BEST FOOT FORWARD
My Weekly’s favourite GP from TV and radio writes for you
Spring may be well underway, but it’s been a dark few months where your feet are concerned, bundled up in thick winter socks and stout shoes. And that’s just the way fungi like it.
Mushrooms thrive anywhere that’s warm and moist, and the microscopic fungi that cause these infections are the same.
Athlete’s foot is a fungal infection commonly seen in people who wear sweaty trainers, but it’s not confined to athletes. Sharing communal showers or using a towel shared with someone else lets you pick up microscopic spores, leading to itchy, scaly skin and painful cracking. It usually starts in the skin between your toes, often little toes first.
Treating the infection with
HAVING DIABETES PUTS YOU AT HIGHER RISK OF FOOT ULCERS – CHECK FEET DAILY AND SEE YOUR DOCTOR EARLY IF YOU NOTICE ANY PROBLEMS
antifungal cream from your pharmacist is the first step. Keep going for several days after the infection has cleared and take steps to stop it coming back. Use a fresh, dry towel to dry your feet; use cotton socks, washed daily; wear open sandals where possible and use flip-flops in communal showers.
Fungal nail infections can certainly dampen your enthusiasm for summer sandals and the infection can spread from athlete’s foot. Your nails (mostly toenails) become thickened, crumbly and discoloured. Up to 1 in 12 people get this infection at some point, and it’s more common in over-60s or if you’re generally unwell or have other long-term conditions like diabetes.
Making a firm diagnosis involves taking a nail clipping and culturing it in a lab – your
GP can arrange this. You don’t always need treatment for mild infections, but options include daily tablets or nail lacquer painted on daily. You may need treatment for up to 6 months.
Bunions – bony outgrowths that form at the base of the big toe – aren’t pretty either, and they can also be very painful. The joint connecting your big toe with the rest of the foot gets deformed, which can lead to rubbing, soreness and inflammation.
For mild bunions, wearing flatter, roomier shoes that don’t press on the joint or force your foot forwards may be enough – adjustable laced shoes are often best. If your symptoms are severe, there are several types of surgery, ranging from trimming the joint to breaking and realigning the bones or even fusing the joint completely. You may be able to get this done under local anaesthetic without an overnight stay.
Plantar fasciitis is another common cause of pain, this time in your heel. The tough band of connective tissue that runs under the sole of your foot to support the arch gets inflamed where it’s attached to your heel bone. The pain is usually worse when you first get out of bed, and you may find a very specific tender spot if you press on the bottom of your heel. It’s thought to be down to repeated minor trauma – often if you suddenly start exercising more or change to shoes that don’t offer much cushioning support.
Being overweight, not surprisingly, puts more pressure on your heels, so losing weight will help. So will rest and supportive, cushioned insoles, along with painkillers or anti-inflammatory tablets. If they don’t work, try seeing a podiatrist for specialist shoe inserts and exercises to stretch the tissue. It can take several months to settle. Next week: Mental Health Update
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