Category Archives: Painful Foot

Tinea Pedis / Fungal Infection / Athlete’s Foot

Summary

Fungal infection can affect people of all ages. It will cause a rash or blisters with itching, dryness, redness, flaking, and sometimes moist white skin between the toes.

How did I get this?

You can pick up a fungal infection anywhere, however they are more common in warm moist environments where there are communal barefoot areas. Care should be taken when using foot spas if they are shared with other people.

What can I do about it?

Various treatments are available from the pharmacy. Most require an application of an antifungal cream or spray as often as twice a day. Use footwear that will allow your feet to “breathe” and moisture “Wicking” socks or natural fibres are next best.

Wear thongs or water shoes in the shower to prevent infecting others.

What help can I get for this?

Your Doctor or Podiatrist will be able to help if you are not sure of the cause of your rash, or if it has not cleared up after 4 weeks. Sometimes a skin sample can be sent to the lab for testing.

Your podiatrist can advise you about disinfection of your footwear and hosiery.

When will it get better?

With the right treatment, fungal infections will usually clear up in a few weeks. More stubborn infections can keep coming back and may require further investigation.

Subungual haematoma – Bleeding under Nail

Summary

Often very painful, a subungual haematoma is a blood blister or bleeding under your toenail, and will cause swelling and bruising under and around your toenail.

How did I get this?

Usually a result of trauma, you may have stubbed your toe, dropped something on it, or been stood on.

You may also see this condition after endurance events e.g. running or hiking, or after wearing shoes that sre too small.

If you are taking anticoagulant medication you should take extra care.

What can I do about it?

Painkillers may help, but avoid those containing anti-inflammatories such as ibuprofen.

Piercing the toenail to release the pressure will give immediate relief, but this should be carried out by a medical professional if possible.

What help can I get for this?

Your Doctor or Podiatrist will carefully release the pressure and fluid from beneath the toenail, and advise you on appropriate dressings.

Your podiatrist can help if the toenail comes loose, or is not growing properly.

When will it get better?

Releasing the fluid from beneath the toenail usually gives immediate relief. Sometimes you will lose the toenail, but it should grow back again.

Plantar Wart – Verruca

Summary

  • Plantar refers to the sole of your foot (nothing to do with gardening)
  • Wart on the sole of your foot or between your toes
  • May be painful due to a build-up of hard skin

How did I get this?

  • The wart is caused by a virus which thrives in warm moist environments
  • I may have been picked up via a microscopic skin tear
  • They are often contracted through communal barefoot areas such as changing rooms and swimming pools
  • Can also be passed on within families.

What can I do about it?

  • Avoid going barefoot
  • Remedies are available at your pharmacy
  • Use a pumice or foot file to reduce thick hard skin
  • Keep the wart covered with a waterproof dressing or tape
  • Make sure you are generally healthy with a strong immune system

What help can I get for this?

  • A Podiatrist will remove any thick hard skin and advise on treatment options
  • Treatment may involve acid, freezing, burning, or laser to kill the virus causing the wart

When will it get better?

  • Most warts will go away on their own after about 2 years
  • Depending on the type of treatment you should expect an improvement in 6-8 weeks

Onychomycosis – Fungal Nail Infection

Summary

Fungal nail infection becomes more common as we get older. It appears as a white or yellow/brown discolouration of the nails. Lots of people get changes to their toenails however only about half are because of Fungal Infection.

How did I get this?

Nail fungus can be picked up almost anywhere, however it is more common in warm moist environments. The fungus can enter through the skin folds around your nail, through a split or damaged nail, or under the end of the toenail. People who are run down, or suffering from other health problems may be more susceptible.

Care should be taken when visiting nail spas to ensure equipment is clean prior to use.

What can I do about it?

Various treatments are available from the pharmacy. Most require an application of antifungal nail paint as often as twice a day, and some also include files or other means of helping the paint to penetrate.

Using nail varnish to hide the problem will also seal the infection in the nail and tends to make it worse.

What help can I get for this?

Your doctor may prescribe antifungal medication. Oral treatments may not be suitable for people with other health problems.

A Podiatrist will help by carefully removing any infected nail tissue and advising on treatment options. This might include Photodynamic Therapy or Laser treatment, and should also address disinfection of your footwear and hosiery.

When will it get better?

Treating Fungal Nail Infection can take many months, perhaps up to a year. Any treatment will require the nail to re-grow until it is clear of infection.

Interdigital Hyperkeratosis – Soft Corns

Summary

  • Painful thick skin between the toes.
  • Sometimes very hard and dry
  • Sometimes the thick skin is soft, white and macerated (soft corn)
  • There may also be a fungal infection
  • The worst cases may blister and form a wound.

How did I get this?

  • Increased pressure between your toes possibly caused by any or all of the following: tight shoes, bony lumps, enlarged joints, thick toenails.

What can I do about it?

  • Wear shoes with a deep wide toebox
  • Wear a pad between the toes
  • Trim your toenails carefully
  • Treat fungal infections

What help can I get for this?

  • Podiatrist will gently remove the thick skin
  • Podiatrists can provide made to measure pads for between your toes
  • Shoe store can fit your shoes carefully
  • Surgeons can straighten toes and remove bony lumps

When will it get better?

  • Removal of the thick skin can provide immediate relief
  • Padding between the toes can help prevent recurring problem.

Hyperkeratosis – Callus – Hard Skin

Summary

  • Painful thick skin (corns and callous) caused by pressure or friction
  • Usually on the sole of your foot or over bony lumps and joints
  • Can become blistered and form a wound if not treated

How did I get this?

