According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.

The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.

Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.

Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.

If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

A bunion is a bump that forms at the base of the big toe. Bunions form when the big toe pushes against the next toe, which forces the big toe joint to get bigger and stick out.  As a result, the skin over the bunion may start to appear red and it may feel sore.

There are risk factors that can increase your chances of developing bunions. People who wear high heels or ill-fitting shoes are more likely to develop them, in addition to those who have a genetic history of bunions or have rheumatoid arthritis.

The most obvious way to tell if you have a bunion is to look for the big toe pushing up against the toe next to it. Bunions produce a large protrusion at the base of the big toe and may or may not cause pain. Other symptoms are redness, swelling, and restricted movement of the big toe if you have arthritis. 

Nonsurgical methods are frequently used to treat bunions that aren’t severe. Some methods of nonsurgical treatment are orthotics, icing and resting the foot, taping the foot, and pain medication. Surgery is usually only required in extreme cases. However, if surgery is needed, some procedures may involve removing the swollen tissue from around the big toe joint, straightening the big toe by removing part of the bone, or joining the bones of your affected joint permanently.

Your podiatrist will diagnose your bunion by doing a thorough examination of your foot. He or she may also conduct an x-ray to determine the cause of the bunion and its severity.

Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.

Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.

To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.

There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.

In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.