Diseases of the foot

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Flatfoot in a 55-year-old woman with ankle and knee arthritis Adult Flatfoot.JPG
Flatfoot in a 55-year-old woman with ankle and knee arthritis
Vascular ischemia of the toes with the characteristic cyanosis Ischemia rotate.jpg
Vascular ischemia of the toes with the characteristic cyanosis
Chilblains, also called perniosis Wintertenen.jpg
Chilblains, also called perniosis
Bunion and hammer toe Hallux valgus und Krallenzehe II (praop.).jpg
Bunion and hammer toe
Foot disease in a Ziguinchor hospital, Senegal, 1973 ASC Leiden - Coutinho Collection - 11 02 - Ziguinchor hospital, Senegal - 1973.tif
Foot disease in a Ziguinchor hospital, Senegal, 1973
Athlete's foot, a fungal infection Athletes foot.JPG
Athlete's foot, a fungal infection

Diseases of the foot generally are not limited, that is they are related to or manifest elsewhere in the body[ citation needed ]. However, the foot is often the first place some of these diseases or a sign or symptom of others appear. [1] 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[ citation needed ].

Contents

The foot may is a complex structure with 26 bones, 33 joints, numerous muscles, nerves and different ligament types. Any part of the foot can be affected by diseases, with symptoms ranging from mild aches to more serious pain hindering one's ability to walk or bear weight. Most minor cases of foot pain can be responded to by home care treatments. However, when severe pain is present, medical attention is required as it is a disabling condition. If foot pain is not treated in time, it can lead to long-term disability and continuing damage to the foot. [2]

Causes

The most common cause of foot 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. [3]

Diagnosis

Besides a physical examination, an x-ray MRI or an ultrasound 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. [4]

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), viral infection of verrucae, and ingrowing toenails 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. [5]

Ingrown toe nail is a disorder where the nail starts to grow into the soft fleshy area of the toe. 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. [6]

Arthritic foot conditions

Arthritic foot conditions often present differently from arthritis other areas of the body. Achilles tendinitis results from stress on calf muscles and Achilles tendon. This strong tendon 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 (Pes planus 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.[ citation needed ]

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. [7] Relieving pain, pressure, changing shoe wear or wearing a type of shoe insert is adequate for most people.

Gout 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 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 may result in painful arterial ulcers of the ankle and foot, or give rise of gangrene of the toes and foot. Immobility of a person may result in prolonged pressure applied to the heels causing pressure sores.

Impaired venous drainage from the foot in varicose veins may sequentially result in brown haemosiderin discolouration to the ankle and foot, varicose stasis dermatitis and finally venous ulcers.

Other disorders of the foot include osteoarthritis of the joints, peripheral neuropathy and plantar warts. [8] [9]

See also

Related Research Articles

<span class="mw-page-title-main">Foot</span> Anatomical structure found in vertebrates

The foot 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 up of one or more segments or bones, generally including claws and/or nails.

<span class="mw-page-title-main">Heel</span> Back of the foot

The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg.

<span class="mw-page-title-main">Toe</span> Digit of a foot

Toes are the digits 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 plantigrade; unguligrade animals are those that walk on hooves at the tips of their toes.

<span class="mw-page-title-main">Callus</span> Thickened and hardened area of skin

A callus is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, but they may occur anywhere on the skin. Some degree of callus, such as on the bottom of the foot, is normal.

<span class="mw-page-title-main">Plantar wart</span> Medical condition

A plantar wart 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 with pressure such that walking is difficult.

<span class="mw-page-title-main">Achilles tendon</span> Tendon at the back of the lower leg

The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle joint, and flexion at the knee.

<span class="mw-page-title-main">Pes cavus</span> Medical condition

Pes cavus, also known as high arch, is an orthopedic condition that presents as a hollow arch underneath the foot with a pronounced high ridge at the top when weight bearing.

<span class="mw-page-title-main">Pointe technique</span> Ballet technique for dancing on the tips of toes

Pointe technique is part of classical ballet involving a technique that concerns pointe work, in which a ballet dancer supports all body weight on the tips of fully extended feet when wearing pointe shoes. A dancer is said to be en pointe when the body is supported in this manner, and a fully extended vertical foot is said to be en pointe when touching the floor, even when not bearing weight.

<span class="mw-page-title-main">Plantar fascia</span> Aponeurosis of the sole of the foot

The plantar fascia or plantar aponeurosis is the thick connective tissue aponeurosis which supports the arch on the bottom of the foot. Recent studies suggest that the plantar fascia is actually an aponeurosis rather than true fascia. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones.

<span class="mw-page-title-main">Plantar fasciitis</span> Connective tissue disorder of the heel

Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the arch of the foot. It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin. The pain typically comes on gradually, and it affects both feet in about one-third of cases.