  • Pressure or friction causes the skin to thicken
  • Enlarged joints or bony lumps may increase pressure
  • Tight footwear and high heels will increase pressure
  • Loose footwear will increase friction

What can I do about it?

  • Wear properly fitting shoes
  • Use a foam pads to relieve pressure
  • Use thin fleecy pads or moleskin to reduce friction
  • Gently remove excess skin with a pumice or foot file

What help can I get for this?

  • Podiatrist will help by removing the thick skin
  • Podiatrist may provide a pad to relieve pressure or friction
  • Podiatrist can provide pressure relief insoles for your shoes, and may stretch shoes for bony lumps
  • Careful Shoe fitting to ensure room for your toes and secure fit.
  • Orthopaedic surgeon can operate to reduce bony lumps.

    When will it get better?

    • Removing the thick skin often provides immediate relief
    • Padding and insoles can help prevent recurring problems

Ingrowing toenail

Summary

  • Ingrowing toenails occur when the hard nail plate causes a wound in the soft flesh around the nail.
  • They can be very painful and become infected.
  • There may be an overgrowth of tissue around the nail due to irritation of the wound.

How did I get this?

  • Direct trauma from tight footwear or stubbing your toe
  • Long term pressure from a thickened or curved toenail
  • Poor nail cutting leaving a sharp corner on the nail
  • Swollen toes and sweaty feet can weaken the skin around the nail.

What can I do about it?

  • Avoid footwear which presses on the toe.
  • Bathe the foot in salt water and apply an antiseptic dressing.
  • Trim the toenail as short as possible but do not cut into the painful side

What help can I get for this?

  • A podiatrist can remove the part of the nail that is causing the problem. This may be done under local anaesthetic if necessary.
  • A Podiatrist can advise on appropriate footwear and how to avoid further problems.
  • A doctor may prescribe antibiotics if the toe is infected, however the nail will still need treatment to prevent further infection
  • A Podiatrist can permanently remove the problem piece of nail and prevent regrowth. This procedure is performed under local anaesthetic and is a lasting solution

When will it get better?

  • Without treatment the nail will continue to grow and penetrate the wound.
  • Removal of the piece of nail provides immediate relief.
  • Careful nail care and the right shoes can prevent recurring problems

Ingrown toenail

Nerve entrapment / Neuroma

Summary

  • Thickening of the tissue that surrounds the nerve leading to the toes. Burning pain in the ball of the foot that may goes into the toes which generally intensifies with activity or wearing shoes. There may also be numbness or an unpleasant feeling in the toes.

How did I get this?

  • Anything that causes compression or irritation of the nerve can lead to the development of a neuroma (e.g. wearing high healed or tight shoes). Foot deformities are risk factors. Injury and trauma to the feet can also lead to this condition.

What can I do about it?

  • Placing an icepack on the affected area helps reduce swelling.
  • Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
  • Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
  • Padding techniques provide support lessening the pressure on the nerve and decreasing the compression when walking.

What help can I get for this?

    • Podiatry consultation for treatments that include footwear advice, padding, orthotics, and may advise guided injections for alleviating the pain.
    • Surgery may be considered if not responded adequately to non-surgical treatments.

When will it get better?

  • Appropriate treatment can provide swift relief, but you will still need to consider long-term measures to help keep your symptoms from returning.

arrow-left

LISFRANC INJURY

Summary

  • Lisfranc injuries occur at the midfoot where a cluster of small bones forms an arch on top of the foot between the ankle and the toes. Lisfranc fracture-dislocations are swollen and painful with some bruising and inability to put any weight on the foot.

How did I get this?

  • Lisfranc injuries occur as a result of direct or indirect forces to the foot. A direct force often involves something heavy falling on the foot. Indirect force commonly involves twisting the foot.Commonly occur in automobile accident victims, military personnel, runners, horseback riders, football players and participants of other contact sports, or something as simple as missing a step on a staircase.

What can I do about it?

  • Refrain from putting weight on the foot.
  • Oral anti-inflammatory medications (ibuprofen) help reduce pain and inflammation.
  • Swelling is reduced by icing the affected area and keeping the foot elevated.

What help can I get for this?

  • Podiatrist will place the affected foot in a cam walker to keep it immobile, and crutches are used to avoid putting weight on the injured foot.
  • Orthopaedic foot surgeon for possible surgical treatment to realign the joints and return the broken (fractured) bone fragments to a normal position.
  • A surgeon to correct the associated deformity which is causing the synovitis.

When will it get better?

  • The majority of the recovery occurs in the first 6 months, but it is often a year or more before patients reach their point of maximal improvement. If the surgical treatment fails or the joint damage from the injury leads to severe arthritis, then a fusion (arthrodesis) of the Lisfranc joints may be necessary. Despite the stiffness of a fused joint most patients with successful fusion of the midfoot joints have good function of the foot.

arrow-left

Synovitis

Summary

  • Inflammation of the tissues that line the joints, often under the ball of the foot. It causes redness, swelling, warmth, and pain on weightbearing or with joint motion.

How did I get this?

  • Pressure overload on the toes due to an associated deformity, wearing inappropriate footwear such as high heels or isufficient width, and arthritis.

What can I do about it?

  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a protective pad.
  • Hot or cold packs may help.
  • See a podiatrist.

What help can I get for this?

  • A podiatrist may provide padding to reduce pressure on the area, footwear advice, orthotics, strapping.
  • Your doctor may administer a cortisone injection in the injured area.
  • A surgeon to correct the associated deformity which is causing the synovitis.

When will it get better?

  • The earlier the diagnosis and treatment, the better and sooner the outcome will be. If left untreated synovitis could result in rupture and permanent deformity.