Diabetic Foot Care Advice

The aim of this blog is to help members of the public to understand their feet better. However the information on this blog should never be regarded as medical advice. Readers with foot problems are strongly encouraged to visit their GP if not the podiatrist for further medical assessment and treatment.

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Friday, May 30, 2008

Risk Factors For Plantar Fasciitis

Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia is the fibrous tissue that connects the heel to the base of the toes. Plantar fasciitis can cause severe pain in the feet. Plantar fasciitis used to be called gonorrheal heel. It was mistakenly thought that plantar fasciitis was related to the sexually-transmitted disease gonorrhea.

There are certain risk factors that increase a person’s chance of developing plantar fasciitis. Plantar fasciitis is caused by overuse. People who are overweight or have jobs that require standing or walking on hard surfaces for long periods of time are prone to developing plantar fascia. Another name for plantar fasciitis is policeman’s heel.

Plantar fasciitis is more prevalent in women due to the inadequate support in shoes that they often wear. Flat feet or very high arches are risk factors for plantar fasciitis. Wearing shoes with stiff or thin soles can cause plantar fasciitis. Shoes should have good heel support or wearing them can put you at risk for this condition.

Walking or running regularly for exercise can increase a person’s risk for plantar fascia. Walkers and joggers who have tight calf muscles prevent them from flexing their ankles normally. This makes them especially at risk. Plantar Fasciitis is sometimes referred to as jogger’s heel or tennis heel. The pain usually occurs after exercise. The worst pain is usually felt first thing on the morning.

People tend to lose some of the resiliency of their ligaments as they get older which makes elderly people more susceptible. Arthritis can make a person more prone to developing plantar fasciitis.

Even small changes in foot movement during normal daily activity can lead to plantar fasciitis. It’s relatively easy to accidentally overstretch the plantar fascia. The best way to prevent plantar fasciitis is to wear shoes that have proper support.

Tuesday, May 27, 2008

Hallux Rigidus

Hallux rigidus impairs the mobility of the joint of the big toe. It commonly starts with stiffness and pain in the toe joint. Hallux rigidus is a progressive disorder. Someone with hallux rigidus may lose the ability to move the effected joint. This is called a “frozen joint.”

Hallux rigidus is a kind of degenerative arthritis. People with fallen arches are prone to this condition. Hallux rigidus may be caused by injury to the toes or foot or by diseases that cause inflammation of the joints, such as rheumatoid arthritis or gout. Pronation of the foot and ankle can make a person susceptible to hallux rigidus.

Hallux rigidus begins as pain and stiffness in the toe joint while walking or bending. At the onset of this condition, the person has limited range of motion, but still has some movement. This condition with limited motion of the joint is called hallux limitus. With hallux limitus, they may have pain or stiffness when the weather is cold and damp or when doing activities that exert pressure on the ball of the foot. Hallux limitus may cause swelling and inflammation around the affected joint.

As the condition progresses, the person develops hallux rigidus. Hallux rigidus causes pain and stiffness in the joint of big toe even while resting. Someone with hallux rigidus may experience problems wearing shoes, especially high heels. It may cause a limp. As the person alters the way they walk in order to reduce the pain and stiffness, they may develop muscle pain in the legs and hips.

Noninvasive treatment starts with wearing shoes that have roomy toe boxes, the area of the shoe that surrounds the toes. Shoes with pointy toes and high heels should be avoided. Nonsteroidal anti-inflammatory drugs (NSAIDs) may provide some relief from the pain. A physician may recommend some vitamin or mineral supplements.

Someone with hallux rigidus should consult a doctor to discuss treatment options. Corticosteroid injections may be administered to reduce pain and inflammation. Physical therapy methods may be used. If noninvasive treatment methods fail to provide relief, surgery may be necessary.

Saturday, May 24, 2008

Hallux Limitus

Hallux limitus is a condition that causes a decrease in the range of motion of the joint of the big toe. This condition can cause stiffness and pain. Hallux limitus can be caused by heredity or an inflammatory disease such as rheumatoid arthritis or gout. It can also be caused by overuse or an injury to the toes or foot. People with fallen arches or have jobs that require excessive squatting are more prone to hallux limitus.

Hallux limitus can be worse during cold or damp weather. It can cause pain or stiffness during activity. Hallux limitus can cause swelling around the affected joint. A doctor should be consulted at the onset of pain and stiffness while walking, bending, or squatting. Early treatment could prevent the need for surgical treatment.

Shoes that are wide and have plenty of room can help reduce the pressure exerted on the feet. Shoes with pointy toes and high heels should be avoided. Over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) can provide some relief of the pain. . It is a progressive condition. If left untreated, hallux limitus leads to hallux rigidus. Hallux rigidus can make the joint immobile.

The physician may prescribe the use of custom-made orthotics for hallux limitus to provide extra support and increase comfort. The doctor may administer corticosteroid injections to reduce pain and inflammation. Physical therapy may be used to provide some relief. Ultrasound therapy is one form of physical therapy that might be used.

