Foot Problems

Arthritis is a disabling disease that affects millions of Canadians. It is characterized by inflammation of the body's joints. Symptoms can include swelling, recurring pain or tenderness, redness or heat, with limitation of motion in one or more joints. Early morning stiffness, and skin changes including rashes and growths may be present as well. Common forms of arthritis include osteoarthritis, rheumatoid arthritis and gouty arthritis. Because each foot contains 33 joints and bears a tremendous amount of weight and pressure, feet may be more susceptible to arthritis than other parts of the body.

Causes of Arthritis:

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

What can you do?

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

What can a podiatrist do for you?

• Request appropriate X-rays, bone scan, CT, MRI or other imaging studies, and joint evaluation.
• Prescribe appropriate anti-inflammatory medications.
• Recommend custom orthoses and/or shoe changes.
• If the problem persists, surgery may be necessary.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

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

Causes of athlete's foot

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

What can you do?

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

What can a podiatrist do for you?

• Obtain a fungal culture.
• Prescribe topical medications.
• Prescribe oral anti-fungal medications.

Source: American Podiatric Medical Association

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

Causes of blisters

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

What can you do?

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

What can a podiatrist do for you?

• Identify the source of friction and discuss treatment options.
• If the blister is painful, drain it.
• Remove the roof of the blister if needed.
• Prescribe appropriate medications, topical or oral.
• Recommend paddings, dressing and friction-reducing measures.
• Recommend shoe changes and/or orthoses.

Source: BC Association of Podiatrists, American Podiatric Medical Association

A bunion is an enlargement at the base of the big toe caused by a mal-alignment of the joint. It may be swollen, tender and painful, especially when wearing shoes.

Statistics:

• 8 out of 1,000 males have a bunion.
• 38 out of 1,000 females have a bunion.
• 55 out of 1,000 people aged 65 or older have a bunion.
• 63% of patients with bunions see a podiatrist.

Causes of bunions:

• Heredity
• Biomechanical abnormalities
• Neuromuscular disorders
• Inflammatory joint disease (arthritis)
• Trauma
• Congenital deformities
• Ill-fitting shoes

What can you do?

• Wear a shoe with good support and a wide toe box.
• Apply cold compresses.
• Soak the foot in lukewarm water to relieve pain.
• Use over-the-counter foot pads.
• Use over-the-counter anti-inflammatories.

What can a podiatrist do for you?

• Perform a physical examination of the foot.
• Request X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding or taping.
• Prescribe orthoses as needed.
• Perform surgery as indicated.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

A callus or corn is a build up of skin that forms at points of pressure or over bony prominences. Generally, calluses form on the bottom of the foot, whereas corns form on the toes.

Statistics

• 65 out of 1,000 people are afflicted with calluses or corns
• 37 out of 1,000 males are afflicted
• 91 out of 1,000 females are afflicted

Causes of calluses/corns

• Repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe or from an ill-fitting shoe
• Clawing of the toes inside a shoe due to biomechanical imbalances
• Heredity disorders

What can you do?

• Wear supportive shoes with a wide toe box and a low heel.
• Use over-the-counter creams, avoiding any acid preparations.
• Use pumice stone or file to treat if not diabetic.

What can a podiatrist do for you?

• Request X-ray, bone scan, CT, MRI or other imaging studies, if needed.
• Perform trimming or padding of the lesions to relieve pain.
• Recommend an over-the-counter arch support or prescribe custom orthoses.
• Perform surgery as indicated.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

Poor circulation in the feet is a major concern because it may signal other health problems. Circulatory problems may be marked by persistent, unusual feeling of cold, numbness, tingling, swelling, burning or fatigue in feet and legs. Other symptoms may include discoloured skin, dry skin, absence of hair on feet or legs, or cramping or tightness in leg muscles.

Causes of poor circulation

• Hypertenstion and/or cardiovascular disease
• Diabetes
• Kidney, heart or circulatory problems
• Smoking

What can you do?

• Don't wear tight clothing on your legs or feet (e.g. pantyhose, girdles, thigh-highs or knee-highs or dress socks that constrict)
• Walking can increase the size and improve the efficiency of the tiny vessels that supply blood to tissues.
• Anyone diagnosed with poor circulation should see a doctor before beginning exercise walking.
• Tell your podiatrist about any pre-existing condition you may have, including hypertension, diabetes, rheumatic heart disease, anemia or kidney problems.

