Standing on Clues

Your feet can tell you a lot about how the rest of your body is doing.

by Beverly Burmeier

July / August 2017

When was the last time you really looked at your feet? Examined them top to bottom, heel to toe?

“You should inspect your feet every day because their condition can provide clues to other health issues,” says Leslie Campbell, DPM, a podiatrist in Allen, Texas, and a representative of the American Podiatric Medical Association.
Symptoms like pain in your heel or big toe, swelling or redness, brittle or pitted toenails, and numbness or cramping should never be ignored. They could signal a systemic disease that requires evaluation—and cause plenty of misery if left untreated.

Nail Woes

Podiatrists often see dry, brittle toenails. While they could be related to environmental factors or a vitamin A deficiency, brittle toenails are often linked to thyroid disease. If moisturizing doesn’t help, Campbell recommends seeing a practitioner.

“The nail plate is just keratin,” notes Gregory Catalano, DPM, podiatrist in Concord, Massachusetts, “so not all vitamin deficiencies will be evident in the structure of the nail.”

Pitted or pockmarked toenails, or nails with white patches, may be signs of psoriasis or psoriatic arthritis; Campbell says consulting a dermatologist would be wise. She also cautions that a dark, vertical line on the nail could be an indication of a hidden melanoma. While only 5% of melanomas affect nails, if left untreated, this skin cancer could spread.

A condition referred to a “spoon nail,” in which there’s a depression in the nail large enough to hold liquid, could signal iron-deficiency anemia or lupus, an autoimmune disease.

Feeling Your Feet

Ever think that losing hair from your toes could be a concern? Healthy hair follicles require good circulation, so losing hair could indicate decreased blood flow to the extremities.

Losing toe hair or having shiny, cracked or purplish skin on the toes—all signs of poor circulation—should be checked out for possible cardiovascular disease or peripheral arterial disease (PAD), in which narrowed arteries can also cause cramping, pain or tiredness in the legs. And while many cases of swollen feet can be caused by excessive sitting or standing, problems with the heart, kidneys or liver can also play a role.

Numb or burning feet, caused by nerve dysfunction, or a sore on the foot that doesn’t heal are widely recognized symptoms of diabetes. People with diabetes, circulation disorders or compromised immune systems should be especially vigilant in having foot problems examined. And having toes that sway away from the mid-line, usually toward the little toe, could be a clue that rheumatoid arthritis is present.

Shooting pain in the heel or arch might be a sign of plantar fasciitis, the result of abnormal strain on connective tissue on the bottom of the foot. Stretching calf muscles, icing the site of pain or modifying activity are recommended to alleviate discomfort. Achilles tendonitis can occur when a high arch puts tension on the Achilles tendon, the bands that attach at the heel and foot bones. Wearing low-heeled shoes with a supportive arch can help stabilize the heel. In some cases shoe inserts or a compression sleeve may help ease the condition.

Excessive pressure may result in Morton’s neuroma, a compression of the nerve between the third and fourth toe. While the enlargement is usually benign, it can cause significant pain and may require removal.

Flatfoot is an acquired condition in adults can be related to arthritis, and can result from either a stretched or torn Achilles tendon or calf muscle. Physical therapy, shoe inserts or bracing may help relieve symptoms. “The focus is on pain and function when determining treatment,” Catalano says. “Pain shouldn’t be a consistent state.”

Foot cramps often result from dehydration or deficiency in potassium or magnesium. Muscular fatigue or vascular problems could be contributing factors, too, says Catalano. Eating a banana before exercising, drinking plenty of water throughout the day, and stretching feet and calves before bedtime help alleviate the problem.

Catalano cautions against going barefoot outdoors; Campbell suggests not going barefoot at all. Both recommend shoes that provide proper support, using either over-the-counter shoe inserts or prescription orthotics if needed. You should also apply sunscreen to the tops of your feet when wearing sandals and moisturize them daily.

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