<span class="mw-page-title-main">Ingrown nail</span> Medical condition

An ingrown nail, also known as onychocryptosis from Greek: ὄνυξ 'nail' and κρυπτός '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 or nail bed. While ingrown nails can occur in the nails of both the hands and the feet, they occur most commonly with the toenails, and for the most part are only problematic and painful on the big toe.

<span class="mw-page-title-main">Achilles tendon rupture</span> Medical condition where the tendon at the back of the ankle breaks

Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.

<span class="mw-page-title-main">Tarsal tunnel syndrome</span> Compression of the tibial nerve in the foot

Tarsal tunnel syndrome (TTS) is a nerve compression syndrome or nerve entrapment syndrome causing a painful foot condition in which the tibial nerve is entrapped as it travels through the tarsal tunnel. The tarsal tunnel is found along the inner leg behind the medial malleolus. The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles travel in a bundle through the tarsal tunnel. Inside the tunnel, the nerve splits into three segments. One nerve (calcaneal) continues to the heel, the other two continue on to the bottom of the foot. The tarsal tunnel is delineated by bone on the inside and the flexor retinaculum on the outside.

A leglock is a joint lock that is directed at joints of the leg such as the ankle, knee or hip joint. A leglock which is directed at joints in the foot is sometimes referred to as a foot lock and a lock at the hip as a hip lock. Leglocks are featured, with various levels of restrictions, in combat sports and martial arts such as Sambo, Brazilian Jiu-Jitsu, catch wrestling, mixed martial arts, Shootwrestling and submission wrestling, but are banned in some sports featuring joint locks such as judo. The technique has been seen across a wide range of different combat sports and is reportedly over 2,500 years old, having been seen in the lost art of Pankration in the original Olympic Games.

<span class="mw-page-title-main">Morton's toe</span> Type of brachymetatarsia affecting the big toe

Morton's toe is the condition of having a first metatarsal bone that is shorter than the second metatarsal. It is a type of brachymetatarsia. This condition is the result of a premature closing of the first metatarsal's growth plate, resulting in a short big toe, giving the second toe the appearance of being long compared to the first toe.

<span class="mw-page-title-main">Corn (pathology)</span> Distinctively shaped callus of dead skin

A corn or clavus is an often painful, cone-shaped, inwardly directed callus of dead skin that forms at a pressure point near a bone, or on a weight-bearing part of the body. When on the feet, corns can be so painful as to interfere with walking. The visible portion of the corn tends to be more-or-less round, but corns are defined by having a hard tapering root that is directed inward, and pressure on the corn pushes this root deeper into the flesh. Pressure corns usually occur on thin or glabrous skin surfaces, especially on the dorsal surface of toes or fingers, but corns triggered by an acute injury may occur on the thicker skin of the palms or bottom of the feet.

Running injuries affect about half of runners annually. The frequencies of various RRI depend on the type of running, such as speed and mileage. Some injuries are acute, caused by sudden overstress, such as side stitch, strains, and sprains. Many of the common injuries that affect runners are chronic, developing over longer periods as the result of overuse. Common overuse injuries include shin splints, stress fractures, Achilles tendinitis, Iliotibial band syndrome, Patellofemoral pain, and plantar fasciitis.

<span class="mw-page-title-main">Ankle problems</span> Medical condition

Ankle problems occur frequently, having symptoms of pain or discomfort in the ankles.

<span class="mw-page-title-main">Toe box</span> Part of a shoe

The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformities, whereas wider toe boxes may be used to treat or prevent common foot conditions such as Morton's neuroma. Toe boxes come in a variety of shapes and styles of construction, some of which are a matter of fashion, and some of which are designed for specialized functions.

Posterior tibial tendon dysfunction is the dysfunction of the posterior tibial tendon. It is a progressive disease that has four stages and is the most common cause of adult flatfoot.

References

  1. Top of Foot Pain: Causes and Treatments. Retrieved on 2017-01-01
  2. Foot Injuries and Disorders Medline Plus. Retrieved on 2010-01-20
  3. Orthopedic Surgery Mayo Clinic. Retrieved on 2010-01-20
  4. "AOFAS ankle-hindfoot score description and calculator – orthotoolkit" . Retrieved January 10, 2018.
  5. Foot & Ankle Fractures, Sprains and Dislocations Archived March 12, 2010, at the Wayback Machine New York Online Access To Health. Retrieved on 2010-01-20
  6. Ingrown Toenails Podiatry Network. Retrieved on 2010-01-20
  7. Foot Disease Archived 2009-12-13 at the Wayback Machine Hammertoe Information. Retrieved on 2010-01-20
  8. Foot Pain Retrieved on 2010-01-20
  9. Foot Pain Causes and Treatments