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Many foot diseases and conditions become more serious and common among the elderly. Some of these conditions include diabetic ulcers, ingrown toenails, fungus, arthritis, corns, and calluses. Unfortunately, it may be harder for older adults to take care of their own feet, but there are some precautions they can take in order to avoid any serious conditions.
Dry, cracked heels tend to be a common problem for older people. In order to avoid this, you should always keep your feet clean and well moisturized. Special feet moisturizers should be used as average lotions might not provide enough moisture for dry and cracked heels. Daily foot inspections are crucial for the elderly to detect any irregularities in their earliest stages. During the aging process, blood circulation tends to slow down causing older people to not feel their feet as well as they used to. This often results in foot problems going unnoticed.
Fungal and bacterial conditions thrive on elderly feet because older adults are less likely to keep their feet clean and dry; this makes it easier for bacteria to take hold in their dry, cracked skin. Elderly people should be sure to thoroughly dry their feet, especially in between the toes, after bathing. This will help them avoid developing any fungal infections. Additionally, clean cotton socks should be worn after the feet are dried.
Cutting toenails straight across will help prevent ingrown toenails. When toenails are cut too lose, the nail might break through the skin resulting in an ingrown nail. Clippers should be used to cut the nails in order to make the cut even.
Elderly people who have diabetes are at risk of developing serious foot problems that may lead to amputation. Ulcers that are left untreated can lead to gangrene. Dry and cracked feet, fungus, and untended cuts under the nails may also lead to infections.
Fortunately, Medicare covers many different types of services for foot care. Elderly people with any of these foot conditions should seek the help of a podiatrist and perform daily foot inspections in order to ensure that they have healthy feet.
When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition. A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case. Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery. Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.
Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome. A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications. Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered. Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.
Care post-surgery will depend on the type of surgical procedure performed. Typically, all postoperative care involves rest, ice, compression, and elevation. To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes. He will also determine if and when you can bear weight. A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.
An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders, or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail. In most cases, however, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.
The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well.
This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.
Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.
Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.
Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.
Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.
An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders, or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail. In most cases, however, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If the bone is removed, it is then replaced with prostheses, synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
Flatfoot is a foot condition in which the arch of the foot has either partially or totally dropped or has never developed. While it is common in babies and small children, it can become a problem for them in adulthood if the arch never forms. For adults, the development of flat feet can be brought upon by injury, as a result of pregnancy due to increased elasticity, or obesity. Those who have health concerns such as rheumatoid arthritis or diabetes may also be at greater risk for developing the condition.
If you suspect that you have flat feet, it is best to consult your podiatrist. Your foot doctor will examine the suspected foot and observe how it looks while you sit and stand. He or she may take an X-ray to determine how serious the condition is. Some common signs of flatfoot include toe drift, in which the toes and front part of the foot point outward, a short Achilles tendon, and a heel that tilts outwardly while the ankle tilts inward.
Once flatfoot has been diagnosed, your podiatrist may suggest one of several treatment options. Flat feet can be rigid, in which the feet appear to have no arch even when the person is not standing; or flexible, in which the person appears to have an arch while not standing, but once standing the arch disappears. Those with flexible flatfoot may be told to reduce any activities that cause pain and to avoid extended periods of walking or standing. Another suggestion may be weight loss, as excessive weight may be placing pressure on the arches
In few cases, if the condition is severe and all other methods have been exhausted surgery may be required. This is normally avoided, however, due to a lengthy recovery time and high cost.
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
Blisters are a common ailment of people who wear shoes that are either too tight or rub against the feet in an uncomfortable way. Knowing the basics of blisters is important for understanding how they are formed and what treatments should be used for them.
A blister on the foot, or any other part of the body, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery-like fluid that usually isn’t cause for concern. However, blisters can fill up with blood if they are deep enough and pus if they have become infected with bacteria.
Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time or when your shoes do not fit you properly. Your feet are also more prone to blisters if they are moist, so keeping them dry and clean is one preventative step you can take.
Preventing infection should be the number one concern when treating blisters, as well as relieving the pain they can cause. Using a bandage to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop. You can also take a sterilized pin and try to pop it yourself.
If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics may need to be taken in order to completely eliminate the bacteria inside the blister. See a doctor to have an antibiotic prescribed.
The best way to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a bandage to an area where you think a blister is about to form is another way you can prevent them.
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.
A bunion is a bump that forms at the base of the big toe. Bunions form when the big toe pushes against the next toe, which forces the big toe joint to get bigger and stick out. As a result, the skin over the bunion may start to appear red and it may feel sore.
There are risk factors that can increase your chances of developing bunions. People who wear high heels or ill-fitting shoes are more likely to develop them, in addition to those who have a genetic history of bunions or have rheumatoid arthritis.
The most obvious way to tell if you have a bunion is to look for the big toe pushing up against the toe next to it. Bunions produce a large protrusion at the base of the big toe and may or may not cause pain. Other symptoms are redness, swelling, and restricted movement of the big toe if you have arthritis.
Nonsurgical methods are frequently used to treat bunions that aren’t severe. Some methods of nonsurgical treatment are orthotics, icing and resting the foot, taping the foot, and pain medication. Surgery is usually only required in extreme cases. However, if surgery is needed, some procedures may involve removing the swollen tissue from around the big toe joint, straightening the big toe by removing part of the bone, or joining the bones of your affected joint permanently.
Your podiatrist will diagnose your bunion by doing a thorough examination of your foot. He or she may also conduct an x-ray to determine the cause of the bunion and its severity.
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
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.
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.
There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.
People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.
Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.
If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.
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