Foot Problems

 

ARTHRITIS

Feet with arthritis.  See swelling.Arthritis is the leading cause of physical disability in the United States. This disabling and sometimes crippling disease affects nearly 43 million people.  Although it can affect any joint, arthritis frequently shows up first in the feet, which causes swelling, pain, tenderness, heat, redness and early morning stiffness in joints. 

This medical condition actually includes some 100 different diseases, but they all have one thing in common, damage to the body's joints and connective tissues, the ligaments, bones to help or slow damage to joints and to control pain.

See your podiatrist right away if you have persistent foot pain.

 

BROKEN TOES

It can't be broken because I can move it. At one time or another, we all have repeated this phrase after stubbing a toe or banding a foot. But in truth, this myth has kept many fractured toes from receiving proper treatment. While you can still walk with certain kinds of fractures, it is imperative that you pay close attention to your feet. If you feel any pain, or see any swelling or discoloration following the impact, you should seek immediate treatment from a podiatrist.

A toe fracture needs prompt attention. If x-rays reveal it to be a simple, undisplaced fracture, care by your podiatrist usually can produce rapid relief. However, x-rays might identify a displaced or angulated break. In such cases, prompt setting of the fracture by your podiatrist will help prevent improper or incomplete healing.  A popular misconception is that broken toes will heal without treatment.  In truth, if a broken toe is not taped properly, it may heal crookedly, necessitating additional surgery. Many people also develop post fracture deformity of a toe, which, in turn, can result in a most painful corn.

A good general rule to remember is: seek prompt treatment for injury to bones in the foot.

 

BUNIONS

A bunion is a swelling or enlargement of the large toe joint on the inner side of the foot. The deformity usually develops gradually and will cause pain from shoes rubbing against the enlarged bone. There may be swelling, redness and deep aching associated with the bunion joint causing a bursitis. 

Bunions develop from a weakness in the bone structure of your foot. Because of the instability of the bones and ligaments that form to various joints and arches in your foot, the joints have a tendency to move out of proper alignment.

Bunions are not caused by improper shoe gear, but are significantly aggravated by improper fitting shoes that place an unusual degree of pressure at the bunion joint. As bunions become more severe the joint moves out of proper alignment and eventually arthritis damages the joint space. The large toe moves sideways towards the 2nd toe and foot tends to widen across the metatarsal area.

As a rule a bunion deformity should be recognized early and evaluated by your podiatrist. As a bunion deformity progresses however, treatment should include modification of shoe gear with a wider shoe to alleviate the pressure at the bunion joint.  Anti-inflammatory medication and/or cortisone injections could be necessary during the acute phase. X-ray findings will determine the severity of the bunion and whether surgery may or may not be recommended.  If surgery is recommended, there are many different surgical procedures that are available and these are base upon the examination and x-ray findings.             

 

BUNION TREATMENTS CAN VARY                                                                              

Foot with a bunion.Bunions, like corns and calluses, are charter members in the foot pain hall of fame. They can develop in childhood, or more often later in life, and are often brought on by heredity, improper footwear, or arthritis.

The bunion, or hallux valgus, occurs when the great toe begins to drift toward the second toe. As it moves, the first metatarsal bone is pushed outward, creating a bony mass at the base of the great toe. 

Women seem to be more predisposed to the condition than men, likely because hereditary factors are enhanced by restrictive footwear.

The treatment plan selected by a doctor of podiatric medicine varies with the age and health of the patient, as well as with the severity of the deformity. Conservative treatment measures may consist of shoes with adequate size to accommodate the bunion, or pads and custom molded shoes. Surgical corrections vary from simply removing the bony prominence to more extensive procedures, such as fusion of joints and joint replacement. Most patients are back into tennis shoes in two to four weeks following surgery. Be aware that laser surgery is not an option for bunion treatment. At this time, no laser exists which can cut bone safely.

