“What Your Feet Say About Your Health?”

 

Cold Feet, Many Culprits: If your toes are always cold, one reason could be poor blood flow -- a circulatory problem sometimes linked to smoking, high blood pressure, or heart disease. The nerve damage of uncontrolled diabetes can also make your feet feel cold to you. Other possible causes include hypothyroidism and anemia. A doctor can look for any underlying problems -- or let you know that you simply have cold feet.

 

Foot Pain: When your feet ache after a long day, you might just curse your shoes. After all, eight out of 10 women say their shoes hurt. But pain that’s not due to sky-high heels may come from a stress fracture, a small crack in a bone. One possible cause: Exercise that was too intense, particularly high-impact sports like basketball and distance running. The weakened bones of osteoporosis increase your risk.

 

Red, White, and Blue Toes: Raynaud’s disease can cause your toes to turn white, then bluish, and then redden again and return to their natural tone. The cause is a sudden narrowing of the arteries, called vasospasms. Stress or changes in temperature can trigger vasospasms, which usually don’t lead to other health concerns. Raynaud’s may also be related to rheumatoid arthritis, Sjögren’s disease, or thyroid problems.

 

Heel Pain: The most common cause of heel pain is plantar fasciitis, inflammation where this long ligament attaches to the heel bone. The pain may be sharpest when you first wake up and put pressure on the foot. Arthritis, excessive exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis. Less common causes include a bone spur on the bottom of the heel, a bone infection, tumor, or  fracture.

 

Dragging Your Feet: Sometimes the first sign of a problem is a change in the way you walk -- a wider gait or slight foot dragging. The cause may be the slow loss of normal sensation in your feet, brought on by peripheral nerve damage. About 30% of these cases are linked to diabetes. Nerve damage also can be due to infection, vitamin deficiency, and alcoholism. In many cases, no one knows what caused the nerve damage.

 

Clubbed Toes: In clubbing, the shape of the toes (and often the fingers) changes. The nails are more rounded on top and curve downward. Lung disease is the most common underlying cause, but it also can be caused by heart disease, liver and digestive disorders, or certain infections. Sometimes, clubbing runs in families without any underlying disease.

 

Swollen Feet: This is usually a temporary nuisance caused by standing too long  or a long flight -- especially if you are pregnant. In contrast, feet that stay swollen can be a sign of a serious medical condition. The cause may be poor circulation, a problem with the lymphatic system, or a blood clot. A kidney disorder or underactive thyroid can also cause swelling. If you have persistent swelling of your feet, see a physician.

 

Burning Feet: A burning sensation in the feet is common among diabetics with peripheral nerve damage. It can also be caused by a vitamin B deficiency, athlete’s foot, chronic kidney disease, poor circulation in the legs and feet (peripheral arterial disease), or hypothyroidism. 

 

Sores That Don't Heal: Foot sores that will not heal are a major warning sign for diabetes. Diabetes can impair sensation in the feet, circulation, and normal wound healing, so even a blister can become a troublesome wound. Those sores also are prone to infection. Diabetics should wash and dry their feet and check them for any wounds every day. Slow-healing of sores also can be caused by poor circulation from conditions such as peripheral artery disease.

 

Pain in the Big Toe: Gout is a notorious cause of sudden pain in the big toe joint, along with redness and swelling. Osteoarthritis is another culprit that causes pain and swelling. If the joint is rigid, it may be hallux rigidus, a complication of arthritis where a bone spur develops. Finally, turf toe is an ailment of athletes, particularly those who play on hard surfaces. It's caused by an injury to ligaments surrounding the joint.

 

Pain in the Smaller Toes: If you feel like you're walking on a marble, or if pain burns in the ball of your foot and radiates to the toes, you may have Morton’s neuroma, a thickening of tissue around a nerve, usually between the third and fourth toes. It is eight to 10 times more common in women than in men. It is caused by injury or too much pressure on the toes.

 

Itchy Feet: Itchy, scaly skin may be athlete’s foot, a fungal infection that's common in men between the ages of 20 and 40. A reaction to chemicals or skin care products -- called contact dermatitis -- can cause itching, too, along with redness and dry patches. If the skin on your itchy feet is thick and pimple-like, it may be psoriasis, an over-reaction of the immune system. Medicated creams can relieve the symptoms.

 

Claw Toe: This foot deformity can be caused by shoes that are tight and pinch your toes or by a disease that damages nerves, such as diabetes, alcoholism, or other neurological disorder. Your toes will be bent upward as they extend from the ball of the foot, then downward from the middle joint, resembling a claw. They may respond to stretching and exercises of the toes or you may need special shoes or even surgery.

 

Foot Spasms: A sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp, which can last many minutes. Overwork and muscle fatigue are common causes. Other causes include poor circulation, dehydration, or imbalances in potassium, magnesium, calcium, or vitamin D levels in the body. The changing hormone levels of pregnancy or thyroid disorders may play a role. If spasms are frequent or severe, see a doctor. Strengthening exercises can help with muscle fatigue.

 

Dark Spot on the Foot: We associate skin cancer with the sun, so we’re not as likely to check our feet for unusual spots. However, a melanoma, the most dangerous form of skin cancer, can develop even in areas that are not regularly exposed to the sun. Melanoma can even appear beneath the nail, where it might look like a black spot.

 

Yellow Toenails: Your toenails tell a lot about your overall health. A fungal infection often causes thickened yellow toenails. Thick, yellow nails also can be a sign of an underlying disease, including lymphedema (swelling related to the lymphatic system), lung problems, or rheumatoid arthritis.

 

Spoon-shaped Toenails: Sometimes an injury to the nail or frequent exposure to petroleum-based solvents can create a concave, spoon-like shape. However, iron deficiency also can cause this unusual shape.

