Take Step in Right Direction to Healthy Feet

People can be their own worst enemies when it comes to foot care and foot health.

“The majority of foot issues I see are from improper-fitting shoes and wearing the wrong shoes,” said Dr. Jared Stanton of Mercy Clinic Podiatry – S. Jackson Suite 102 and Mercy Clinic Podiatry – Carthage.

While feet can hurt for a variety of reasons, shoes that are too tight and shoe trends such as high heels can lead to foot problems as much as injuries and heredity, according to the Mercy doctor of podiatric medicine.

“Podiatrists can recommend brands or shoe types after evaluating patients,” he said of most often diagnosing and treating patients with foot problems between the ages of 40 and 60.

What foot conditions can be caused by poor-fitting shoes? The list includes hammertoes, bunions and nerve ailments, although all can develop for other reasons, as well.

Let’s take a closer look at causes of foot problems, when shoes can play a part and treatment options:

Sprains or fractures

While a foot sprain or fracture typically will send a patient to primary care or the emergency department, podiatrists often will see patients for non-acute conditions like stress fractures from repetitive stress to a bone, according to Dr. Stanton.

When is it time to see a podiatrist after injuring a foot? When every step is painful and/or when pain persists longer than about a week.
“Usually, foot injuries will improve within a week or two,” he said. “If you have pain longer than that, there’s probably something deeper going on than a minor sprain.”

Most often sprains are in the arch area, but you also can also injure the ligaments in your toes, Dr. Stanton said. Treatment for sprains and stress fractures typically include immobilization, elevation and ice, a compression wrap, anti-inflammatory medications and possibly a walking boot or crutches. More serious fractures may require a hard cast or even surgery.

Sprains and fractures can take six to eight weeks to heal, Dr. Stanton said. “If patients have continued pain beyond two months with basic treatment, it’s time to get detailed examination and imaging.”

Developed foot deformities

These include hammertoes or bunions that affect part of the foot. Some conditions can be hereditary, but often develop over time.
A hammertoe, in which the toe has an abnormal bend in the middle joint, most often develop after age 40 and can get progressively worse, according to Dr. Stanton. A bunion, a bony bump that forms on the joint at the base of the big toe, can help cause a hammertoe. Both usually are caused by a muscle or tendon imbalance.

Treatment for both can be something as simple as changing shoes to adding padded devices or as complex as surgery to correct the deformity. It may be time to see a podiatrist if these conditions impact daily activities to the point that you are modifying activities, Dr. Stanton said.

Hereditary deformities

Conditions that could exist at birth and never improve include flat feet. People with flat feet can experience extra stress along the arch, which can affect knee and hip joints.

Treatment includes special shoe inserts or proper-fitting shoes. If nothing seems to help and the condition impacts daily life, Dr. Stanton said, surgery may be an option.

Another hereditary condition is in-toeing, also known as being “pigeon-toed,” where feet turn inward instead of pointing straight ahead. It’s often noticed by parents when a baby begins walking. If the child doesn’t outgrow the condition, treatment can include special shoes, stretching exercises or surgery.

Toe walking is common and occurs when children walk on their toes. It occurs when the Achilles tendon or the calf muscle are too tight.

“We see it often from when kids start walking to age 10,” Dr. Stanton said, adding treatment includes physical, therapy, shoe inserts and bracing.

Nerve conditions

Two of the more common problems are neuroma and neuropathy.

Neuroma is a painful condition sometimes referred to as a “pinched nerve” that is a benign growth of nerve tissue frequently found between the third and fourth toes. It can cause a burning sensation, tingling or numbness between the toes and the ball of the foot.
Neuropathy is general weakness, numbness and pain from nerve damage in the feet.

Both conditions can be caused by ailments such as diabetes, alcoholism and back pain, all of which can affect smaller nerves in the hands and feet, as well as not wearing proper shoes. In the case of alcohol, toxins can get in the blood stream and affect nerves in the feet.

Treatment for nerve conditions includes medication, vitamin supplements, proper shoes and shoe inserts.

It’s important to see a podiatrist at the first sign of numbness or tingling, Dr. Stanton said, to rule out more severe neurological conditions such as brain or spine conditions or even multiple sclerosis, where symptoms often show up in lower extremities first.

Another common foot problem is plantar fasciitis, an inflammation of a thick band of tissue that connects the heel bone to the toes. It can be caused by straining the ligament that supports the arch. Repeated strain can cause tiny tears in the ligament.

Symptoms include stabbing pain near the heal that might be worse in the morning. Treatment includes physical therapy, shoe inserts, steroid injections or surgery.

Whether or not someone has foot problems, Dr. Stanton recommends weekly self-exams of the feet and toenails to look for dry areas, rashes or other problems.