Diseases of the foot generally are not limited, that is they are related to or manifest elsewhere in the body. However, the foot is often the first place some of these diseases or a sign or symptom of others appear. This is because of the foot's distance from the central circulation, the heart and its constant exposure to pressures from the ground and the weight of the body.
The foot may look simple but is a complex structure with 26 bones, 33 joints, numerous
muscles, nerves and different
ligament
A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the:
* Peritoneal li ...
types. Any part of the foot can be affected. Some foot disorders may present with just a mild ache, but other foot disorders can be very serious and limit ability to walk or bear weight. Most minor cases of foot pain respond to home care treatments except when severe pain is present as it is a disabling condition and usually needs some type of medical attention. If foot pain is not treated in time, it can lead to long term disability and continuing damage to the foot.
Causes
The most common cause of
foot
The foot ( : feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made ...
pain is wearing ill fitting shoes. Women often wear tight shoes that are narrow and constrictive, and thus are most prone to foot problems. Tight shoes often cause overcrowding of toes and result in a variety of structural defects. The next most common cause of foot disease is overuse or traumatic injuries.
Diagnosis
Besides a physical examination, an
x-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
MRI or an
ultrasound
Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
study may be obtained to assess the soft tissues and blood vessels. Standardized questionnaires and scoring systems, like the American Orthopaedic Foot & Ankle Society (AOFAS) foot and ankle questionnaires, can help elicit the history and physical exam necessary to make and accurate diagnosis of foot and ankle conditions.
Skin and nails
Often there is a distinction made between conditions of the
dorsal skin and
plantar skin. Common examples include
callus thickened skin, fungal infections of the skin (
athlete's foot) or nails (
onychomycosis
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Toenails or fingernails may be affected ...
), viral infection of
verruca
A plantar wart, or verruca vulgaris, is a wart occurring on the bottom of the foot or toes. Its color is typically similar to that of the skin. Small black dots often occur on the surface. One or more may occur in an area. They may result in pain ...
e, and
ingrowing toenail
An ingrown nail, also known as onychocryptosis from el, ὄνυξ () 'nail' and () 'hidden', is a common form of nail disease. It is an often painful condition in which the nail grows so that it cuts into one or both sides of the paronychium ...
s that may cause bacterial nail infections (
paronychia).
Corns and calluses are chunky tough layers of skin that develop on the foot to protect underlying skin from pressure and friction. Corns and calluses are very common and do not look pleasant. Corns and calluses generally need treatment only if they cause problems. For most people, the best treatment of corns and calluses is to eliminate the source of friction or pressure.
Ingrown toe nail is a disorder where the nail starts to grow into the soft fleshy area of the
toe
Toes are the digits (fingers) of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being ''digitigrade''. Humans, and other animals that walk on the soles of their feet, are described as being ''plant ...
. It causes intense redness, pain and
swelling. Ingrown toe nails often affect the big toe. The best treatment for ingrown toe nails is to get the
nail partially or completely removed.
Arthritic foot conditions
Arthritic foot conditions often present differently from arthritis other areas of the body.
Achilles tendinitis
Achilles tendinitis, also known as achilles tendinopathy, occurs when the Achilles tendon, found at the back of the ankle, becomes sore. Achilles tendinopathy is accompanied by alterations in the tendon's structure and mechanical properties. The ...
results from
stress on calf muscles and Achilles tendon. This strong
tendon
A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
often gets inflamed while playing sports like basketball. The tendon gets irritated and does cause moderate pain . When treated promptly, the tendinitis is relieved. Sometimes, the Achilles tendon can rupture if it is overstretched. When the Achilles tendon ruptures, one may feel a sudden pop followed by sharp pain. Rupture of the Achilles tendon makes it impossible to walk.
Bunion is an abnormal bony mass that forms on the big toe and points outwards. This deformity is unsightly and painful. When the big toe enlarges at the base, it can force the other toes to crowd against each other. Over time, the big toe pushes outwards and alters the normal outline of the foot. Bunions occur for many reasons but the most common is not wearing proper shoes, arthritis and different inherited structural defects.
Flat feet
Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born ...
(
Pes planus
Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born ...
foot) essentially means that the arch inside the foot is flat. This very common painless disorder may occur at birth or after pregnancy. Flat feet generally do not cause problems but may sometimes cause the foot to rotate inwards (pronation). There are orthotic shoe insoles (foot orthotics) that help correct flat feet. Surgery does not correct flat feet and should be avoided.
Hammer toes are unsightly and reveal a toe that is curled due to a bend in the middle joint of the toe. A hammer toe occur chiefly because the shoe is too tight at the front or the heels are too high. In such situations, the toe is strained against the front of the shoe and results in an abnormal twist. Relieving pain, pressure, changing shoe wear or wearing a type of
shoe insert
A removable shoe insert, otherwise known as a foot orthosis, insole or inner sole accomplishes many purposes, including daily wear comfort, height enhancement, plantar fasciitis treatment, arch support, foot and joint pain relief from arthritis, ...
is adequate for most people.
Gout
Gout ( ) is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint, caused by deposition of monosodium urate monohydrate crystals. Pain typically comes on rapidly, reaching maximal intensit ...
often presents with pain and tenderness at the base of the big toe. Generally women are more prone to gout after menopause. An acute attack of gout is intensely painful and walking on the foot is impossible. Gout is essentially a disorder caused by precipitation of
uric acid crystals in the joint.
Plantar fasciitis is a very common cause of heel pain. The thick fibrous bands at the bottom of the heel get inflamed and cause excruciating pain. The pain occurs the moment you step out of bed. After a few hours, the pain does subside but can return after prolonged periods of standing.
Plantar fasciitis is most common in runners, obese individuals, women who are pregnant and those who wear shoes with inadequate heel support. The treatment of this agonizing disorder involves pain control, steroid injections, proper foot wear and rest.
Pain relief
In some cases, foot diseases and painful conditions can be treated. Synovium hydrates the
cartilage
Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...
in the heel and can bring pain relief quickly. Synovium gel looks as well as strongly smells like urine, straying some consumers away. However this only occurs after expiration.
Blood thinners can also work however are deemed as bad relievers by medical practitioners due to the fact that they can contribute to headaches and in some cases increase foot pain afterwards.
Vascular disorders
Atherosclerotic restriction to the arterial supply in
peripheral artery occlusive disease
Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular diseas ...
may result in painful
arterial ulcers of the ankle and foot, or give rise of
gangrene
Gangrene is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness. The feet and hands are most commonly affected. If the ga ...
of the toes and foot. Immobility of a person may result in prolonged pressure applied to the heels causing
pressure sore
Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combi ...
s.
Impaired venous drainage from the foot in
varicose veins may sequentially result in brown
haemosiderin
Hemosiderin image of a kidney viewed under a microscope. The brown areas represent hemosiderin
Hemosiderin or haemosiderin is an iron-storage complex that is composed of partially digested ferritin and lysosomes. The breakdown of heme gives rise ...
discolouration to the ankle and foot, varicose
stasis dermatitis
Stasis dermatitis refers to the skin changes that occur in the leg as a result of "stasis" or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins.
Insuffic ...
and finally
venous ulcer
Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing." ...
s.
Other disorders of the foot include osteoarthritis of the joints, peripheral neuropathy and plantar warts.
Foot Pain
Retrieved on 2010-01-20
See also
* List of disorders of foot and ankle
References
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