September Articles 2014

Blisters on the Feet

Blisters are a common ailment of people who wear shoes that are either too tight or rubbed up against their feet in the wrong way while wearing them. In order to better understand how they are formed and what treatment should be used for them, you have to start with the basics of what a blister actually is.

A blister on the foot, or any other part of the body for that matter, 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 should not cause any concern. However, blisters can fill up with blood if they are deep enough and even 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 for example, or when your shoes simply do not fit you properly. They also form faster and easier if your feet are moist, so keeping them dry and clean is a preventative step you can take to avoid getting blisters.

Preventing infection should be the number one concern when treating blisters, as well as alleviating the pain they can cause. Using a band aid 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, or you can take a pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics might need to be taken in order to completely eliminate the bacteria inside the blister, and that needs to be prescribed by a doctor.

However, one of the best ways 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 band aid to an area you think might get a blister before one pops up is another way you can prevent them.

Athlete's Foot: The Sole Story

Do you suffer from itching, burning, dry, and flaking feet? It could be athlete's foot. Athlete's foot, also known as tinea pedis, can be extremely contagious, often infecting shower floors, gyms, socks and shoes, and anywhere else feet might contact. It's commonly found in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools. "Commons" areas in prisons and residential care facilities are frequently caught feeding the fungus as well. One step in the wrong direction can be enough to start the fire that can be tremendously difficult to treat.

Athlete's foot is most often caused by the same fungus that causes ringworm (tinea). It can be spread by direct contact with an infected body part, contaminated clothing, or by coming in contact with other objects or body parts that have been exposed to the fungus. Although the feet are more frequently assumed to get athlete's foot, tinea can invade other parts of the body as well so long as the proper growing conditions are met.

Tinea thrives in a dark, warm, and moist environment. Body parts that are often infected include the hands, groin, and scalp. Although many people never experience athlete's foot, around 70% of the population suffers from tinea at some point in their lifetime. Like most ailments, some people are more likely to acquire this fungal infection than others. People with a history of tinea or other skin infections are more likely to suffer from recurrent, or even additional, unrelated infections. The extent to which a person is tormented by the fungus can vary greatly as well.

While some people are never even aware that they have been infected with athlete's foot, others are pestered with mild to moderate symptoms like dry and flaking skin, itching, and redness. Still others are bothered by more severe symptoms including cracked and bleeding skin, intense itching and burning, and even pain when walking. In the worst cases, tinea can cause blistering as well.

The treatment for athlete's foot begins with prevention. Changes in the environment infected with athlete's foot can prevent spreading. Keeping the area that is infected clean and dry with the use of medicated cleansers and powders is essential. Allowing the area to breathe is important in the treatment as well. Exposure to cool air and light can make conditions undesirable for tinea. Treating the infected area with miconazole, tolnaftate, or other medicated creams, ointments, or sprays not only helps to kill the fungus, but helps prevent recurrences as well. White vinegar-based foot soaks can also be beneficial. Seeing a podiatrist is often a good idea when treating athlete's foot, since more often than not, other skin infections can develop from the initial infection, and recurrences are common.

Ankle Sprains

Ankle sprains, while not as severe as a broken ankle, are still a serious injury that needs immediate attention. They can lead to limited mobility and a significant amount of pain, and are often characterized by swelling and sometimes discoloration of the skin. An ankle sprain occurs when the ligaments are stretched beyond their limits, and even though this can happen in other places, such as the wrist, the ankles are the most common place for a sprain.

Ankle sprains can occur in many different ways, even just by simply walking. They happen when the ankle rolls over itself or twists under the foot, causing the ankle and tendon to snap or pop. Athletes who continually push their bodies to the limits are often at risk, as are people who have previously suffered accidents involving the lower extremities.

In most cases, ankle sprains are not severe enough to warrant medical help, such as going to a hospital. There are many self-care remedies you can use to treat your ankle, including applying ice packs to reduce swelling, remaining off your feet to reduce pressure, and elevating your feet above your head to reduce blood flow and inflammation. Often times an ACE bandage and over the counter pain relievers are enough, but it is still important to remember to stay off the ankle for some time to avoid re-aggravating it.

Even though most of these cases are mild, a severe ankle sprain can occur which will require professional, medical care. A sprain that causes a tear in the ligament or damage to the muscles is severe enough to warrant surgery and keep you off your feet for a prolonged period of time. Post-surgery physical therapy is often required in order to completely rehab the ankle back to health, and this will be administered and monitored by your podiatrist.

Even though ankle sprains may seem harmless and only mildly painful, if you are experiencing non-stop pain over a long period of time, if walking is becoming too painful for you, if the swelling is much more severe than initially anticipated, or if numbness and tingling is present, this may be signs that your sprain is a much more severe broken ankle. It is highly recommended to seek treatment right away for these symptoms.

Often times, preventative care is one of the best ways to avoid ankle sprains. Wearing appropriate fitting shoes that provide both ankle and arch support will help, as well as stretching before any kind of physical activity, including sports, weight training, or even simply jogging.

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

Plantar Fasciitis

 Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be inaffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one time out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.