Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Your feet bear the full weight of your body every time you take a step. You may take their support for granted, but it involves dozens of bones, small joints, nerves and muscles.
Arthritis may be most common in knees, hips and spine, but your feet aren’t immune – and protecting your feet from constant jolting goes a long way to protecting them.
Trainers and well cushioned shoes act as shock absorbers, reducing the impact of hard pavements on your feet. But, just like car tyres and shock absorbers, they wear out – so you need to upgrade them regularly.
Bunions are a bore – and can be very painful. The bony V-shape at the base of your big toe can make shoes
THE HEAVIER YOU ARE, THE MORE STRAIN YOUR FEET ARE UNDER – SO SHEDDING A FEW EXCESS POUNDS CAN WORK WONDERS FOR FOOT PAIN.
hard to find and cause rubbing and inflammation over the skin. Tight shoes or high heels cause squashing and can bring on or worsen symptoms. If your symptoms are mild, the right footwear may be all you need, but if your symptoms are severe, your doctor may recommend surgery.
Pain under your heel is normally due to a problem called plantar fasciitis – inflammation of the tough connective tissue that supports the sole of your foot, attached towards the front of your heel. It’s most common in 40-60-yearolds. It is often worse just after you get up or when you’ve been on your feet a long time. Walking upstairs or standing on tiptoe can also cause pain.
Many people have a “spur” of bone at this point,
and it used to be thought this was the cause of the problem – we now know it isn’t, so X-raying the foot doesn’t help with the diagnosis. Anti-inflammatory tablets, the right footwear and possible arch supports from a podiatrist are likely to be recommended; a steroid injection into your foot helps if the pain is severe or doesn’t settle.
Regular exercises to stretch the tissues help settle symptoms and prevent them returning – head to WWW.PATIENT.INFO and look for heel pain for a leaflet and video of exercises from a physiotherapist.
Pain under the sole of your foot can be due to inflammation of the head of your metatarsals – the five long bones behind your toes – or a squashed nerve between these bones, called Morton’s neuroma.
A podiatrist can help with both, and may be able to remove a Morton’s neuroma with minor surgery. Otherwise, rest, antiinflammatories and roomy, cushioned shoes are in order.
Athlete’s foot is a fungal infection, usually starting between your fourth and little toes and spreading. It causes itching, sore splits in the skin and smelly flaking. Fungal nail infections don’t usually hurt but are a common cause of discoloured, flaky and thickened toenails. Medical treatment for the two is different, although both are available from your pharmacist. For athlete’s foot, cream applied to the affected area and 4-6cm around it will kill the fungus, but you need to keep going for up to two weeks after the rash settles.
Getting rid of fungal nail infections takes months, but a medicated nail lacquer applied regularly usually does the trick. If not, your doctor may recommend antifungal tablets.
Next week: Do you have arthritis?
SUDDEN SWELLING AND SEVERE PAIN AT THE BASE OF YOUR BIG TOE IS OFTEN DUE TO GOUT. IT USUALLY SETTLES IN DAYS BUT MAY NEED REGULAR TABLETS.
TRAINERS AND WELL CUSHIONED SHOES ACT AS SHOCK ABSORBERS’’