Bunions may be common but the discomfort they cause can bring on uncommon misery. Doctors of podiatric medicine can provide complete information on effective bunion surgery procedures.                                                                                                                           

 

BUNIONS AFFLICT MILLIONS

According to a recent survey by the U.S. Department of Health and Human Services, more than 80 million Americans have foot problems. About seven million of those unlucky souls suffer from bunions, generally regarded as the most painful disfiguring of foot problems. This condition is five times as common among women as men, but evenly divided between whites and blacks. As deformities of the toe and joint, bunions rise sharply with age and except for the lowest income bracket, decline with income.

What are bunions?

Bunions are misaligned big toe joints that become swollen and tender. The deformity causes the first joint of the big toe to slant outward and the second joint to angle toward the other toes. Bunions tend to be inherited, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe. There are conservative and preventive steps that can minimize the discomfort of a bunion, but surgery is frequently recommended to correct the problem.

Self-care includes wearing shoes that don't cramp your toes and the bony area immediately behind your toes. Also, soaking your feet in warm water will help relieve the pain. Your podiatric physician may recommend special shoes or the wearing of foot/shoe supports (orthosis). Surgery sometimes is necessary to realign the toe.                                         

 

CHILDREN'S FEET - TAKE A CLOSER LOOK

It is very difficult to describe what a perfectly normal foot should look like in a child. But there are warning signs and symptoms that parents should watch for to head off foot trouble for their children later in life.

Is the arch of your child's foot high or flat? Are there any bone deformities - toes bent or crooked, or a bunion condition, characterized by bumps or enlargements on the big toe joints?

How about ingrown toenails? Are they present, along with corns or calluses or warts on his or her toes, or on the tops of bottoms of the feet? When your child walks, does he or she walk on the inside or outside of his or her toes?

Remember that lack of complaint is not a reliable sign that everything is fine. Because the bones in a child's feet are soft and pliable, they can be bent twisted even before any pain is felt, or with only momentary discomfort.

Careful parents, of course, want what is best for their children. Because foot health begins in childhood, regular checkups, and prompt treatment at the first signs of trouble can ensure a lifetime of pain-free walking for your child. And that is a truly precious gift.                 

 

 

COMMON CONDITIONS AND DISEASE OF THE FOOT AND ANKLE

Achilles Tendonitis - This is a painful inflammation of the Achilles Tendon (which connects the calf muscle to the heel), commonly found among females who wear high heels.

Ankle Sprain - Over extension of ligaments resulting from trauma, athletic injury or an inherently unstable ankle.

Arthritis - Symptoms include joint stiffness, pain or tenderness that persists two weeks or more. The cartilage protecting the joint is eroding and pain is caused by bone rubbing against bone.  Rheumatoid arthritis and osteoarthritis are the two most common forms of the disease; though more than 100 varieties exist.

Athlete's Foot - A contagious fungal infection, recognizable by red, dry, cracked and itchy skin between the toes. Can lead to more serious skin problems when left untreated.

Bunion - Painful condition caus3ed by misalignment or enlargement of the bone at the base of the big toe (usually from improperly fitting footwear or excessive physical activity); bunions can lead to joint arthritis if left untreated.

Calluses - Thickened, irritated dead skin, usually found on the heel or ball of the foot. In diabetics and other individuals with poor circulation, the skin can become ulcerated and infected.

Corn - A hard, painful area of thickened skin, usually covering a protruding bone or in between the toes. Often caused by the irritation of improperly fitting shoes.

Fallen Arches (a.k.a. flat feet) - Low or non-existent arches can lead to further disability with advancing age and inactivity.

Hammer Toe - A tightening of ligaments and tendons causing the toe joints to buckle, forcing the toe upward and leading to shoe abrasion, inflammation, bursitis, corns and calluses.

Heel Pain (Plantar Fasciitis) - Irritation of the ligament situated along the bottom of the foot and attaching to the heel. Usually causes pain upon waking in the morning. Prolonged inflammation can cause bone spurs to develop.

Hematoma - Blood beneath the nail, usually a result of injury or excessive physical activity. Possible indicator of toe fracture.

Ingrown Toenail - Excessively curved nail that causes pain by growing into the skin. Sometimes a chronic condition.

