“Only a fool tests the depth of the water with both feet”
Common foot conditions
common foot conditions
Why do my feet hurt?
Your feet are an integral part of your everyday life, the foundation of our bodies, with 42 muscles, 26 bones, 33 joints, and at least 50 ligaments and tendons made of strong fibrous tissues working in harmony to keep all the moving parts together, plus 250,000 sweat glands and as such they experience a lot of wear and tear. In fact, it’s estimated that you’ll likely have walked 75,000 miles by the age of 50. Because of all this use, chances are you’ll develop several foot problems throughout your life.
Through activities of living, the feet can change structurally over time, causing a reshaping of the feet. This can give rise to a number of medical conditions and deformities. In addition, the feet are susceptible to infections—including bacterial, fungal, and viral infections. Systemic illnesses can also affect and change the feet, which can limit daily activity and quality of life.
For more information on common foot conditions, click on the links below.
Verrucaes are a viral infection of the skin and are a common complaint amongst adults and children.
They can vary in size and number and can occur anywhere on the foot.
Appearance & Symptoms
They are circumscribed (well defined) lesions with little black dots which are blood vessels that have been pushed towards the surface of the skin.
They appear similar to corns but are more superficial in depth but can be surrounded by hard skin. Pain is usually felt on lateral pressure i.e. pinching the lesion from the sides.
Their colour is usually paler than the usual tone of the skin.
They can manifest as a single lesion or multiple lesions i.e., Mosaic/ Satellite warts.
They may or may not be painful depending on the location on the foot. If on a weight bearing part of the foot then there is an increased likelihood of pain.
All Verrucaes are caused by the Human Papilloma Virus (HPV).
They enter by a break or scratch in the skin and are commonly contracted in communal places of high moisture such as swimming pools, showers and changing areas.
Excessive moisture or dryness of the skin can create a portal of entry for the virus.
They can resolve on their own but if they are painful or spreading then treatment may be required.
Over the counter products that contain salicylic acid can be applied or more concentrated acids may be applied professionally. However these should not be used if a person has an allergy to aspirin, has diabetes or poor circulation.
Other forms of treatment include cryotherapy (freezing) and electrosurgery (surgical excision).
This is a common term used to describe a fungus infection of the skin that can occur on any aspect of the foot especially between the toes. If left untreated it can spread.
This condition can cause a great deal of discomfort. The skin may range from being red and swollen with sticky fluid filled papules to dry scaly rashes on the bottom and sides of the feet. The skin between the toes can appear very white and macerated and can lead to open painful sores.
Dry and itchy lesions that can break open and become painful or infected.
Patients can complain of a burning or stinging sensation.
The nails may become infected (onychomycosis).
As the fungus thrives in moist areas it can spread in environments such as swimming pools, bathrooms and changing rooms.
People who are in enclosed footwear, all day. who do not change their socks, on a regular basis, therefore not giving the feet the opportunity to breathe.
Those, with a predisposition to sweaty feet (Hyperhydrosis).
Antifungal preparations that are available over the counter or via the GP. These can be in the form of creams, sprays or powders.
Change shoes and hosiery regularly and wear cotton socks.
Dry between the toes after bathing and use cooling agents like surgical spirit.
Seek advice professionally from a podiatrist especially if you are diabetic or have extremely sweaty feet.
Corns and Calluses
Calluses can cause burning and tired feet. Calluses if left untreated may develop into potential corns or may cause cracking in the skin (fissuring).
Corns result in pain on direct pressure or in ill fitting footwear. Corns can cause inflammation and swelling around the area of the lesion. If left untreated may entwine with nerves of the foot i.e. (neurovascular corns) which are extremely painful and may need surgical intervention.
In addition, may cause bursitis ( formation of a painful fluid filled sac) beneath the corn or a development of an ulcer. Can lead to biomechanical problems, in the feet or legs, as patients may alter their walking (gait) to relieve pain.
Calluses can cause burning and tired feet.
Calluses if left untreated may develop into potential corns or may cause cracking in the skin (fissuring).
Corns result in pain on direct pressure or in ill fitting footwear.
Corns can cause inflammation and swelling around the area of the lesion. If left untreated may entwine with nerves of the foot i.e. (neurovascular corns) which are extremely painful and may need surgical intervention.
In addition, may cause bursitis ( formation of a painful fluid filled sac) beneath the corn or a development of an ulcer.
