Cold or Warm Therapy: What's Better For Your Feet?

January 29, 2020

What’s hotter right now? Warm or cold therapy.

Each of the two methods have their places in treating foot pain and conditions, although the two serve different purposes. By cold therapy, we mean applying something cold – an ice pack, for example – to an area. Similarly, using warm therapy means applying heat to an area through a towel or a hot tub.

Generally, cold therapy should be used for acute injuries and foot pain as ice constricts blood vessels and swelling. Heat has the opposite effect. Applying heat to an area increases blood flow and relaxes the muscles and encourages an extended range of motion. As such, muscle soreness or tightness may benefit from warmth, rather than cold therapy.

Cold therapy

Cold therapy works best on acute injuries and intense foot pain. Why? Because cold therapy helps restrict blood flow to the area, thus reducing swelling which can aid in normal mobility and joint motion. Additionally, cold therapy numbs sensory fibres which reduces the immediate pain and offers you relief. Finally, restricting blood flow to the area means reduced blood loss after an acute injury, such as a twisted ankle.

Apply cold therapy by doing one of the following:

Ice baths
Gel packs
Frozen water bottles (for Morton’s neuroma and plantar fasciitis)
Cryotherapy
Cold shower
Cold therapy socks

As a general rule of thumb, you should never apply heat or cold directly to the skin. Instead, use a towel or an intermediary to protect your skin. For example, freezing a water bottle and using that on your feet is better than applying ice directly to your skin.

Use ice packs for 5-10 minutes, or however long you see fit depending on feel. Other methods, like a cold shower, can be used for more minor pain, and can be shorter.

Let’s use a case example to illustrate how cold therapy can help keep your feet feeling their best. Many people are diagnosed with plantar fasciitis, which is characterized by inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. This often causes intense pain, especially early in the morning when muscles are tense. The inflammation may be the result of overuse – as is the case with runners – or because your overweight, or over-stretched the area causing micro-tears in the tissue.

As a form of treatment, you can use a frozen water bottle as a form of cold therapy for plantar fasciitis. Icing the area this way reduces pain because it numbs the area, and helps in recovery because ice reduces swelling. However, icing can be part of a greater treatment plan known as RICE – recovery, icing, compression, and elevation.

Those who suffer from metatarsalgia, which refers to any pain found in the ball of the foot, where the metatarsals of the foot lie, may also benefit from cold therapy for the same reasons. Interestingly, both warm and cold therapy

Warm therapy

Warm therapy is best for chronic injuries characterized by soreness, tension, and dull pain. Why? Heat therapy improves blood circulation, as it expands blood vessels. Heat therapy also relaxes muscle fibres, increasing mobility. That’s why, for example, when you do hot yoga, you may feel more flexible than a regular session.

Additionally, warm therapy encourages the healing of damaged tissue as blood vessels of the muscles to dilate, which increases the flow of oxygen and nutrients to the muscles.

So, heat therapy is particularly useful for people suffering from arthritis, muscle stiffness and soreness, and chronic aches and pain.

A variety of methods encompass warm therapy including:

Hot tub/bath
Hot towel
Sauna

Heat therapy has become increasingly popular in recent years, especially among athletes. Author Alex Hutchinson has written extensively about the benefits of both heat and cold therapy for Outside. In one research-backed article, Hutchinson notes that “eight weeks of hot-tubbing produces really profound changes in markers of cardiovascular health like blood pressure and artery stiffness, perhaps due to increased blood flow when you’re hot.”

Warm + cold therapy together

There is also a warm-cold method that has been popularized in recent years, although evidence of its effectiveness is relatively unknown. According to the University of Michigan Medicine Department, alternating between warm and cold therapy creates a kind of pump. “Heat causes blood vessels to get bigger and cold causes them to get smaller,” they write. “Alternating between heat and cold means the blood vessels alternate between bigger and smaller. This change in blood movement could help reduce inflammation and swelling, and that could improve range of motion in the joint.”

To alternate between warm and cold, you can try contrast baths. This is how to do it:

Submerge your limb in a bucket of ice-cold water (as cold as can be tolerated) for about two minutes.
The limb is then moved into a second bucket filled with lukewarm (not hot) water, around (40°C), for 30 seconds.

Beyond basic, do-it-at-home treatment, if you continue to experience pain in your feet, book an appointment to see a licensed chiropodist. You can book an appointment below or by calling us at 416.769.3338(FEET).

Here’s to Many More Years of Foot Care!

At Feet First Clinic, we’re always excited to welcome new clients! After a successful 12 years of treating our amazing patients, we’re ready to continue offering only the best foot care services and products. Give us a call to ask our friendly staff any questions you may have! Our Toronto foot specialists are ready to help!

Call us at 416-769-3338 or Book Your Assessment Today!

