All too often, we think about our feet only when it’s time to give them an airing at this time of year, or if they start to give us gyp. But foot problems can have a big impact on our life.
'Your feet are a good barometer of your overall health.' Dr Wendy Denning
And that’s not all: ‘Believe it or not, your feet are a good barometer of your overall health, frequently showing symptoms of a disease before any other part of the body,’ says private GP Dr Wendy Denning, who specialises in integrated and nutritional medicine. All good reasons to give your tootsies some TLC this summer.
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The foot is one of the most complex structures in the human body. The foot and ankle contain 26 bones, 33 joints and more than 120 tendons, muscles and ligaments.
A pair of feet has around 250,000 sweat glands, which together can produce approximately half a pint of perspiration every day.
The skin on the sole of the adult foot is the thickest on the body.
There are more nerve endings per square centimetre in the foot than in any other part of the body and they constantly supply us with information about the surfaces we walk on, without us even being aware of it.
The bones of both feet combined account for around a quarter of all the bones in the human body.
Facts supplied by The College of Podiatry (scpod.org)
What cold feet could mean
It could be an underactive thyroid, because feeling cold all the time is a classic sign. And it’s not just the feet that are affected. ‘Sufferers feel the cold in their whole body,’ observes GP Dr Dawn Harper of Channel 4’s Embarrassing Bodies.
Cold feet can also be a sign of the circulatory disease Raynaud’s phenomenon. Symptoms are generally worse during the winter, but sudden changes in temperature, such as air conditioning and cool evenings, can spark symptoms in summer, too.
What to do about cold feet
See your GP. An underactive thyroid is treated with levothyroxine, a medication to top up low thyroid hormone levels. Keep feet warm with socks, exercise regularly and eat a healthy diet. Yoga and breathing exercises help to improve circulation. Seek medical help if symptoms are severe, worsening and/or affecting daily life.
Learn more about cold hands and feet
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What foot cramp could mean
It could be muscle overuse. Cramp in the feet caused by muscle overuse becomes more common as we get older and can be worsened by dehydration, drugs such as diuretics, and mineral deficiencies such as potassium, calcium and magnesium.
Usually harmless, cramp can sometimes be linked to underlying medical conditions affecting the nervous system or circulation, so if they are severe and simple measures don’t help, see your GP.
What to do about foot cramp
Stay hydrated. If cramp strikes, sit with legs outstretched, lean forward and flex your toes towards you, using your hands, a fitness band, tie or towel as an aid if necessary. Applying ice or heat, or soaking in warm water, can help to ease cramp. ‘Anti-inflammatory tablets may also help,’ says Dr Harper.
Find out what causes leg cramps
What a foot ulcer could mean
It could be diabetes. ‘When someone has diabetes, nerve damage can mean they don’t feel pain and they may continue to walk around with a cut or injury causing an ulcer. Smoking and other conditions that damage nerves, such as multiple sclerosis, may also be culprits,’ says Dr Harper.
What to do about a foot ulcer
It is rare that a foot ulcer is the first symptom of diabetes. But prevention is better than cure. If you have diabetes, you should pay attention to foot care, avoid going barefoot and make sure problems, such as corns, are promptly treated. Try to avoid sitting with your legs crossed as this constricts circulation, and be sure to see a podiatrist regularly.
Note A non-healing sore can also be a sign of skin cancer, so don’t ignore it – see your GP as soon as possible.
What a red, swollen, hot, painful big toe could mean
It could be gout. More common in older men, and women after the menopause, gout can be linked to medications, such as diuretics, taken for high blood pressure and/or medical problems, such as high cholesterol.
Being overweight and high alcohol consumption, especially beer (not port, contrary to popular belief) can also be contributing factors.
What to do about gout
Treatment includes anti-inflammatory medication, staying a healthy weight, moderating alcohol intake, regular exercise and staying hydrated. If you get recurrent attacks of gout, cutting down on red meat, offal, seafood, sugary drinks and snacks, full-fat dairy products and alcohol may all help to reduce it.
Learn more about gout
What hairless toes could mean
It could be circulatory problems. ‘Your feet are the furthest body part from your heart, which means they are the last to receive blood and may not get enough nutrients to supply the hair follicles,’ says podiatrist Dr Bharti Rajput of Dundee’s Sole Body Soul Foot Clinic (solebodysoul.com). Mottled discolouration of the foot can be another sign you have a circulation problem, adds Dr Harper.
