During pregnancy, it's not uncommon for women to experience an array of aches and pains all over the body. Among these complaints are tired, swollen, achy feet - a common and painful symptom experienced by mothers-to-be during their nine months of pregnancy.
One of the most common foot problems to occur during pregnancy is swelling, or edema, which results from an extra accumulation of blood. The natural weight gain and enlarging uterus puts pressure on the veins that lead to the legs, causing circulation to slow down and increasing fluid retention. The legs and feet may become swollen, making shoes tight, and in some cases causing pain and discomfort. Slight swelling during pregnancy is normal and usually subsides after giving birth. Women should pay close attention to edema symptoms. Swelling to the face or a sudden onset of swelling could be a sign of a more serious condition called preeclampsia and should be reported immediately.
Another troubling foot problem that can occur during pregnancy is over-pronation (flat feet) which is caused when a person's arch flattens out upon weight bearing causing the feet to turn in abnormally. This condition develops when the dense band of tissue in the arch of the foot called the plantar fascia becomes strained and inflamed due to increased flattening of the feet. Over-pronation is common in pregnancy due to the increased weight gain which stresses the feet and flattens the arches. Walking can become very painful, and women may experience increased discomfort and strain on the feet, calves and back.
There are various remedies available to help minimize and alleviate foot pain during pregnancy.
- Take short breaks during the day and elevate your feet to relieve pressure and swelling.
- Drink plenty of water.
- Wear shoes that are soft, comfortable and give your feet room to move.
- Wear seamless socks that do not constrict circulation.
- Exercise or walk regularly to promote overall health.
- Stretch legs frequently and avoid crossing your legs when sitting.
- To prevent arch pain, stretch daily, avoid going barefoot and wear supportive low-heeled shoes.
When foot pain persists, visit your podiatrist. We'll work with you to find the best treatments for your foot pain. Pregnancy and pending motherhood should be a pleasant, enjoyable experience. Understanding the causes of foot pain and learning easy home remedies can help women step more comfortably throughout these special nine months.
Plantar warts are benign growths that develop on the bottom of your feet, and are caused by direct contact with the human papilloma virus (HPV). This is the same virus that causes warts on other areas of the body. Some people are more susceptible than others to HPV, and not everyone will develop plantar warts if they come into contact with the virus. Individuals with weak immune systems or damaged skin on the feet are at a higher risk for plantar warts.
Plantar warts most often develop on the weight-bearing areas of the foot - the heel or the ball of the foot - causing sharp, burning pain. They can appear as a single wart (solitary) or a cluster of warts (mosaic). Common symptoms may include:
- Pain or discomfort when walking or standing
- Thick, scaly skin that often resembles a callus
- Hard, flat growths with well-defined boundaries
- Tiny black specks (clotted blood vessels) that often appear on the surface of the wart
Most warts disappear with home care and do not require medical treatment. You can take steps to prevent and treat plantar warts, which include:
- Changing your shoes and socks daily
- Keeping your feet clean and dry
- Avoid picking at warts as the virus may spread
- Avoid direct contact with an individual who has plantar warts
- Checking your child's feet periodically
- Refrain from walking barefoot, especially in public areas like showers, swimming pools and locker rooms
- Never ignore skin growths or changes in your skin
You should always seek care from a podiatrist when warts interfere with your daily life, aren't responding to home treatments, or if you have circulatory disorders. Contact us if your warts:
- Change color or shape
- Cause unbearable pain and discomfort
- Interfere with activities
- Multiply or reappear
Without treatment, plantar warts can grow, spread and prompt new warts to grow as fast as the old ones disappear. If you can't confidently identify a growth on your foot, visit your podiatrist to ensure a correct diagnosis. Early diagnosis and treatment can decrease the risk of the wart spreading and multiplying.
Why Are My Feet Swollen?
There are a number of causes of swelling in the feet and legs and many of them are not as bad as you might think. The most common causes of swelling are chronic health issues and, if treated correction, the swelling doesn’t pose a serious health risk. The most common causes of swelling in the feet and legs are peripheral vascular disease (PVD)/ varicose veins, water retention due to kidney issues, congestive heart failure, arthritis, tendinitis, chronic joint diseases (such as rheumatoid arthritis), injuries and surgery.