 

White Nails: Injury to the nail or illness anywhere in the body can cause white areas in the nails. If part or all of a nail separates from the nail bed, it can appear white -- and may be due to an injury, nail infection, or psoriasis. If the nail is intact and most of it is white, it can sometimes be a sign of a more serious condition including liver disease, congestive heart failure, or diabetes. Talk with your health care team about any concerns.

 

Pitting of the Nails: Pitting, or punctured-looking depressions in the surface of the nail, is caused by a disruption in the growth of the nail at the nail plate. It affects as many as half of people with psoriasis.

Reviewed by Louise Chang, MD on September 19, 2011

REFERENCES:

American Academy of Orthopaedic Surgeons.
American Podiatric Medical Association.
Memorial Hermann Baptist Hospitals.
DLife.com.
National Heart Lung and Blood Institute.                                       
The Neuropathy Association.
National Institute for Neurologic Disorders and Stroke.
The Plantar Fasciitis Organization.
Am Fam Physician.
Walker HK. Clinical Methods: The History, Physical, and Laboratory Examinations, Butterworths, 1990.
American College of Food and Ankle Surgeons.
Arthritis Today.
American Academy of Podiatric Sports Medicine.
Psoriasis Cure Now.
Hyde Park & Magill Podiatry.
MedlinePlus.
National Psoriasis Foundation.

COMMON FEET PROBLEMS:

Avoid a Sandal Scandal: Is a bunion, corn, ingrown toenail or a bad case of athlete's foot causing you foot pain or embarrassment? Keep your feet healthy by learning to recognize and treat common foot problems.

 

Bunion: A bony bump at the base of the big toe, a bunion causes that toe to deviate toward the others. Throwing foot bones out of alignment and producing the characteristic bump at the joint's base, a bunion can be very painful due to pressure or arthritis, and may also lead to corns. Pain relievers, pads to cushion the bunion, custom shoe inserts, or surgery may help, as will wearing roomy shoes and avoiding high heels.

 

Corns and Calluses: Friction causes the thick, hardened, dead skin of corns and calluses, which form to protect sensitive skin. Appearing cone–shaped, corns point into the skin, and usually occur on areas that bear little weight. Calluses may appear anywhere there's friction, and are more diffuse. Both may be caused by ill–fitting shoes and will fade when friction stops. Moleskin pads can help relieve a corn; calluses can be trimmed or surgically corrected.

 

Gout: A form of arthritis, gout is characterized by sudden pain, redness, swelling, and stiffness, usually in the large joint of the big toe. Gout can also occur in the foot, ankle, or knees and is caused by too much uric acid (UA) in the body, which can form hard crystals in joints. Attacks can last days or weeks, and may be treated with anti–inflammatories or UA–lowering medication. Talk to your doctor about diet changes that help break down UA.

 

Plantar Warts: Plantar warts are tough, horny growths that develop on the soles of the feet. Contagious, they're caused by a virus entering through broken skin, and often spread via public pools and showers. Plantar warts are harmless and can be left untreated, but in many cases they're too painful to ignore. Topical salicylic acid may help, while burning, freezing, laser therapy, and surgical removal are more aggressive options for more severe cases.

 

Athlete's Foot: A fungal infection that can cause peeling, redness, itching, burning, and sometimes blisters and sores, athlete's foot is mildly contagious, passed by direct contact or by walking barefoot in areas such as locker rooms, or near pools. The fungi then grow in shoes, especially tight ones without air circulation. Athlete's foot is usually treated with topical antifungal lotions or oral medications for more severe cases.

 

Fungal Nail Infection: Occurring when microscopic fungi enter through a break in the nail, a fungal infection can make your nails thick, discolored and brittle. If left untreated, the nail infection won't go away -- and can be hard to treat. Thriving in warm, wet places, the fungi can be spread from person to person. Topical creams may help mild cases but antifungal pills are your best chance of curing a severe infection.

 

Hammertoe: When toe muscles get out of balance, they can cause painful toe problems. While some people are prone to hammertoe, other risks include tight footwear. Hammertoe generally causes the middle joint of the toe to bend downward, with toes appearing raised near the foot. Well–fitted footwear with the correct amount of space in the toe box, shoe supports, and surgery may offer relief.

 

Ingrown Toenail: A toenail that has grown into the skin, an ingrown toenail can result in pain, redness, swelling, even infection. Cutting nails too short or not straight across, injury to the toenail, and wearing tight shoes are culprits. For mild cases, soak the foot in warm water, keep it clean, and wedge a small piece of cotton under the corner of the ingrown nail to lift it off the skin. Minor surgery can remove all or part of the nail.

 

Flatfoot (Pes Planus): Flatfoot is characterized by the sole of the foot coming into complete or near–complete contact with the ground. It may be inherited, caused by an injury, or by a condition, such as rheumatoid arthritis. Flatfoot symptoms are rare, though weight gain, ill–fitting shoes, or excessive standing may cause pain. Treatment includes foot–strengthening exercises, and shoes with good arch support or orthotics.

Reviewed by Andrew Seibert, MD on September 30, 2011

REFERENCES

American Academy of Family Physicians.
American Academy of Orthopedic Surgeons.
Community Health Care Medical Library.
Jonathan Cluett, M.D, "About.com," Orthopedic Surgery Fellow in Sports Medicine and Arthroscopy, California.
Milton S. Hershey Medical Center College of Medicine.
National Health Services (NHS) Direct.
National Institute of Arthritis and Musculoskeletal and Skin Diseases web site.
National Institutes of Health.
University of California, Davis, Student Health Services web site.

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