Watch your step! As it’s Health Month in April, we’ve been chatting to some experts to help you feel in tip-top condition. With summer on its way (despite what the weather may say) it will soon be time to get those tootsies out and flash your feet in the sun’s rays.
Whether it’s bunions, flat feet or general foot pain that is ailing you and making you hide those feet away in layers of fluffy socks, podiatrist Simon Bennet Cairns-Nagi of Croft View Podiatry offers some great advice to get you back on your feet.
What is it?
The arch, or instep, is the inside part of the foot which is usually raised off the ground when you’re standing, whilst the rest of the foot remains flat on the ground. Most people have a noticeable space on the inner part of their foot (the arch). The height of the arch varies from person to person, but a person with flat feet has low arches, or none at all.
What are the symptoms?
Flat feet do not usually cause problems but they can put a strain on your muscles and ligaments. This may cause pain in your legs when you walk.
If you have flat feet you may experience pain in any of the following areas:
- Inside of the ankle;
- Arch of the foot;
- The outer side of the foot;
- Knee, hip or back.
How can I treat it?
- If the feet ache, the achiness can usually be relieved by wearing supportive shoes that fit properly – you may need to wear shoes that are wider than normal;
- If your feet over-pronate (roll inwards), you may need to wear a special orthotic (a device used to help correct the foot problem) placed inside the shoe to stop the feet rolling inwards when you walk or run -these will usually need to be made and fitted by a podiatrist;
Ecco offer a selection of shoes with removable insoles for this purpose;
- In cases where flat feet are the result of a condition that affects the nervous system, special shoes, insoles, or supportive foot or leg braces may be needed (in severe cases, an operation may be required to straighten your feet).
Foot pain is a common problem with a wide range of possible causes. If it is severe or persistent you should see your GP or local podiatrist/chiropodist. Simon talks us through some of the common causes of foot pain.
If you have done more activity than you are used to, the pain may just be a foot sprain. This means that tissues in the foot have been stretched but they are not permanently damaged. An example of a sprain may be pain and swelling at the base of the big toe caused by spraining the ligaments around this joint. This condition is known as turf toe and is commonly seen in dancers and footballers who play on artificial turf.
Gout is a type of arthritis caused by a build-up of uric acid (a waste product) in the body. Crystals of uric acid can form in the joint of the big toe, causing severe pain and inflammation even when the body is at rest.
Usually, gout affects the joint of the big toe first before it affects other joints. It can sometimes be hard to tell the difference between gout and a severely inflamed bunion.
In older people, repeated attacks of foot pain can be a sudden worsening of osteoarthritis, the most common type of arthritis in the UK.
Osteoarthritis causes swelling of the tissues in and around the joints, including the big toe and heel joints.
Less commonly, foot pain can be caused by rheumatoid arthritis, a crippling type of arthritis caused by the immune system attacking the joints and causing the joint tissues to become inflamed. It almost always affects other joints too, so foot pain would not be the only symptom experienced.
Bunions (halluz valgus)
A bunion is a deformity of the base joint of the big toe. A bunion develops when the big toe is angled toward the second toe. This causes a bump on the side at the base of the big toe. There is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful.
It is not always clear why a bunion develops. It may be genetic or associated with a joint problem such as osteoarthritis or rheumatoid arthritis or ill-fitting footwear such as high heels or wearing incorrect shoe size. However, whatever the underlying cause, wearing tight or badly fitting shoes tends to worsen the problem, as wearing such shoes puts extra pressure on the big toe joint and causes friction on the overlying skin.
What are the symptoms?
- You may have difficulty walking due to pain;
- Inflammation and swelling at the base of the toe (this sometimes becomes infected);
- The foot may become so wide that it can be difficult to find wide enough shoes;
- Arthritis may develop in the big toe;
- The second toe can become deformed;
- In severe cases, the big toe can push the second toe out-of-place.
How can I treat them?
Wearing good footwear does not cure the deformity but may ease symptoms of pain and discomfort.
Advice may include:
- Wear shoes, trainers or slippers that fit well and are roomy;
- Do not wear high-heeled, pointed or tight shoes;
- Shoes with laces or straps are more suitable and are more accommodating to the problem;
- Padding over the bunion may help.
Surgery is the only way to correct a bunion. Bunions usually get worse over time, so a bunion left untreated is likely to get bigger and become more painful.
If your bunion is causing a significant amount of pain and affecting your quality of life, your GP or podiatrist/chiropodist may refer you to be assessed for bunion surgery.
The aim of bunion surgery is to relieve pain and improve the alignment of your big toe. Surgery is not usually carried out for cosmetic reasons alone. Even after surgery there may still be limits to the styles of shoe you can wear. As a practising podiatrist, I always advise surgery as a last resort for treatment and only if the patient is persistently in pain.