Metatarsalgia - Pain in the ball of the foot, usually caused by excessive wearing of high-heeled shoes.

Nail Fungus - Discoloration (yellow or brown) or thickening of the toenail; can lead to skin infection.

Neuroma - Painful enlarged growths of nerves, usually between third and fourth toe, causing burning, tingling or numbness.

Neuropathy - Loss of sensation of pain, heat and cold in feet. Frostbite is a common cause of this condition; neuropathy can lead to serious infection if left untreated.

Sesamoiditis - Inflammation of bones underneath the base of the big toe, usually caused by excessive physical activity and improperly fitted shoes.

Stress Fractures - Partial break of the metatarsals (the long bones of the foot), caused by repeated pounding or trauma. Pain intensifies as exercise continues.

Ulcer - Open sores or breaks in the skin, often an indicator of circulation problems and/or diabetes.

Warts - Virus causing abnormal growths on the skin.                                              

 

DIABETIC FEET:  HANDLE WITH CARE 

Diabetics have many health concerns and not the least of them is paying greater attention to their feet. Because they're at a greater distance from the heart, the poor circulation and nerve impairment that diabetes can cause often puts the feet at risk. But a regular program of hygiene, some common sense, and regular podiatric medical examinations can keep diabetics on their feet and walking.

Poor blood circulation mans that the feet have harder time fighting infections and healing, and the resulting complications can be as serious as ulcers, or even amputation. Numbness or tingling, coldness, or a bluish discoloration is symptoms of circulatory trouble. When nerves are impaired, the feet can be injured without a moment of pain. Even a hot bath can be an occasion for a serious burn.

Diabetics should visit their podiatric physicians twice a year. Daily foot hygiene and regular inspections are also essential, as is avoiding activities or habits that can restrict circulation, such as crossing legs, exposing the feet to cold temperatures, wearing garters, or smoking.

The American Podiatric Medical Association has produced a brochure that outlines much more information on the topic of foot care for diabetics. For a free copy, call 1-800-     FOOTCARE.                                                                                                                          

 

DIABETIC FOOT PROBLEMS

Foot problems are a leading cause of hospitalization of the sixteen million persons in the United States who have diabetes (almost half of whom are unaware of their condition*).  It is estimated that 15% of all diabetics will develop a serious foot condition at some time in their lives.

Common problems include infection, ulceration, and gangrene (too often leading to amputation of toe, foot or even leg).

Causes of diabetic foot problems

* Ulceration, usually caused by excessive pressure, or trauma; pre-existing foot deformity greatly increases risk.
* Poor circulation, restricting adequate delivery of oxygen and nutrients, in turn contributing to mobility reduction and the ability of wounds to heal properly.
* Neuropathy causes reduced sensation, leading unnoticed symptoms and possible delays in treatment of infection, ulceration, and progressive foot deformities.
* Decreased resistance to infection due to white blood cell difficulties, especially problematic with the conditions listed above.

Foot Deformities

Foot deformities such as hammertoes, bunions, and metatarsal disorders have special significance in the diabetic population. A deformity places the foot at increased risk for developing corns, calluses, blisters and ulcerations. Neuropathy may render symptoms relatively painless.

Special deformities can occur in persons with neuropathy regardless of circulatory condition. A Charcot joint, resulting from trauma to the insensitive foot, causes the foot to collapse and widen. This destructive condition is often heralded by persistent swelling and redness, mild to moderate aching, and an inability to fit into shoes. If this occurs, it is important to stay off the foot and see a podiatric surgeon immediately.                                                

 

FOOT AND ANKLE INJURIES

pain

You miss a step racing across the street and sprain and ankle. Ouch! A bag of groceries tears open, and bottles and cans fall on your foot. Ouch!

Accidents of this type happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. And when a foot or ankle injury does happen, it is critical that you seek immediate medical treatment. Probably the most important rule to follow in preventing foot and ankle injuries is not to take your feet for granted. By simply keeping them healthy, following safe work practices, and wearing the appropriate shoes for your job or sports activity, you will ensure the ability to use your feet with ease and comfort for a long, long time.

