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Don't overlook your feet when it comes to your health

January 07, 2011|By MARIE GILBERT | marieg@herald-mail.com
  • Problems such as calluses, bunions as well as improperly cutting toenails can lead to serious aliments of the feet if not correctly treated. Doctors warn that people with diabetes have to be especially careful when it comes to protecting their feet.
By Kevin G. Gilbert/Staff photographer


Greg Vincent remembers his grandfather's aching feet.

It was hard not to notice, he said — especially when the elderly man spent hours soaking his toes in warm water, trying to relieve the pain from his bunions and calluses.

Vincent thought of his grandfather recently when his own foot problems landed him in a podiatrist's office.

"Suddenly, I could sympathize," the Hagerstown man said.

He also realized he wasn't alone. Sitting in the waiting room, Vincent said he was surprised at the number of patients.

"Makes you wonder how many thousands of people are walking around with bad feet," he said.

In a recent survey for the American Podiatric Medical Association (APMA), 53 percent of respondents reported foot pain so severe that is hampered their daily function.

The APMA estimates that one in six American adults has foot problems. The ratio increases to one in three older than the age of 65.

On average, according to the study, most people said they began to develop pain in their 60s, while others had problems when they were much younger.

Yet, despite warning signs, most people don't take care of their feet.

In the recent APMA survey, 73 percent said their feet were not examined by a doctor on a regular basis.

"A lot of people think foot pain is part of getting older and accept it," said Dr. Evan Boeski of the Institute on Aging. "They continue to function and walk with pain."

Though some foot problems are inevitable, certain treatments can slow the progress, he said.

That's why he believes it's important, at the first sign of stress, to visit a podiatrist.

Signs of foot trouble include pain, excessively dry skin, thickened or discolored nails, swelling, redness and unusual sensations.

Whatever the problem, Boeski said, don't ignore it and hope it will go away.

Pain in the feet can lead to pain in the legs, hips and back, he said.

And some foot problems can signal a more serious disorder. For example, changes in the structural appearance of the foot can be a sign of abnormalities such as tendon rupture. And tingling or numbness in the feet can be a sign of diabetes.

The U.S. Food and Drug Administration reports that the average person walks the equivalent of three times around the Earth in their lives. That's enormous wear and tear on the bones, joints, tendons, ligaments and muscles that make up the foot.

And if you're diabetic or have poor circulation, ignoring your feet can create a whole other set of problems.

The American Diabetes Association, for instance, warns that a problem that seems minor for many people — such as fungal infection or sores on the feet ??? can become catastrophic for people with diabetes.

Diabetes is the leading cause of non-traumatic foot amputations each year.

According to the APMA, the most common foot conditions that occur with age are arthritic joints, thinning of the fat pads cushioning the soles, plantar fasciitis (inflammation of the fibrous tissue along the sole), bunions, poor circulation and fungal nails.

Prescription drugs for treating foot problems include pain medicine, antibiotics for infections and anti fungal medicine. For bunions and hammer toes, a cortisone injection may be given to relieve inflammation and pain.

Surgery also is an option to correct certain foot problems. According to the USDA, advanced surgical techniques have improved outcomes for bunion surgery and there have also been advances in less invasive foot and ankle surgery. Newer surgical plates and screws let surgeons repair fractures with less trauma. Smaller incisions mean less bleeding and tissue damage.

Despite the drugs and surgery options available, the USA says prevention is the best medicine ??? and it often begins with your shoes.

As stylish as they might be, high heels, shoes that squeeze the feet and shoes that do not fit properly are linked to a host of foot problems, including misaligned toe joints.

The APMA says shoes should be comfortable from the moment you buy them.  Most people don't have their feet measured when they buy shoes. But the organization says shoe size can change as you age because the feet can spread and lengthen.

In a 2006 study of 440 U.S. veterans with an average age of 67, researchers found that only 25 percent of test subjects wore appropriately sized footwear.

Even more startling, individuals with a foot ulceration or loss of sensation (neuropathy) because of diabetes were over five times more likely to have poorly fitting shoes than those without either complication.

If you exercise or play sports, the USDA recommends throwing out inadequate and worn-out shoes.  Improper fit can result in lack of support, calluses, ingrown nails, infections and deformities.

And, while on the subject of exercise, the American Academy of Podiatric Sports Medicine says walking or jumping on hard surfaces and failing to stretch and do warm-ups could contribute to shin splints, plantar fasciitis and heel spurs.

And any sharp pain, bruising or swelling after a foot injury warrants medical attention.

Contrary to popular belief, the academy says, it's possible to walk, even if a foot bone is broken.

Proper foot hygiene also is important, reducing the risk of both foot odor and fungus infections. 

For those who pamper themselves with a salon pedicure, the USDA says to make sure that proper cutting, whirlpool and safety measures are followed, reducing the risk of infection.

While feet do change as people age, pain is never a normal part of aging, according to the APMA.


A few of the common foot aliments



There are more than 300 foot ailments. Here are a few common foot problems in the elderly.

  •  Fungal and bacterial conditions, including athlete's foot, occur because feet spend a lot of time in shoes ??? a warm, dark and humid place that is perfect for fungus to grow. If not treated right away, an infection can occur.  To prevent infections, keep your feet clean and dry. Change socks and shoes often to help keep feet dry, and dust feet daily with foot powder.
  •  Corns and calluses are caused by friction and pressure when the bony part of your feet rub against your shoes. See your doctor. Treating corns and calluses yourself may be harmful, especially if you are diabetic.
  •  Warts are skin growths caused by viruses. They are sometimes painful and, if untreated, may spread. Over-the-counter preparations are unpredictable. See your doctor.
  •  Bunions develop when the joints in your big toe no longer fit together as they should and become swollen and tender.  Bunions tend to run in families If a bunion is not severe, wearing shoes cut wide at the instep and toes or wearing pads that cushion the bunion may help the pain. Sometimes surgery is needed to relieve the pressure. Doctors can prescribe anti-inflammatory drugs for pain. Other treatments include physical therapy and wearing orthotic devices or shoe inserts.
  •  Ingrown toenails occur when a piece of nail breaks the skin, which can happen if nails are not trimmed properly. A doctor can remove the part of the nail that is cutting into the skin, allowing the area to heal.
  •  Spurs are calcium growths that develop on the bones of your feet. They are caused by muscle strain in feet. Standing for long periods of time, wearing poorly fitting shoes or being overweight can make spurs worse. Treatments include using foot supports, heel pads and heel cups. Sometimes, surgery is needed.
— Marie Gilbert

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