28 March 2011

Foot matters: Q & A

Other than the odd blister, foot health isn't big news - they're designed to carry you and they're designed to last, right? Well, here are some questions for when things go wrong.


Q:  Flat foot surgery for daughter age 9

Is it best to do both feet at the same time or individually? The surgeon has also indicated that he prefers to perform the surgery whereby he removes some bones from her leg as opposed to inserting a pin - please advise me regarding the best options.

A:  There are different causes and outcomes of flat feet in children. One is a very mobile flat foot which does well with the pin, and the other are rigid flat feet which need an abnormal bone in the foot removed to correct the condition.

Operating on both feet at the same time does increase the complication rate, and difficulties with getting around after the op -  but it does sort the problem out immediately without the worry of having to go through the whole process again with the other foot. 

Q:  Plantar fasciitis

Please could you give more info on this. I have never had this before. I have gone to see my GP and sent me to have inner-soles made for my feet. These inner-soles have not helped, as I still have the pain under my right foot. Could this be from the safety boots I wear? What is plantar fasciitis caused by?

A:Plantar fasciitis is inflammation of a band of tissue under your foot. This holds up your arch and acts like a spring. The condition is due to repetitive injury to the attachment on the heel and is very difficult to treat. If inserts are not helping, the next step would be a corticosteroid injection.  And yes, this could be from saftey boots as they are hard and rigid.

Q: Ugly dry feet

I have dry and scaly white skin on the bottom and sides of my feet, and it's very embarassing to walk around in sandals as well. I've tried all the treatments for dry, hard skin I could find and a foot file, but nothing makes it better. Any advice as to what I can use to get rid of this embarrassing problem?

A:  I suggest that you try using Milky Feet available at pharmacies. You can also consult a podiatrist for advice.

Q:  Athlete's Foot

I have a fungal infection underneath my one foot. I need to know what to do about it. I have tried tea tree oil, Mycota cream, capsules prescribed by my GP, and Listerine. I walk barefoot as often as I can, I hate having to wear shoes. Is this bad for me?
1. How do I disinfect my socks and shoes?
2. How do I stop it spreading to my hands and the other foot?
3. It's a painful condition..... what can I do for the pain?
Please help as I am now feeling quite desparate.

A:  You will have to consult a dermatologist, to have tests done to confirm if you have a fungal infection. Treatment will depend on the severity of the infection. By washing your hands and feet and keeping them dry, you will prevent the infection from spreading. Mycota powder is sufficient to keep your socks and shoes free of infection.

Q:  Puffy toes

My toes feel "thick" and puffy. They do also look a bit puffy. There is no puffiness elsewhere on my foot and nothing around the ankles either. I am not diabetic. What can be the cause?

A:  Swollen toes could be caused by inflammation of the joints, infection of the skin between the toes, allergies (contact dermatitis) due to chemicals in leather in shoes. If it is just the one foot I think you should let your doctor examine the area to see what the possible cause is.

Q:  Parkinson's Symptoms?

I've noticed over the last year that my mother-in-law's big toe on her right foot has a tremor when she's relaxed. Last week her husband had a health issue that she thought was a stroke. I saw her just after they'd been to the doctor and her whole foot shook even when I held it. She often complains that her right foot gets cramps.

I suggested to her that she has it checked out but she's sure it's nothing. Am I worrying unnecessarily?

A:  It could be the beginning of a neurological problem like Parkinsons disease so it may be better to let a neurologist examine her. The danger is that she may not be able to control it, and that it may lead to falls and injuries.

Q:  Diabetic – foot cramps

I was diagnosed with diabetes in 2010, at age 43- I am a T1 and am on Humolog x3 per day and a lantus injenction at night.

I am getting the worst cramps in my legs, lower under the knee, more to the front and over the front of my foot at night.  They wake me up and I could scream it is so sore.  This is happening quite often, at least 2 to 3 times a week. 

Last night I got up and started walking around the house, which seemed to ease the pain. I am overweight and unfit, I have had these type of cramps over the years, but usually in my calves. 

The current cramps occur down my shins and take an age to subside.  I take no other meds or vitamins and do not have any other conditions - my heart, blood pressure etc are all working well at moment. My legs are killing me, today I'm hobbling around because of the cramps last night.

A:  This could be due to nerve damage caused by diabetes, or it may be due to low calcium or magnesium levels. Nerve pain is usually burning, needles and pins, or sharp electric shock pains. Muscle pains are usually due to muscle contraction and will pull the foot up. If you are sure that it is due to cramps, you can ask your doctor to check your electrolyte levels, calcium and magnesium with a blood test to see if you need supplements. Taking a muscle relaxant like Norflex may also help.

Q:  Foot injury

My husband hurt his foot while power-walking. It is the outer part of the foot that is painful. There is minimal swelling and not much bruising but he is a lot of pain. He can walk about 3 metres and then it becomes painful. It is not painful if he rests it. I have suggested he put ice on it and then deep heat and strap it up but he is stubborn. Do you think he has torn ligaments? How should we treat it.

A:  If he can only walk 3 meters, it is possible that his foot has a small fracture and he will therefore, have to consult his doctor for an examination and x-ray of his foot. In the interim, he should rest his foot, elevate it and use Ibuprofen for pain.

See the Foot FAQ's at the Leg and Foot Centre

Get advice from the Orthopaedic Expert

(Joanne Hart, Health24, March 2011)




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