Help in Halesowen and Stourbridge with Pain in the Ball of the Feet

PLANTAR FAT PAD ATROPHY is a common cause of pain in the BALL OF THE FOOT, due to thinning of the protective fatty cushion located under the heads of the metatarsal bones (the main bones of the foot).

When we walk, we propel ourselves forward through our toes and ball of the foot and at this point our body weight is transferred onto the small metatarsal heads, which are usually well cushioned and protected by this area of fat.  As this pad absorbs the shock instantly, giving the correct amount of cushioning, pain is not normally felt. Reduction of this fat pad can lead to pain, discomfort, ulcers and callus formation.

CAUSES

• Ageing – The supporting adipose (fatty) tissue is reduced. Genetics can play a role in this.
• Metatarsal Head displacement – A displacement of the head of the metatarsal bone can put pressure on the fatty tissue underneath.
• Rheumatoid Arthritis – This can lead to displacement of the fat pad.
• High Arches – Leading to a shortening of the toes and displacement of the fat pad.
• Diabetic Patients – If there is neuropathy present with toe deformity, displacement of the fat pad can occur.
• Neuroma Treatment – After surgery, damage to the fat pad can arise, together with fat pad atrophy resulting from steriod injections.
• General Surgery or Fracture – Resulting in a change in the gait.
• High Heels/Thin Soled Shoes Or barefoot walking may initiate or worsen the condition.

SYMPTOMS

• Pain, soreness and tenderness in the area.
• Walking without shoes very uncomfortable.
• Callus (hard skin) formation or ultimately ulcers
• The metatarsal bones appear prominent.

TREATMENT for Ball of The Foot Pain

1. Wear soft supportive insoles and good quality shoes which offer support and cushioning, avoiding thin soled footwear.
2. Avoid excessive pressure during every day activities.
3. Avoid high heels.
4. Avoid walking barefoot.
5. Keep your weight within the recommended guidelines to avoid unnecessary load.
6. Avoid sports/activities which put added pressure on the ball of the foot.

It is always advisable to seek the help of a professional Foot Health Practitioner, Podiatrist or Chiropodist to assess the course of action which best suits your needs.

For further help and advice call Suzanne on 07738 521042.

What is a Chilblain

A CHILBLAIN is an inflammatory condition caused by chilling and a drop in extremity temperature; an injury caused by cold, damp and wetness. It does not occur on cold, dry days.

When the body core temperature drops nature will attempt to preserve life. We can liver without fingers and toes, even arms and legs, and these will be sacrificed in order to support the centrally placed vital organs deep within the body.

Chilling of the extremities causes a state of paresis/paralysis of the tissue cell walls and blood capillary walls and this prevents a return to normality on artificial warming from an external heat source. The paresis prevents the normal transport of interstitial fluids through the cell walls and capillary walls by osmosis, diffusion and filtration. This is an important part of the reaction of the tissues to injury in inflammation. Hence the cells and tissue spaces around them fill with excess fluid and inflammation products which build up and cannot be readily dispersed by the bloodstream.

There are 4 stages that occur in the progression of chilblains:

CYANOTIC Chilling which is not felt by the patient and goes unnoticed.

HYPERAEMIC The patient will feel symptoms and is noticeable on examination. There will be a reddening of the skin followed by inflammation. The afflicted area is now bright red.

CONGESTIVE The affected areas are now red/purple and may itch due to the presence of the excess tissue fluid. The chilblain may resolve from this stage or could progress to the fourth stage. Depending on susceptibility of the patient and external conditions, the area may become tightly swollen and red/blue in colour.

ULCERATIVE This last stage may incur secondary infection of the broken ulcerated lesion. Chilblains that become injured, traumatically broken or ulcerated can take weeks to heal.

Chilblains are easily recognised on the end of toes as these areas may be red/purple or often purple with a red border. The ends of the toes may be distended with itching and burning.

Chilblains unfortunately respond quite poorly to treatment but applying warming creams from Autumn onward and throughout the Winter months with passive massage is helpful. Further advice can be obtained from Suzanne at 4Happy Feet, Plaza Mall, Dudley.