If non-surgical methods do not provide relief from hallux limitus, surgery may be recommended. When diagnosing hallux limitus, the surgeon may manipulate the foot to determine the effects of the disorder. A surgeon may order hallux limitus x-rays to judge the severity of the damage.

The surgeon will consider the age and activity of the patient when determining which surgical can include the removal any bone spurs and damage to the joint. The surgeon will realign the bones of the foot. In more severe cases, surgery may include fusing the joint or the replacement of the joint.

Wednesday, May 21, 2008

Puncture Wounds To The Foot

As people walk barefooted in the summer months, the risk for puncture wounds to the feet increases. A puncture wound is a wound that is caused by a pointed object. Common pointed objects that can cause puncture wounds to the feet are nails, carpet tacks, pins, thumbtacks, glass, seashells, toothpicks, or needles.

When someone sustains a puncture wound, the risk of infection is the primary concern. Puncture wounds can easily become infected due to the depth of the wound. Regular cuts and scrapes are much easier to clean. Dirt can get trapped inside a puncture wound and cause infection. If part of the foreign body is trapped in the puncture wound and removal is neglected, a hard cyst could form.

It is important to make sure the wound is cleaned properly and that no part of the object remains embedded in the foot. Professional attention, such as at the doctor’s office or emergency room, is highly recommended.

As part of the treatment for the puncture wound, a tetanus shot may be necessary. Tetanus is a rare, but serious disease caused by the bacterium Clostridium tetani. This bacterium is commonly found in soil. Whether or not someone needs a tetanus shot is dependent on the length of time since their last tetanus vaccine or booster and the nature of the puncture wound. Lockjaw, neck stiffness, tightening of the abdominal muscles, fever, sweating, and difficulty swallowing are all symptoms of tetanus. If someone experiences any of these symptoms after sustaining a puncture wound, they should contact their doctor immediately.

If the object had deeply penetrated the tissue of the foot, it could cause other complications. A doctor can monitor the healing process and check for any tissue damage that requires medical intervention. Painful scarring is a possible complication for puncture wounds to the foot.

Saturday, May 17, 2008

Bunions

A bunion is a bony protrusion commonly located at the base of the big toe. A bunion alters the structure of the foot, causing a misalignment of the bones of the foot. Bunions can be extremely painful. The word “bunion” comes from the Latin word for turnip, “bunio.”

Bunions cause the big toe to point towards the other toes. Bunions affect the skeletal alignment of the front part of the foot. The condition of this altered alignment of the big toe is called hallux valgus. This misalignment of the big toe and the bones in the foot causes the bump on the along the instep of the foot.

A small bunion on the outside of the foot is called a bunionette or tailor’s bunion. This smaller type of the bunion usually happens to people who have regular bunions. Tailor’s bunions can be the result of restrictive footwear.

Bunions are most often caused by ill-fitting shoes. Bunions occur predominantly in woman due to wearing ill-fitting shoes that lack proper support. High heels are especially problematic. Bunions can be a complication of arthritis. Only 3% of the cases of bunions are caused by genetics.

Bunions cause pain, numbness, redness, inflammation, or a burning sensation. Some people don’t have any symptoms. Symptoms may worsen when wearing shoes that have narrow toes. Pain and other symptoms may progressively get worse. As the bunion gets larger, shoes will put more pressure on the toes, which in turn causes the bunion and its symptoms to get worse.

A bunion left untreated usually gets larger as the bones become increasingly misaligned. The tendons of the foot contribute to forcing the big toe into an abnormal position. The bunion may eventually cause the big toe to lie under or over the second toe. The second toe may develop hammer toe. Hammer toe is when the toe is constricted and the middle joint of the toe points upwards.

Diagnosing a bunion is easy since it is a noticeable bump along the inside of the foot. A doctor may order foot x-rays to determine the severity of the deformity. After the doctor has determined the severity of the condition, the doctor can suggest treatment options.
People with bunions should work with their doctor to determine the best course of treatment to prevent this progressive disorder from getting worse.

Tuesday, May 13, 2008

Understanding The Plantar Fascia And Plantar Fasciitis

The plantar fascia is the ligament on the bottom of the foot that connects the heel with the base of the toes. The plantar fascia is also called plantar aponeurosis or aponeurosis plantaris. It is a strong layer of thick, white, fibrous, connective tissue. Moving away from the heel, it divides into five strands which correspond with each toe.

The plantar fascia stabilizes the arch of the foot. The plantar fascia stretches whenever the foot hits the ground. It is also involved during the part of the step when the heel rises from the ground.

With every step, the plantar fascia is under pressure. If this ligament becomes inflamed due to injury or overuse, the person may develop plantar fasciitis. Repetitive trauma, such as one might experience while playing sports or running, causes tiny tears in the plantar fascia. Plantar fasciitis is the most common ailment affecting the plantar fascia.

