Jefferson University Hospitals

Frequently Asked Questions

About 75 percent of Americans have foot problems at some point during their lives. A complex structure of 26 bones, 40 joints, and an intricate maze of tendons, muscles, and ligaments, the average foot endures remarkable stresses throughout a lifetime. Yet, as much as we use our feet, we often take them for granted.

Although most foot problems are not life threatening, their presence can spoil many of life's enjoyable activities.

What are the common foot problems?

Many foot problems can be corrected by modifying shoes, by medication, or through a simple procedure to relieve pain and suffering. Some common foot problems are listed below.

  • Bunions
    Bunions are swellings or enlargements that develop at the joint of the big toe where it meets the foot. Women develop bunions about 10 times as often as men, and the prevalence of bunions increases with age. Left untreated, bunions may lead to bursitis (inflammation of the sac that cushions the joint), pressure and foot pain. Changing the type of shoe to accommodate the bunion will usually reduce pain. If this doesn't work, surgery may help.
  • Corns and calluses
    Thickened and hardened patches of dead skin cells, these cause pain as they transmit pressure to the bones of the feet. Corns usually develop on the toes, while calluses are more likely to occur on the soles. 
  • Diabetes
    People with diabetes are particularly prone to foot problems because of nerve damage associated with the disease. Pressure sores or infections often occur in people with diabetes. Because diabetes may impair the sense of feeling in the feet, people with this illness need to be particularly vigilant about foot care. Sores and infections may take much longer to heal, so any cuts should receive immediate medical attention.
  • Fallen arches (flat feet)
    This is a condition in which the arch of the foot has dropped, causing muscle fatigue and aching, pain or stiffness in the feet, legs and lower back. Custom-designed orthotics may be prescribed to alleviate the problem. Sometimes, surgery is indicated.
  • Fungal and bacterial conditions
    Athlete's foot and similar conditions can cause redness, peeling, blisters and itching of the skin. If not treated promptly, these can become chronic and difficult to cure.
  • Hammertoes
    A hammertoe is a painful deformation of the toe joint in which the toe curls downward, resembling a claw. Pain occurs on the top of the middle joint of the toe. Roomier shoes, splints, exercises and orthotic devices can alleviate pain. In more severe cases, surgery can provide relief.
  • Heel pain
    Pain occurring around the heel can often be attributed to nerve compression or inflammation of the tissues attached to the heel bone. Wearing well-fitted shoes, using orthotic devices or casts, stretching exercises, prescribed medications and, in severe cases, surgery, are all methods used to correct this problem.
  • Ingrown toenails
    The result of poor trimming of the nails or pressure from a nail deformity, ingrown toenails can cause infection and disabling pain. Once infected, they require medical attention.
  • Morton's neuroma
    This condition is the inflammation of a nerve in the ball of the foot. Pain sometimes extends toward the tip of the toe or to the ankle and lower leg. Your doctor may suggest roomier shoes, shoe pads, or cortisone injections. If these treatments don't work, surgery may be recommended.
  • Ankle sprains
    Patients can frequently injure the ligaments of their ankles with simple twisting injuries. About 23,000 ankle sprains occur daily in the United States. Most of these improve by themselves when treated with rest, ice compression and elevation. Some patients will need to see their physician for additional treatment, bracing or a physical therapy prescription. Sometimes, patients with chronic ankle sprains, or pain which does not improve with physical therapy or conservative treatment, may require operative intervention. This may incorporate arthroscopic procedures
    or open procedures.
  • Arthritis of the foot and ankle
    Arthritis can affect any joint of the foot and ankle just as it affects the larger joints throughout the body. Forms of arthritis include inherited, traumatic, overuse and inflammatory. These can be treated with medication, modified shoe wear and physical therapy. Arthritic conditions of the foot and ankle may require operative intervention involving arthrodesis, also known as fusion, in which joints are screwed together. Arthrodesis is often performed to relieve pain and improve function. Ankle replacement surgery is a new and potentially promising form of therapy for patients with ankle arthritis.
  • Plantar warts
    These are viral skin infections found on the soles of the feet. Plantar warts require medical attention.

Who treats foot problems?

Orthopaedic surgeons are medical doctors who have received additional, specialized training to treat the bony structures of the body. You should see an orthopaedic surgeon to treat more complex foot and ankle problems. Orthopaedic surgeons specialize in Foot and Ankle Surgery. Doctors of podiatric medicine, or podiatrists, are medically trained specialists who diagnose and treat problems and diseases of the foot, ankle and lower extremities. They are recognized legally and professionally as full members of the health care team. Podiatrists can correct most minor foot and ankle problems.

People with diabetes are nearly three times as likely to have a stroke than someone who does not have the disease. This increased risk may be due to some of the same complications that result from diabetes are also associated with stroke.

What is a stroke?

Stroke is a medical emergency, just like a heart attack. That's why experts in the field now refer to it as a "brain attack." Strokes result from a sudden decrease in the flow of blood to parts of the brain. When blood can't reach the brain, its cells are deprived of oxygen and die, so functions normally controlled by the damaged brain areas are impaired. Among the possible effects are temporary or permanent paralysis of various parts of the body or impaired speech or vision.

What is diabetes?

Diabetes is a disease which affects a person's ability to move blood sugar (or glucose) out of the blood and into the cells – where it is used as the body's primary source of fuel.

There are two types of diabetes:

  • Insulin dependent (Type 1) – found in childhood and is characterized by the body's inability to produce enough insulin, which is a hormone that permits the body to metabolize blood sugar (glucose).
  • Non-Insulin dependent (Type 2) – more common type of diabetes that makes up over 90 percent of all diabetes cases. It usually develops in adulthood and may go unnoticed for some time. The body is able to produce insulin, but tissues develop a resistance to its actions and blood sugar levels rise above normal.

Why is there a link between stroke and diabetes?

There are a number of risk factors that increase the chance of vascular complications in individuals with diabetes. At the top of this list is high blood pressure.

Hypertension is twice as likely among patients with diabetes. This contributes to a higher stroke risk, and can lead to a stroke from a blood clot or hemorrhage.

Heart disease is another common problem that can result in higher stroke risk among patients with diabetes. Myocardial infarction (heart attack) and atrial fibrillation (irregular beating pattern) are common and increase stroke risk.

Brain damage may be more severe and extensive if blood sugar is high when a stroke happens. Careful regulation of blood sugar, either with insulin or oral blood sugar-lowering drugs, can reduce vascular complications.

What is the treatment for diabetes?

Both types of diabetes can be controlled, reducing the risk of long-term health complications such as stroke. Type I is treated closely by monitoring blood sugar and taking daily insulin injections. Type II, which is worsened by obesity, can frequently be controlled through weight loss, dietary changes and exercise. Daily insulin injections are not usually necessary and are reserved as a last resort.

For an appointment with a Jefferson physician, more information or health information and education programs, please call 1-800-JEFF-NOW (1-800-533-3669).

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