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Understanding Corns and Calluses

Corns and Calluses are both hardened layers of thickened skin that develop because of friction. Both ailments are typically found on the feet and may be unsightly. Although they have similarities, corns and calluses are different from each other.

Some causes of corns and calluses may be wearing ill-fitting shoes and not wearing socks. If you wear tight shoes, your feet will constantly be forced to rub against the shoes, causing friction. If you fail to wear socks, you are also causing your feet to endure excess friction.

There are some signs that may help you determine whether you have one of these two conditions. The first symptom is a thick, rough area of skin. Another common symptom is a hardened, raised bump on the foot. You may also experience tenderness or pain under the skin in addition to flaky, dry, or waxy skin.

There are also risk factors that may make someone more prone to developing corns and calluses. If you are already dealing with bunions or hammertoe, you may be more vulnerable to having corns and calluses as well. Other risk factors are foot deformities such as bone spurs, which can cause constant rubbing inside the shoe.

Corns tend to be smaller than calluses and they usually have a hard center surrounded by inflamed skin. They also tend to develop on the parts of the body that don’t bear as much weight such as the tops and sides of toes. Corns may also be painful for those who have them. On the other hand, calluses are rarely painful. These tend to develop on the bottom of the feet and may vary in size and shape.

Fortunately, most people only need treatment for corns and calluses if they are experiencing discomfort. At home treatments for corns and calluses should be avoided, because they will likely lead to infection. If you have either of these ailments it is advised that you consult with your podiatrist to determine the best treatment option for you.

Hyperhidrosis of the Feet

Each foot, on average, has about 250,000 eccrine sweat glands that produce half a pint of sweat each day. Sweating is a natural and important bodily function. It regulates the body’s temperature by cooling the skin so that it does not overheat.  In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than what is required. People with plantar hyperhidrosis experience an excess amount of sweat on their feet. It is estimated that 2% to 3% of all Americans suffer from some form of hyperhidrosis. This condition is often caused by neurologic, endocrine, infectious, and other systemic disease. Other factors that may trigger the condition are heat and emotions.

People with hyperhidrosis may notice an overabundance of sweat on their feet, along with a strong odor. The feet may also have a wet appearance coupled with infections such as athlete’s foot or toenail fungus. The sweat may even appear in low temperatures, such as during the winter months. People with plantar hyperhidrosis often need to change their socks several times throughout the day.

The specific cause of hyperhidrosis is unknown, and many believe it may be caused by over-activity. However, others believe the condition is genetic.  Caffeine and nicotine are known to cause excitement and nervousness which are two emotions that may make the condition worse.

If you are looking to treat your hyperhidrosis the most important thing you should do is wash your feet every day.  You may even need to wash your feet twice a day, if necessary.  You should also make sure you are wearing the right socks. Wool and cotton socks are both known to be good for ventilation, meaning they allow the feet to breathe. You should avoid socks made from nylon which trap moisture and lead to sogginess. Other common treatment options are over-the-counter antiperspirants that contain a low dose of metal salt.  In some cases, prescription strength antiperspirants that contain aluminum chloride hexahydrate may be necessary. In severe cases, surgery may be required.

Untreated hyperhidrosis can easily lead to complications.  Some complications that may arise from the disorder include nail infections, warts, and bacterial infections.  Consequently, it is important that you seek treatment from your podiatrist if you suspect that you may have plantar hyperhidrosis.

Dealing with Stress Fractures of the Foot and Ankle

Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.

Blisters

Blisters are small pockets of fluid that occur on the top layers of the skin for several reasons. Friction, burns, and diseases are all known causes of blisters.  Smaller blisters are known as vesicles, while larger blisters are referred to as bulla. The fluid inside the bubble can be blood, pus, or serum; which is a clear liquid that protects the skin. In most cases, blisters are not a major health issue, but they can be an indicator of a more serious condition.  

Causes of blisters vary. Blisters are commonly caused by wearing poorly fitted shoes that rub against the foot. However, there are many other causes besides from friction; including burns, sunburn, insect bites, frostbite, poison ivy/oak, chemical exposure, impetigo, eczema, viral infections, and more.

Most blisters heal by themselves and do not require immediate medical care. If you have a blister, do not pop it since this may cause infection; it is advised to put a bandage over the blister to protect it. If the blister is large, causes pain, or if you have a fever, it is recommended that you see a doctor who can provide proper care. Blisters are easy to diagnose, and if considered prudent by the doctor, can easily be drained of fluid with a sterile needle as well.

To prevent blisters on the feet, wear shoes that fit properly and don’t cause rubbing. Socks can help prevent friction and it is recommended that you wear them if you are wearing shoes. Hand blisters can be avoided by wearing gloves during activities that cause friction against the hand. If you have a blister that pops, do not remove the dead skin, wash the area, apply antibiotic ointment, and cover with a bandage. It is okay in most cases to not seek immediate medical care for a blister if it was just caused by friction. However, if the blister causes pain or does not go away, it is suggested that you see a doctor for a diagnosis.