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April 3, 2023

Foot Pain: Causes and Treatment

Are your feet giving you a hard time? Foot pain can have many causes, including injury, overuse, medical conditions, and poor footwear. The underlying cause will dictate how to treat your foot pain, which can include anything from supportive footwear, to stretching exercises, to rest, to medication. In this article, we'll go through six common causes of foot pain and how to treat them: Plantar Fasciitis Achilles Tendonitis Bunions Ingrown Toenails Osteoarthritis Plantar fasciitis Causes Plantar fasciitis occurs when the plantar fascia (the band of tissue that connects the heel bone to the toes) becomes inflamed. It is caused by inadequate arch support or overexerting the plantar fascia. For instance, poorly constructed shoes, obesity and pregnancy, high-impact activity, and long periods of standing (like if you have a standing desk or work in a standing-first occupation) cause strain on the plantar fascia. Treatment Plantar fasciitis treatment involves rest and recovery, which should be the first course of action. Then physical therapy, like massaging your arch and stretching and strengthening exercises, are effective. Additional treatment methods include shockwave therapy, taping, wearing a splint or boot cast, and custom orthotics designed to provide additional arch support. Read more: See our complete guide on plantar fasciitis. Achilles tendonitis Causes Achilles tendonitis is an injury to the Achilles tendon, the part of the leg that connects the calf to the heel bone. It is usually caused by overuse. Overworking the Achilles heel is done through various avenues. The most common causes include overexercising, weight gain, joint disorders like rheumatoid or psoriatic arthritis, bursitis, a sudden fall or past trauma, and biomechanical abnormalities. Treatment Within 72 hours of injury, the first form of treatment you should pursue is rest and recovery. Good R&R prevents aggravation and stops the condition from worsening at its most vulnerable. Once you remove the cause, effective treatment methods include shockwave therapy, strengthening and stretching exercises (see our how-to), custom orthotics, and anti-inflammatories. Read more: See our complete guide on Achilles tendonitis. Bunions Causes Bunions are a type of joint deformity where the base of the big toe shifts outwards. There is a combination of factors that can either cause, directly or indirectly, bunions. Genetics (namely foot shape or joint-related), tight footwear or high heels, flat arches, and activities that stress the toe base (like running or ballet) can lead to bunions. Treatment Treatment options include footwear modification, anti-inflammatories, bunion splints, bunion aligners, taping, shoe stretching, orthotics, shockwave therapy, and surgery. Note that bunions are progressive, meaning non-invasive treatment focuses on preservation rather than reversing damage already done. Surgery is an option if you'd like to remove the bunion. Read more: See our complete guide on bunions. Ingrown toenails Causes Ingrown toenails occur when the edges of the toenail grow into the skin, causing pain and swelling. Ingrown toenails can be caused by: Cutting the nail too short or too far down along the edges Poorly fitted shoes. Injury to the nail bed. A genetic disposition to ingrown toenails. Treatment In some cases, you can treat ingrown toenails at home; otherwise a foot specialist can treat the condition. To treat your ingrown toenail at home, soak your foot daily in warm water with Epson salts, massage the skin at the edges of the nail, wear shoes with a wide toe box, and let the toenail grow out. When it does, cut the nail straight across. Never try to cut out your own ingrown toenail as this can lead to infection. If the toenail doesn't improve within 3–5 days, it's time to call the foot specialist. A foot specialist can safely treat ingrown toenails at any stage. In-office ingrown toenail treatment includes antibiotics, softening the skin around the nail, removing or cutting open the area to drain pus, Onyfix nail correction system, partial or complete nail avulsion, phenol, or surgery. Read more: See our complete guide on ingrown toenails. Osteoarthritis Causes Osteoarthritis is the most common form of arthritis and is caused by wear-and-tear of the cartilage between the joints. Getting old is the most common cause of osteoarthritis. Our joints get more mileage as we age and eventually wear down. Low bone density (for instance, in post-menopausal women) can also lead to osteoporosis, contributing to osteoarthritis (it would be like having defective brake pads). Additionally, unhealed trauma or injury, weakened deconditioned muscles, sudden weight gain, and biomechanical abnormalities like hammer toes or bunions can all lead to osteoarthritis. Treatment Treatment of osteoarthritis focuses on management, as it's a progressive condition. Physiotherapy, stretching, and light exercise to strengthen the muscles in the lower body is vital for managing osteoarthritis symptoms and preventing the condition from worsening. This can be done in conjunction with proper footwear and medication like anti-inflammatories. Custom orthotics can also help by effectively rebalance the weight distribution across your feet while adding support. Read more: See our complete guide on osteoarthritis.

