Everyone’s feet benefit from TLC, but when you have a chronic condition, paying attention to your feet becomes essential. Here are the most serious illnesses that can affect your feet and that require extra care.
Diabetes
One of the consequences of high blood sugar is nerve damage called neuropathy. It’s extremely dangerous when it affects the nerves in your feet because it prevents you from feeling even minor injuries, like a cut, enabling them to quickly escalate to a dangerous infection and consequences such as amputation.
In addition to getting and keeping blood sugar under control, it’s imperative that you check your feet and toes daily. If you can’t see them directly because of any physical limitations, use a magnifying mirror that you can place on the floor to reflect the soles or have a loved one check for you. Note any sign of a problem, including swelling, irritation, redness, or abnormal odor. Sometimes the cause of a cut or irritation is your shoes. Perhaps your big toe gets red on one side every day or you get repeated blisters.
Even if you don’t experience loss of feeling, diabetes makes feet more prone to dryness and cracking, a potential source of infection. If you experience dryness, try the Gehwol (gehwolfootcare.com) line of creams with products for either cracked or callused feet. Never put cream between your toes. Any type of moisture there can be a breeding ground for infection. Always dry your toes thoroughly after cleansing.
Gout
Often an inherited form of arthritis, gout occurs when your body can’t clear uric acid, the byproduct of proteins in foods called purines. It’s also made worse by dehydration. Uric acid can coalesce as crystals in the big toe joint as well as on the side of your foot and in finger joints and elbows, causing pain that rivals passing a kidney stone.
The classic sign of gout is a red and swollen big toe that could look like an infection to the untrained eye.
Gout is treated with systemic drugs such as allopurinol to clear the crystals and colchicine to calm the inflammation. The pain of a flare can be eased by a steroid injection in the toe by a podiatrist.
The long-term answer is working with a dietitian to figure out which foods in your diet brought on gout—sausages, shrimp, brie and other cheeses, cured olives, and alcohol are the big offenders.
Rheumatoid arthritis and other autoimmune diseases
Thanks to biologics called TNF blockers, rheumatoid arthritis’ destruction can be limited. Follow your rheumatologist’s advice for controlling flares to minimize RA’s effect on all joints, including those in your feet. Whether or not you’ve already experienced any RA foot deformities, it’s a good idea to be fitted for shoes appropriate to the shape of your foot at a specialty shoe store. It’s difficult for anyone to get their feet into pointy shoes and nearly impossible with feet affected by RA. It also helps to add a layer of protection with soft insoles, good advice when you’re living with any chronic condition affecting the feet, especially autoimmune diseases like lupus and psoriatic arthritis.
Psoriasis, often a precursor to psoriatic arthritis, can cause pitted toenails (and fingernails). Once your condition is under control, you may be able to have the pitting gently smoothed away by a podiatrist or dermatologist.
Reynaud’s syndrome is an autoimmune disease that noticeably targets feet and hands. They turn white in response to cold and can even develop frostbite from exposure as commonplace as being outside waiting for a bus. Wear the proper clothing for the weather, including thick socks (and mittens) and even heated socks.
Osteoarthritis
This wear-and-tear arthritis can affect any joint, including those in the feet. In addition to treatment from a rheumatologist and/or physical therapist, try an anti-inflammatory topical cream, including those made with the botanical arnica or the nonsteroidal anti-inflammatory drug diclofenac (Voltaren Gel). Orthotic inserts will make walking less painful. Your podiatrist might suggest custom-made ones, or try over-the-counter brands PowerStep and SuperFeet.
Kidney diseases
The fluid retention associated with kidney disease can lead to swollen feet and ankles (as well as hands). When you’re sitting, elevate your feet on an ottoman or with pillows. Get your circulation moving with foot exercises like making circles with your ankles, and stay hydrated.
Peripheral artery disease (PAD)
Characterized by a loss of circulation that prevents nourishing blood from reaching your feet, PAD can lead to foot sores and stunted toenail growth. Massage a rich emollient like Aquaphor into your feet and ankles to increase blood flow. Important: If you smoke, you must stop—it’s the greatest cause of the disease and its progression.
Cancer treatment
Chemotherapy drugs can temporarily cause peripheral neuropathy in your feet and hands, leading to tingling or painful sensations. Among the treatments for this side effect is the use of topical numbing agents. Among the strongest is an over-the-counter anesthetic cream made of benzocaine, lidocaine and tetracaine called BLT for short. Keeping your feet warm and snug in cotton socks and soft booties can also be soothing.
