Foot Care Basics: Preventing and treating common foot conditions

Do your arches ache or your heels hurt? Got gout or battling bursitis? If so, you are among the three out of four Americans who will suffer some kind of foot ailment in their lifetimes. This Special Health Report covers the most common foot problems and helps you prevent and treat them.

Foot Care Basics: Preventing and treating common foot conditions Cover

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Give your feet the care they need. Foot Care Basics, from Harvard Medical School, will help you keep your feet looking younger, feeling stronger, and pain-free.

This report will answer questions from how to treat a bunion to how to recognize a stress fracture. Are warts contagious? What causes heel pain? Is there a cure for flat feet? What’s the difference between a corn and callus? Do arches really “fall?”

You’ll learn how to address plantar fasciitis, the leading cause of heal pain, without surgery. You'll gain the know-how to properly treat a sprain, to determine if you've broken a bone, to halt toenail fungus, and to effectively soothe pain of osteoarthritis in the feet.

The report is also packed with practical steps to keep your feet strong, supple, and problem-free. You’ll be alerted to the mistakes people often make when buying shoes, walking, or even clipping nails. Plus, you’ll be briefed on the latest advances in minimally invasive surgery, pain relieving medications, and more.

Discover how you can prevent and treat those conditions that can make walking painful and how you can achieve and maintain the “foot fitness” that will help you stay mobile, active, and engaged.

Take a step in the right direction and order your copy of Foot Care Basics today!

Prepared by the editors of Harvard Health Publications in consultation with Christopher P. Chiodo, M.D., Instructor in Orthopedic Surgery, Harvard Medical School Orthopedic Surgeon, Brigham and Women’s Hospital, and James P. Ioli, DPM, Instructor in Orthopedic Surgery, Harvard Medical School, Chief of Podiatry, Brigham and Women’s Hospital. 48 pages. (2012)

  • The fantastic foot
    • Foot structure
    • Your walking gait
  • Your age in miles
    • Birth to age 30
    • 30s and 40s
    • Age 50 and over
  • Special section: Keeping your feet healthy
  • Heels that hurt
    • Plantar fasciitis and heel spurs
    • Achilles’ tendinitis and Achilles’ tendinosis
    • Posterior heel bursitis
  • Arches that ache and flat feet
    • Flexible flat feet
    • Rigid flat feet
    • Posterior tibial tendon dysfunction
  • Tormented toes
    • Bunions and bunionettes
    • Hammertoe
    • Osteoarthritis
    • Gout
    • Sesamoid pain
  • Missteps and mishaps: Foot injuries
    • Fractures
    • Stress fractures
    • Sprains
  • Skin and toenail problems
    • Ingrown toenails
    • Blisters
    • Calluses and corns
    • Toenail fungus
    • Athlete’s foot
    • Warts
  • Other health conditions
    • Diabetes
    • Nerve problems
    • Skin cancer
    • Vascular problems and cold feet
  • Foot surgery
  • Treating foot pain
  • Shoes for healthy feet
  • Resources
  • Glossary

If you’ve got gout, you feel it. Gout is a painful inflammation of the joints that is becoming more common. Gout causes arthritic symptoms when uric acid, a normal byproduct of digestion, accumulates in the joints. A person with gout either makes too much uric acid or cannot excrete it properly. As a result, the uric acid forms crystals that settle in the joints and cause inflammation, sudden jabs of pain, soreness, redness, and swelling. In the foot, gout most often affects the joint at the base of the big toe.

Although everyone makes uric acid naturally, levels of this compound can increase when you eat certain foods that contain substances known as purines, such as organ meats, sardines, and some shellfish. Purines increase production of lactate, which competes with uric acid for excretion. Gout affects men more frequently than women, probably because men have higher uric acid levels than women. That changes at menopause, however, which explains why men tend to develop gout between ages 30 and 50, while women are more likely to develop it after age 50.

Symptoms of gout

  • Jolts of pain in the affected joint
  • Possible inflammation in the joint
  • Increase in symptoms after eating some foods

Treating gout

To treat an attack of gout, your doctor will usually begin by prescribing an NSAID. Avoid aspirin, as it may raise uric acid levels. If you cannot tolerate NSAIDs or if they do not help, your doctor may suggest a corticosteroid, such as prednisone, to reduce inflammation. Corticosteroids may be taken orally; less frequently, they are injected directly into the affected joint (usually numbed ahead of time with a nerve block). Another option is an injection of adrenocorticotrophic hormone, a compound that directs your adrenal gland to make more cortisone. Although the medication colchicine may be given in pill form, it tends to cause unpleasant side effects (nausea, vomiting, cramps, and diarrhea). To reduce uric acid levels over the long term, some physicians prescribe allopurinol (Zyloprim). More recently, the FDA approved febuxostat (Uloric). The most common side effects of these medications is rash. If a rash appears, discontinue the medication and talk with your doctor. Other side effects include nausea, joint pain and liver function abnormalities.

Your doctor is also likely to recommend making dietary changes, such as drinking more water and eating fewer foods that contain high amounts of purines, such as beef, goose, liver, sweetbreads, mussels, anchovies, and herring. Even poultry, seafood, and some vegetables—including spinach, asparagus, beans, lentils, mushrooms, and dried peas—contain purines. Lowering your alcohol consumption should also help reduce uric acid levels and relieve your symptoms.

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An extremely comprehensive overview of feet, their intricacies, what goes wrong, how to address problems - very informative and helpful. However, I would have liked to see something on plantar fibromatosis - the report only touched on plantar fascitis?
It is a good overall up to date informative booklet, however, did not include the issue of Plantar Fibromas. I wanted to know what the Harvard people would say about it. Fibromas are not that rare, and at least small mention should have been included in the area of Plantar Fasciitis.
FOOTCARE BASICS Clearly set out, starting with an initial examination of the structure of the foot and then dealing with problems relating to heels, arches, toes, foot injuries, foot skin problems, and issues such as diabetes and nerve problems. This last is what I was looking for information on, as for the last four months I have had a sharp tearing pain on the outside of my right foot and had not got satisfactory diagnosis or remedy from my GP or a couple of physios I consulted – they variously diagnosed heel pad atrophy or plantar fasciitis; and suggested anti-inflammatory tablets, or expensive shock wave therapy (of which this publication gave me an objective review, on p. 12), and if these didn’t work then cortisone. But they could not explain the sharp jagged pain I experienced when I reached out to my foot and gently twisted it towards my body. After reading this Harvard publication, I became more aware of how my weight (I put on 6 kg six months ago, and haven’t been successful in losing it) impacted on my foot health. I felt more in control of my health after reading the publication on Footcare Basics, and decided to research sural nerve issues on the internet, and have understood my problem better now. A point for improvement might be inclusion of therapies such as acupuncture – I decided to try acupuncture rather than anti-inflammatories or shock wave therapy, and after 5 sessions so far the sharp jagged pain is much muted and less painful. I don’t know how acupuncture works, but it fortunately appears to, in my case, and I am so thankful?
Excellent Booklet (42 Page on care for your feet) I have been living for 15 years with periodic pain. Hot, tingling, shooting pains (if I stepped on anything with shoes off). Now after 2 months I can feel a tremendous difference.
I was very disappointed that there was no mention of tarsal tunnel. I ordered the book because I haven't been able to find a lot of information about it and I thought this book would cover it.