can recur or resist treatment (consult a doctor before taking or using any medication). Wart removal is best left to a doctor; podiatrists can safely treat any wart on the foot using a variety of methods, such as prescription medications, surgical removal, and laser cautery.