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Wound Care

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

All About Plantar Warts

Plantar warts are warts that are only found on the feet, hence the term “plantar”, which means “relating to the foot.” They are caused by the human papillomavirus, or HPV, and occur when this virus gets into open wounds on the feet. The warts themselves are hard bumps on the foot. They are easily recognizable, mostly found on the heels or ball of the foot. Plantar warts are non-malignant, but they can cause some pain, discomfort, and are often unsightly. Removing them is a common step toward treating them.

Plantar warts can cause some pain while standing, sometimes felt as tenderness on the sole of your foot. Unless the wart has grown into the foot behind a callus, you will be able to see the fleshy wart. A podiatrist should only be consulted if there is an excessive amount of pain. Plantar warts are not cancerous or dangerous, but they can affect your walking and continually reappear. Anyone who suffers from diabetes or a compromised immune system disease should seek out care immediately.

Podiatrists are easily able to diagnose plantar warts. They usually scrape off a tiny bit of the rough skin to make tiny blood clots visible and examine the inside of warts. However, a biopsy can be done if the doctor is not able to diagnose them from simply looking at them. Although plantar warts usually do not require an excessive amount of treatment, there are ways to go about removing them. A common method is to freeze them off using liquid nitrogen, removing them using an electrical tool, or burning them off via laser treatment. For a less invasive treatment option, topical creams can be used through a doctor’s prescription. This treatment method takes more time, however. Keep the wart covered for protection in between daily treatments.

The best way to avoid developing plantar warts is to avoid walking barefoot in public places. Avoid this especially if you have open sores or cuts on your feet. It is also important to avoid direct contact with warts in general, as they are highly contagious.

Rheumatoid Arthritis in the Feet

Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.

Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.

To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.

There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.

In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.

Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

Heel Pain

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Treating Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Plantar Fasciitis

The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.

Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.

Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.

For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.

No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.

What Are Plantar Warts?

Plantar warts are described as small growths that appear on the heels or other areas of the feet that bear a large amount of weight. The pressure in these areas causes plantar warts to hide behind thick layers of skin called calluses. In most cases, plantar warts are not a serious health issue, and they usually go away without treatment. However, it is still important be mindful of them.

Plantar warts are caused by infections with human papillomavirus (HPV) in the outer layer of skin on the soles of the feet. The plantar warts then develop when the virus enters the body through weak spots at the bottom of the feet, such as tiny cuts and breaks. Plantar warts are not guaranteed for all who encounter the virus. Everyone responds differently to the affects of HPV.

Plantar warts are most common in the following groups: children and teenagers, people with weakened immune systems, people with history of plantar warts, and people who walk barefoot. Exposure to HPV is common in environments such as locker rooms or pool areas.

One of early signs to look out for is a callus, since many plantar warts hide behind them. You can also locate these warts by looking for small, fleshy, rough, grainy growths near the base of the toes and the heel. Early signs of plantar warts are shown by black pinpoints, which are small, clotted blood vessels. Lesions that interrupt normal lines and ridges in the skin of your foot may also be a sign of plantar warts. Any feeling of pain while walking or standing can also be a symptom of plantar warts.

Although most cases are not serious, some conditions may require a visit to your podiatrist.  If you are uncertain that your lesion is a wart, if you have diabetes, or if you are experiencing bleeding, you may need to see a seek professional treatment. Your doctor may offer treatments such as prescribing stronger peeling medicine or using cryotherapy by applying liquid nitrogen to the wart. More serious cases may require minor surgery or laser treatment.

There are simple solutions available to help prevent plantar warts. One common task is to avoid walking barefoot in swimming pool areas and locker rooms, as this is where HPV is commonly present. Keeping your feet clean and dry, while changing shoes and socks daily can also help prevent future plantar warts. If you know someone who has plantar warts, it is important to avoid direct contact with their warts. You should also refrain from picking or scratching your wart if you happen to develop one.

Flatfoot

Flatfoot is a foot disorder that is not as straightforward as many people believe.  Various types of flatfoot exist, each with their own varying deformities and symptoms.  The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot.  Other signs of flatfoot include:

  • “Toe drift,” or the pointing outward of the toes and the front part of the foot
  • The tilting outward of the heel and the tilting inward of the ankle
  • The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
  • Hammertoes
  • Bunions

One of the most common types of flatfoot is flexible flatfoot.  This variation usually starts in childhood and progresses as one ages into adulthood.  Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing.  When not standing, the arch returns.  Symptoms of flexible flatfoot include:

  • Pain located in the heel, arch, ankle, or along the outside of the foot
  • Overpronation, or an ankle that rolls in
  • Shin splint, or pain along the shin bone
  • General foot aches or fatigue
  • Pain located in the lower back, hip, or knee

Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit.  X-rays may be taken to define the severity and help determine the treatment option best for your condition.  Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices.  If nonsurgical methods prove ineffective, surgery may be considered.  Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.

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