On Wednesday, May 23, 2012, Dr. Jeff Stewart, Podiatrist, presented a program on foot problems and what can be done about them. He emphasized that he does everything possible before considering surgery for foot problems. Life is good, he said, until our feet start hurting, and this pain leads to lack of activity, impacting our overall well-being. Dr. Stewart spoke mainly on two of the most common foot problems: neuropathy and plantar fasciitis.
NEUROPATHY symptoms include burning, tingling and/or numbness in the feet. Balance and sensation are affected. Usually the long peripheral nerves are affected first, and symptoms begin in the toes. People tend to widen their stance (walk or stand with legs farther apart than normal) for stability. This condition is very common in diabetics, in which the nerve endings tend to deteriorate, leading to lack of feeling, which can lead to rubbing, sores, infection and even amputation. This is also seen in alcoholics, people who work for long periods with chemicals, and people undergoing chemotherapy. In some cases, the cause is unknown ("idiopathic"). While this cannot be cured, the symptoms can be treated with Vitamin B-12 supplements, physical therapy and controlling diabetes with personal doctor participation.
PLANTAR FASCIITIS is a common injury for runners. The first symptom is often one's first step in the morning, causing severe pain in the foot. The ligament tightens overnight during sleep; you step on the foot upon getting out of bed, and the ligament stretches and hurts. Development of a heel spur (abnormal bone growth) is a sign that there is a lot of tension in the plantar ligament. Treatment includes stretching, ice, cortisone injections and orthotics for arch support in shoes. In extreme cases, endoscopic (through a scope) surgery can be done to cut the ligament. Bone spurs can usually be left alone as long as they do not point downward. Exercise is good to increase blood flow, and therefore nutrition, to the foot.
THICK RIDGED TOENAILS are usually the result of a fungal infection. Topical creams can be used as well as oral medication, to get rid of this problem. Liver function blood tests must be done regularly if one takes the medication.
FOOT SWELLING can be associated with damaged and decreased venous blood flow in the legs. The valves in the veins wear out or are injured, so they function poorly and blood is not moved efficiently out of the legs. Swelling typically worsens over the course of the day. Treatment includes elevation of the legs, compression hose, and diuretics.