What can a podiatrist do for you?

• Conduct vascular examination.
• Provide advice on preventing the development of sores, infections or non-healing ulcers.
• Evaluate the need for referral to a vascular surgeon.

Source: British Columbia Association of Podiatrists, American Podiatric Medical Association

Diabetes affects the circulation and immune system, which in turn impairs the body’s ability to heal itself. Over time, diabetes can damage sensory nerves (this is known as “neuropathy"), especially in the hands and feet. As a result, people with diabetes are less likely to feel a foot injury, such as a blister or cut. Unnoticed and untreated, even small foot injuries can quickly become infected, potentially leading to serious complications.

Daily foot care

As always, prevention is the best medicine. A good daily foot care regimen will help keep your feet healthy.

Start by assembling a foot care kit containing nail clippers, nail file, lotion, a pumice stone and a non-breakable hand mirror. Having everything you need in one place makes it easier to follow this foot care routine every day:

1. Wash your feet in warm (not hot) water, using a mild soap. Don’t soak your feet, as this can dry your skin.
2. While your feet are still wet, use a pumice stone to keep calluses under control.
3. Dry your feet carefully, especially between your toes.
4. Thoroughly check your feet and between your toes to make sure there are no cuts, cracks, ingrown toenails, blisters, etc. Use a hand mirror to see the bottom of your feet, or ask someone else to check them for you.
5. Clean cuts or scratches with mild soap and water, and cover with a dry dressing suitable for sensitive skin.
6. Trim your toenails straight across and file any sharp edges. Don’t cut the nails too short.
7. Apply an unperfumed lotion to your heels and soles. Wipe off excess lotion that is not absorbed. Don’t put lotion between your toes, as the excessive moisture can promote infection.
8. Wear fresh clean socks and well-fitting shoes every day. Whenever possible, wear white socks – if you have a cut or sore, the drainage will be easy to see.

Best advice

Do wear well-fitting shoes. They should be supportive, have low heels (less than 5 cm high) and should not rub or pinch. Shop at a reputable store with knowledgeable staff who can professional fit your shoes.
Do wear socks at night if your feet get cold.
Do elevate your feet when you are sitting.
Do wiggle your toes and move your ankles around for a few minutes several times a day to improve blood flow in your feet and legs.
Do exercise regularly to improve circulation.
Do inspect your feet daily and in particular, feel for skin temperature differences between your feet.

Don’t wear high heels, pointed-toe shoes, sandals (open toe or open heel) or worn-out shoes.
Don’t wear anything tight around your legs, such as tight socks or knee-highs.
Don’t ever go barefoot, even indoors. Consider buying a pair of well-fitting shoes that are just for indoors.
Don’t put hot water bottles or heating pads on your feet.
Don’t cross your legs for long periods of time.
Don’t smoke. Smoking decreases circulation and healing, and significantly increases the risks of amputation.
Don’t have pedicures by non-healthcare professionals.

When to see your doctor

If you have any swelling, warmth, redness or pain in your legs or feet, see your doctor right away.

If you have any corns (thick or hard skin on toes), calluses (thick skin on bottom of feet), in-grown toenails, warts or slivers, have them treated by your doctor or a foot care specialist (such as a podiatrist, chiropodist or experienced foot care nurse). Do not try to treat them yourself.

Have your bare feet checked by your doctor at least once a year. In addition, ask your doctor to screen you for neuropathy and loss of circulation at least once a year.

Take your socks off at every diabetes-related visit to your doctor and ask him or her to inspect your feet.

A diabetic ulcer

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

Causes of diabetic ulcers:

• Uncontrolled diabetes mellitus
• Vascular insufficiency
• Lack of sensation
• Chronic irritation from ill-fitting shoes
• Trauma

What can you do?

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

What can a podiatrist do for you?

• Perform a physical examination.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Perform debribement and wound care.
• Conduct laboratory tests.
• Initiate total medical team approach, which may include your family practice doctor, endocrinologist, internist, vascular surgeon, and infectious disease specialist.

Source: American Podiatric Medical Association and Canadian Diabetes Association

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

Causes of flat feet

• Heredity
• Arthritis
• Trauma
• Musculoskeletal disorders

What can you do?