If you do hurt your foot or ankle, podiatrists suggest you get off your feet immediately. Next, elevate the injured foot higher than the waist to reduce swelling and pain, and use cold compresses in a 20 minute on 40 minute off cycle. For bleeding lacerations, cleanse well, apply pressure with gauze or a towel, cover with a clean dressing and get to a podiatrist’s office as quickly as possible.                                                                                                

 

FOOT HEALTH CARE FOR OLDER AMERICANS

Mobility, the ability to move about, is essential for older people to live useful, satisfying, lives, but foot problems often interfere with their mobility and independence. According to the United States National Center for Health Statistics, impairment of the lower extremities is a leading cause of activity limitation in older people.

There are more than 300 different foot ailments. Some of these ailments can be traced to heredity, but for aging population, most of these ailments stem from the cumulative effect of years of neglect and abuse. However, many foot problems can be treated successfully, and the pain of foot ailments relieved.                                                                                

 

AN OUNCE OF PREVENTION

Healthy feet mean limitless activity and exercise and, contrary to popular belief, feet don’t need to hurt. Caring for one's feet should be as much part of a regular routine as brushing teeth. By following these general foot health guidelines, feet should last a lifetime:

* Practice daily foot hygiene and care. Inspect your feet every day or have someone do this for you. If you notice any redness, swelling, cracks in the skin, or sores, consult your podiatry surgeon
* In an aging body, toenails begin to thicken causing more difficulty. For some, trimming the toenails straight across is recommended. Corns and calluses, which plague the feet of active seniors, must be care for by a professional
* Wear proper fitting shoes. For more strenuous walking and running, an athletic shoe with gel soles, rubber bottoms, arch supports and a size larger are recommended. If mall walking is preferred, a supportive walking or running shoe will suffice. Wear thicker socks for more cushion. Shop for shoes in the afternoon; feet tend to swell during the day
* Stretch daily and remain active. As a body ages, circulation suffers; daily stretching will help warm up the muscles to begin exercise and help cool down tired muscles after activity
* As people age, their feet tend to spread and lose the fatty pads that cushion the bottom of the feet. Additional weight can affect the bone and ligament structure. Older people, consequently, should have their feet measured for shoe sizes more frequently, rather than presuming that their shoe sizes remain the same
* Have your feet examined by a podiatric surgeon or podiatrist at least twice a year.

 

YOU DON'T HAVE TO LIVE WITH FOOT ODOR

No other parts of the human body put up with as much verbal abuse as the feet. They're often labeled the "ugliest part of the body", for example, and they seldom escape being prefaced with the adjectives, "smelly" or "stinky".

But nobody has to live with smelly feet. It's a treatable problem, often caused by improper foot hygiene or excessive perspiration. These two culprits can provide a medium producing a flourishing crop of odorous bacteria and with over a quarter of a million sweat glands in a pair of feet, these bacteria have an almost unlimited food supply.

What's a person to do? Obviously, clean your feet thoroughly. Just standing in soapy water while you take a shower isn't enough. Soap up and rinse your feet, then dry them completely, especially between the toes where odor begins. Then apply a good foot powder to control that perspiration. Finally, limit the wearing of nylon hosiery and boots. Wear natural-fiber socks, or socks that provide a "wicking" action to draw away perspiration. And wear "breathable" shoes made of leather or canvas.

If odor still persists, see your podiatric physician. Treatments may include medicated soaps, antibiotics, or antiperspirants, but the result will be the same: foot odor will just be a bad memory.                                                                                                                              

 

DON'T FOOL WITH FROSTBITE OF THE FEET IN SUB-FREEZING WEATHER

When the feet are exposed to extremely cold weather for a long time they are in danger of frost bite, a painful condition that can result in permanent tissue damage or even loss of toes.

If your feet are painful after exposure to cold, you could be in danger of frostbite. Another warning is when pain gives way to numbness, in either case, seek a heat source as quickly as possible, or move about to help blood circulation. Never remove boots or shoes to examine your feet while still outdoors.

