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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Wednesday, July 30, 2008

Over-The-Counter Corn Treatments

Corns are hardened, raised bumps of skin that commonly occur on the toes in response to pressure or friction. Ill-fitting shoes, excessive time spent standing or walking, being flat-footed, and advanced age can be contributing factors for developing corns.

There are over-the-counter treatments available to treat corns. Over-the-counter remedies for corns usually contain acid that attacks the hardened skin of the corn. Keep in mind that the acid may also damage the surrounding, healthy skin. Be careful to follow the directions to minimize any such damage.

Corn pads or corn cushions without acid are used to protect the corn from any additional friction from shoes. They are foam, donut-shaped cushions. They will not remove the corn, but they can prevent it from getting worse.

Corn plasters are over-the-counter corn treatments. They are felt pads that contain an acid, often salicylic acid. Before applying a corn plaster, the person may want to jumpstart the treatment by soaking the foot for at least ten minutes, then removing some of the hard skin by rubbing the corn with a pumice stone. The foot should be dried thoroughly before the corn removal pad is applied.

Though over-the-counter treatments may eliminate the corn, it is likely to recur unless the cause has been addressed. If the corn was caused by friction from ill-fitting shoes and the person continues to wear shoes that don’t fit properly, the corn is likely to return. If the corn was caused by hammertoe, that deformity needs to be corrected by a podiatrist in order to stop corns from forming.

People with diabetes or atherosclerosis should avoid attempting to remedy foot problems on their own. They should seek medical attention for foot problems. Some doctors warn against the use of over-the-counter corn removers due to risk of infection or injury to healthy skin.

Sunday, July 27, 2008

Arch Strain

Arch strain is characterized by pain or a burning sensation in the arch of the foot. Arch strain can be caused by injury to the foot or a structural imbalance. It can be caused by another condition such as plantar fasciitis, flat feet, or tarsal tunnel syndrome. Plantar fasciitis is a painful condition affecting the plantar fascia, which is fibrous connective tissue on the bottom of the foot that runs from the heel to the ball of the foot.

Obesity and a sudden increase in foot activity can be causes of arch strain. It is important to warm up before increased activity to prevent strains. Wearing improper shoes can be a contributing factor. One symptom of arch strain is difficulty standing tiptoe. A person with a strained arch often feels tenderness in the inner soles of the foot.

Treatment of arch strain is focused on allowing the plantar fascia to heal properly. Rest and avoiding high heels are highly recommended. A podiatrist may prescribe the use of an orthotic to ease the pressure on the plantar fascia. Wearing supportive shoes, like athletic shoes, can encourage healing.

Ice packs can help alleviate inflammation at the onset of the arch pain. Ice packs should not be applied directly to the skin. Heating pads are sometimes used, especially if there is no swelling. Over-the-counter non-steroidal, anti-inflammatory medication can help reduce pain and inflammation. Over-the-counter arch-supporting insoles may provide some relief. If pain persists, the person with arch pain should seek care from a physician.

A physician may order x-rays to check for the presence of heel spurs. The physician may tape the arch to give it support while healing and restrict foot movement. Exercises may be suggested. Persistent arch pain could indicate problems with the foot, such as arthritis or damaged nerves, which require medical attention.

Wednesday, July 23, 2008

Surgery For Hammertoe

Hammertoe refers to a condition that causes the toes to become unnaturally bent. Hammertoe affects the smaller toes of the foot, not the big toe. This condition can be painful when shoes are worn due to friction on the tops of the bent toes. It can also cause pain if the bones of the toes to become dislocated.

Surgery is often the recommended treatment for hammertoe. Mild cases may be treated with orthotics, but moderate to severe cases may require surgical intervention. The surgery to correct hammertoes is done under local anesthesia as an outpatient surgical procedure. Typically, the surgery lasts approximately fifteen minutes per toe.

Before surgery, the podiatrist will determine which surgical intervention is best suited for the condition. There are many different surgeries designed to treat hammertoes. The rigidity of the toes that developed hammertoe is one consideration in determining which surgical intervention is appropriate.