• Wear supportive shoes.

What can a podiatrist do for you?

• Perform a physical examination and gait analysis.
• Request X-rays, bone scans, CT, MRI or other imaging studies.
• Recommend shoe changes, over-the-counter arch supports or prescribe custom orthoses.
• Perform surgery as indicated.

Source: American Podiatric Medical Association

Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections and other serious injuries - can occur at any time. The following are the most common:

Strains & sprains - Sprains involve injury to ligaments, whereas strains involve injury to muscles. Ankle sprains and strains usually occur when the foot turns inward, causing swelling and pain on the outside of the ankle.

Shin splints - Shin splints can result from repetitive over-extension or strain of one of the leg muscles.

Stress fracture - A stress fracture in an incomplete crack in the bone caused by overuse or strain of the foot. A foot that is not structurally sound is prone to developing stress fractures. Even a normal foot can easily develop a stress fracture from repetitive use or a sudden increased activity level. Other causes include medical conditions such as osteoporosis, medications such as steroids. Symptoms may include pain, redness, bruising and swelling.

Break, fracture, crack - Fracture, break and crack are different ways of describing a broken bone.

Prevention

• Wear the correct shoes for any event. Good walking shoes provide more comfort and better balance.
• Wear hiking shoes or boots in rough terrain.
• Different sports activities call for specific footwear to protect feet and ankles. Use the correct shoes for each sport. Don't wear any sports shoe beyond its useful life - generally after 800 kilometres of use.
• Wear safety shoes if you're in an occupation that threatens foot safety. There are specific safety shoes for a variety of on-the-job conditions. Be certain they are fitted properly.
• Always wear hard-top shoes when operating a lawn mower or other grass-cutting equipment.
• Don't walk barefoot on paved streets or sidewalks.
• Watch out for slippery floors at home and at work. Clean up obviously dangerous spills immediately.
• If you get up during the night, turn on a light. Many fractured toes and other foot injuries occur while attempting to find your way in the dark.

What can you do?

• Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatrist. If an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatrist are easy to remember if you can recall the word "RICE," which stands for rest, ice, compression and elevation.

  Rest. Cut back on your activity, and get off your feet if you can.

  Ice. Gently place a plastic bag of ice, wrapped in a towel, on the injured area in a 10-minute "on," 20-minute "off" cycle.

  Compression. Lightly wrap an Ace bandage around the area, taking care not to pull it too tight.

  Elevation. Sit in a position that you can elevate the foot higher than the heart, to reduce swelling and pain.

• Switch to a soft shoe or slipper, preferably one that your podiatrist can cut up in the office if it needs to be altered to accommodate a bulky dressing.
• For bleeding cuts, cleanse well, apply pressure with gauze or a towel, and cover with a clean dressing. It's best not to use any medication on the cut before you see the doctor.
• Leave blisters unopened if they are not painful or swollen.
• Foreign materials in the skin, such as slivers, splinters, and sand, can be removed carefully with a sterile instrument. A deep foreign object, such as broken glass or a needle, must be removed professionally.
• Treatment for an abrasion is similar to that of a burn, since raw skin is exposed to the air and can easily become infected. Cleansing is important to remove all foreign particles. Sterile bandages should be applied, along with an antibiotic cream or ointment.

What can a podiatrist do for you?

• Perform a physical examination.
• Request X-ray, bone scan, CT, MRI or other imaging studies and future exams as needed.
• Immobilize or cast the foot/leg.
• Prescribe medications when indicated.
• Realign bones when indicated.
• Perform surgery if necessary.
• Recommend physiotherapy to aid recovery.
• Prescribe custom orthotics for long-term control and prevention.

Foot Injury Myths

"It can't be broken, because I can move it." False. This widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: breaks of the thinner of the two leg bones; small "chip" fractures of either foot or ankle bones; and the frequently neglected fracture of a toe.

"If you break a toe, immediate care isn't necessary." False. A toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatrist usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatrist will help prevent improper or incomplete healing. Many patients develop post-fracture deformity of a toe, which in turn results in formation of a painfully deformed toe with a most painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.

"If you have a foot or ankle injury, soak it in hot water immediately." False. Don't use heat or hot water if you suspect a fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing effect, and prevents swelling and pain. After seeing a podiatrist, warm compresses and soaks may be used.