A plantar fascia rupture is more severe than plantar fasciitis. With a plantar fascia rupture, the whole ligament is torn, as opposed to the tiny tears that cause plantar fasciitis. Plantar fasciitis ruptures are much less common than plantar fasciitis.

Plantar fascia ruptures can occur in athletic injury. Marathon runners and sprinters are susceptible to plantar fascia ruptures. A rupture causes intense pain at the time of the injury. The doctor may prescribe the use of a cast to allow the ruptured plantar fascia to heel. A plantar fascia rupture can be a complication of receiving corticosteroid injections to treat plantar fasciitis.

The plantar fascia can be put under excess pressure if the person is overweight or has sudden weight gain. Traumatic injury to the foot can cause problems for the plantar fascia, including infection. Streptococci are the most likely suspect in plantar fascia infections.

Having diabetes or arthritis can cause problems for the plantar fascia. Diabetics sometimes experience a thickening of the plantar fascia. Diabetics are also more susceptible to infections of the foot. Having arthritis in the foot increases the risk of developing plantar fasciitis.

With plantar fasciitis, a heel spur may develop at the site of the injury to the plantar fascia. A heel spur is a small piece of bone. The pain of plantar fasciitis used to be blamed on heel spurs. Heel spurs are a symptom of plantar fasciitis, not the cause. The presence of heel spurs does not always cause additional pain.

Using supportive shoes is the best way to prevent problems with the plantar fascia. Shoes should fit comfortably and provide support and cushioning to the arch, ball, and heel of the feet. Athletic shoes should be replaced regularly, because they lose their ability to cushion and support the feet over time with use.

Thursday, May 8, 2008

Proper Foot Care

Proper foot care can prevent some foot health problems. Here are some tips to follow to help ensure that your feet remain healthy.

1. Wash your feet daily with soap and water. If dirt is left on the skin of the feet for too long, it can cause irritation and inflammation.
2. Cut toe nails straight across. Do not cut toe nails too short, especially along the sides of the nails. Cutting nails improperly can lead to ingrown toe nails.
3. If dry skin is a concern, apply foot cream to the feet after washing them.
4. Periodically remove hardened skin with a pumice stone or foot file. People often find this easiest to do immediately after washing the feet.
5. Only wear shoes that fit properly. Shoes that are too small or too narrow can cause foot problems like corns and blisters. Shop for shoes in the afternoon since feet tend to swell during the day. New shoes should be bought so that they fit both feet comfortably in the afternoon or evening.
6. Change socks at least daily.
7. Wear sandals or flip-flops in public showers and locker rooms.
8. Do not wear pointy-toed shoes or high heels for extended periods of time.
9. Do not attempt to cut off corns or bunions yourself. Seek medical attention to treat these foot problems. Cutting your feet can make them prone to infection.
10. Treat foot problems promptly to prevent the condition from worsening or causing permanent damage.
11. Never share socks or shoes with other people.
12. Wear shoes that are conducive to foot health. They should be supportive and have a wide toe box.

Taking care of your feet daily can help prevent painful conditions from developing. Changes in your feet should be reported to your doctor. Certain conditions, such as fallen arches and bunions, can develop in adulthood and require a physician’s care. Children should be taught basic foot hygiene to encourage continuing foot health.

Thursday, May 1, 2008

Infections From Pedicures

As sandal-weather approaches, people are more likely to visit a nail salon for a pedicure to prepare for summer footwear. Without proper precautions, salons can spread fungal and bacterial infections from client to client. The infections can spread from tools that were not sanitized or tubs that were not cleaned properly. Infections can also occur if the person sustains a cut during the pedicure.

When visiting a salon, a person should check for signs of unsanitary conditions. The foot tubs or whirlpools should look clean. There should not be any sign of nail clippings or sandings left around the salon. The salon should never use razors during pedicures. The use of razors during a pedicure is banned due to the increased risk of injury and infection.

The most likely source of the spread of an infection is contaminated instruments. The instruments used in pedicures must be sanitized after every use. If someone neglects to do this, fungal and bacterial infections are easily spread. Some clients opt to bring in their own instruments in order to minimize the risk of infection.

The symptoms of fungal infection are soreness and redness of the skin around the nail. Fungal infections of the nail lead to thickened, discolored nails. Bacterial infections can cause soreness, redness, and pus to form. Infections can occur under the nail or to the skin surrounding the nail.

Paronychias are infections to the skin that surrounds or hangs over the nail. If left untreated it can cause a severe infection affecting the entire toe. Paronychias are usually bacterial infections but they can be fungal.

To treat nail infections, the doctor may prescribe an oral antibiotic depending on the severity and type of infection. If an abscess, or pocket of pus, has formed, the doctor will drain the abscess using a scalpel. The doctor may recommend foot soaks as part of the treatment.

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