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Additional Information
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The human foot has 26 bones, 33 joints, and more than 100
tendons, muscles, and ligaments. With such a complex structure,
a lot can go wrong. While some foot problems are inherited,
many occur because of years of wear and tear.
Signs of foot trouble include pain, excessively dry skin,
thickened or discolored nails, swelling, redness, and unusual
sensations. "Consumers should know that these symptoms are
not normal," says Joshua Kaye, D.P.M, a podiatrist in Los
Angeles. "Whatever the problem is, don't bury it in your
shoe and hope it will go away."
Pain in the feet can trigger pain in the legs, hips, and
back. Some foot problems can even signal a larger disease,
which is why the American Podiatric Medical Association (APMA)
suggests that people take their socks off when they go to
their primary care physician for a regular checkup. In a
recent APMA survey of more than 600 people, 73 percent said
their feet were not routinely inspected at doctor visits.
Toenails that are rounded inward instead of outward could
signal iron deficiency anemia. Kidney disease, heart disease,
high blood pressure, and circulatory problems can cause the
feet to swell. Tingling or numbness in the feet and slow-healing
wounds could be signs of diabetes or other serious diseases,
according to the APMA. Chronic stiffness in the toes could
be a sign of arthritis.
"Changes in the structural appearance of the foot can also
be signs of abnormalities such as tendon rupture, rheumatoid
or osteoarthritis, or neuropathic disease," says Barbara
Buch, M.D., acting clinical deputy director of the Food and
Drug Administration's Division of General, Neurological and
Restorative Devices.
Foot Hygiene
The foot has more than 250,000 sweat glands. It's the mixture
of sweat and bacteria in our shoes and socks that makes feet
smelly. "Clean, dry feet can lower the risk of both foot
odor and fungus infections," says Kaye.
Feet should be washed every day with soap and lukewarm water,
especially between the toes, and then dried completely with
a soft towel. Any mild soap or antibacterial hand soap works
fine.
"People spend a lot of time shampooing and conditioning
their hair and applying soaps and lotions to their body,
but then probably don't spend 10 seconds washing their feet," Kaye
says. "Washing the feet with a wash cloth or similarly abrasive
product is important because it helps remove the dead skin,
bacteria, and fungus." For patients who can't reach their
feet during a shower because of obesity, arthritis, or instability,
Kaye recommends using a long-handle brush like a shower back
brush.
People who want to soak their feet should use warm, soapy
water, Kaye says. "Soaking feet in Epsom salt can cause
excessive drying of skin," he says. "This is an important
consideration for diabetics or with those who have existing
dry or fragile skin. Consider soaking feet in warm water
with a small amount of liquid dishwashing solution that has
skin softeners. There is no benefit in soaking feet in Epsom
salt compared to regular table salt."
Some people tell Kaye they soaked their feet in very hot
water because they were trying to kill bacteria. He says, "Unfortunately,
that type of home treatment often results in skin burns.
If someone is diabetic or has poor circulation, hot water
bottles or heating pads also shouldn't be used on the feet."
Applying moisturizing lotion on the feet after bathing can
alleviate dry skin. "During dry winter months, apply a small
amount of lotion a few times per day," Kaye says. "Inexpensive
generic creams are usually equally effective as expensive
brand-name products."
Kaye estimates that half of the ingrown toenails he treats
are due to improper nail clipping. "Toenails should be trimmed
straight across and not too short," he says. "Many people
incorrectly cut the corners, leaving a small point of nail
that then grows into the skin or they accidentally cut the
skin."
People who pamper themselves with a salon pedicure also
need to make sure that proper cutting and safety measures
are followed. In the last few years, there have been reports
of infections linked to nail salon whirlpool footbaths that
hadn't been properly cleaned or disinfected.
Andersen suggests that people check to see that salons and
their employees are licensed. "You could ask how they clean
their tubs and instruments and how often," she says. "Some
people bring their own instruments." People with diabetes
should exercise caution when having salon treatments, and
may be advised by their physicians to avoid treatments by
anyone other than a trained podiatric or medical specialist.
Non-Prescription Drug Products
The types of OTC products for foot health include pain medicines
such as nonsteroidal anti-inflammatory drugs and products
that treat athlete's foot, corns, calluses, blisters, and
warts.
Depending on the intended use, some OTC foot products, such
as lotions for moisturizing the skin, are considered cosmetics
and not drugs. There are medicated powders and creams to
treat athlete's foot. For corns and calluses, there are nonmedicated
pads to improve comfort when walking, as well as medicated
pads and patches that work to get rid of dead skin. Similar
products are used to shrink warts. These products are typically
made of salicyclic acid. They should be used with care so
that healthy skin isn't harmed, and they should never be
used by people with diabetes or poor foot circulation.