If the hammertoe still has some flexibility, tendon release surgery may be performed. Tendon release is a surgery during which the tendon of the toe is repositioned in order to loosen the tension on the toe joint. If the tendon is released and not repositioned, the procedure is called a tenotomy.

Arthroplasty and fusion are surgical methods to treat rigid hammertoes. During an arthroplasty, part of the affected toe joint is removed. The toe is straightened. The joint may be replaced with an implant. Without the implant, the bones of the toe become connected with scar tissue while healing. This allows the treated toe to regain some flexibility.

Fusion is a surgical procedure during which some cartilage and some bone are removed. Once the toe is straightened, it is held in position with a surgical pin. The pin is temporary and will be removed after several weeks.

Each surgery for hammertoe allows the person to bear weight on the foot following the procedure. It is important to follow the surgeon’s aftercare instructions to allow the toes to heal properly.

Research On Effectiveness Of Custom Orthotics

Recent research has been conducted to evaluate the effectiveness of custom-made orthotics to relieve foot pain. Eleven studies conducted by Australian researchers concluded that custom-made orthotic devices helped alleviate certain types of foot pain. One such study found that custom orthotics for the shoes eased the foot pain experienced by people who had abnormally high arches.

Custom orthotic devices differ from over-the-counter orthotics and insoles in that custom orthotics are prescribed by a physician. The physician captures a model of the patient’s foot, either with a plaster cast or a scanning device, such as the Xtremityscan. This allows the device to offer the best possible support for that individual.

The effectiveness of custom-made orthotics to ease pain has been studied for plantar fasciitis, high arches, rheumatoid arthritis, and bunions. The ability of orthotics to alleviate pain from plantar fasciitis is considered limited by a recent study. The level of pain relief was found to be better if the use of orthotics for shoes is combined with wearing night splints at night for the treatment of plantar fasciitis.

The research has indicated that custom-made orthotics provide the most effective pain relief from pain caused by high arches. It was noted, however, that not every patient with high arches will receive significant relief from pain with the use of orthotics. Custom-made orthotics has been shown to provide relief of pain due to bunions, though they are not as effective as surgical intervention.

One study indicated that custom-made orthotics ease the foot pain of those afflicted with juvenile idiopathic arthritis which is a form of arthritis that affects children. The study failed to show if custom-made orthotics were more effective than over-the-counter insoles.

Though the effectiveness of custom-made orthotics varied depending on the condition causing the pain, research has shown that the use of orthotics was better than no treatment.

Tuesday, July 22, 2008

Fish Pedicures

Fish pedicures are foot soaks in a tub that contains small fish called garra rufa or doctor fish. The small fish are a species of carp. They are toothless and nibble on the dead skin on the feet. This is a replacement of the traditional razor treatment previously used to remove dead skin. Razor treatments have been deemed unsanitary by many states’ regulations.

This spa treatment is new to the United States. They have begun offering them in spas in the Washington D.C. area. Fish pedicures were initially used in Turkey and have become popular in some Asian countries. In March 2006, a few Japanese resorts and spas began to offer doctor fish spa treatments which include foot and hand soaks.

Clients report that the fish pedicures cause a tickle or tingling sensation as if the foot is asleep. After the feet are soaked in the tank containing about one hundred little carp, a traditional pedicure is administered to finish the foot care regimen. The cost of the fish pedicures range from $35 to $50.

Garra rufa are native to hot springs in Turkey. Since the doctor fish live in warm water that does not support plant life, they are accustomed to eating whatever is available. They eat the dry, dead skin on the feet, but do not harm healthy tissue. Garra rufa are different from the tench fish known as “doctor fish” in the U.K.

Doctor fish have been used to treat psoriasis and rheumatism. Immersing the body in a pool of small fish can provide a natural exfoliation treatment of the exposed and submerged skin.
People have visited the hot springs of the Kangal district in Turkey for treatment of psoriasis, abscesses, and skin conditions. Some people who have significant build up of dry skin have experienced minor bleeding while bathing in the hot springs. However, the minerals of the spring water are said to promote healing.

