Cures for the Top Foot Ailments

Your feet are virtually a biological miracle. Like sleek, finely tuned race cars, they are composed of hundreds
of tiny parts that all function together in perfect unison to do their job. Yet just as race cars are temperamental
and demand careful care to keep purring along smoothly, so do your feet. If you don't take proper care of
them, then like a Mercedes or Lexus, they are apt to break down. And, while even an ingrown toenail sounds
like "not much," it can be extremely debilitating and painful if infected.

BUNIONS

Bunions are painful, enlarged bumps on the outside of the first joint of the big toe. The big toe is normally
straight -- but when you have a bunion, it leans into the second toe. Another type of bunion, known as tailor's
bunion, occurs on the other side of the foot at the base of the pinkie toe. Redness and inflammation often
surround bunions.

Causes: Bunions are caused by misalignment of the toe joints, and having flat feet predisposes people to
developing them. Contrary to popular opinion, tight shoes don't cause bunions... however, ill-fitting shoes
aggravate them.

What to do: Over-the-counter (OTC) padding and anti-inflammatory medication such as ibuprofen (for
example, Advil or Motrin) provide relief from swollen and tender bunions. It also helps to wear comfortable
shoes, with wider widths and larger toe box areas than usual. If these measures fail, a podiatrist may
prescribe stronger anti-inflammatory medicine or orthotic devices (special inserts you put in shoes to control
the biomechanics of the foot). In some cases, surgery is necessary.

CORNS

These thick deposits of compacted, dead skin cells most commonly occur on the sides of pinkie toes, or on
the tops of the second, third or fourth toes. Pain and burning go hand in hand with corns.

Causes: Many corns are due to the rotation of pinkie toes, which curl under due to tendon imbalance or the
habitual wearing of tight, narrow shoes that squish them. In other cases, corns are caused by the repeated
pressure and friction of skin rubbing against shoe irregularities or bone spurs (bony overgrowths) on the
toes.

What to do: OTC moleskin or protective padding often relieves the pain of corns. If not, your podiatrist can trim
the dead skin. It is also a good idea to make sure shoes fit properly. A chronic problem is that corns tend to
keep growing back if the underlying cause is a bone spur. If this proves to be the case, you may want to
consider surgery to remove the offending spur.

FLAT FEET/ARCH PAIN

Most flat feet, especially in children, are not painful. However, as one ages, there is generally diminished
strength in muscles, tendons and ligaments as well as decreased circulation. This can lead to further
deterioration in the foot and resulting arch pain.

Causes: A person with flat feet places a greater load on the main tendon supporting the arch of the foot. Over
time, this can gradually cause the heel to rotate outward and the foot to rotate inward at the ankle (pronation),
which makes the muscles on the bottom of the foot work harder and grow fatigued. This is what we feel as
arch pain.

What to do: It is essential to wear shoes with good support. In particular, wear good-quality running shoes
with firm, stiff heels. Your treating physician also may prescribe orthotics. Surgery is rarely necessary.

FUNGAL NAILS

Thickened yellow or brownish toenails are most commonly due to fungal infection. A fungus may affect one
nail or multiple nails, one foot or both. There is usually no pain, and you may not even notice the infection until
it is well established. Until they penetrate the skin, most fungi are harmless.

Causes: Fungi are everywhere around us, and the warm, dark, moist surroundings created by shoes, socks
and sweaty feet provide an ideally hospitable environment for them.

What to do: Once it gets into toenails, a fungal infection is very difficult to treat. You can take care of the
cosmetic side of things by trimming and smoothing the nail. However, to get rid of the underlying infection,
topical antifungals are insufficient, and a three-month course of prescription oral antifungal medication is
necessary.

HAMMERTOES

The buckling and contracting of hammertoes can strike any or all of the lesser toes (as opposed to the big
toes), although the second toe is most often the victim. Hammertoes cause chronic pain and inflammation
on the tops of affected toes. In this condition, toes are curled under in a claw-like position, so you end up
walking on the tips of your toes. Not surprisingly, this can be painful.

Causes: Hammertoes are caused by joint, tendon or muscle imbalance, as when a bunion slants the big toe
into the second toe or the pinkie toe curls under itself. Ill-fitting shoes and socks aggravate the condition.

What to do: Helpful measures include padding and wearing shoes with large toe boxes. A physician also
may recommend stretching exercises to correct faulty foot biomechanics that contribute to the problem. If
conservative treatments fail and the hammertoe grows rigid (meaning that it will no longer straighten even
when pressure is applied), surgery may be necessary to realign toes to their proper position.