"Applying an elastic bandage to a severely sprained ankle is adequate treatment." False. Ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. Imaging Studies( X-ray, bone scan, CT, MRI or the like), immobilization by casting or splinting, and physiotherapy to insure a normal recovery all may be indicated. Surgery may even be necessary.

Source: American Podiatric Medical Association

Foot odour most often results from bacterial growth associated with excessive perspiration from the more than 250,000 sweat glands in the foot. Sweaty and smelly feet are not uncommon. While some people experience excessive odour or sweating throughout the whole body, (such as with anemia or with an overactive thyroid), usually the problem is limited to the feet.

Causes of foot odour

• Excessive sweating and bacteria growth
• Pantyhose and nylon socks that contribute to excessive sweating
• Cotton socks, which dry slowly providing time for bacteria to grow
• Shoes made of synthetic materials contribute to excessive sweating

What can you do?

• Practice good hygiene, including daily washing of the feet with soap and water.
• Wear socks made of wool, acrylic or polypropylene, whenever you wear shoes.
• Wear shoe made of leather or other natural fabrics that "breathe."
• Change your shoes daily to allow the other pair to air out.
• Change your socks, perhaps even more frequently than daily.
• Change insoles.
• Soaking feet in dilute black tea, or vinegar and water, can help lessen odour.
• Use a spray or roll-on antiperspirant.
• If odour is accompanied by skin colour changes, see a podiatrist immediately.

What can a podiatrist do for you?

• Perform a physical examination of the foot to determine possible other causes of foot odour, including athlete's foot, or other skin disorders or systemic problems.
• Prescribe topical medications.
• Prescribe oral anti-fungal medications.
• Prescribe antibiotics.

Sources include: B.C. Association of Podiatrists, American Podiatric Medical Association

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

Causes of hammertoe

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

What can you do?

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

What can a podiatrist do for you?

• Perform a physical examination/
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Perform trimming and padding.
• Recommend an over-the-counter arch support or prescribe a custom orthoses.
• Perform surgery as indicated.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

Heel pain can generally be traced to faulty biomechanics, which places too much stress on the heel bone, ligaments or nerves in the area. Stress could result while walking or jumping on hard surfaces, or from poorly made footwear. Being overweight is also a major contributing factor. Some general health conditions — arthritis, gout, and circulatory problems, for example — also cause heel pain.

Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot, resulting in arch and heel pain.

Heel spurs are growths of bone on the underside of the heel bone. They can occur without pain; pain may result when inflammation develops at the point where the spur forms.

Pump bump (Haglund's deformity) is a bone enlargement at the back of the heel bone in the area where the Achilles tendon attaches to the bone. The deformity generally is the result of faulty biomechanics causing increased motion of the heel bone against the shoe counter.

Achilles tendinitis is an irritation and inflammation of the tendon that attaches to the back of the heel bone. Achilles tendinitis can be caused by improper warm up or over-training. It can be treated with ice, rest, aspirin or anti-inflammatory medications. Chronic pain or any swelling should be professionally evaluated.

Statistics

• 15% of patients who see a podiatrist complain of heel pain.
• 73% of patients with heel pain are diagnosed with either plantar fasciitis or heel spur syndrome.
• 90% of those who suffer from plantar fasciitis or heel spur syndrome respond to non-surgical care.
• 83.5% of patients with plantar fasciitis or heel spur syndrome experience pain with first steps in the morning.
• Plantar fasciitis can occur with or without a heel spur present.
• Plantar fasciitis and heel spur syndrome affect women more than men.

Causes of heel & arch pain

• Over-stretching the long band of tissue that connects the heel and the ball of the foot
• Muscle imbalance
• Bone deformity
• Obesity
• Trauma
• Tightness of the muscles on the back of the leg
• Improper warm-up or over-training

What can you do?

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

What can a podiatrist do for you?

• Perform a physical examination.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend taping.
• Recommend an over-the-counter arch support or prescribe a custom orthoses.
• Prescribe appropriate medications.
• Administer injections.
• Perform surgery if necessary.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

Toenails often serve as barometers of our health; they are diagnostic tools providing the initial signal of the presence or onset of systemic diseases. For example, the pitting of nails and increased nail thickness can be manifestations of psoriasis. Concavity-nails that are rounded inward instead of outward-can foretell iron deficiency anemia. Some nail problems can be conservatively treated with topical or oral medications while others require partial or total removal of the nail. Any discoloration or infection on or about the nail should be evaluated by a podiatrist. The most common nail problems include the following: ingrown toenails , fungal nails and blackened toenails.