After you've gotten out of the cold, check the color of your toes. If the skin is white or blue-black instead of pink, you need immediate medical attention. A podiatric physician, specially trained in diseases of the foot, can save damaged toes if medically possible.

If medical attention is not available, warm the feet gradually (warm water is best), and massage then to stimulate the circulation. Analgesics, like acetaminophen or ibuprofen, will help ease the pain warming up.

Insulated, waterproof footwear is the best way of preventing frostbite. Lace boots to the top, but not too tight. Socks should be thick, but not layered so thickly that circulation is lost.

 

HEALTHY FEET AND YOUR BACK

Doctors of podiatric medicine, trained and accustomed to relieve foot pain arising from a variety of sources, have been discovering that some of the ways they overcome foot problems can also have a positive effect on one of mankind's more mysterious kinds of pain - back pain.

The keys are orthosis - hand-crafted "arch supports" inserted in footwear to correct foot deformities or abnormalities, which can cause irregular walking patterns and lead to pain in the legs, hips and back as well as the feet.

Podiatrists have long been aware of cause-and-effect relationships between foot pain and back pain (back problems can lead to foot pain, too).

Now, high technology has produced computerized gait analysis equipment that enables them to get much more precise measurements of the irregularities, and create more effective orthosis.

The podiatrist is not licensed to treat the back directly, and there is a lot of back pain that doesn't have a thing to do with the feet.  

But, in the absence of clear-cut causes for back pain in people who are otherwise physically fit, gait analysis may be able to pinpoint a direct link between foot pain and back pain, neither of which are normal.                                                                                               

 

HEEL PAIN: NO GAIN

People ask a lot of their heels. The largest bones in the foot, they bear the brunt of every step we take. It's no surprise heels end up hurting occasionally.

Having flat fee, an abnormal gait, ill-fitting shoes, or a weight problem can all lead to heel pain. But a variety of conservative treatments by a podiatrist can quickly alleviate such pain.

Most heel pain involves a membrane surrounding the heel bone that anchors a long band of connective tissue, called the plantar fascia, which stops at the ball of the foot. When the fascia is stretched too far, the tissue tears and inflames, creating a condition known as plantar fasciitis.

Stretching of the fascia can also contribute to the formation and development of heel spurs.

While rest and applied heat provide temporary relief from heel spurs and plantar fasciitis, it is best to consult with podiatric physicians for permanent treatment.

With x-rays, a podiatrist can identify the condition and prescribe anti-inflammatory medication, physical therapy, or orthotic shoe inserts to relieve stress and correct biomechanical problems.

Surgical removal of the heel spurs is rarely required. But if surgery is the best option in your case, it can be performed in the office or in a hospital.                                                      

 

HEEL PAIN

Heel pain is commonly caused by plantar fasciitis (which is also referred to as a heel spur); this can affect 2.5 million people each year.

The ligament that stretches along the bottom of the foot, the plantar fascia, is responsible for maintaining the arch of your foot. When the plantar fascia pulls away from the bone your heel becomes painful. Your body may react by filling this space with new bone, which results in heel spurs.  Most people think that heel spurs are the cause of their foot pain, but the actual pain is caused by the inflammation or the irritation of the plantar fascia ligament.

There are many treatments for heel pain, including changing of shoe gear, taking non steroidal anti-inflammatories, sometimes custom molded orthotics are needed, some patients may even need cortisone injections as well as physical therapy.

Shock wave treatment, which is a non-surgical treatment, can also be utilized to help relieve the pain.

If you have heel pain, the earlier the treatment the faster you will get better. Your podiatrist can usually diagnose this condition in the office and treatment can commence immediately.

 

People hiking.

HIKING FOR GOOD HEALTH

There's no better way to enjoy the lush greens of summer or the fiery reds of autumn than hiking. With the right footwear and some common sense, it's a good way to commune with nature and improve cardiovascular fitness.

Stretching out leg muscles before a hike and wearing proper boots are very important for safe hiking. Hiking boots prevent mishaps on rocky trails that can injure an ankle and ruin and outing.