Friday, July 18, 2008

Foot Exercises

Foot exercises are recommended to promote healthy circulation. Exercising the feet and leg muscles throughout the day can prevent tension, cramps, and aches in the legs and feet. If you are sitting for extended periods of time, drop a few pens or pencils on the floor and pick them up one by one with your toes. Also while sitting, rest the ankle of one foot on the knee of the opposite leg. Gently push the toes backward until you feel a stretch in the bottom of your foot. Relax and repeat with the other foot.

If your feet feel tense during the day, shake them. Shake one foot at a time, then relax and flex your toes upwards before relaxing. Then, flex them downwards. Rotating the feet in circles can help. While seated in a chair, remove your shoes and lift your legs so that the thighs are slightly raised from the chair. Rotate the ankles to create clockwise circles with the feet. Do that several times, then, rotate the feet in the counter-clockwise direction.

Rolling the feet over a tennis ball can help stretch the muscles of the arches. If the feet are sore, you may want to try a plastic tennis ball tube container containing ice. Simply fill an empty tennis ball tube with water and freeze. Roll the feet back and forth over the tennis ball container.

For an Achilles tendon stretch, stand about two feet away from a wall. Lean forward against the wall. With one leg bent comfortably, straighten the other leg, placing it about six inches behind you. Lower the heel of the back foot to the floor. Hold for several seconds. Switch positions and stretch the other leg. Repeat twenty times. This exercise should be done as a gentle stretch of the Achilles tendon in the extended leg. The Achilles tendon is the tendon that is above the heel in the back of the foot.

Thursday, July 17, 2008

Foot Odor

Foot odor is caused by bacteria. The medical name for foot odor is bromhidrosis.This bacteria flourishes in the dampness created by the lack of ventilation in shoes and socks. The feet have thousands of sweat glands. The perspiration secreted by these sweat glands is composed of water, sodium chloride, fat, minerals, and acids. The bacteria break down the perspiration which results in foot odor.

There are several home remedies for problematic foot odor. Washing the feet daily with antibacterial soap and wearing shoes and socks that are of natural fibers which allow for proper ventilation can solve most cases of foot odor. Some people find it helpful to avoid wearing the same shoes every day. Alternating shoes allows the shoes to dry out thoroughly which prevents the buildup of dampness in the shoes.

If additional treatment is needed, a salt foot soak is one home remedy for foot odor. Soaking the feet in a combination of kosher salt and water will encourage the feet to be dry. However, it can also dry out the skin. If dry skin develops, either from the salt foot soak or use of antibacterial soap, reduce the frequency of use and apply moisturizer at night.

One way to fight food odor is to decrease the amount of perspiration that the feet produce. Stress increases sweating, so deep breathing and relaxation methods could actually help alleviate foot odor. Some people use antiperspirants on their feet to control foot odor. Antiperspirants reduce the amount of perspiration, thus reducing the perspiration available to the bacteria.

There are some over-the-counter foot powders that may provide some relief. Some powders can be applied directly to the feet. Other powders are for application to the shoes. There are also antifungal sprays for the shoes. If the shoes retain odor after being worn, they should be washed, if possible, then allowed to dry thoroughly before being treated with a spray.

Even though foot odor is a common problem, it is often a source of embarrassment. Someone experiencing foot odor should see improvement in the condition if they use these treatment methods. If the condition persists, a doctor should be consulted.

Wednesday, July 16, 2008

R.I.C.E. Therapy For Overuse Injuries

Overuse injuries, sprains, and strains commonly affect the feet and ankles. If you suffer an overuse injury, there is an acronym that can help you remember the proper treatment for such injuries. R.I.C.E. therapy is an acronym to help you remember the steps for treatment that can help reduce swelling and promote healing of overuse injuries, sprains, and strains.