Ingrown toenail

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

Causes of ingrown toenails

• Heredity
• Improper nail trimming
• Trauma
• Pressure from ill-fitting shoes
• Biomechanical foot imbalances

What can you do?

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

What can a podiatrist do for you?

• Perform a physical examination.
• When Necessary request an X-ray, bone scan, CT, MRI or other imaging studies.
• Remove the ingrown portion of the nail.
• Culture the nail.
• Prescribe appropriate medications, such as antibiotics.
• Perform surgical correction of the nail when indicated.

Fungal nail

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

Causes of fungal nails

• The spread of athlete's foot to the nails.
• Shoes and socks create a warm, dark and humid environment, which encourages fungal growth.
• Systemic disease.
• Trauma.
• Heredity.

What can you do?

• Practice good foot hygiene, including daily washing of the feet with soap and water; drying feet carefully, especially between the toes; changing shoes regularly.
• Keep shoes and socks dry as a preventative measure.
• Wear shoes made of materials that breathe.
• Wear socks made of fibres that "wick" away moisture faster than cotton socks.
• Avoid wearing excessively tight hosiery, which promotes moisture.
• Shower shoes should be worn when possible in public areas.
• Disinfect home pedicure tools and instruments used to cut nails.
• Don't apply polish to nails suspected of infection-those that are red, discoloured or swollen.

What can a podiatrist do for you?

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

Blackened toenail

A blackened toenail is caused by pooling of blood, or a hematoma, beneath the toenail. Hematomas are very common result of an active lifestyle, especially among people who jog or play tennis.

Causes of blackened toenails

• The repeated rubbing of the toes against the shoe (top, end or bottom).
• A fracture, especially after an injury (such as dropping a heavy object on the end of the toe).

What can you do?

• Wear properly fitting shoes that don't rub
• Wear hard-top shoes if there is a job-risk to your feet
• Keep toenails trimmed short

What can a podiatrist do?

• Perform a physical examination.
• Request an X-ray, bone scan, CT, MRI or other imaging studies if the hematoma is the result of a trauma injury.
• Create a tiny hole in the nail to release the blood and relieve the pain, if the hematoma is treated within the first few hours of forming.
• If several days have passed and the blood clot becomes painful, the nail may require removal so that the nail bed can be cleaned. Some podiatric surgeons prefer to remove the nail whenever blood forms beneath the nail because the blood can attract fungi and lead to infections.
• Remove the nail to treat a bone fracture beneath the hematona. Nails that have been removed will grow again within three to six months. If the bone has been fractured but has not moved out of its normal position, a splint may be used to keep the toe aligned during healing.

Sources: B.C. Association of Podiatrists, American Podiatric Medical Association, American College of Foot and Ankle Surgeons

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

Cause of neuromas

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

What can you do?

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

What can a podiatrist do for you?

• Perform a physical examination.
• Request an X-ray, bone scan, CT, MRI or other imaging studies to rule out other causes.
• Recommend padding and taping.
• Recommend over-the-counter arch supports or prescribe custom orthoses.
• Prescribe anti-inflammatory medication.
• Administer cortisone injections.
• Perform surgery when indicated.

Source: B.C. Association of Podiatrists, American Podiatric Medical Association

A wart is a growth in the skin caused by a viral infection. Warts tend to be hard and flat with elevated, rough surfaces with well-defined boundaries. Some have one or more black pinpoints. They are frequently called plantar warts because they appear on the plantar surface, or sole of the foot. Children, especially teenagers, tend to be more susceptible to warts than adults.

It is possible that a variety of other more serious lesions, including carcinomas and melanomas (cancers), can be mistakenly identified as warts. Because of those identification problems, it is wise to consult a podiatrist about any suspicious growth or eruption on the skin of the feet. If warts are left untreated, they can grow and spread into clusters of several warts.

Causes of warts

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

What can you do?

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

What can a podiatrist do for you?

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

Source: American Podiatric Medical Association