Written by Victor Fletcher DipBMec, DipCTec, FPSPract, Podiatrist (ret)

Diabetes: ‘Most NHS costs wasteful, says Diabetic Medicine’!!

· Diabetes costs ‘out of control’
· Diabetes blood pressure warning
· Diabetes issues ‘at record high’

The majority of NHS spending on diabetes is avoidable, says a report in the journal ‘Diabetic Medicine’.

It suggests that 80{76538c1e13c71f07e689cf26caa978d500acd4b32509678cf1e3af41f6de1939} of the NHS’ £9.8bn annual UK diabetes bill goes on the cost of treating complications.

Experts say much of this is preventable with health checks and better education – something the Department of Health says it is tackling.

The report also predicts that by 2035, diabetes will cost the NHS £16.8bn, 17{76538c1e13c71f07e689cf26caa978d500acd4b32509678cf1e3af41f6de1939} of its entire budget.

“Unfortunately, many people in hospital with diabetes do come to harm as a result of, I’m afraid to say, inadequate care in hospital”.

Diabetes accounts for 11{76538c1e13c71f07e689cf26caa978d500acd4b32509678cf1e3af41f6de1939} of all NHS inpatient expenditure and costs the service around £23.7bn last year, a figure projected to increase to just under £40bn by 2035.

27 April 2012 BBC News Health

Where recurring pressure or constant friction occurs on the foot or toes the body tries to protect itself by building up layers of skin which over time become hard. Unlike Callus or Hard Skin which tends to form over a larger area of the foot, a corn tends to be more focused in a small area roughly round in shape, penetrating quite deep into the skin and often no bigger than the tip of your little figure.

Hard corns commonly occur on the top of the smaller toes or on the outer side of the little toe. These are the areas where poorly fitted shoes tend to rub most.

Another problem area is that between toes where soft corns sometimes form, most commonly between the fourth and fifth toes. These are softer because the sweat between the toes keeps them moist. Soft corns can sometimes become infected.

Corns on toes

What causes corns?

The foot consists of many small bones particularly in the toes. Where the bones of the toes and feet become a little broader and bumpy closer to the joints, extra rubbing (friction) or pressure can occur on the skin overlying a small rough area of bone, this will cause the skin to thicken. This may lead to corns forming.

Common causes of rubbing and pressure are tight or poorly fitting shoes which tend to cause corns on the top of the toes and side of the little toe. Long bouts of walking or running can also lead to calluses on the sole of the feet.  Corns are more likely to develop if you have very prominent bony toes, thin skin, or any deformities of the toes or feet which cause the skin to rub more easily inside shoes.

What are the treatments for corns?

If you develop a painful corn it is best to get expert advice from a Foot Health Practitioner to diagnose and treat foot disorders . You should not cut corns yourself, especially if you are elderly or have diabetes.

Advice and treatments for the removal of corns include the following:

Trimming (paring down)

The thickened skin of a corn or callus can be pared down by a Foot Health Practitioner by using a scalpel blade. Any pain caused from the corn is usually removed as the corn is pared down and the pressure on the underlying tissues eased. Sometimes, repeated or regular trimming sessions are needed. Once a corn has been pared down it may return if properly fitted shoes are not worn. Where there is a bio-mechanical disorder orthotics should be prescribed.

Toe protection and foot pads for corns

Typically corns are caused due to ill fitting shoes or slight deformities of the feet which causes the foot or toes to rub against the inside of the shoe. Depending on the position of a corn, placing a cushioning pad or shoe insole in the area of pressure may be of benefit. If there is a corn between the toes, a special sleeve worn around the toe may ease the pressure. A special toe splint may also help to keep your toes apart to allow a corn between toes to heal. As a Foot Health Practitioner I will be able to advise you on any appropriate padding, insoles or appliances you may need.

Surgery

If you have a foot or toe abnormality causing recurring problems and all other routes have been exhausted, surgery may be the only option left for you. Surgery may help to straighten a deformed toe, or to cut out a part of a bone that is protruding out from a toe and is causing problems. If an operation is required you will be referred to a surgeon who will be able to discuss this with you in more detail.