Can lead to biomechanical problems, in the feet or legs, as patients may alter their walking (gait) to relieve pain.
Ill fitting footwear, or a seam or stitch within a shoe that leads to rubbing against the foot.
Conditions such or bunions, clawed or hammer toes, high and low arched feet, excessive pronation (rolling in off the feet) or previous lower limb surgery.
Any condition that affects the walking pattern (gait), of a patient, e.g. Rheumatoid or Osteoarthritis.
Avoid tight, loose and ill fitting footwear.
Use files and pumices to tackle the build up of skin.
Apply emollients and creams regularly to keep skin supple and nourished.
Do not use medicated corn pads as they can lead to the destruction of healthy tissue and lead to infection. Do use non medicated pads to try and relieve the pressure.
Podiatrists will be able to remove corns and callus build up and offer advice on the causative and preventive actions that may need to be taken.
Cracked (fissures) heels are usually the result of excessive callus build up and dry skin. The fissures if left untreated can become deep and painful and in some cases may bleed.
Due to the excessive build up of hard skin around the outer edge of the heel patients may experience pain whilst walking and increased discomfort in thin soled or open back shoes.
Dry skin or inactive sweat glands (anhydrosis).
Flat or high arched feet.
Abnormalities in gait (walking) or long periods of standing.
Open backed or ill fitting footwear.
Skin conditions such as eczema or psoriasis.
Seek advice from Podiatrist to enable hard skin to be removed and for fissuring to be debrided.
Use a foot file or pumice regularly to reduce build up of hard skin.
Use an emollient to moisturise the affected area.
Change footwear and cushion impact on heels.
Fungal Nails (Onchomycosis)
Fungal nail infections are caused by a group of fungi classified as Dermatophytes that grow in the nail bed and feed off keratin. They are stubborn infections that can be difficult to treat. As the nail and the nail bed is composed mainly of keratin it provides a suitable environment for them to flourish.
The infection usually begins at the distal edge of the nail and then proceeds over the whole of the nail. The infected nail will appear brown or yellow in discolouration and can become quite thickened, brittle and porous with an offensive odour.
The infection can spread to other nails if left untreated.
The nail becomes thickened and painful from pressure of footwear or due to pinching of the skin. This may in turn lead to inflammation of the surrounding tissue and the possibility of an ingrown nail.
The nail may split due to its porous nature and catch on hosiery.
The nail may detach completely with repeated episodes of regrowth.
Over (Excessive) Pronation
This condition is the most common cause of foot and leg discomfort and can lead to a host of deformities and problems.
An ‘excessive ‘inward tilting of the foot causes the arch to flatten, collapse and the soft tissues to over stretch. This causes the foot on contact with the ground to become very loose, flexible and unstable leading to overuse and abnormal strains on the muscles, tendons and ligaments.
Ankle sprains are very common injuries. The sprains are usually associated with damage to the lateral (outside) ligaments of the ankle. Most sprains are caused by simply walking on uneven ground, pivoting or physical trauma to the area or by side to side sports like tennis or football.
The severity of the strain is dependent on how the much of the ligament in question has been damaged.
Possible swollen, painful and bruised area.
An audible ‘pop’ or ‘snap’ at time of injury.
A sudden twist of the ankle.
If total rupture or fracture then a referral is needed to Orthopaedics.
If not ruptured consult podiatrist but follow the acronym RICE. That is apply ice immediately and intermittently over the first 36-48 hours. Then use strapping and elevate the limb.
Once the acute phase has passed the patient can weight bear with the support of strapping to try and resume a normal walking pattern however slowly.
Apply heat to stimulate the circulation.
Exercises may be needed to strengthen the ligaments and muscles and orthotic intervention to provide stability and avoid repeat occurrences.
Bunions (Hallux Abducto Valgus)
Hallux Abductovalgus (HAV) or bunions as they are most commonly called are a very common foot deformity. The general appearance is due to a displacement or movement of the big toe towards the 2nd toe. Bunions may cause pain due to a variety of soft tissue and bony complications.
Bunions are more common in women then men due to restrictive footwear.
There may be a hereditary (family history) of bunions.
Abnormal foot function e.g., excessive pronation or other abnormalities of walking ie one leg being longer than the other.
Degenerative diseases such as osteo or rheumatoid arthritis.
Obesity or trauma.