Hammertoe

Hammertoe is a foot deformity that occurs due to an imbalance in the tendons, muscles, or ligaments that are responsible for holding the toes in their normal position. This condition may be caused by poor footwear, foot structure, trauma, and disease. The most common solution for hammertoe is to relieve the pain by changing your footwear and wearing orthotics. In severe cases, surgery may be required.

The shoes that are most likely to cause hammertoe are high heeled shoes or shoes that are too tight in the toe box. Tight shoes will force your toes to crowd together in a curled position. This position will likely continue when you take your shoes off. Another cause is trauma. When you stub your toe, you are increasing the chance that you will develop hammertoe.

There are risk factors that may make you more likely to develop this condition. Women are more likely to have the condition compared to men, and it is also more likely to appear in those who are older in age.

Many different foot problems can be avoided by wearing shoes that have adjustability, adequate toe room, and low heels. Furthermore, if you want to buy new shoes, you should look to purchase them at the end of the day and make sure you know your correct size. The importance of buying shoes at the end of the day is that your feet swell as the day progresses. You should also ensure that you are wearing your correct size because your shoe size may change as you grow older.

To diagnose someone with hammertoe, your podiatrist will need to conduct a thorough examination of your foot. Your doctor may even order an x-ray to evaluate the bones and joints of your feet and toes.

If you have hammertoe, your podiatrist may recommend that you wear shoes that fit you better along with inserts to place inside them. Additionally, he or she may suggest special exercises for you to perform to stretch your toes. One helpful exercise it to pick up marbles with your feet or crumple a towel with your toes.

Prior to meeting with your podiatrist, it will be helpful to make a list of all the symptoms you are experiencing. You should also make a note of medications you are taking and important personal information about your medical history.

Treating Toenail Fungus

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

What to Know About a Broken Toe

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options. 

Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

Obesity and the Feet

Obesity is a common problem in American society. Approximately one third of the U.S. population is obese. Obesity is defined as a body mass index greater than 30. Obesity has the power to affect different aspects of the body, and one of the most common problems it causes is foot pain. There have been many studies that found a connection between an increased BMI and foot problems. A simple activity such as walking up a flight of stairs can increase pressure on the ankle by four to six times.

Being overweight causes the body to compensate for the extra weight by changing the way it moves. Consequently, people who struggle with obesity commonly have arch problems in their feet. Obesity causes the arch to break by stretching the ligaments and tendons that hold the bones in the foot together. When the arch lowers, the foot may eventually fall flat. Collapsed foot arches fail to provide adequate shock absorption which eventually leads to foot pain. Other conditions that may be caused by flat feet are pronation, plantar fasciitis, weak ankles, and shin splints.

Foot problems that are caused by obesity may be treated by wearing proper footwear. Proper shoes will allow your feet to have better circulation around the arch and ankle. Additionally, those with obesity often discover that typical heel pain remedies are not effective for them.  They will find that their plantar fascia is easily injured, and it is often inflamed. The best way to treat this problem is to implement lifestyle changes. A few good ways to improve your diet are to reduce calories, fill up on fruits and veggies, and to limit sugars.

Custom foot orthotics can prevent foot problems if you’re carrying excess weight or are trying to lose weight. The purpose of orthotics is to provide shock absorption to decrease the amount of stress on the joints to prevent arthritis.

How to Treat Heel Spurs

Heel spurs are calcium deposits that cause bone protrusions on the heel bone. Heel spurs are usually associated with plantar fasciitis, which occurs when the plantar fasciitis in the foot becomes inflamed. Typically, heel spurs don’t cause any symptoms. However, they can produce chronic or intermittent heel pain. Those who have had the condition often describe the irritation as a stabbing pain.

There are risk factors that may make you more likely to develop heel spurs. People who have abnormal walking gaits, run and jog on hard surfaces, are obese, or wear poorly fitting shoes are more likely to develop heel spurs.

Fortunately, there are precautions you can take to avoid developing heel spurs. One of the best ways to do this is by wearing well-fitting shoes with shock-absorbent soles. Another preventative technique is to choose running shoes if you plan on running, and walking shoes if you plan on walking. Shoes are made for different activities and it is important to research a shoe before you purchase a pair.

The pain associated with heel spurs often decreases the more you walk. However, a recurrence of pain after an extended period of rest or walking is likely to occur with this condition. Those with severe heel spur pain may opt to go the surgical route for treatment.  However, more than 90% of those with the condition get better without surgical treatment. If you have a heel spur and want to know if surgery is right for you, you should go to your podiatrist and he or she will be able to conduct a pre-surgical test or exam to determine if you are an optimal candidate for surgery.

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