Matthew Holman, Ph.D., a scientist in the FDA's Office of
Nonprescription Products, says consumers need to pay close
attention to drug labels. "Consumers should read the indications,
directions, and warnings carefully," Holman says. "A product
won't be effective if you are trying to treat a condition
that's not in the label. If it says to only use the product
on intact skin with no open sores, that's important. If a
product isn't working or the condition becomes worse, you
need to seek a doctor's advice." People with heart disease,
diabetes, and circulation problems should never self-treat
because of the risk of infection.
Common Foot Ailments
Fungal Nails
Discolored toenails. Infection can spread to other nails.
Fungal infection can be picked up in damp areas like swimming
pools and locker rooms. Clean, dry feet help prevent it.
Treatments are topical and oral antifungal medications and,
in severe cases, surgery to remove the nail.
Ingrown Toenails
Nails whose corners or sides dig painfully into skin, often
causing infection. Can be caused by improper nail trimming,
pressure from shoes that are too small, injury, fungus infection,
heredity, and poor foot structure. Trim toenails straight
across to prevent problems. Soak the foot in soapy water,
apply antiseptic, and bandage. Wear well-fitting shoes. If
a toenail is painful or infected, the doctor may remove the
ingrown portion.
Athlete's Foot
A skin disease that can spread from the feet to other parts
of the body and is caused by fungus. This disease doesn't
typically spread from person to person. Signs are dry, scaly
skin; itching; inflammation; and blisters. Athlete's foot
can be prevented by daily washing with soap and water, drying
feet, changing sweaty shoes and hose and socks regularly,
and wearing shoes or sandals in public environments like
the locker room or pool.
Warts
Caused by a virus that enters the skin through small cuts
and infects the skin. Children tend to be more susceptible
than adults. Most warts are harmless, though they can be
unsightly and painful. They can be caused by walking barefoot
on dirty ground. Treatments include over-the-counter and
prescription topical acids, and laser or surgical removal.
Bunions
Misaligned big toe joints that can become swollen and tender.
The first joint of the big toe slants outward, angling the
big toe toward other toes. Bunions tend to run in families,
but can be aggravated by tight shoes. Conservative treatment
includes padding, choosing shoes with wide toe box, and orthotic
devices. Pain medicines and surgery to relieve pain may be
needed in severe cases, but should not be done for cosmetic
purposes.
Hammertoes
The toes are bent like a claw. This condition occurs most
frequently with the second toe because of bunion slanting.
It can be caused by muscle imbalance or can be made worse
by tight shoes or tight socks. Pain medicine or orthotic
devices may help. Surgery may be needed to realign toes.
Blisters: Caused by skin friction, especially from poorly
fitting shoes. A band-aid should be worn until the blister
heals, and socks should be worn with shoes. If the blister
breaks, it should be washed, and an antiseptic and sterile
bandage applied. It shouldn't be popped. It should be drained
only by a professional.
Corns and Calluses
Protective layers of dead skin cells. Calluses appear on
the soles of the feet, and corns appear on top of toes. They
are caused by friction from skin rubbing and shoes. Pain
may be relieved by moleskin or padding. They should never
be cut with an instrument.
Plantar Fasciitis
Stretching or tearing of the plantar fascia, which runs
along the bottom of the foot and supports the arch of the
foot. Heel pads, pain medicines, or cortisone injections
may help. Other conservative care includes splinting, stretching,
avoiding walking barefoot, and physical therapy. Shock wave
treatments use shock wave energy to relieve inflammation
and are an alternative to surgery.
Neuroma
Enlarged benign growths of nerves, most commonly between
the third and fourth toes. This nerve condition is caused
by bones rubbing against and irritating the nerves. It is
also caused by abnormal bone structure or pressure from poorly
fitting shoes. It may cause pain, burning, or numbness between
toes and in the ball of the foot. Treatment includes padding,
taping, orthotic devices, and cortisone injections. Sometimes,
surgical removal is required.
Heel Spurs
Calcium growths on the underside of the foot bones often
associated with plantar fasciitis. Pain may occur if there
is inflammation. Treatments range from exercise and custom-made
orthotics to anti-inflammatory medication.
To read the rest of this extensive article from the Food and Drug
Administration, please click here: http://www.fda.gov/fdac/features/2006/206_feet.html
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