May be asymptomatic (Not painful).
May be symptomatic with redness, swelling and pain which can be exacerbated by restrictive footwear.
Secondary soft tissue lesions like corns and calluses may develop on the joint, between and on top of the toes or on the soles due to shearing and friction against prominent bones.
The 2nd joint may become fixed which is referred to as a ‘Hammer Toe’ due to the big toe pushing underneath it. The other toes may become clawed or retracted.
The nails may become affected with over thickened nails or the possibility of in- growing nails.
A fluid filled sac called a ‘Bursitis’ may develop over the joint.
Changing footwear and avoiding high heels is essential.
Padding to alleviate bony prominences or strapping to stabilize areas may help.
Corns and calluses may need to be reduced to avoid secondary complications.
The use of insoles/orthotics to stabilize foot function and reduce excessive motion may be required.
The big toenail is the one that is commonly affected although the smaller nails can be affected as well.
An ingrowing nail is usually caused by a splinter of nail piercing into the surrounding skin.
Calluses can cause burning and tired feet.
The toe will become painful to touch.
The toe may become inflamed and infected (septic).
The surrounding skin may swell. (hypergranulation).
Improper nail cutting (cutting down the sides or at an angle)
Trauma to the nail plate.
Restrictive footwear or hosiery.
Initially a podiatrist may try conservative methods to remove the offending piece of nail and use packing material to allow and aid normal growth.
If the condition does not respond to the above then surgical intervention may be required. This involves removing the offending splinter(s) or the whole nail if necessary. This surgical procedure is called a Partial or Total Nail Avulsion and requires the use of anaesthesia and a process called phenolisation in order that the problem does not reoccur.
Antibiotic cover may be required if the nail is infected. The healing process generally takes up to 4-6 weeks.
High Arched Foot (Pes Cavus)
Pes Cavus is a general term which covers all types of abnormally high arched feet.
At the front of the sole the 1st metatarsal and 5th metatarsal bone may be significantly dropped and prominent leading to pressure and thus causing callus and corn formations.
Pain and discomfort may be experienced in the arch area and a general stiffness in the feet.
The toes may retract and become clawed.
Pain may be experienced in the heel, calf, knee or hip.
May be due to a neurological disorder e.g. spina bifida, poliomyelitis, cerebral palsy.
May arise from structural anolomies.
Debridement of secondary skin lesions i.e. corns and calluses.
Insole or orthotic intervention is required to alleviate pressure areas and provide stability.
Flat Feet (Pes Planus)
This occurs when the normal arch of the foot has dropped significantly or there is no presence of an arch at all.
A common term people use is that of having ‘fallen arches’. Most people with this foot type will have an excessive amount of rolling in of the foot (excessive pronation).
The symptoms will vary depending on the severity of the condition.
The abnormality of the walking cycle and excessive weight bearing may increase compressive and shearing forces on the feet resulting in calluses and corns.
Pain or discomfort may develop in the arch or heel.
May develop plantar fascitis due to excessive pronation.
May complain of pain in the back, knee or ankle due to prolonged instability.
A Biomechanical dysfunction. (abnormal walking pattern).
A ruptured tendon may lead to a flat foot.
May be caused by conditions such as spina bifida, cerebral palsy or muscular dystrophy.
Debridement of secondary skin lesions i.e. corns and calluses.
Footwear will need to be reviewed and possibly changed to increase stability.
Insole or orthotic intervention is required to alleviate pressure areas and provide stability to overused muscles, tendons and ligaments.
Pain in the heel is a very common foot complaint in young adults, although it occurs more frequently in patients over the age of 40. The main causative factor is due to the over stretching and inflammation of a broad band of tissue that runs from the heel to the ball of the foot. This band is called the plantar fascia and the inflammation of it is called plantar fascitis.
Can have a profound effect on a persons lifestyle due to considerable discomfort and pain it may cause.
Pain is usually worse in the morning or after periods of rest.
May feel a deep tender spot when applying pressure from your thumb.
In long term chronic heel pain, the persistent inflammation of the fascia may lead to a bony growth (spur) on the calcaneus (heel bone). This condition may produce a dull ache which is present most of the time with intermittent episodes of sharp pain in the centre or margins of the heel.
A flat foot may increase shearing and friction due to excessive lowering or collapse of the arch of the foot.
A high arched foot may cause excessive compression on the heel area.