R.I.C.E. therapy stands for rest, ice, compression, elevation. Rest is appropriate to allow the joint and affected muscles to heal. Activity should be reduces as much as possible following such an injury. It is recommended that the person with a sprained or strained ankle avoids putting much weight on the injury, especially for the first forty-eight hours.

Ice should be applied to the injury as soon as possible. Ice should be applied in twenty-minute intervals and should not be applied directly to the skin. The ice should be applied several times a day. A physician can give directions on the precise routine that the patient should follow.

A compression bandage is often used to help reduce swelling. An ace bandage is commonly used for foot and ankle injuries. Some sprains required more immobilization. A removable cast may be used. The doctor will suggest the appropriate level of care.

The injured foot or ankle should be elevated above the level of the heart. This helps reduce swelling. R.I.C.E. therapy is largely focused on reducing swelling of the injury. In many cases, an over-the-counter pain reliever such as a non-steroidal anti-inflammatory drug (NSAID) is suggested.

If the injury is minor, following R.I.C.E. therapy and using NSAIDs may be all that is necessary. However, it is strongly recommended that the injury be examined by a physician, especially if bruising occurs. A black and blue bruise can indicate that a bone is broken instead of a joint sprain.

Friday, July 11, 2008

Foot Baths

Foot baths, or foot soaks, are used for a variety of reasons. Foot baths are commonly used to treat minor foot ailments such as dry skin or athlete’s foot. They are also used for relaxation and to invigorate tired feet.

In order to prepare a foot bath, ingredients are added to the water for soaking feet. Most foot soaks start with a combination of water and Epsom salt. People add varying ingredients to obtain the desired effect. Some people prefer to boil the water before adding the salt and other ingredients. If you boil the water, make sure it has cooled properly before using it as a foot bath.

For relaxation, some like to add a couple drops of lavender essential oil to the combination of water and Epsom salt. Some people prefer tea tree oil, sandlewood, or Ylang Ylang oil instead of the lavender. Sandlewood and Ylang Ylang oil have soothing effects. Tea tree oil has an antifungal property and is sometimes used as a treatment for athlete’s foot.

One peppermint foot soak is to add a few drops of peppermint essential oil, a drop of eucalyptus essential oil, and one drop of lemon essential oil to plain, boiling water. Let the boiling mixture cool before using it as a foot soak.

You may choose to experiment with essential oils that are relaxing or invigorating to you. When doing a foot soak, just relax the feet in the prepared foot bath for at least several minutes. If the goal is to relax, create a relaxing environment in the room where you will do the foot soak. You may choose to light candles in that room or do another relaxing activity, such as reading, while you soak your feet.

If the skin of the feet is dry, pat the feet dry after the foot bath and apply liberal amounts of moisturizer. One natural remedy for dry feet that can effectively follow a foot bath is to apply shortening to the damp feet and put on socks. The socks prevent to shortening from rubbing off and getting the greasiness on floors and furniture. This can be done at night before going to bed.

Thursday, July 10, 2008

Home Remedies For Athlete's Foot

Athlete’s foot is a common fungal infection. It causes itching and burning sensations of the affected area. The fungal infection occurs in between the toes and can cause inflammation and peeling skin. There are some home remedies that have been used to treat athlete’s foot.

To cool the infected skin, some people use a foot wash that includes soothing herbs. Thoroughly blend fresh basil and salt with a cup of water. Heat the water to a boil. Allow the water to cool, then use as a foot soak. After soaking and drying the feet, you may want to try one of the following home remedies that attack the fungus.

Grapefruit seed extract or tea tree oil can be applied to the feet a few times a day to treat the infection. For grapefruit seed oil, rinse your hands and apply a few drops with to the infected skin with your wet hands. Tea tree oil can be applied with dry hands. Continue to use tea tree oil for several days after the infection has seemed to clear.

Several people use Listerine to treat athlete’s foot. Simply use the original formula Listerine as a foot soak. Another foot soak treatment uses cornmeal or cinnamon. For the cornmeal treatment, place some cornmeal, preferably the kind used to kill fungus on plants, in a basin and cover with water. Allow the cornmeal mixture to set for about an hour before adding warm water and soaking the feet. For the cinnamon remedy, add broken cinnamon sticks to boiling water. Simmer for five minutes and allow the water to cool before using it as a foot soak.