March 2, 2023

The Role of Chiropodists in Preventing and Treating Foot Injuries

Many different foot issues fall under the "foot injuries" umbrella. From sprains and broken bones that leave you bedridden to overuse injuries that make your days more painful, it would take a full day to discuss every foot injury in detail! That's why we're aiming to give this article a positive spin by switching the focus to treatment and how a chiropodist can help you. But first, it's important to discern between the two types of injuries and how the type you have will determine your approach to treatment. Today's blog will discuss the following: What are some common foot injuries? Examples of overuse injuries Examples of acute injuries How do chiropodists treat and prevent foot injuries? What Are Some Common Foot Injuries? When discussing foot injury treatment, it's important to distinguish the cause of the injury and whether or not sudden, acute pain is present. Some injuries cause everyday pain flair-ups that can be a real nuisance but aren't enough to make you feel like you must go to the hospital. These are "overuse" injuries because they stem from straining your muscles and joints and withstanding repetitive, mild trauma. These injuries arise when we exert intense physical activity too quickly without proper stretching, exercising and footwear. However, you don't have to be an athlete to succumb to an overuse injury; you can also develop one due to wearing ill-fitting, unsupportive shoes while working on your feet all day. On the other hand, some injuries are sudden and result from a fall or misstep. They can also result from the blunt impact of an object falling on your foot. These are often more debilitating in the days that follow the injury. Examples of Overuse / "Everyday" Foot Injuries Achilles Tendonitis: Occurs due to Achilles tendon inflammation (connects your heel and calf along the back of the foot). Plantar Fasciitis: Inflammation of the thick band of tissue that runs along the bottom of the foot (plantar fascia). Often caused by overuse, poor footwear choices and repeated walking on hard surfaces. Morton's Neuroma: Results from the irritation and thickening of the tissues surrounding the nerves that lead to your toes. Patients notice pain in the ball of the foot. Shin splints: Pain along the shin bone caused by overworking muscles, tendons and bone tissues, commonly found in athletes and dancers. Heel spurs: A calcium deposit that causes a bony protrusion underneath the heel bone. They may be painless or cause sporadic heel pain. Capsulitis (big toe or second toe): Joint inflammation in the area where the toe's base meets the foot's ball. Stress Fractures: Tiny cracks in the weight-bearing bones of the lower leg and foot due to overuse and playing sports with excessive jumping and running. Examples of Sudden (Acute) Foot Injuries Ankle sprains Broken bones in the foot due to blunt force trauma Bruises(contusions) Puncture wounds Ruptured tendons How Do Chiropodists Treat and Prevent Foot Injuries? Overuse / Everyday Injuries Treatment and Prevention Chiropodists are known for successfully treating and preventing overuse injuries. They pride themselves on giving patients the tools to manage pain and improve their quality of life. Some of the most effective services include: Custom orthotic fittings Recommending exercises and stretches Shockwave therapy Footwear modification guidance Periodic foot assessments Custom Orthotic Fittings These inserts fit into virtually all of your footwear, help stabilize your feet and ankles, and take the stress off the weight-bearing areas of the feet. They are one of the most multi-purposeful medical devices for foot injury recovery and can aid almost every foot condition. The goal is to use your foot as the blueprint to create the perfect pair of orthotics that keep your foot in the ideal position for healing and pain management. Recommending Exercises and Stretches for Target Muscles, Tendons, Ligaments and Joints Feet First Clinic's Pinterest Board has several options for stretches that help with plantar fasciitis, Achilles tendonitis, ankle strengthening, and much more. These routines are also tools you can use to strengthen your foot, protecting you from a future overuse or sudden injury. These stretches and exercises also fit nicely into your foot care regimen! Shockwave Therapy This modern and non-invasive therapy treats soft tissue injuries like Achilles tendonitis, plantar fasciitis, Morton's neuroma and muscle strain. After thorough preparation, a chiropodist uses an applicator to deliver energy pulses to the affected areas. It is a quick, pain-free treatment lasting only 5-20 minutes. Footwear Modification Guidance Chiropodists have a keen sense of what shoes to recommend depending on individual needs. A shoe fitting at a foot clinic keeps you from developing an overuse injury and can help in the rehabilitation phase of a more severe injury. Periodic Foot Assessments A foot assessment is like a full body physical that focuses solely on your feet. Likewise, you will need updates on how your overuse or acute injury is recovering and if your progress is continuing along nicely. For those without glaring foot issues, a foot assessment is recommended once per year. If you have a healing injury, you should see your chiropodist for an assessment every six months or less, depending on your situation. Sudden Foot Injuries Treatment and Prevention Now let's get into the more debilitating foot injuries. First and foremost, you shouldn't immediately see your chiropodist after experiencing a blunt form trauma injury, sudden ankle sprain or any other type of acutely painful accident. On the day you sustain such an injury (and the immediate days that follow), you may have to get MRIs or X-ray images in addition to crutches or a physical exam from a physician. You should then practice the R.I.C.E (rest, ice, compression, elevation) method from home while you take it easy and avoid walking. However, chiropodists can help immensely with injury recovery after the acute pain phase passes. Chiropody treatment for ankle injuries like sprains or broken bones in the foot typically occurs during rehabilitation or when the patient has begun healing and needs to regain control of their motion via therapeutic intervention. To learn what treatment methods are available, you can simply revert to our list for overuse injuries. You can also use the preventative measures we've already mentioned, but we have a few additional tips worth noting: Reduce your chances of ankle sprains by focusing on stretches that improve ankle flexibility and strength. Watch your step when walking and playing sports to avoid breaking a bone or sustaining a sprain. Wear shoes that offer extra ankle support to avoid sprains. To prevent accidents at home, wear shoes or orthopaedic slippers indoors and take your time walking while tired or impaired for any reason.

February 9, 2023

What is Capsulitis?

