Foot health: corns, big toe pain, puffy ankles & more

Health correspondent

Walking is one of the easiest and most effective forms of exercise, so make sure your feet are up to it

Many minor foot problems can be effectively treated by a podiatrist, who can also advise you on how to keep your feet in the best possible shape. John Durkin of Fulham Podiatry in West London, answers some of the most common questions on foot health

Q I get a stabbing pain in the soles of my feet when I walk. What could it be?

A Pain in the soles of the feet or at the heel is usually caused by plantar fasciitis, inflammation of the thick band of fibrous connective tissue, which runs from the heel bone to the bases of the toes and helps to maintain the arches. Badly fitting shoes, pronation (rolling your foot in when you walk), tight calf muscles, or sudden exercise can all trigger it.

Daily calf muscle stretches, switching to more sensible shoes, orthoses or a type of acupuncture known as dry needling may relieve symptoms. In extreme cases your podiatrist may be able to offer you a cortisone injection or refer you to your GP for one. If all else fails surgery may be an option, although this is not recommended.

Q My feet are very stiff – how can I make them more flexible?

A Feet tend to become more rigid as you get older and arhtritis may be a contributing factor. Walk as much as possible and keep moving your feet. Daily exercises such as extending and flexing your toes, or circling your feet while sitting down can help and standing on tiptoes can increase flexibility. Regular foot massages or reflexology can also help.

Q Can anything be done about bunions?

A Contrary to popular opinion wearing badly fitting shoes does not cause bunions although they may make them worse. Your foot type increases your risk: for example, if you have excessive pronation (flat feet that tend to roll inwards as you walk) or feet that are 'hypermobile', meaning they are more flexible, you may be more susceptible. Wearing sensible shoes, exercises, orthoses (special devices inserted into shoes) or night splints, which hold toes straight overnight, can help to keep early bunions in check. Surgery is the only way to correct the deformity but is not always completely successful and full recovery can take months. A different form of operation called a scarf osteotomy can have better results and a shorter recovery time, but you may have to pay as it is not available in all NHS hospitals. Read more in the May 2007 issue of Saga magazine.

Q My big nail is starting to crumble and go yellow. What could it be?

A This is a sign of a fungal infection under the nail, which has usually spread from an area of athlete’s foot somewhere else on your foot.

A topical anti-fungal nail cream may clear it up but in severe, long-standing cases you may need tablets on prescription from your GP. A more drastic solution involves removing the whole toenail.

Q Why do I get puffy ankles?

A Poor circulation due to heart problems, varicose veins, lymphatic problems, liver disease or an ankle injury can all cause ankles to swell. Self-help measures include wearing support stockings (which should be properly fitted), putting your feet up as much as you can and gentle exercises. If the problem persists see your GP who will look for any underlying causes and prescribe appropriate medication.

Q Why are my feet often cold?

A Some of us are naturally more susceptible to cold feet than others, but poor circulation is the most likely culprit, says Durkin.

Wearing an extra pair of socks and keeping your feet moving can help. Insulated insoles available over the counter at the pharmacy are also worth a try. It is important to try to keep the temperature of your feet constant – suddenly going from cold to hot may cause chilblains.

Q I've got a pain in my big toe, could it be gout?

A Sudden, acute painful swelling of the big toe joint is the first sign of gout. It is caused by a build up of uric acid deposits in the joint or arthritis. 'Gout can be inherited but foods containing purines, such as beans and peas, may exacerbate it, as will alcohol,' says Durkin. 'Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve swelling in the short term. However if a podiatrist suspects gout they will advise you go to your GP who will take a blood test and prescribe the appropriate medication,' adds Durkin.

Q Why do I keep getting corns?

A Pressure or friction from badly fitting shoes or skin rubbing against prominent bony areas of the feet while walking or running are the usual reason.

‘In the first instance emollient creams, emery boards and a pumice stone may help to alleviate the problem,’ says Durkin. Self-use of blades is not recommended nor are corn plasters containing acids. If corns keep returning, regular visits to the podiatrist will help to keep them under control.

Shoes should:

  • be foot shaped
  • be laced or strapped and barred with a small heel ( ideally no more than 1/2in)
  • have a firm heel counter (heel feels firm when pressed on either side)
  • have a manmade sole
  • have leather uppers that are neither too floppy or soft

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