Swollen Feet: Sign of Aging or a very Serious Medical Problem?

You feet are an indicator of your overall health. Swelling in your feet could act as a warning sign of a much worse systemic disorder. On the other hand, swelling in your feet could be completely harmless and go away quickly with the proper actions. So, how can you tell whether your swollen feet is a call to action for a serious health disorder or just a sign of aging.

Swollen feet during pregnancy

The most common time we see swollen feet is during pregnancy. This occurs because the fluid volume in your body doubles during pregnancy and the fluid must pool somewhere. As the baby grows within the uterus, it can begin to compress the inferior vena cava, which is the main route of blood return to the heart from the lower limbs. Since the return is slightly blocked, the blood has a harder time being pumped from the feet back up. Some tips to help reduce swollen feet during pregnancy are: wear shoes that are open or just go barefoot (the phrase barefoot and pregnant had to come from somewhere), elevate your feet so that gravity does not play such a large role, massage your feet to increase blood return and finally exercise so that the muscles around the veins can help push the blood back up.

Swollen feet in the non-pregnant

The arterial system, which delivers blood to our feet and other organs, is actually comprised of vessels with a small layer of muscle actively pushing blood out to the organs; unfortunately, the venous system, for returning the deoxygenated blood to the heart, is much less efficient. It works with a much more passive process eliciting help from the muscles around the veins pulsating and pushing the blood under a much lower pressure. As we grow older, our veins lose their elasticity, and it becomes harder to work against gravity pushing them back down. So, in these cases, the blood is pooling around the feet. This is not a major medical problem. It can be helped with compression stockings, exercise, massage, reducing time on your feet and elevated feet.

Unfortunately, swollen feet are not always due to an inefficient venous system. It could be a sign of a failing heart muscle, diabetes or a blood clot if the swelling is in only one leg. All of these cases require medical attention. Please ask your podiatrist, if you are concerned about your swollen feet.

Are high heels to blame for Posh Spice's Bunion?

Rich or Poor, high heels or tennis shoes, child or adult, bunions can afflict any person at any time in their life. Posh Spice and Lady Gaga are just two examples of celebrities suffering with this sometimes painful foot condition. Bunions are the resulting bony prominence just below the big toe when it is pushing towards the rest of the toes. The big toe pushes towards the other toes, but the bony joint beneath it pushes outwards causing the big “bump” on the inside of the foot. When the big toe pushes on the other toes, it may come to rest underneath the second toe, which begins to contract called a hammertoe. This toe can also become painful when it pushes up causing a blister as it rubs on the shoe. Symptoms of a bunion may include: redness, swelling and pain along the inside of the foot. Critics of Posh Spice may blame her high heels for the deformity, but bunions are found in all people, high heels or not. Hereditary and biomechanical factors can also be a major contributor. In these cases, choice of constrictive shoes can exacerbate the problem, but not be the cause.

So, what are Posh Spice and Lady Gaga’s options for relief of their bunion pain? In my professional opinion, this depends on many factors. Some people have no complaints of pain. If the patient is elderly or it is a mild bunion deformity, I would typically recommend conservative options include shoe gear modification, orthotics, anti-inflammatories, and other options in which we could discuss. In patients complaining of pain and worsening deformity, surgery may become an option if conservative attempts fail. There are many different surgical options, but the most common involves trimming of the bone and realignment of the joint, which does incur a 6-8 week healing period. However simple the procedure, all surgery have some inherent risk.

Howard Stern teaches a lesson for Broken Toes

Doorways, desk legs, and bed posts, what do these things have in common? As Howard Stern found out, they are all enemies of our pinky toe. Two weeks ago, Howard Stern broke his little toe on the leg of his desk. Every week, I see patients with broken toes that have been stubbed on some object. Many times, they are presenting with some other pain, and the fact that they stubbed their toe just comes up in conversation. Like myself, many people live with an aching toe or foot after they have cracked it on some benign object in the house. The myth is that we cannot do anything for a broken toe, but all fractures should be diagnosed and treated. The fracture could be displaced resulting in the bone not healing properly possibly causing chronic swelling and pain if not surgically corrected. The other concern is that a non-displaced fracture could become displaced if we injure it further. Howard did the right thing by seeing his podiatrist. He had X-rays confirming the break in the fifth toe and confirming that it was lined up together ensuring proper healing. His podiatrist placed him in a fracture walking boot to immobilize it and is taping it to the fourth toe, called a buddy splint. Since bone takes 6-8 weeks to heal, he will have to put his running routine on hold for a few weeks at which time he can slowly work back into it.

A broken toe needs to be diagnosed and treated. If you fear that you may have broken your toe, please follow Howard Stern’s lead by seeing a podiatrist. We may not be able to speed up the healing time of it, but we can prevent it from becoming worse and causing pain years away.

New Treatment for Plantar's Warts

Verruca Plantaris, which are more commonly known as plantar’s warts, are usually found on the soles of the feet. A wart is a virus that infects the skin and can grow as a single lesion or as a cluster of lesions. Most plantar’s warts do not stick out above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Plantar’s warts usually appear as a thickened spot of skin. For this reason, they are commonly confused with corns and calluses. A common discrepancy between warts and calluses is that warts are painful when being squeezed sideways. Unlike corns and calluses, warts are not typically painful when being pushed directly.

Traditional Treatments for plantar’s warts include:

-Over the counter acid patches containing (salicylic acid)

-Freezing products (can be over the counter or in the clinic)

-Duct tape occlusion

-Surgical excision

The podiatrists at Community Foot Care have recently began a new treatment protocol for plantar’s warts. We begin by shaving away the callused skin that has built up around the lesion. Once the dead skin has been removed, we apply a small amount of Cantharone directly to the wart. We then cover it with a band aid in order to allow it to act on the lesion. The skin on the foot is likely to blister underneath of the wart. The blistering helps to cut off the wart’s blood supply.

The normal actions of these medications are to form a blister underneath the wart. This occurs within 24 hours of application. Since warts are highly vascularized, the blister formation kills the wart by cutting off its blood supply. There maybe some pain associated with the Cantharone application, in which case we recommend washing it off. Sometimes, it only requires one application for destruction of the wart. If needed, we can continue to apply Cantharone every two weeks until complete resolution. We have had great success with this wart treatment. If you have unresolving lesions on the bottom of your foot, please call your podiatrist.