Toe pain can be mysterious. There are numerous causes, and sometimes you can live your life assuming you know why it's there, only to be completely wrong! Case in point: a lesser-known toe condition called capsulitis. Capsulitis is an overuse injury that mainly targets the second toe and the surrounding area. Today we'll thoroughly dive into the topic by addressing the following: What is capsulitis? Symptoms of capsulitis Causes of capsulitis Treatment and prevention Complications What is Capsulitis? Capsulitis, also known as frozen toe, hallux rigidus or turf toe, is a foot condition characterized by joint inflammation in the area where the base of the toe meets the ball of the foot. The specific area affected is called a "capsule" and is technically a dense ligament structure found at the base of the joint. According to the American Academy of Orthopaedic Surgeons, capsulitis in the feet usually targets the second toe. However, it can sometimes affect the big toe and the third and fourth toes. Another technical term for capsulitis in the toe is metatarsophalangeal synovitis (MTP joint pain). Healthline also notes that capsulitis is often confused with Morton's Neuroma since pain radiates toward the ball of the foot in both conditions. However, Morton's Neuroma results from compressed nerves and capsulitis from inflammation. A chiropodist can help you tell the difference between the two conditions. Symptoms of Capsulitis Capsulitis often worsens as time progresses. This means that symptoms can vary depending on the stages of development. It's important to be in tune with your foot health and seek help if you notice the following: Pain in the ball of the foot. A persistent feeling that something is "bunched up" in your shoe or the feeling that you're walking on a pebble or marble. Swelling in the base of the affected toe. Discomfort while wearing shoes. Pain that worsens when you're barefoot. Crossover toe: as degradation of the ligament progresses, the joint in the second toe can fail to stabilize (stay in the right position). This can cause your second toe to move towards the big toe and lay on top of it. What are Some Causes of Capsulitis? Capsulitis is technically an overuse injury that targets the ball of the foot. And as with many foot conditions, one issue can often be a risk factor in developing another. The following may lead to capsulitis development: There is a connection between severe bunions and capsulitis. Other prominent foot deformities like hammertoes can also be a risk factor. Both conditions can lead to too much pressure on the ball of the foot and subsequent inflammation. Abnormal foot mechanics can put you at risk. It's important to note that this is not the same as a severe foot deformity. It simply means any mild structural factors that lead to excessive weight-bearing pressure in the ball of the foot underneath the toe. If your second toe is longer than your big toe, you may experience capsulitis. An unstable foot arch, like high arches and flat feet, can contribute to capsulitis. Excessive bending of the toes. This can happen if you wear poorly designed shoes or high heels. Capsulitis Treatment and Prevention It's relatively easy to tackle early-stage toe capsulitis. You can purchase many items from a pharmacy, general store or foot clinic that can relieve the pain. A chiropodist can also use their unique expertise to ensure the condition improves. Here are some effective treatment methods: Ice or heat packs. Compression can help reduce swelling, and applying heat or ice (while resting with your foot elevated) can help with pain management. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Supportive footwear with proper arch support and strong soles. Rocker bottom-sole shoes can be especially helpful as they offset pressure away from the ball of your foot. Custom orthotics can lessen excessive pressure on the weight-bearing foot areas. Toe taping can align the second toe and prevent crossover toe. Complications Unfortunately, if crossover toe is present, it usually means that the second toe will never revert to its natural position without intervention. If this is the case, you may need surgery from a foot and ankle surgeon.