A good hiking boot has a high top for ankle support, is flexible, but has a firm outsole, excellent traction, and water resistance enough to withstand puddles or streams without soaking the feet.

Boots should be worn with socks and laced to the top. Ill-fitting footwear invites injuries, so never borrow anyone else's boots.

When hiking, look out for rocks that cause feet to roll and ankles to twist. If you do twist an ankle, remove the boot and rest a few minutes. Apply ice if available, and elevate the foot. Check for swelling and discoloration - both are signs of more serious injury.

If you can put the boot back on without lots of pain, it's OK to make for home. But if severe pain continues, don't try to move without assistance, wait for help. Seek treatment from your podiatrist or family doctor.                                                                                         

 

ORTHOTICS

If you've worn arch supports in the past to help you walk and move normally, you will be surprised to learn that the new "arch supports" are not really arch supports at all.

A field of medical technology called biomechanics has developed new foot supports; the new science deals with human motion and can "custom make" any device you need to support your feet.  Some people may still refer to them as "arch supports", but there is a world of difference and new comfort for those who need them so that they can be helped to walk normally without aches and pain.

Functional foot orthotics are made from neutral foot position castings.  The practitioner then sends the casts and clinical information to an orthotics lab.  The technician reviews the cast and prescription.  The orthotics are then fabricated and dispensed to the patient.  They usually require a gradual break in period of two to four weeks. After which time the patient is wearing them daily, depending on the problem, the diagnosis and how your foot responds to orthotic control.

In time the orthotic devices will allow your feet and legs to function normally again.

ORTHOTIC DEVICES

Bill has been feeling lower-back pain for a month. A weight lifter, Bill thought he could alleviate the pain by curtailing his heavy squats. It didn't help.

Chris, a cyclist, recently decided to get more serious about his training. He had no trouble increasing his distances, but now he's mystified by persistent shin pain.

Joan, who takes aerobics classes four times a week, feels pain in one heel at the beginning of each class, but doesn't take it seriously because it gradually lessens as the hour passes.

Three athletes, three sports, three complaints, all of which may have on solution: orthotic devices.

Properly called orthosis, orthotic devices are removable shoe inserts, custom-molded of various materials, designed to correct a foot misalignment deformity, or dysfunction. Orthotic devices perform functions that make standing, walking and running more comfortable and efficient, by altering slightly the angles at which feet strike a walking or running surface.

Doctors of podiatric medicine prescribe the use of orthosis as conservative approaches to many foot problems; their use is a highly successful, practical treatment form. The aim is to improve the foot function and minimize stress forces that could otherwise cause foot deformities, which have been traced to many back, hip and knee problems.                   

 

SELECTING THE RIGHT SHOES

Feet bear much of the burden for most athletic activities. Selective the right athletic shoe is as equally important as selectingthe right golf club or tennis racket. A well-fitting, well-made and properly used athletic shoe can help reduce foot problems and increase performance.

Depending on the sport of choice, there is a shoe to meet your foot care needs. Different sports call for specific footwear to protect feet and ankles. For example, a running shoe is built to accommodate the impact that concentrates on the forefoot, while a tennis shoe is made to give relatively more support to the ankles, and permit sudden stops and turns

. Shoes displayed on the wall of an athletic store.

Following is a rundown of sports and recommended shoe type:

Cycling: Select a cycling-specific shoe that is right for you among models designed for racing and mountain biking. The casual rider without known foot problems can use cross training shoes (i.e. combination cycling hiking shoes), which provide the necessary support across the arch and instep in a shoe as well as the heel lift that cycling shoes give.

Golf:  No longer driven by fashion, today's golf shoes are constructed using basic principles of athletic footwear. Advanced technological innovations keep golf shoes light and add strength.

Running:  A good pair of running shoes is the most important piece of equipment for a runner. Shoe choice should be determined by weight, foot structure, and running regimen. Shoes have different shapes, and sizes are not uniform from shoe to shoe.

Tennis:  Proper tennis shoes "give" enough to allow for side-to-side sliding. In addition, tennis shoes need to have padded toe boxes to prevent injuries.