INGROWN TOENAILS

A couple of decades ago, an infected ingrown toenail meant hospitalization and painful surgery in which the
entire nail was removed. This is an area of medicine in which treatment has improved exponentially, as
doctors now routinely take care of ingrown toenails in the course of a short office visit.

Causes: Ingrown toenails, which most commonly affect the big toe, may be the result of inherited architecture
of the nails, or improper trimming of them. Trauma, such as sports injuries, and wearing narrow, pointy
shoes also may be contributing factors.

What to do: Ingrown toenails often become infected, with swelling and pain developing along the side of the
nail. There may be clear or cream-colored drainage. When this happens, it's time to see a podiatrist, who will
drain the infection and remove the edge of the nail. (Unless the problem is severe, it's no longer the norm to
remove the entire nail.) Afterward, you may need to take antibiotics to clear up any infection. To prevent
ingrown toenails: Trim nails straight across, slightly longer than the end of the toe. Do not cut nails in corners
or on sides. People with diabetes should have their nails trimmed by a health-care professional.

MORTON'S NEUROMA

This nerve entrapment, or pinched nerve, most commonly occurs between the third and fourth toes. Morton's
neuroma can result in sharp or shooting pain, cramping, burning, tingling or numbness between the toes
and in the ball of the foot.

Causes: Bones and other tissue rub against and irritate the nerves. As with nearly all foot ailments, ill-fitting
shoes contribute to the problem.

What to do: When pain strikes, remove the shoe and massage the sore area. This provides temporary relief.

More self-care options: Eliminate tight-fitting shoes, apply special pads to the bottom of your foot or tape it. A
physician may prescribe orthotics or cortisone injections, and in some cases a surgical procedure is
necessary.

PLANTAR FASCIITIS

This is an inflammation of the broad band of connective tissue that runs from the bottom of the heel to the
ball of the foot (the plantar fascia ligament). Plantar fasciitis causes sometimes crippling heel pain,
especially when you first get up in the morning, or if you've been sitting in a car or at your desk for a while.

Causes: Plantar fasciitis is most common in people who have flat or high-arched feet. When the foot muscles
tighten up overnight or during periods of inactivity, the pull on the plantar fascia increases and can make your
first steps agonizing. Heel pain is also often linked with bone spurs in the heels -- when pressure is put on
them and further stretches the plantar fascia.

What to do: Do-it-yourself measures include stretching the Achilles tendon and calf muscles to relieve
tightness... anti-inflammatory medicine such as ibuprofen... inserting a heel pad or heel cushion in your
shoe... wearing insoles to support the arch and reduce tension on the ligament... and taping or strapping.
During painful periods, it's important to take pressure off the foot by avoiding sports or excessive walking. If
the pain persists, your physician may prescribe stronger anti-inflammatory medications, cortisone injections
or orthotic devices. A promising new treatment alternative is shock therapy, in which high-energy shock
waves are focused on the heel under local anesthetic to break up the spur.

PLANTAR WARTS

These painful, flat growths most often appear on the plantar surface, or sole, of the foot. They have a
cauliflower-like appearance, and sometimes black or reddish dots. Children, especially teenagers, are more
susceptible to plantar warts than adults. Although basically harmless, these growths are extremely
contagious.

Causes: Plantar warts are caused by the human papilloma virus (HPV), which infiltrates the skin through
small cuts and abrasions.

What to do: See your doctor rather than trying to treat stubborn plantar warts on your own. Prescription acid
treatments to dissolve warts include medicated pads or disks. Warts can also be removed under local
anesthesia with a scalpel or laser. To prevent plantar warts: At the gym or health club, never go barefoot.
Always wear flip-flops in the locker room and shower.

Surgical removal of plantar warts is not always the final answer, as new warts have a nasty habit of
appearing.

A SPECIAL WORD OF CAUTION FOR DIABETICS

When it comes to people with diabetes, a different set of rules prevails. Diabetes wreaks havoc on nerves
and blood vessels, and is the number-one cause of non-traumatic limb amputation. This means that
diabetics must take scrupulous care of their feet. Examine them daily and promptly report even minor nicks or
sores to your physician before they develop into major problems. In addition, see a health-care professional
to examine your feet on a regular basis.

PUT YOUR BEST FOOT FORWARD

In the long run, much of good foot care is just common sense -- make sure shoes fit correctly, avoid walking
barefoot, practice good foot hygiene, inspect your feet regularly and see a podiatrist if you experience
persistent foot pain or disability. Little pains in the foot can become big irritants that severely limit your
lifestyle. There's no need for that with simple preventive care and the treatment options available. Stay tuned
for more on treatment options from the naturopathic perspective.