A Biomechanical dysfunction (abnormal walking pattern).
Ill fitting footwear.
Increased activity or periods of long standing.
Obesity or a sudden increase in weight e.g., pregnancy.
See Podiatrist for biomechanical evaluation and the prescription of orthotics.
Change footwear if required.
Stretching exercises may be needed to improve strength and elasticity of ligaments and muscles.
NSAIDs (Non Steroid Anti-inflammatory Drugs) may be prescribed but note that these treat the symptoms and not the cause of the pain.
Steroid injections may be administered.
Sweaty or Dry Feet (Hyperhydrosis & Anhydrosis)
Hyperhydrosis is due to an excessive production of sweat from the soles of the feet and is not generally linked to any disease process but is more a physiological action. It may affect either gender but men are particularly prone to sweaty feet or there may be a family history of this condition.
When sweating does not occur then the term anhydrosis is used. It may occur as an isolated symptom or in association with other neurological defects.
Hosiery and shoes may become saturated and pools of sweat may form. Malodour (Bromhidrosis) of the feet may occur. This is due to the breakdown of hard skin that may have formed on weight bearing areas. These may appear as multiple superficial pits ‘worm eaten’. Athletes Foot may be associated with this condition. May result in the formation of blisters.
Dry skin can lead to painful cracks (fissures) appearing or increased callus formation. It can also be a portal of entry for bacterial infection.
Consult a Podiatrist to advice on recommending treatment products and reducing any secondary skin lesions. Advice on footwear and hosiery may be given.
See Podiatrist for removal of excessive callus build up. Advice may be required on footwear and use of emollients.
Pain in the ball of the foot (Metatarsalgia)
Metatarsalgia is a general term used to describe pain eliciting from the metatarsal region of the foot. The region is just under the toes of the foot i.e. the ‘knuckles of the foot’. It is symptomatic of many different conditions.
Pain or inflammation of the metatarsal bones.
Excessive build up of callus or the formation of corns in areas of high impact.
May cause restricted movement in the 1st toe joint or lead to the formation of a bunion.
Stress fracture or arthritis.
Biomechanical dysfunction (abnormal walking pattern)
Plantar digital neuritis (Mortons Metatarsalgia) is where pain arises between the 3rd and 4th interdigital space due an impingement of the nerve. It can produce symptoms of pins and needles like sensation or pain that radiates to the toes.
Ill fitting footwear that leads to overloading of the ball of the foot.
High arched foot.
Tendonitis of the Foot
Tendonitis occurs due to the overuse of a particular tendon of the foot. This tendon is called the Posterior Tibial Tendon and its function is to maintain the arch of the foot and prevent the feet from rolling in too much.
Achilles Tendonitis is also a painful condition that as its name suggests affects the tendon that attaches the heel bone to the calf muscle.
Pain and or inflammation along the tendon or at its points of insertion.
May develop a fluid filled sac called a bursa on the tendon.
In Posterior Tibial Dysfunction (PTD) due to the inflammation of the nerve a patient may experience a burning, tingling, shooting or stabbing pain in the foot. If a patient is asked to stand on their toes, this will lead to increased pain in the arch of the foot.
Flat foot or biomechanical dysfunction (abnormal walking).
Ill fitting footwear e.g., changing to flat shoes from wearing high heels may cause strain due to the lack of elasticity of the tendon. In addition if the footwear is loose and there is a shearing of the tendon resulting from the rub of the shoes this may inflame the tendon.
Walking or hill running.
Tight calf muscles may cause Achilles tendonitis.
Rest, Ice and Compression are immediate courses of action.
In PTD all sporting activities must cease.
Consult Podiatrist for causative factors and management.
Strapping and padding may need to be applied professionally.
Advice on footwear and exercise regime may need to be given.
Insole or orthotics may need to be prescribed to correct biomechanical dysfunction.
In severe cases i.e. if the tendon has ruptured, surgical intervention may be required.
Available ‘off the shelf’ in shops, pharmacies and clinics.
General arch support.
Standard degree of control and function and made to average foot shape.
Not suitable for everyone and may be uncomfortable.
Longevity very limited.
Prescriptive device made specific to a patients foot type & function.
Biomechanical evaluation and Gait analysis required before device dispensed.
Greater degree of control, better fit, feel & function.
Can incorporate materials that aid better cushioning and shock absorption properties or made from plastics that provide greater stability.