Too often, we ignore the very platform that supports everything else – our feet. Without a solid base, the rest can come tumbling down. Foot pain can not only be uncomfortable or painful, it can prevent us from maintaining an active lifestyle, and in some cases, completely immobilize us. Maintaining foot health is essential and often as simple as well fitting, supportive shoes, partnering with a reputable podiatrist or asking a specialty shoe store what is the best shoe to suit our needs. Here are some of the most common foot ailments, their causes, and treatments.
A bunion is a bony prominence from realignment of the joint at the base of the big toes. Bunions most commonly affect the inner foot at the base of the big toe but also can affect the outside of the foot at the base of the little toe, referred to as a bunionette or tailor’s bunion. The misalignment causes the big toe to point outward and rotate (medically termed hallux abducto valgus deformity) toward the smaller toes.
Bunions affect both women and men, however they are more common in women. Bunions may may not always present symptoms, but can be tender or cause pain. A small fluid-filled sac (bursa) near the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. At times, arthritis may develop in later stages of the deformity, causing further symptoms and deep joint pain.
What causes bunions?
What you wear on your feet won’t directly cause bunions, but it can certainly aggravate the issue. It is thought that bunions form as a result of the mechanics of the foot- and movement such as over pronation (where the foot tilts outwards during the stride), abnormal anatomy of the joint, and genetic factors may all come into play. A study has found a significant genetic tie between bunion deformity and those of Caucasians of European descent.
Other less common causes of bunion deformities include trauma like fractures, sprains, etc., neuromuscular disorders (polio). Limb-length discrepancies (one leg shorter than the other) may result in the longer leg developing a bunion as a result of overpronating. Those that have arthritic conditions like rheumatoid arthritis are also more likely to develop bunions, as are those that have gout.
Some studies report that bunion symptoms occur nearly 10 times more frequently in women. This may also be concluded due to the difference in footwear between men and women; high-heel and narrow-toed shoes may factor in aggravating the pain and cause swelling enlargement of bunions. Sometimes you have to wear those incredible shoes. Just remember the impact they can create over years of use.
Wearing supportive shoes (with insoles that provide additional support) and opting for wider shoes that don’t put unnecessary pressure on the affected area are options in helping alleviate the symptoms of bunions. Custom orthotics can help counteract overpronation and hold off progression of bunions. Treatments such as anti-inflammatory medications may also be an options, as is icing the area for short-term relief. There are also options such as bunion pads that can be worn within shoes to help cushion the area, as well as splints that can be used to help straighten the joint if the bunion hasn’t progressed. If a bunion is so large that fitting into any shoe is impossible, surgery can be considered.
A hammer toe is a toe that has an abnormal bend in its middle joint, making the toe bend downward to look like a hammer. It is a very painful condition, and is due to an imbalance in the surrounding muscles, tendons, or ligaments that normally keep the toe straight. If the hammertoe isn’t treated, it will lose flexibility and become fixed, requiring surgery to correct the condition. Symptoms include:
- Pain in the affected toe, especially when moving it or wearing shoes
- Corns and callouses on top of the middle joint of the hammer toe
- Swelling, redness, or a burning sensation
- Inability to straighten the toe
What causes hammertoes?
Hammertoes have many of the same risk factors as bunions. Some causes are:
Choice of footwear: high heels or pointy shoes that do not have a wide enough toe-box can force the toes into a flexed position. As well as flip flops, backless, and other shoes that provide no other support than flexing the toes to keep them on.
Gender and Age: Women are more likely to get hammertoes (again, likely linked to footwear), and you are more likely to develop foot issues, like hammertoes, as you age.
Injuries: If toes are broken, stubbed, or jammed, the injury can lead to hammertoes
Other health issues: Arthritic conditions and even diabetes can lead to foot problems such as hammertoes.
Depending on the severity of the hammertoe, treatment can range from opting for better supporting shoes and those with enough space in the toe-box. Treatment for issues caused by the pressure points arising from hammertoes, such as corns and sores resulting from wearing ill-fitting shoes are shoe pads and insoles. Gentle massage of the toes to relieve tension and relax the joints, or splinting the hammertoe to keep the muscles from tightening in the curled position may give relief. In severe cases, surgery may be required to correct the hammertoe.
Toenail fungus can be painful and also cause thickened, cracked nails. Other symptoms include:
- Whitish to yellow-brown discoloration
- Distorted in shape
- A dark color, caused by debris building up under your nail
- Smelling slightly foul
Nail fungus can affect fingernails, but it’s more common in toenails.
What causes nail fungus?
Fungal nail infections are caused by various fungal organisms (fungi), yeast and molds. Fungal nail infections are most common in older adults as a result of reduced blood flow and slower growing nails. But, anytime the nail becomes brittle and cracks, there is potential for fungi to enter. Compromised immune systems, or reduced blood circulation to the feet as a result of other health concerns (such as diabetes) may also play a role in the development of fungus.
Toenail fungus can also originate from a case of athlete’s foot and spread from one nail to another. Mani-pedis are also source if the technicians don’t maintain sterile tools and allow water to get trapped under the nail and grow the fungus. Unfortunately, just wearing nail polish and artificial nails can lead to a fungal infection.
Other risk factors include:
- Sweating heavily
- Having a history of athlete’s foot
- Walking barefoot in damp communal areas, such as swimming pools, gyms and shower rooms
- Having a minor skin or nail injury or a skin condition, such as psoriasis
- Wearing the same sweaty shoes daily
Toenail fungus treatment
In the case of toenail fungus, preventing the fungus from developing (or spreading) goes a long way. Regular washing of hands and feet, cutting toenails straight across, wearing sweat absorbing socks to reduce moisture around the feet, and using shoes made with breathable materials are all methods to prevent fungus from developing. If you have a case of athlete’s foot, hand washing after touching the affected area will help prevent it from spreading and keep the area as dry as possible.
Other options for treating fungus include:
- Oral antifungal drugs: This option helps a new nail grow free of infection, slowly replacing the infected nail. Options include terbinafine (Lamisil) and itraconazole (Sporanox). Treatment may take up to 12 weeks, and isn’t complete until the impacted nail has grown out. There are some side effects such as a skin rash, and the potential for liver damage so speak to your provider to see what the best option is for you. Doctors may not recommend them for people with liver disease or congestive heart failure or those taking certain medications.
- Medicated nail polish: Your doctor may prescribe an anti-fungal nail polish called ciclopirox (Penlac). You paint it on your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. You may need to use this type of nail polish daily for almost a year.
- Medicated nail cream: Anti-fungal cream, is rubbed into your infected nails after soaking. Sometimes, it is recommended that the nails be thinned with a urea-infused lotion or with a nail file or tool to better allow the medication to reach the fugus.
- Surgery: In severe cases, it may be necessary to have surgery to remove the affected nail in order for a doctor to directly apply the anti-fungal treatment to the area.
Your feet not only carry you through life, compromised foot health can impact your ability to maintain your overall health. Foot pain may prevent you from exercising (causing weight gain, cardiovascular concerns, and other problems as a result of a sedentary lifestyle), hinder your ability to walk even short distances, not to mention the symptoms themselves can be uncomfortable and painful. Bunions, hammertoes, and toenail fungus are just a few foot ailments; plantar fasciitis, blisters, heel spurs, etc., are all issues people commonly experience. Choose properly fitting, supportive shoes, and if you experience foot issues, speak to your provider to stay ahead of any issues.