Foot Care for People With Arthritis

Years of wear and tear can be hard on our feet. Disease, poor circulation, improperly trimmed toenails, and wearing shoes that do not fit properly can also cause foot problems.

Problems with our feet can be the first sign of more serious medical conditions, such as:

• Diabetes
• Nerve disorders
• Circulatory disorders
• Arthritis

You should check your feet regularly, or have a member of your family check them. Podiatrists and primary care doctors are qualified to treat most foot problems. Sometimes the special skills of an orthopedic surgeon or dermatologist are needed.

It also helps to keep blood circulating to your feet as much as possible. You can do this by:

• Putting your feet up when you are sitting or lying down
• Stretching if you've had to sit for a prolonged period
• Walking
• Having a gentle foot massage
• Taking a warm foot bath
• Use foot warmers

Avoiding certain actions or behaviors can help to prevent foot problems.   

• Try to avoid pressure from shoes that do not fit right.
• Try not to expose your feet to cold temperatures.
• Do not sit for long periods of time (especially with your legs crossed).
• Do not smoke.
• Wearing comfortable shoes that fit well can prevent many foot ailments.

Here are tips for making sure your shoes fit properly.

• The size of your feet changes as you grow older. Always have your feet measured before buying shoes.
• The best time to measure your feet is at the end of the day when your feet are largest.
• Most of us have one foot that is larger than the other. Fit your shoe to your larger foot.
• Do not select shoes by the size marked inside the shoe but by how the shoe fits your foot.
• Select a shoe that is shaped like your foot.
• During the fitting process, make sure there is enough space (3/8" to 1/2") for your longest toe at the end of each shoe when you are standing up.
• Make sure the ball of your foot fits comfortably into the widest part of the shoe.
• Do not buy shoes that feel too tight and expect them to stretch to fit.

Your heel should fit comfortably in the shoe with a minimum amount of slipping - the shoes should not ride up and down on your heel when you walk.

Walk in the shoes to make sure they fit and feel right. Then take them home and spend some time walking on the carpet to make sure the fit is a good one.

• The upper part of the shoes should be made of a soft, flexible material to match the shape of your foot.
• Shoes made of leather can reduce the possibility of skin irritations.
• Soles should provide solid footing and not be slippery.
• Thick soles cushion your feet when walking on hard surfaces.
• Low-heeled shoes are more comfortable, safer, and less damaging than high-heeled shoes.

Fungal and bacterial conditions, including athlete's foot, occur because our feet spend a lot of time in shoes - a warm, dark, humid place that is perfect for fungus to grow. Fungal and bacterial conditions can cause:

• Dry skin
• Redness
• Blisters
• Itching
• Peeling

If not treated right away, an infection may be hard to cure. If not treated properly, the infection may recur. To prevent infections, keep your feet clean and dry, especially the area between your toes. Change your shoes and socks or stockings often to help keep your feet dry. Try dusting your feet daily with foot powder. If your foot condition does not get better within 2 weeks, talk to your doctor.

Dry skin can cause itching and burning feet. Use mild soap in small amounts and a moisturizing cream or lotion on your legs and feet every day. Be careful about adding oils to bath water — oils can make your feet and bathtub very slippery.

Corns and calluses are caused by friction and pressure when the bony parts of your feet rub against your shoes. If you have corns or calluses, see your doctor. Sometimes, wearing shoes that fit better or using special pads to solve the problem. Treating corns and calluses yourself may be harmful, especially if you have diabetes or poor circulation. Over-the-counter medicines contain acids that destroy the tissue but do not treat the cause. While these medicines may reduce the need for surgery, check with your doctor before using them.

Warts are skin growths caused by viruses. Warts are sometimes painful and, if untreated, they may spread. Since over-the-counter preparations rarely cure warts, see your doctor. A doctor can:

• Apply medicines
• Burn or freeze the wart off
• Take the wart off surgically

Bunions develop when the joints in your big toe no longer fit together as they should and become swollen and tender. Bunions tend to run in families.

Your doctor may prescribe anti-inflammatory drugs or recommend cortisone injections to relieve pain. Surgery may be needed to relieve the pressure and repair the toe joint, if the bunion is severe or when other conservative treatments provide inadequate pain relief.

Ingrown toenails occur when a piece of the nail breaks the skin. This can occur if you don't cut your toenails properly.

Ingrown toenails are very common in the large toe. A doctor can remove the part of the nail that is cutting into the skin. This allows the area to heal. Ingrown toenails can often be avoided by cutting the toenail straight across and level with the top of the toe.

Hammertoe is caused by a shortening of the tendons that control toe movements. The toe knuckle is usually enlarged, drawing the toe back. Over time, the joint enlarges and stiffens as it rubs against shoes. Your balance may be affected. Wearing shoes and stockings with plenty of toe room is a treatment for hammertoe. In severe cases, surgery may be needed.

Spurs are calcium growths that develop on bones of your feet. They are caused by muscle strain in the feet. Things that can make spurs worse include standing for long periods of time, wearing shoes that don't fit, and being overweight. Sometimes spurs are completely painless. Other times, spurs can be very painful. Treatment for spurs includes using foot supports, heel pads, or heel cups. When severe, surgery may be needed.

For more information on foot care, contact:

• American Podiatric Medical Association (www.apma.org)
• American Orthopaedic Foot and Ankle Society (www.aofas.org)