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Our Aching Feet

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When it comes to your feet, Dr. Jacob E. Hanlon of Delaware Podiatric Medicine in Middletown, recommends against self-diagnosis. Photograph by Tom NutterOur feet may be hurting, but we’re not beating a path to the podiatrist’s door. More than 75 percent of Americans suffered at least one foot ailment within the past year, yet almost a third did nothing to address the problem, according to a survey for the American Podiatric Medical Association.

Another 40 percent of respondents relied on over-the-counter self-treatment. In fact, we are more likely to consult family or friends (25 percent) about our sore feet than we are to seek the expertise of a podiatrist (17 percent).

Bad idea, says Jacob E. Hanlon, DPM, of Delaware Podiatric Medicine in Middletown. People who self-treat often get it wrong. Over-the-counter orthotics are another sore point with Hanlon, who says the remedy often does more harm than good.

Here’s an expert guide to common foot ailments.
 

Athlete’s Foot

This term refers to fungal infections of the skin between the toes or on the bottom of the foot. Symptoms include dry, scaly skin, itching, inflammation and blisters.

Treatment The condition can be treated with over-the-counter athlete’s foot medication, but see your doctor if the infection persists for longer than 10 days. Prescription medication may be required.

Prevention Fungi love moist environments, so wear white socks, and change them frequently if your feet sweat or get wet, says Patricia McIlrath, DPM, of Health One Podiatry in Wilmington.
 

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Bunions

This degenerative disease occurs when the joints of the big toe are misaligned. The extra pressure on the joint causes bone to grow, which can result in swelling and tenderness. 

Treatment If the bunion does not cause pain, you can simply wear shoes that accommodate the extra bone. Often, however, bunions do cause pain and require surgery. “The surgery involves re-aligning the joint to reduce the deformity,” says Jeffrey Barton, DPM, of Kent Foot & Ankle Center. “The removal of the bony protuberance is only about 10 percent of the surgery.” The recurrence rate is low.

Prevention The condition is hereditary, but wearing shoes that fit properly can delay bunion growth.
 

Corns and Calluses

When the skin rubs repeatedly against a shoe or a bony area, protective layers of compacted, dead skin cells develop. Corns typically develop on toes while calluses develop on the soles. Both can cause pain.

Treatment The problem can sometimes be resolved by padding the affected areas and wearing shoes that fit properly. The APMA cautions against using home remedies, so seek professional help. The treatment might include trimming, application of a salicylic patch or, in rare cases, surgery to correct the alignment of the bone causing the problem.

Prevention Wear shoes that provide ample room for toes, thus do not rub against the toes or feet.
 

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Hammertoes

Hammertoe is a progressive, mechanically induced condition that often appears in a person’s 30s or 40s. A muscle imbalance, be it genetic or acquired, causes one or several of the toes to bend into a claw-like position.

Treatment In mild cases, an orthotic can help to change the way the muscles work when you walk, thereby slowing progression. Splinting the affected toe can also help. Surgery might be required to relieve pain. A surgeon will lengthen the tendon that attaches to the toe, which corrects nine out of 10 hammertoes, Barton says.

Prevention Avoid pressure on the toes as much as possible. Though hammertoes usually stem from a muscle imbalance, they are often aggravated by ill-fitting shoes or socks.
 

Heel Pain-Instep Pain

Heel pain affects six in 10 Americans. Though there are many potential causes, the most common is plantar fasciitis, an inflammation of the tissue that connects the heel bone to the base of the toe. Plantar fasciitis can also present as pain in the arch. At first the pain might occur only in the morning, but can increase in duration if left untreated.

Treatment Conservative treatment includes anti-inflammatory drugs, as well as frequent stretching. One stretch: Place the ankle of the affected foot over the other knee and pull back on the toes. Your podiatrist can demonstrate other effective stretches. Barton notes that custom orthotics will help address the cause and help prevent recurrence.

Prevention Wear supportive shoes that can effectively absorb shock. Stretch the foot before exercising. 
 

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Ingrown Toenails

Ingrown toenails are nails whose sides dig painfully into the skin, often causing infection.

Treatment If recognized before infection sets in, self-care may be sufficient to address the problem. Soak the foot in warm water several times a day, wear comfortable shoes with adequate room for toes, and take ibuprofen or acetaminophen for pain. You might need to gently lift the toenail from its embedded position and insert cotton or waxed dental floss between the nail and the skin. Change the packing daily. If the problem does not clear up in a few days or if the nail becomes infected, see a podiatrist, who might need to remove all or part of the nail.

Prevention Trim toenails straight across, slightly longer than the end of the toe, with toenail clippers. McIlrath notes that some people are genetically predisposed to ingrown toenails.
 

Tendinitis Pain

Caused by inflammation of tendons in the ankle is caused by overuse and improper stretching.

Treatment Tendinitis is treated with rest, icing, anti-inflammatory medications and-or cortisone injections, and stretching exercises. Barton recommends use of a heel insert or brace “to alter the mechanics that caused the problem in the first place.”

Prevention Wear supportive shoes, stretch before exercising, and vary your exercise routine. The treadmill, elliptical machine, Stairmaster and bicycle all put different types of stresses on the body. Variation helps to protect against too much of any one stressor.

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