Garlic is touted as a crucial element in many home remedies. Some people crush garlic cloves and apply the garlic directly to the infected skin. Some people add crushed garlic cloves to warm water and use it as a foot soak. One home remedy for athlete’s foot includes adding the several teaspoons of the dried herb, licorice, to the warm, garlic-infused water before soaking the feet.

If the athlete’s foot does not clear with the use of a home remedy or an over-the-counter treatment, a doctor should be consulted.

Monday, July 7, 2008

Normal Aging Of The Feet

Over time, normal changes to the feet can occur. The feet are under a tremendous amount of pressure during daily activity. While walking, each step puts two to three times as much force as the person’s body weight.

This pressure can alter the structure of the foot as the person ages. Feet can become slightly longer and wider. Some women experience such changes during pregnancy due to the added pressure of pregnancy-related weight gain.

There might be a slight flattening of the arch of the foot. This is normal as long as it is neither excessive nor causes pain. The foot and ankle may lose some flexibility with age as does many joints and muscles in the body. The pad of fat at the bottom of the heel may become thinner with age. Though these changes are unlikely to cause serious problems, they may be accompanied with a loss of balance.

Any foot changes that cause pain or deformities should be checked by a physician. Thickening of calluses such as corns or bony growths like bunions are not part of normal aging. Changes in the shape or alignment of the toes could be signs of problems with the muscles of the foot. A physician can diagnose the condition and recommend appropriate treatment.

Pain is not part of normal foot changes. Pain can indicate a problem with the nerves, such as Morton’s neuromas. It could also be due to fasciitis or other painful foot problems. Discolorations of the feet should not occur. Discoloration could be a sign of a circulation problem.

Arthritis is a common problem among older adults. Arthritis can cause problems with the feet. Arthritis in the feet can cause pain, swelling, and stiffness. Though there is no cure for arthritis, medical treatment can limit its damage and debilitating effects. A doctor should be consulted for any foot problems that are not part of normal aging.

Saturday, July 5, 2008

Proper Shoes For Cycling

Cycling is a popular and very healthy hobby. However, many people neglect to take proper precautions to ensure that the health of their feet is not negatively impacted while cycling. People often take a great of effort to selecting the appropriate bicycle. Many cyclists do not realize that the proper shoes are important cycling equipment.

Cycling shoes must provide stability and support. The shoe needs to efficiently transfer power from your feet to the pedals. A lack of support in sneakers allows the arch of the foot to collapse through while pedaling. This compromise of the arch can cause arch pain, tendon problems, or burning under the bottom of the foot.

A good, supportive athletic shoe with significant arch support will protect the feet from the stress of pedaling. Cycling-specific athletic shoes are available. Purchasing cycling-specific shoes can be somewhat expensive. If the cyclist has foot health problems or spends a significant amount of time cycling, these can be a worthwhile investment.

If a cyclist wears orthotics for an existing foot health problem, make sure the shoes worn for cycling will accommodate them. Because cycling requires a considerable amount of forefoot activity, the doctor should be consulted on the effects of the orthotics and the effects of this activity on any foot health problems. People who have bunions, corns, hammertoes, or bunionettes should always use shoes that are wide enough not to cause further friction on the foot.

Cycling-specific shoes vary for the type of cycling activity. Some cycling-specific shoes are designed for racing, while others are for mountain biking. As long as it has excellent arch support, supportive cross-training athletic shoe is all that is necessary for someone who uses cycling as a hobby. These shoes should provide the appropriate support and heel lift necessary for cycling. One popular cross-training shoe for cycling is designed for a combination of cycling and hiking.