February 6, 2023

Common Foot Conditions in the Elderly and How to Treat Them

Age is just a number, but age starts to catch up with us at a certain point. As much as we want aging to slow, getting older comes with its fair share of aches and pains. Few people age the same; it is a complex process. Environment, genetics, exercise, and many other factors mould who we become as we enter our elderly years. This also applies our feet. As we age, our feet become more susceptible to various conditions such as arthritis, plantar fasciitis, bunions, foot injuries and chronic pain. Our latest blog is all about common foot conditions in the elderly and how to treat them. What happens to our feet as we age? Did you know that when you turn 70, you'll be 25,550 days old? That helps put the body's remarkable ability to withstand constant wear and tear into perspective. Beyond just a number, there are also physiological changes that occur as we age. Your feet may get bigger. Your feet may widen. Muscles, tendons, and ligaments also wear down, putting you at greater risk of certain foot conditions. You may notice you experience foot pain and other problems more often. Any number of the following may happen: Weakness Frailty Exhaustion Gait alteration Balance difficulties Increased swaying while walking Decreased walking Walking speed As we age, it's essential to check how you feel regularly. A bonus would be to have your feet checked regularly. Our team of expert foot specialists can help you manage acute and chronic conditions that affect the toes, feet, and ankles. Most common foot conditions in the elderly Foot conditions amongst the elderly may include bone injuries, toenail damage, foot deformities, and muscle and tendon damage. It's important to note that most of these conditions are not specific to the elderly, but age contributes to increased risk. Below we break down the following common foot conditions in the elderly and how to treat them: Bunions Osteoarthritis Fat Pad Atrophy Thickened or Discoloured Toenails Gout Plantar Fasciitis Stress Fractures 1. Bunions What are bunions? A bunion is a deformity of the first metatarsophalangeal joint ("MTP" joint for short). The first MTP is the joint of the big toe. (Essentially, the big toe's "knuckle.) Damage to this joint can cause bone misalignment over time. Eventually, the bone shifts and protrudes at the base of the big toe. Bunions affect approximately one quarter to one third of adults, and women experience the foot condition more often than men. As we age, bunions worsen. Although there is no "cure" for a progressive foot deformity, you can lessen the effects and pain associated with bunions through several habitual changes. How can I treat bunions? You can choose either invasive treatment or non-invasive bunion treatment. In most cases, you can manage bunions with non-invasive treatments, though surgery is the only way to remove the bump altogether. Footwear modification: Avoid tight shoes that squeeze the toes and ditch your high heels. You may also find that orthopedic shoes that stretch or come in wide widths effectively accommodate your bunion in your footwear. Shoe stretching is also an effective method for changing the structure of your current footwear. Anti-inflammatories: Specific medication like NSAIDs or ibuprofen reduces joint inflammation and relieves pain. Splints/aligners: Medical-grade bunion splints and bunion aligners help stabilize the joint. You can choose from medical-grade plastics or a toe sleeve based on your preferred rigidity. Taping: A specialist tapes the joint to keep the big toe in place, prevent further misalignment, and manage pain and inflammation. Supportive insoles or custom orthotics: Supporting your arches and correcting poor biomechanics can reduce pressure and strain on the first MTP joint. Bunion exercises: Basic exercises to strengthen foot muscles can better support and stabilize the joint, thus decreasing pain over time. The treatments you see above are all available at Feet First Clinic. 2. Osteoarthritis What is osteoarthritis? Osteoarthritis is not only the most common variant of arthritis; it is also one of the most common foot conditions in the elderly. Osteoarthritis is the "wear-and-tear" arthritis that causes degeneration of the cartilage in our joints. Reduced cartilage in our joints causes pain and can lead to other foot conditions like bone spurs. Your toes are most susceptible to osteoarthritis. Age plays a significant role in developing osteoarthritis. Wear and tear of our joints accumulate over time. Also, post-menopausal women risk developing osteoarthritis through osteoporosis (low bone density). How can I treat osteoarthritis? Osteoarthritis is a degenerative condition, meaning what's done cannot reverse. The cartilage in your joints doesn't re-grow, so treatment aims to slow the effects of osteoarthritis and reduce pain. Effective treatment includes a combination of the following: Active rehabilitation: Physiotherapy, massage, and exercise all help reduce the effects of osteoarthritis by promoting solid muscles. Stronger and more balanced muscles and feet reduce the strain on affected areas where you may have osteoarthritis. Medication: Anti-inflammatories can help control inflammation. Proper footwear: Specialized shoes can accommodate deformities of osteoarthritis (like bunions or hallux rigidus). The right shoes or boots can support your feet, provide balance, and offer cushion. Custom orthotics: Orthotics can be customized to add or reduce your reliance on certain parts of your feet. Controlling the impact on affected joints can help prevent further joint damage by distributing the impact and weight elsewhere. Limit awkward movements: If you find your joints are sore after a particular activity, consider reducing, modifying, or stopping the activity. For instance, if lunges hurt your foot, consider finding a replacement exercise. Surgery: If the joint is damaged extensively, a doctor may recommend surgery. Surgery and removing part of a bony outgrowth can be effective if the sheer volume of bone buildup is the culprit. If you experience osteoarthritis and are looking for orthotics, a gait analysis, or proper footwear, visit Feet First Clinic for solutions. 