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Care for your hard-working feet

Created date

April 26th, 2011

People tend to ignore their feet as they age, says Neil Scheffler, D.P.M., a podiatrist at Sinai Hospital in Baltimore, Md., and author of the book 101 Foot Care Tips for People with Diabetes. Some are so accustomed to having their feet hurt that they think it s normal. But the longer you ignore a problem, the worse it might become. Years of wear and tear, disease, bad circulation, poorly trimmed toenails, and wearing shoes that don t fit can all cause problems. Being vigilant about foot care can keep you comfortable and active for years to come.

Attend to the small things

Corns and calluses are caused by pressure when the bony parts of your feet rub against your shoes. They can lead to pain or infection and should always be treated, Scheffler says. Reduce friction by wearing shoes with a better fit or using non-medicated pads. Gently using a pumice stone while bathing may help, Scheffler adds, but never try to shave off a corn or callous. Avoid over-the-counter treatments because they can cause chemical burns that may not heal especially in someone with diabetes or circulation problems. Most importantly, find out why you are developing corns and callouses, and talk to your podiatrist to find out how to prevent them, Scheffler says. Ingrown toenails may not seem like a big deal, but they can cause infections and pain. Some people have difficulty trimming their toenails. A podiatrist can do it for you and Medicare covers toenail clipping if you have a qualifying medical condition, Scheffler explains. A seemingly minor problem like dry skin can also lead to skin breakdown and infection, says Roland Lascari, M.D.

Persistent fungus

Older adults are not immune to fungal infections like athlete s foot, Lascari says. Shoes are warm, dark, and moist the perfect place for fungus to grow. Symptoms such as redness, blisters, itching, and peeling can indicate a fungal infection. Over-the-counter antifungal powders or creams might help, but if the problem persists for more than two weeks, talk to your doctor. Fungus in the toenails can be dangerous sometimes leading to serious bacterial infections, Scheffler explains. A topical medication may be available at your podiatrist s office that is effective for toenail fungus. It doesn t affect the liver, like pills, and it s less expensive than laser treatments. Prevent infections by keeping your feet clean and dry. Change your socks and stockings often if your feet are sweating. Dust your feet with talcum-free foot powder if needed.

Surgery not always needed

Many people don t seek treatment for problems like bunions and hammertoes because they think surgery is their only option, Scheffler says. A bunion is an inflamed joint that develops at the base of your big toe. Hammertoe is caused by a shortening of the tendons that control toe movements. If these conditions are not particularly painful, wearing shoes cut wide at the toes and instep or using inserts may help. Taping or padding may also bring relief. Spurs are bony bumps that grow on bones of your feet. Conservative treatments include foot supports, heel pads, and heel cups. People often think they have heel spurs when in fact they have plantar fasciitis [inflammation of the thick band of tissue that connects the heel bone to the toes], Scheffler says. Treatment may include stretching exercises, anti-inflammatory medication, physical therapy, strapping, or orthotics. You can also have problems with the nerves in your feet. Tingling, numbness, or pain may be signs of a neuroma an enlargement of the nerve that typically occurs between the bones of the third and fourth toes. Injections or shoe inserts that remove pressure on the area may help, Scheffler says.

Simple prevention

Wash your feet every day with a mild soap. Use a moisturizer, but avoid bath oils since they can make your feet, bathtub, and floor very slippery. See a podiatrist regularly, Lascari advises. Inspect your feet carefully. Use a mirror, or ask someone for help if necessary. If you have diabetes or circulation problems, a daily meticulous foot inspection is imperative. Put your feet up when you are sitting to facilitate circulation and ease swelling. Stretch, walk, or have a warm foot bath or a gentle massage. Make sure your shoes fit well. A shoe should be comfortable, but comfort alone does not mean it s the best fit. Always have your feet measured before buying shoes.

When extra caution is needed

If you can t feel your feet, you don t know if a problem is developing, Scheffler says. People with diabetes or circulation problems often have decreased sensation in their feet due to nerve problems or decreased blood flow. Foot problems are sometimes the first sign of a more serious medical condition. Joint stiffness could indicate arthritis, for instance. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure. And poor foot function can exacerbate existing problems like arthritis or lead to balance problems. There are so many things that affect the feet as we get older. Everyone should have an individualized treatment plan based on their needs and the presence of other conditions or medications, Scheffler says.