The vein network in the lower leg, ankle and foot is unique and works differently than other parts of the body. This anatomic difference, along with gravity, is the cause of many of the types of swelling. This difference is in the system which returns blood to the heart. There are two systems of veins that return blood to the heart: the superficial and deep systems. In the rest of the body, the deep vein system is the main way the blood is returned, but below the knee it is the superficial system (the veins that are visible). Inside these veins are valves, which keep blood from flowing backward due to gravity. The valves are vital to the proper function of the veins. This different pathway of blood return is central to the problem of swelling in the foot and ankle and when there is damage to these veins the result is peripheral vascular disease (PVD).
The most common cause of swelling in the feet and legs is peripheral vascular disease (PVD). The most common cause of PVD is high blood pressure over the course of several years. A chronic increase in blood pressure causes damage to the arteries and veins, leading to thickening and hardening of the walls of the arteries and damage to the valves in the veins. Hardening of the arteries is called atherosclerosis and creates increased pressure on the veins, which causes them to dilate (swell). When the veins dilate, the valves inside of them no longer work correctly. This causes pooling of blood in the legs and feet, leading to chronic swelling. Varicose veins result from this chronic pressure.
If severe and untreated, chronic swelling in the legs and feet due to PVD can cause issues, including venous stasis dermatitis (which is a rash) and venous ulceration (which is an open wound on the leg). The first line of treatment, and often the best, is compression stockings, which help create pressure against the dilated veins to help them do their job better, clearing out the chronic swelling. There are some procedures, which are performed by a vascular surgeon, which can help with severe PVD including scerlosing injections and laser vein ablation. These procedures can help improve chronic swelling due to PVD.
Water retention is another common cause of chronic swelling in the legs and feet. This condition is usually due to kidney issues. The kidneys are responsible for removing wastes from the body, but also serve an important function in regulating the amount of fluid in the body. When the kidneys are not functioning as they should, too much fluid is retained in the body. The body’s response to this is to deposit the fluid in the legs to get it out of the blood stream. The swelling that results is called “pitting edema”, and this name is given because when the skin is pressed with a finger, a dent will stay in the skin for a few seconds, creating a “pit”. The treatment for this type of swelling is aimed at helping the kidneys function better to remove the fluid. Compression stockings are also helpful. A kidney specialist (nephrologist) is an important part of the process for best results.
Congestive heart failure is another common cause of leg and foot swelling. This is caused by a variety of factors, many of which are genetic but high blood pressure plays a big role as well. In congestive heart failure, as in kidney disease, there is too much fluid in the blood stream and so it is deposited in the legs and feet to get rid of it. This kind of swelling is also “pitting edema”. Treatment is very important and a cardiologist is the right specialist to handle this type of condition. Compression stockings can also be helpful in this case but care must be taken to use them under the supervision of a cardiologist.
Chronic joint and tendon problems can also lead to swelling in the feet and legs. This can be a chronic or acute condition. One of the big hallmarks of arthritis in all its forms (osteoarthritis, rheumatoid arthritis, psoriatic arthritis, reactive arthritis) is swelling around the affected joint. Swelling in these cases is caused by the inflammatory process, which your body uses as a defense mechanism, much like during a fever during a viral illness. The problem in arthritis is that the inflammatory process is trigged by a misinterpretation by your body of a disease, especially in cases such as rheumatoid arthritis, where the immune system tells the brain that normal parts of the joints are foreign invaders and must be killed. Rheumatoid arthritis is an example of an autoimmune disease, meaning that the immune system attacks the body’s normal tissues because it is confused and thinks they are going to hurt the body. Other examples of autoimmune diseases are Psoriasis, Crohn’s disease, Lupus and Parkinson’s disease.
Both Psoriasis and Crohn’s disease are ones that can cause chronic swelling in the feet and legs. In Psoriasis, the body attacks the skin, but it can also attack the joints of the foot, most commonly the toe joints and cause a “sausage digit”, which as the name sounds is severe swelling in the toes. Swelling due to Crohn’s disease is known as reactive arthritis. The immune system in this case attacks the intestines but can also cause chronic arthritis, leading to swelling.
Injuries and surgery to the foot and ankle can cause significant swelling during the initial (acute) phase. Swelling in these cases is usually accompanied by bruising, pain and inability to walk. Much to the chagrin of most people, the swelling is usually the last symptom to go away when the injury or surgery is healed. The bones and/or ligaments and tendons heal but the swelling remains. Veins die, are reabsorbed and re-grow constantly in the body as part of normal maintenance. When many are disrupted as part of the injury or surgical process, the vein network must be repaired and this takes on average 6 months to return to normal. Swelling in this case, in the absence of pain, is not something to be concerned about and will resolve in almost all cases.
No matter the cause, new swelling should be investigated to find the underlying cause. If properly treated, all forms of swelling can be improved.