3. Fat pad atrophy What is fat pad atrophy? The heel fat pad is a cushion to absorb shock and distribute plantar force on impact. As we age, the heel fat pad gets atrophies and gets thinner. This can put you at a greater risk of heel injuries and other foot conditions. The increased pressure on the heel can cause you to overcompensate with other parts of your body, and weight distribution becomes unevenly distributed. How can I treat fat pad atrophy? You should reduce the pressure on your heel if you suffer from fat pad atrophy. Custom orthotics are effective as the personalized insoles provide padding and support and help distribute weight across the complex network of foot muscles. Be sure to also wear shoes with lots of padding and cushioning, like the ASICS Gel-Nimbus. 4. Thickened or Discoloured Toenails What are thick or discoloured toenails? Thick toenails and discoloured toenails are a byproduct of aging and are one of the most common foot conditions in the elderly. As we get older, toenail growth declines. As such, nail cells begin to accumulate at a faster rate than nail growth. The accumulation of onychocytes (nail cells) causes thickened toenails. Alternatively, reduced circulation or acute trauma can cause thickened toenails. Discoloured toenails, on the other hand, indicate damage to the nail or nail bed. Acute trauma to the nail causes discolouration, but so does reduced circulation. At an older age, we're at a greater risk of diabetes and peripheral vascular disease. Both diabetes and peripheral vascular disease cause reduced circulation in our feet and discoloured toenails. How can I treat thick or discoloured toenails? Toenail treatment for thickening and discolouration varies. To properly diagnose your feet and nails, book an appointment with a specialist at Feet First Clinic. Our nail care services involve proper trimming and filing of the toenails, addressing any pain or discomfort, and educating patients on proper hygiene and care. For more information, visit our nail care and treatment page. 5. Gout What is gout? Gout is a form of inflammatory arthritis targeting the foot's joints. You may experience intermittent bouts of severe pain, including inflammation and hypersensitivity. During these episodes, any kind of activity becomes challenging, leaving you less mobile. The prevalence of gout increases in older people. Elderly people are susceptible to gout for a few reasons: Renal function declines with age, there can be dietary changes, you may experience sudden weight gain, and certain medications for age-related conditions have indirect side effects that may lead to gout (i.e.: water pills, blood pressure medication). How can I treat gout? Before any treatment, the first step is to see a family doctor and a rheumatologist. Once diagnosed, you may be prescribed the following treatments, all of which aim to prevent future attacks, reduce pain, and improve quality of life: Change your diet: Ditch food containing excessive purines. Avoid foods like red meat, certain types of seafood like sardines and mussels, alcohol, high fructose beverages, and yeast. Diet also impacts your weight. Maintaining a healthy and consistent diet can help reduce sudden weight gain and keep inflammation at bay. NSAIDs: Non-steroidal anti-inflammatory drugs reduce joint inflammation. Alternatively, corticosteroids are an option if one doesn't react to NSAIDs. Stay or become active: Light-strengthening exercises, relaxing physical activity, and physiotherapy can improve quality of life and mobility in people with gout. Keeping your muscles strong also makes them less susceptible to inflammation build-up, which can trigger gout attacks. Supportive footwear: Proper footwear can help you deal with any pain associated with gout as it reduces the impact on the joints. 6. Plantar fasciitis What is plantar fasciitis? Plantar fasciitis is a condition of the heel. The band of tissue on the underside of the foot gets inflamed and causes pain. Often, plantar fasciitis develops gradually over time. Changes in our body as we age can make this condition more common in the elderly. How can I treat plantar fasciitis? With proper care and treatment, most cases of plantar fasciitis heal with time. A foot specialist can guide you through the healing process and provide options for preventing it from recurring in the future. There are several treatment methods available for plantar fasciitis. Rest: Take a break, and let your heel recover by staying off your feet. Supportive footwear: Wearing supportive footwear with strong arch support and a good heel counter is essential for managing and even preventing plantar fasciitis. Stability shoes are particularly helpful. Check out this article for our top recommended shoes for plantar fasciitis. Rolling: Gently massage your heel using a tennis ball or frozen water bottle under the foot. Rolling helps massage and relieve the plantar fascia and encourages faster recovery. Add stretching and strengthening exercises to your routine. Shockwave therapy: Shockwave therapy delivers sound wave pulses to the injured fascia. This triggers your body's the healing process, making for a natural recovery. Shockwave therapy is extremely effective for cases of plantar fasciitis persisting more than 6 months. Taping: Taping the heel engages other muscles and tendons of the foot, reducing the load on the plantar fascia. Wear a splint: A splint helps keep your foot stable while you sleep. Supportive Insoles or Custom Orthotics: A good supportive insole, like Superfeet Green, is tried, tested and true for helping with plantar fasciitis. If that doesn't work, or if there are biomechanical factors contributing to your plantar fasciitis, you can look into custom orthotics. 7. Stress fractures What are stress fractures? Stress fractures are micro-breaks of bones are another common foot condition in the elderly. When we age, bone growth slows, losing more bone than we generate. Our bone density also reduces. If your bone density drops too much, you develop osteoporosis. Weaker bones put the elderly at greater risk of stress fractures, whether acute, like when you fall or by too much repetition, like walking. How can I treat a stress fracture? The RICE method is critical to treating a stress fracture. Rest, ice, compression, and elevation. Untreated stress fractures can lead to bone shift, permanently altering the foot's biomechanics.