Serious cyclists use toe clips. A clip-less system is newer than the traditional clips. A clip-less system is a shoe and cleat ensemble. Therefore, when buying this system, the cyclist needs to be aware if the shoe fitting the system will accommodate or aggravate any current foot health problems or orthotics. Not only do proper shoes for cycling help support the foot, but can positively affect the efficiency of the expended energy during cycling.

Friday, July 4, 2008

Recovery From Bunion Surgery

Taking measures to ensure proper healing of the foot and prevent the recurrence of the bunion is important during the recovery from bunion surgery. Patients can take an active approach to receiving the most benefit from the surgery by following their surgeon’s orders and avoiding future use of problematic footwear.

It typically takes three to five weeks to recover from bunion surgery. The patient may experience some swelling for up to six months. During the first five weeks of recovery, a patient should do what they can to allow the foot to heal properly. Patients should be aware of complications and signs of infection.

The doctor should be notified if the bandage comes loose or gets wet. While healing, the person should avoid putting too much weight on the healing foot. The doctor may prescribe the use of a cane, crutches, or a walker after bunion surgery. Walking unassisted on the healing foot too soon after surgery can cause the muscles of the leg to tighten. The doctor will probably want the patient to keep their foot protected by a special postoperative shoe. The postoperative shoe will help cushion the foot and prevent further injury.

The foot should be kept elevated after surgery. The doctor will instruct the patient on elevating the foot and applying ice packs to help reduce swelling. There are certain activity restrictions that should be followed to allow the foot to heal. The patient should not drive during the first week after surgery.

Stiffness in the affected foot is common after surgery. The surgeon may give the patient instructions that include exercises to increase flexibility and strength of the healing foot. The surgeon or doctor is likely to recommend some physical therapy after bunion surgery. Physical therapy is usually started one to two weeks after surgery. It can help decrease stiffness, reduce swelling, decrease pain, and improve the strength of the muscles.

The doctor should be notified immediately if they experience signs of infection. The signs of infection include fever, chills, inflammation of the affected foot, increased pain, and swelling of the calf above the healing foot.

Tuesday, July 1, 2008

Bunion Surgery

A bunion is the formation of a bony hump on the inside of the foot. Bunions can be extremely painful. It Is best to meet with a doctor to determine the best treatment for the bunion. The doctor is likely to take a family history, examine the bunion, and order x-rays so the doctor can judge the severity of the deformity. Non-invasive treatment measures are generally tried first. Many people find relief with these simple treatments.

Bunions that cause considerable pain despite a trying a less invasive alternative to bunion surgery may require surgical intervention. A bunion operation is called a bunionectomy. A bunion removal surgery is usually performed on an outpatient basis.

To prepare for surgery, the doctor may do a complete physical to assess the patient’s lungs and general health. It’s important for the doctor to know all the medications the patient is taking. A special set of x-rays may be ordered to help the surgeon plan for the procedure.

An anesthesiologist evaluates the patient before the bunion operation. General anesthesia may be used. Bunion operations are commonly performed using an ankle block anesthesia. Ankle block anesthesia numbs the foot while the patient remains awake. Bunion operations typically take approximately one hour. Most people are able to leave the hospital one or two hours after bunion surgery.

More than 90% of patients do not have any complications after a bunionectomy. Infection is a possible complication. Recurrence of the bunion, nerve damage, and failure to eliminate pain are other possible bunion surgery complications. Aftercare instructions are things for the patient to do to help prevent these complications and encourage the foot to heal properly.

Recovering usually takes three to five weeks. Bunion surgery post op care is very may include physical therapy or exercises to strengthen the foot. Exercising after bunion surgery may help improve the flexibility and range of motion of the foot. Antibiotics may be prescribed to help prevent infection. The doctor may instruct the patient to elevate the foot and apply ice to help reduce swelling. The swelling may last up to six months.

The patient may have to use a cane, crutches, or a walker. The doctor may prescribe the use of a postoperative or bunion surgery shoe to help protect the foot from injury while it heals. The doctor or surgeon should be notified if the bandages come off, loosen, or get wet or if the patient develops signs of infection. Bunion stitches after surgery are removed about two weeks later.

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