What to do about hairless toes
A podiatrist can assess the circulation in your feet using Doppler ultrasound and, if necessary, refer you to your GP for further assessment.
What sausage toes could mean
It could be psoriatic arthritis. Swollen fingers and toes – medically called dactylitis – are signs of psoriatic arthritis.
More signs include pain and swelling in the heels caused by inflammation where the Achilles tendon attaches to the bone, and pitting, discolouration and thickening of the nails on feet and hands.
General joint pain and stiffness, stiff neck, pain in the back, knee, buttocks, hip and chest and fatigue are other clues.
What to do about psoriatic arthritis
Anti-inflammatory medications, steroid injections and specific skin treatments are the mainstay of treatment. Self-help includes quitting smoking if you need to, regular exercise and a healthy diet, plus routine visits to the podiatrist.
Learn more about psoriatic arthritis
What clawed toes could mean
It could be nerve damage, which can weaken the foot muscles, possibly caused by trauma, inflammation and medical conditions including diabetes, alcoholism and Parkinson’s disease. The clawing can lead to pressure problems such as corns on the top of the affected toes or under the ball of the foot.
What to do about clawed toes
Foot exercises, wearing roomy shoes and, if toes remain flexible, splinting or taping them to keep them in the correct position can all help. In later stages the toes may become permanently clawed. Pads to redistribute weight and alleviate pressure, plus special shoes to accommodate the toes, can help. Surgery may occasionally be necessary.
What a bony bump at the base of the big toe could mean
It could be a bunion. Blame your parents, not your shoes – if a parent had bunions there’s a chance you will too. A bunion, or hallux vulgas, is a deformity that leads to changes in the structure of the big toe joint and other parts of the foot. But although genes play a bigger part than footwear in bunion development, as Dr Harper observes, ‘Poorly fitting shoes can press and rub on bunions, increasing discomfort’.
What to do about a bunion
Give your bunions space by wearing wide-toed comfortable shoes. Gel pads and/or over-the-counter or custom-made inserts can also help short term. However, the only way to get rid of a bunion is with surgery.
Try Carnation Gel Bunion Protector, £5.20, with a soft, flexible gel, cushions the bunion. Sole Bliss shoes are specifically designed for feet with bunions and are comfy and stylish (solebliss.com).
The Society of Chiropodists and Podiatrists advises…
Wash, dry and moisturise feet daily, taking care to dry between toes. Avoid applying moisturiser between toes, as this can encourage infection.
Keep an eye on hard skin and calluses and remove with a pumice stone or foot file, but be careful not to overdo it.
Trim toenails regularly using proper nail clippers. Cut straight across, never at an angle or down the edges, to avoid ingrowing toenails.
See a podiatrist every six months for a check-up, but go sooner if you develop foot pain or an issue that does not resolve itself within three weeks.
For more information and to find your nearest podiatrist, visit scpod.org.
What crumbly discoloured nails could mean
It could be a fungal infection. ‘This often occurs after a trauma to the nail, which allows fungus to get under the nail plate,’ says Dr Rajput. White or yellow streaks and changes in nail texture such as brittle, thickened, flaking or easily broken nails are also all signs.
What to do about a fungal infection
Fungal infections can be stubborn and hard to treat. Try a topical antifungal treatment containing urea and, if this doesn’t work, see a podiatrist or your GP as you may need a stronger ointment or oral medication. Laser treatment can be another option, although the jury is still out on its effectiveness.
Try Canespro Fungal Nail Treatment Set, £29.99 (canesten.co.uk and chemists). A 40% urea ointment, it softens the infected part of the nail, which can then be removed gradually with a plastic tool. It claims to work within two to three weeks.
What stabbing heel pain could mean
It could be plantar fasciitis. ‘The band of tough, fibrous tissue, the plantar fascia, between the heel and ball of the foot becomes inflamed and causes that stabbing pain, especially with the first few steps in the morning,’ says Dr Rajput.
What to do about plantar fasciitis
Rest, painkillers, calf stretches, gel ice packs, rolling your foot over a tennis ball or massage foot roller and/or orthotic insoles may all bring relief. See a podiatrist, physiotherapist or your GP if the pain persists. A steroid injection may be advised.
Learn more about plantar fasciitis
Try Enertor Comfort Insoles, £24.99. Offering 41% more shock absorption than any other insole, these reduce stress on the plantar fascia and distribute pain away from the heel; 69% of sufferers reported that they helped heal their plantar fasciitis.
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Dr Dawn Harper is brand ambassador for Sole Bliss shoes