December 8, 2022

5 Causes for Numb Feet or Toes

Have you ever felt a prickling, tingling, or pins and needles sensation in your feet? You may be experiencing numbness in your toes. At times, it may even feel like your foot has fallen asleep, which occurs after keeping your foot in the same position for an extended duration. What's happening in your foot and toes when they go numb? The underlying sensation is likely a result of peripheral neuropathy. Peripheral neuropathy is a catch-all term for more than 100 types of peripheral neuropathy. It refers to damage to the nervous system, which hinders the network of nerves that relays information to your brain. There are various reasons why you experience numbness in your feet or your toes. Possible causes may include poor blood circulation or a byproduct of diabetes. The sensation may be numb; in other cases, you may not feel anything since your feet or toes lack feeling. In this article, we outline five potential causes for why your feet or toes may go numb. Frostbite/Frostnip It's no secret that Canada experiences cold winters. Low temperatures and high humidity can make keeping your feet warm and dry difficult. That's why frostnip, and its successor, frostbite, are possible during Canada's winter months. There are various degrees of skin and tissue damage due to cold. They are: Frostnip is a mild cold exposure injury that doesn't cause permanent skin damage. A slight numbing sensation may occur during the frostnip stage and minor (but temporary) nerve damage. Frostnip should subside naturally by escaping the cold and returning to warmer temperatures. Superficial frostbite is the second stage of cold damage to your toes. Your skin may feel warm, and you likely experience a more intense numbing or tingling sensation. Deep frostbite is the third stage and most severe form of cold damage. You may experience total numbness and loss of sensation in your toes. The toe muscles and joints may no longer work, and you're at risk of permanently damaging the skin and nerves in your toes. Blisters form 24-48 hours after exposure. Afterwards, the area may turn black and harden as the tissue dies. It's critical to recognize signs early. If you're outside for extended periods and feel your feet and toes are cold, it's time to head inside. Once you reach the numbing and tingling sensation, the damage begins to occur and will only worsen if not addressed. With minor forms of frostnip, the feeling will return to your feet and toes with no long-term effects. With frostbite, you risk permanent and irreversible damage. Diabetes Diabetes is a severe condition characterized by high blood sugar levels that can lead to blood flow and nerve issues. 3.4 million Canadians, or roughly 8.1% of the population, live with diabetes as of 2017–2018. Regarding the foot, diabetes can complicate the nerves and blood vessels in two ways: Diabetic neuropathy, a common long-term complication of Type-2 diabetes, causes nerve damage, leading to loss of sensation in the legs, feet and toes. A lack or loss of feeling in your feet and toes is dangerous as it can mask injuries, cuts, or other conditions. In peripheral vascular disease, sugar accumulates in the bloodstream and can cause poor blood circulation. Blood vessels can narrow, block, and spasm due to PVD. The best action for diabetes is to monitor your symptoms consistently. Further, a foot specialist can check for adequate circulation, signs of neuropathy, and risk for foot ulcers. Rheumatoid arthritis Both rheumatoid arthritis and rheumatoid vasculitis can cause numbing and tingling in your feet and toes. RA, an autoimmune disease where your immune system mistakenly attacks healthy cells in your body, can affect the nerves in your feet through inflammation and swelling. Similarly, rheumatoid vasculitis targets the blood vessels in the feet, inhibiting their ability to transport blood. Reduced circulation can cause your feet and toes to be numb, creating a tingling sensation. Typically, one develops rheumatoid vasculitis after having RA for some time. Tarsal tunnel syndrome Tarsal tunnel syndrome is an ankle nerve condition that has downstream effects on the feet and toes. Analogous to carpal tunnel syndrome in our hands, tarsal tunnel syndrome occurs when a nerve becomes compressed—specifically, the posterior tibial nerve inside the ankle. The tarsal tunnel itself is a narrow space next to the ankle bones. It's covered with thick ligaments and contains veins, arteries, tendons, and nerves (including the tibial nerve). When the tunnel becomes compressed, so does everything inside. Compression reduces blood circulation and puts pressure on the nerves that connect your feet and toes with the rest of your body. The exact cause of tarsal tunnel syndrome can be tricky. In many cases, it's a variety of factors, including: Flat feet Bone spurs and cysts in the ankle Varicose veins Inflammation Osteoarthritis Tight shoes Acute ankle injuries Tarsal tunnel syndrome symptoms include sharp, shooting pain, pins and needles, or a burning sensation on the inside of your foot, close to where your foot meets your ankle. The numbness may radiate to the toes as well. Morton's neuroma You may suffer from Morton's neuroma if you've ever felt a sensation akin to having a pebble stuck in your shoe. This type of neuroma targets the base of the third and fourth toes. When the muscles and tendons become inflamed, the nerve becomes increasingly compressed, inhibiting its function. You may develop Morton's neuroma with poor biomechanics - namely, overpronation (when your foot rolls too far inwards when walking or running). Biomechanical abnormalities unevenly distribute weight in your feet, adding too much (and too little stress) to certain parts of the foot. Over time, overpronation adds stress to the ball of the foot, causing it to thicken and become inflamed. As such, the foot's nerves can become compressed. High heels (which promote poor biomechanics) are also a common contributing factor to Morton's neuroma. The best course of action to treat Morton's neuroma is for a foot specialist to fit you with proper footwear or custom foot orthotics. Fixing your footwear and correcting your biomechanics will help distribute weight and stress in your feet more evenly. Other causes of numb feet or toes You may experience numb feet or toes for reasons other than those outlined above. For instance, your feet may fall asleep when you are asleep, and as a result, your feet may feel numb upon waking up. Being sedentary and keeping your feet and toes in the same position for extended periods may also create a numbing or tingling sensation. Other, more uncommon causes may include: Charcot-Marie-Tooth disease is a group of conditions that can cause nerve damage. It's genetic, and the mutations in the genes affect the nerves in your feet and the protective coating of your nerves, which can inhibit signals between your feet and brain. Guillain-Barré syndrome is a rare disorder where your immune system attacks your body's nerves. You may experience weakness, tingling, and numbness when it affects your feet. Vasculitis describes inflammation of blood vessels. Most types of vasculitis are rare. Vasculitis can cause a numb sensation in the feet due to a thickening blood vessel wall. As such, the thickening of the vessels can restrict blood flow to the limbs. When in doubt, if you ever feel numb or have a tingling sensation in your feet for abnormal or irregular reasons, contact a professional for a proper diagnosis.

