A Doctor’s Foot Health Guide For Aging Patients

The foot is a magnificent structure working intricately like a Swiss clock to help you stand and move. Your feet withstand a lot of stress and strain over a lifetime, but are well designed to cope with this. Over time, however, the feet gradually wear down, and extra care must be taken later in life to keep them healthy. This article will discuss how to take care of your feet to keep them at their very best and prevent future problems.

Each foot contains skin, blood vessels, bones, tendons, muscles, ligaments and nerves. Each of these parts requires care and upkeep, as disease can affect how well they function. We will begin with discussing the skin. The skin is the largest organ in the body, and has an important role in the health of your feet. Skin is continuously regenerating over a lifetime to keep fresh, healthy tissue covering the body. As we age, our skin will gradually become dry and flaky. Sometimes this is just natural skin dryness, sometimes this is Athlete’s foot or sometimes it is an allergic reaction. To treat dryness, you should moisturize the skin once or twice daily. Foot soaking is not necessary, and tends to dry out the skin even more by leaching vital oils. Avoid placing moisturizer in between toes, as this can increase the likelihood fungus will develop. If fungus does infect the foot skin, it will cause Athlete’s foot. This condition creates redness and itching on the bottom of the feet or in between the toes, and needs medical treatment to destroy the invading fungus. Sometimes over-the-counter medication works well, and sometimes prescription medication is needed. Skin can also become thinner over time. Because of this, sores, scrapes, blisters or minor cuts may need medical attention as healing can take longer. The feet should be protected for this reason by wearing properly fitted shoes at all times.

Corns and calluses are caused by pressure from bones as they squeeze overlying skin against your shoes or the ground. As we age, the natural fat pad in our feet slowly move and shrink, making bones more prominent. This causes a protective build-up of skin under our feet where the bone prominence lies, as well as on the tops of the toes that are contracted up against shoes. Softening corns and calluses with a daily moisturizer and using a pumice stone or file after showering will help smooth them out. Avoid medicated corn pads, as they can burn the surrounding healthy skin. More severe corns and calluses may require professional trimming and padding, or even surgery to correct the underlying bone prominence.

Nails are also part of the skin. Over time, nails can become thickened, malformed, and discolored. This may be due to a nail fungus, which can also cause pain and nail lifting. Nail fungus is difficult to treat, and infected nails are difficult to trim by oneself. Options for treatment include a prescription pill, specially formulated topical oils, or toenail removal. The nails can also look abnormal due to bruising or other medical conditions which can mimic nail fungus. The formation of ingrown nails over time can also occur. The nail root changes as we age, and may begin to grow the nail into the skin. This may need medical attention to avoid infection. Cutting the nail back at an angle may temporarily relieve pain, but the problem will occur again later.

The circulatory system to and from the foot is vitally important to the health of the foot. Blood vessels (arteries) bring nutrients and oxygen to the feet, and remove waste chemicals and unoxygenated blood back to the heart and lungs to get more oxygen (veins). As we age, these vessels can sometimes suffer from disease. Poor circulation is not uncommon in aging people. Arteries may harden with blockage, reducing flow of some or most blood to the foot and leg. Symptoms of poor artery circulation include thin skin, loss of toe or foot hair, cold feet, and a purplish-red color to the skin. Severe disease of the arteries can cause leg pain and cramping after walking a short distance, night pain in legs relieved by the dangling feet, and deep purple or black toes. Exercise can keep blood flowing to the feet. Socks can be used to warm cold feet to promote more blood flow. Sometimes medication and a consultation to a vascular doctor is necessary for treatment in severe cases. Veins return blood to the heart, and poor blood flow from the foot back to the heart is also not uncommon in aging people. Veins may loose the ability to pump blood and fluid out of the foot. Symptoms include large varicose veins, small spider veins, and leg swelling. Activity helps pump blood back to the heart by activating the leg muscles. Compression stockings or support hose can help by pushing blood up from the outside. Sometimes your doctor may need to prescribe water pills to help get rid of the extra fluid.

Your musculoskeletal system contains several parts, including your skeleton (bones) and the muscles that move those bones. As we age, our bones soften a little and are more likely to break in an injury. Even something as simple as stubbing your foot or toe can cause a fracture. Obviously, not all accidents can be prevented, but if you drop an object on your foot or leg, or kick something unintentionally, and the pain does not go away within a couple of days you should see your doctor for x-rays and an exam. Even small fractures can create big problems. All falls and ankle twists should be given medical attention, as they may be fractures in disguise. Fractures can cause swelling, pain, warmth, and redness. Sprains can also cause all of the above, making self-diagnosis difficult. Both require a good treatment plan to recover quickly. Treatment for sprains can consist of rest of the injured area, ice (not heat), compressive wraps like an ACE wrap, brace support, and elevation. Treatment for a fracture can be as simple as wearing a protective shoe for a short period of time, although more involved fractures need casting and perhaps surgery.

Bunions and hammertoes are common foot deformities caused by the foot type you have inherited from your parents. Your choice of shoes did NOT cause these conditions, but may have aggravated them. Wearing wider or deeper shoes can help take away the pain associated with these conditions, and padding and shoe inserts can also help. Bunions and hammertoes will not go away on their own, and sometime surgery is needed for permanent relief. The foot can be made comfortable by using different shoes and padding to avoid surgery, however surgery is advised for very painful bunions and hammertoes in which a change in shoes and padding does not help.

Arthritis is another condition that affects the musculoskeletal system in aging people. The foot has many small joints that may develop arthritis, either naturally or through disease or injury. Some larger joints, like the big toe joint and the ankle joint, can be treated easily while smaller joints are tougher to treat. Arthritis medications can help with the pain and good supportive shoes and inserts or braces can control foot movement and lessen movement on arthritic joints. Surgery is a last resort.

The soft part of the musculoskeletal system, including tendons, muscles, and ligaments, can also be injured. Common areas of pain caused by soft tissue injury includes heel (bottom and back), the ball of foot, the big toe joint, and the top of the foot. Minor aches and pains in the foot are treated with good supportive shoes (walking or athletic), ice, and anti-inflammatory medication like Motrin if not restricted by your doctor. Any ache lasting longer than a couple of weeks, aches with swelling, or foot sprains with weakness need to have medical attention.

The final part of the foot to discuss is the nervous system. As we age, our nerves are not as sensitive as they once were. Most people do not develop outright foot “numbness”, but the ability to feel temperatures or sharp objects may be decreased (especially in diabetics). Ways to prevent harm from poor sensation is to check tub or soaking water carefully with several areas of the body to ensure correct temperature, wearing shoes with socks outside and wearing house slippers inside. Give yourself a brief foot inspection from time to time to look out for skin injuries and possible infections that you cannot feel well. All people with poor sensation should be periodically monitored by a podiatrist.

Your feet should last you a lifetime. They need care just as much as any other body part. Keep them healthy and they will keep you walking. All this will be made easier by keeping your skin moisturized and protected, wearing properly fitting and supportive shoes, staying as active as possible, and getting prompt medical attention to injuries.

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