Walking:  The ideal walking shoe should be stable from side to side, and well cushioned, and it should enable you to walk smoothly. Running shoes are acceptable for a walking program, but specialty-walking shoes tend to be slightly less cushioned, not as bulky and lighter than running shoes.

Proper fit is the key in selecting athletic shoes. Keep these tips in mind when you're buying athletic shoes:

* Have your feet measured while you're standing
* Always try on both shoes, and walk in the shoes before buying them
* Buy for the larger foot; feet are rarely the same size
* Shoes should feel comfortable immediately, not needing a break-in period
* Shop for shoes later in the day; feet swell during the day
* Be sure that the widest part of your foot corresponds to the widest part of the shoe
* Try on shoes while you're wearing the same type of sock you'll be wearing with the shoe.
                                                                                                                                     

 

SENIOR'S FEET NEED EXTRA TLC

America's senior citizens are more active than ever before - and their quality of life is all the better for it. But no matter what their exercise, be it walking, biking, or even a set of tennis, the feet of these active adults need extra protection to prevent injury and preserve comfort.

Feet are designed to remain healthy for a lifetime, and if they begin to hurt it simply means that something is wrong. Bones in the feet of older men and women naturally become more fragile and the feet's natural cushioning also tends to become thinner with age, with an accompanying loss of shock-absorbing ability.

For these conditions, shoes with good shock-absorbing soles, cushion insoles, and shoe inserts or orthotic devices prescribed by a podiatrist should keep seniors in the swing of things.

lder people's feet also show other signs of wear and tear, including a tendency for them to spread. In such cases, wider shoes should be the order of the day.

Feet are marvels of engineering, but even the most sophisticated pieces of equipment need routine care and maintenance. Regular foot examinations by your doctor of podiatric medicine are the best insurance for pain-free activity in the year ahead.                        

 

SMOKING: UNHEALTHY DOWN TO YOUR FEET

The dangers of cigarette smoking are well publicized, but many people may not realize the health risks of smoking extend down to the feet.

Smokers notice their feet and hands feel cold after lighting up outdoors in the cold weather. That's because the nicotine in tobacco smoke constricts the blood vessels, particularly the small veins and capillaries in the extremities.

But the danger is greater than just cold feet. Constriction of the blood vessels by smoking leads to neuropathy - nerve damage that results in a loss of feeling in the feet.

When you can't feel pain, heat or cold in the feet, injuries go unnoticed. Neuropathic feet also have less blood flowing to naturally fight the infections that come with usually inconsequential wounds like punctures, scratches, or even ingrown toenails.

Because the body's ability to fight infections is diminished, they can fester and degrade into a serious condition like gangrene, which could lead to amputation.

Your podiatric physician can treat neuropathy with medication, but he or she will tell you that quitting smoking is the most important step to regaining healthy feet. Unless the source of the problem is corrected, treatment can't fully restore circulation.

If you smoke, inspect your feet regularly and have them evaluated by a podiatrist. If your feet suffer from smoking, just think what's happening to the rest of your body.              

 

UNDERSTANDING GOUT

gout

For many people, gout is a subject of humor. Some remember the original comic strip, "The Captain and the (Katzen-jammer) Kids", in which the captain frequently was put out of action by gout in his big toe, which he suffered because his appetite for rich food and drink was legendary.

For people with gout, it is anything but humorous. It can be excruciatingly painful, some say the most intense pain a man can experience. It's often connected to rich diets, with lots of red wine and brandy.

Gout is a form of arthritis, which strikes the lining of the joints. The big toe joint is a common target. Gout is caused by the body's inability to process uric acid, which leads to buildup of the acid's salts in the blood stream, and their eventual deposit in a joint. The joint becomes inflamed, swollen, and painful to the touch.

You can get some relief by applying warm compresses and elevating the foot.

However, you should also see a doctor of podiatric medicine, who can prescribe drugs that will relieve the pain and inflammation, and decrease the accumulation of uric acid crystals in the joint. The podiatrist will also tell you that gout left untreated can lead to some more serious afflictions, and that your diet probably needs revision.