December 5, 2022

5 Reasons Why Your Feet Hurt When Walking

Walking is one of the best forms of exercise. Walking is low-impact; it doesn't require fancy or expensive equipment, helps improve blood flow, and can lower blood pressure, amongst other benefits. Fundamentally, walking is how we get around. Because we rely on this form of movement, we must keep our feet healthy to ensure walking is pain-free. However, the feet are complex, and some foot conditions may make walking painful or uncomfortable. The foot contains more than 25 bones. More broadly, the foot splits into three sections: the toes, the midfoot, and the heel and low ankle. The foot's various bones and muscles need to work in unison. If not, biomechanical abnormalities can cause multiple foot conditions. This article explores five main reasons why your feet hurt when walking. Common foot conditions Plantar fasciitis If you experience pain in the heel of your foot, it could be plantar fasciitis. The plantar fascia is a band of tissue (called the fascia) that runs along the bottom of the foot. The fascia connects the heel of the foot to your toes. Pain when walking would be felt within the bottom of the foot, specifically the underside of your heel. Since most people heel strike (I.e., the first body part to touch the ground), much of the impact of walking or running is in the plantar. The band can tear, swell, and inflame when the plantar fascia becomes overloaded or damaged. Plantar fasciitis develops over time rather than being an acute injury. If recognized early, treatment can be as simple as rest and icing. Early signs and symptoms include a dull pain in the heel of the foot and bottom of the foot pain first thing in the morning. Metatarsalgia Pain in the ball of your foot may be metatarsalgia. The ball of your foot lies between your arch and toes. Metatarsalgia is a condition where the ball of the foot becomes inflamed. It is usually a result of overuse or faulty foot mechanics. Inflammation of the bones and soft tissue follows. Flat feet You may experience pain in the arch of your foot when walking. A common cause of pain when walking is flat feet. Flat feet are not necessarily a condition but rather a biomechanical abnormality which may cause imbalances in the bones and muscles of your feet. Uneven distribution of weight when walking can put added stress on specific parts of the foot. A low or collapsed arch characterizes flat feet. Flat foot disrupts the foot's biomechanics by impeding the arch's ability to properly support our body weight and absorb the force of our movement. The load is then displaced onto the toes, ankles, knees, hips and lower back. As a result, pain can develop in these areas and the feet. Morton's Neuroma You may suffer from Morton's neuroma if you experience pain in the base of your toes. Morton's neuroma is a foot condition that targets the balls of your feet - most often in the area between your third and fourth toes. The foot condition arises when the toe's tissues thicken and swell, eventually leading to inflammation, pain, and a tingling/numbing sensation. A familiar anecdote for Morton's neuroma is akin to having a pebble in your shoe. You may experience pain from Morton's neuroma during walking because of your gait. When walking, you typically land on your heel and take off with your toes and forefoot. Thus, if the pain you experience is more on the "up" than the "down" of how you walk, the underlying condition could be Morton's neuroma. Arthritis You may experience pain anywhere in your foot as a result of arthritis. Arthritis is a broad term that describes a disease known for inflammation (redness, swelling, and pain) in the body's joints. We can break arthritis more broadly into several specific foot conditions. Types of arthritis that may impact your ability to walk and cause pain include: Hallux rigidus: Hallux rigidus is arthritis of the big toe. When one suffers from hallux rigidus, the metatarsophalangeal joint (MTP) stiffens. Over time, arthritis can lead to a bone spur. Osteoarthritis: Osteoarthritis is the most common form of arthritis. Consistent wear and tear over time cause the cartilage between the joints in your body to break down. Rheumatoid arthritis: Rheumatoid arthritis is an auto-immune disease that causes chronic joint inflammation. It commonly targets the small joints in the feet by attacking the tissue and causing inflammation and calcification. The result is stiff joints, chronic pain, and joint dysfunction. Foot pain treatment RICE RICE stands for rest, ice, compression, and elevation. This essential combination of treatments is highly effective against several chronic foot conditions. RICE allows for proper rest and promotes recovery by reducing inflammation and promoting blood flow. Orthotics Custom orthotics are custom-built corrective shoe inserts designed to support the unique structures of our feet. Orthotics act to correct or accommodate biomechanical abnormalities, foot deformities, and a variety of joint and muscle conditions. Orthotics intend to improve your gait, manage pain, and better disperse your body's weight when walking and running. Proper footwear The correct footwear is critical for healthy feet. For instance, proper footwear can provide structure, balance, support, and protection when walking. Ill-fitting shoes are the leading cause of foot pain and problems: according to a study published in the Journal of Foot and Ankle Research in 2018, "Between 63 and 72% of participants were wearing shoes that did not accommodate either width or length dimensions of their feet". A study done amongst older adults in 2020 also found that 90% we wearing shoes with worn-out soles. Visit us at Feet First Clinic for a shoe fitting session and we can help you find footwear perfect for you. Visit our chiropodists Our dedicated licensed chiropodists are committed to providing quality care and services for all your foot and ankle needs. Chiropodists can diagnose, treat and help manage various foot conditions, from callus removal to ingrown toenails to bunions.

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