The doctors at Advanced Foot and Ankle Center have comprehensive training in all forms of foot and ankle conditions and are here to serve you. Please call with any questions you may have.
Eric Silvers, DPM
Christopher WItt, DPM
Heel pain is most often caused by plantar fasciitis, an inflammation of the long, dense band of connective tissue (the plantar fascia) that runs from the heel to the ball of the foot.
Repeated strain on the plantar fascia can cause tiny tears in the ligament. As tension and tearing increases, so does inflammation and irritation of the affected area. Risk factors of plantar fasciitis include foot arch problems (flat foot and high arches); excess weight; running; and a tight Achilles tendon.
The most common symptom of plantar fasciitis is gradually developing pain on the bottom of the heel. The pain is usually worst in the morning and after sitting or standing for a long period of time. For some, the pain subsides after walking or stretching.
To reduce pain associated with plantar fasciitis:
- Rest. Limit and/or avoid activities that make your heel hurt.
- Ice. Reduce pain and swelling by icing the affected area each day.
- Stretch. Stretch your heel throughout the day, especially when you first wake up in the morning.
- Footwear modifications. Wear shoes that provide good arch support and a cushioned sole. Ask your podiatrist about pads and shoe inserts to relieve your heel pain.
When conservative treatments aren't effective, or your pain persists for more than a few weeks, schedule an appointment to discuss your symptoms and treatment options. A podiatrist can recommend an appropriate treatment plan for your individual needs. This may include stretching exercises, shoe padding, orthotic devices, night splints or therapy. Most patients respond to non-surgical treatments, but for pain that won't go away, surgery may be required.
With proper rest and treatment, recovering from plantar fasciitis can take just a few months. Visit us when you first experience pain for a diagnosis and an appropriate treatment plan for your individual needs.
Toenail fungus is a common problem and can happen to anyone. It is characterized by thickness, discoloration, darkness, brittleness and/or flaking of the nails and the big and little toes are most commonly involved. These issues can become worse over time if not treated and can lead to a fungal infection of the skin as well (athlete’s foot).
Fungus is a slow growing organism that thrives in a warm, moist and dark environment and shoes, especially closed toed shoes, are a perfect place for it to reproduce. Most people with a healthy immune system fight off fungus and prevent infection of the nails. However, people with a compromised immune system, such as those with diabetes, HIV, poor circulation, cancer and those taking certain medications, are at increased risk for nail fungus.
The most common cause of contracting fungus is from trauma to the nails, which opens an avenue for fungus to get in. This doesn’t have to be from dropping something on the toe. It can be from repetitive small traumas, such as wearing tight shoes, certain walking patterns that increase the pressure on the big toenail and pedicures. The fungus lives deep at the base of the nail and infects the nail as it grows out making it necessary for treatment to get deep to the root.
Fighting toenail fungus has proven very difficult. It is hard to contract, but once fungus gets inside it is very difficult to get rid of. However, there is hope. There are many treatments available, including over the counter and prescription topical medications, prescription oral medications, laser therapy and total removal of the toenail. Each of these treatments can be effective against nail fungus depending upon the type of and severity of the fungal infection. Having your nails evaluated by a podiatrist is important to select the proper treatment for you.
Topical medications have been shown to be effective in fighting nails that are partially or more superficially infected. There are prescription nail polishes and creams that can help slow the growth of the fungus and improve the health of the nail. Topical medications are advantageous because there are little to no side effects or risks.
Oral medications are very effective in treating nail fungus and the most common one used is Lamisil. Lamisil has been shown to be very effective in treating more severe types of nail fungus, where the entire nail is involved and the infection has been present for a long period of time. Lamisil does carry risks of liver damage, however, and patients must be closely monitored.
Laser therapy is a relatively recent treatment for nail fungus but has been proven effective. The laser kills the fungus using light waves that destabilizes its ability to live and reproduce. The laser therapy is painless, is fast to administer, and has similar effectiveness to other treatments. This modern technology has helped many patients without the health risks associated with other nail fungus treatments.
With all treatments for nail fungus, patience is a virtue. It takes 9 months to a year for the nail to see full resolution of the fungus, because it takes that long for the nail to grow from the root all the way out to the end. It is similar to dying your hair and waiting for it to grow out. The nail is damaged by the fungus and that damaged nail must grow off and new healthy nail replace it.
The doctors at Advanced Foot and Ankle Center have significant experience in all forms of treatment for toenail fungus. Call for an appointment today!
Eric Silvers, DPM
Dustin Lloyd, DPM
Christopher WItt, DPM
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