Common foot conditions
Bunions
Bunions are characterized by a noticeable "bump" on the side of the big toe, resulting from a misalignment of the big toe joint where it leans toward the second toe instead of pointing straight ahead.
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Symptoms of bunions include swelling, tenderness, and pain, particularly when wearing shoes, with the affected area possibly becoming reddened and warm to the touch. These conditions can be exacerbated by factors such as gradual changes in bone alignment, genetic predisposition, ill-fitting footwear like pointy-toed or high heels, prolonged standing, and arthritis.
Corns and calluses
A callus or corn occurs when the skin thickens in response repetitive pressure or friction. While calluses typically manifest on the bottom or side of the foot, corns tend to form over the joints or "knuckles" of the toes, distinguished by a hard center surrounded by inflamed skin.
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Corns, smaller than calluses, often occur in non-weight-bearing areas like the tops and sides of the toes and can cause discomfort under pressure. Conversely, calluses commonly develop on weight-bearing areas such as the sole, particularly on the heel or ball of the foot. Symptoms of both include tenderness or pain, which can develop and worsen with ongoing friction or pressure on the foot and poorly fitting footwear or hosiery.
Ingrown toenails
An ingrown toenail occurs when the side of the toenail curves downward, piercing the surrounding skin, or when the nail grows into the skin itself, leading to considerable pain and a restriction in daily activities.
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Once the skin is breached, the area is susceptible to infection or inflammation, commonly affecting the big toe but potentially any toe. Symptoms include redness, swelling, and pain, with potential pus discharge if infected, alongside an overgrowth of skin at the nail's edge. Ingrown toenails typically result from sharp nail spikes penetrating the skin, improper nail trimming, wearing ill-fitting footwear or socks, toenails that curve inward, or congenital deformities.
Plantar Fasciitis
Plantar fasciitis, a prevalent and distressing ailment, arises when the plantar fascia ligament, spanning from the front of the heel to the ball of the foot, becomes inflamed. Symptoms typically manifest as pain along the bottom of the foot, particularly acute upon initial steps after rest, gradually diminishing with continued movement.
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The condition's intensity can vary, ranging from mild discomfort to persistent and severe pain. Causes include trauma from injury, excessive exercise without adequate warm-up, or irritation of the plantar fascia, exacerbated by wearing inadequately cushioned or supportive footwear, as well as factors such as weight gain or pregnancy.
Diabetic complications
Diabetes, a metabolic disorder characterized by insufficient insulin production or ineffective insulin utilization, affects millions of Canadians. Foot and lower leg complications are prevalent among individuals with diabetes, often resulting in hospital admissions.
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Diabetes can impair circulation and nerve function in the feet and lower legs, leading to decreased blood flow and neuropathy—a primary cause of diabetic foot problems. Neuropathy manifests as numbness, pain, burning, and tingling in the feet, rendering individuals unable to detect injuries. Consequently, seemingly minor cuts, if untreated, can escalate into infections, potentially necessitating amputation.
Fungal infections
Athlete’s foot (tinea pedis) presents as a fungal infection affecting the skin, with potential complications if left untreated, including the spread of the fungus to the toenails, leading to nail thickening and discoloration.
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This contagious condition can be transmitted through contact with contaminated towels, floors, or shared footwear. Symptoms include dry, itchy, scaling, and burning skin, accompanied by blisters or peeling between the toes, with a possible foul odor. Causes of athlete’s foot involve microscopic fungal organisms thriving in warm, damp environments, exacerbated by factors such as excessive perspiration or a compromised immune system, creating an ideal breeding ground for the fungus within the confines of shoes.
Heel spurs
The heel (or calcaneus) is the largest bone in the foot and bears significant weight during walking and standing, absorbing roughly 50% of the body's weight. Heel spurs, bony-like growths originating from the heel bone where the plantar fascia ligaments attach, often form on the underside of the heel over several months.
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While some heel spurs are asymptomatic, others cause pain, particularly for individuals with plantar fasciitis, as heel spurs occur in approximately 50% of these cases. Symptoms include pain and stiffness on the bottom of the foot, sometimes extending to the arch, with discomfort potentially worsening over time. Contributing factors to heel spur development include overstretching of the plantar fascia, inadequate warm-up before activity, obesity, foot structure abnormalities such as flat feet or high arches, and wearing ill-fitting shoes.
Plantar warts
Plantar warts are caused by a viral infection, and can develop gradually over days, weeks, or even months, as the virus enters the body through a microscopic opening in the skin. Typically found on the sole of the foot, these warts may emerge individually or in clusters.
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They can vary in size from minuscule to substantial, and range from painless to highly uncomfortable. While anyone can contract the virus responsible for plantar warts, children are often more susceptible than adults. These warts, appearing raised and spongy, may exhibit tiny black dots and have the potential to spread if left untreated, especially if located on weight-bearing areas of the foot. Given their contagious nature, precautions should be taken to prevent transmission.
Morton’s Neuroma
Morton’s neuroma is a condition impacting one of the nerves situated amidst the long bones (metatarsals) within the foot, characterized by a thickening of the surrounding tissue enveloping the nerve towards the toes.
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Predominantly affecting the nerve nestled between the third and fourth metatarsal bones, this condition induces pain and numbness in the third and fourth toes. Symptoms typically manifest gradually and encompass sensations of pain, burning, numbness, or tingling between the toes, often likened to the discomfort of walking with a pebble in the shoe. Swelling between the toes may also be observed. Contributing factors to its onset include irritation, pressure, or injury to the nerves supplying the toes, exacerbated by the wearing of high-heeled, pointed-toe, or snug-fitting footwear, with individuals having bunions, high arches, or flat feet being particularly vulnerable.
Hammertoes
A hammertoe is a condition when a toe bend or curls downward instead of pointing forward, typically resulting from flexion or bending of its middle joint. While this condition can affect any toe, it most commonly impacts the second or third toe.
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Hammer toes can be classified as flexible or rigid, with the former allowing movement and the latter limiting mobility. Discomfort while walking and pain during attempts to stretch or move the affected toe or adjacent toes are common symptoms, which may range from mild to severe. The shape of the hammer toe can lead to the formation of corns or calluses due to consistent friction against footwear, along with toe cramping, weakness, and the development of calluses on the ball of the foot.
Charcot Foot
Charcot foot presents as a rare yet severe complication primarily affecting individuals with peripheral neuropathy, particularly those diagnosed with diabetes. This condition impacts the bones, joints, and soft tissues of the foot or ankle, rendering the bones weak and susceptible to fractures while causing potential dislocations in the affected joints.
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Early-stage symptoms include redness, warmth, and swelling of the foot, with subsequent stages leading to arch collapse and alterations in foot shape when the midfoot is involved. Contributing factors to its development include diminished sensation and muscle control in individuals with neuropathy, heightening the risk of Charcot foot, while inadequate treatment of foot or ankle fractures can exacerbate deformities, potentially leading to foot ulcers and infections.
