Friday, December 18, 2015

Top Causes of Foot Pain and Options for Treatment

December 18, 2015 | 114,807 views



By Dr. Mercola
The feet are a very common source of pain, with 8 in 10 Americans experiencing some form of problem with their feet. One in 4 says they’re unable to exercise due to foot pain.
This isn’t so surprising when you consider that 25 percent of your bones are located in your feet and ankles, and your feet are the foundation of your body, carrying all your weight.
With 26 bones and 33 joints in each foot, there’s plenty of opportunity for something to go wrong — especially if you fail to walk and run with proper form and posture. Certain footwear, including flip-flops, and tight-fitting or high-heeled shoes may also damage your foot structure and aggravate the situation.
Moreover, few people pay attention to exercising their feet, and without proper muscle strength in your feet, your body may become imbalanced, which can lead to pain in other areas.
Simple foot exercises can make a big difference for problems such as bunions and hammertoes. Other common foot problems include plantar fasciitis (heel pain), ingrown toenails, and fungal infections, and in these instances other remedies are warranted.
In this article, I’ll review several common foot problems that cause pain and discomfort, with recommendations for simple and inexpensive treatments.
Plantar Fasciitis
Plantar fasciitis — inflammation in the ligament that runs along the sole of your foot — is one of the most common chronic injuries in runners. The ligament attaches to the bottom of your heel bone, which is why the pain is often felt in your heel.
The cause can be traced to excessive stress placed on the heel bone and soft tissues, causing inflammation. Improper footwear is typically part of the problem, and research1 by Michael Warburton, a physical therapist in Australia, found that running barefoot decreases the likelihood of plantar fasciitis.
Treatments typically focus on relieving tension on the heel and lowering inflammation. While cortisone and anti-inflammatory drugs are typically prescribed, I would suggest trying non-drug alternatives first.
For starters, you’ll want to make sure you’re on an anti-inflammatory diet high in healthy fats and low in sugars and non-vegetable carbohydrates. There are also plenty of anti-inflammatory foods that may do the job in lieu of pharmaceutical drugs. This includes:
  • Herbs and spices such as cloves, ginger, rosemary, and turmeric
  • Animal-based omega-3 fat, such as krill oil
  • Fermented vegetables and traditionally cultured foods, which quell inflammation by “reseeding” your gut with beneficial bacteria that help optimize your immune function
  • Shiitake mushrooms also contain strong compounds with the natural ability to discourage inflammation, such as Ergothioneine, which inhibits oxidative stress
Exercises for Plantar Fasciitis


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Foot and calf stretches can be helpful. The video above demonstrates a program consisting of five exercises to address plantar fascia pain:
  • Wall stretch, to stretch and elongate your calf muscles
  • Tennis ball massage, to stretch your plantar fascia
  • Pick up a sock or towel with your toes, to tone your plantar fascia
  • Seated calf stretch
  • Belt stretch
Surgery is not recommended for plantar fasciitis anymore. As previously noted by Dr. John E. Mancuso, doctor of Podiatric Medicine and Surgery:2
“[F]or the past 10 years, Manhattan Podiatry has been using a non-surgical therapy called Extracorporeal Shock Wave Therapy (ESWT) for patients who did not respond to conservative treatments.
ESWT uses high-intensity sound waves to heal the injured plantar fascia. In our practice, this innovative treatment has reduced the need for invasive surgical treatments by approximately 90 percent.”
Bunions
Bunions are an inherited condition in which your metatarsal bones are displaced, causing your big toe to lean toward your other toes, thereby producing that hallmark “bump” at the base of your big toe.
This projection causes your foot to widen, and tight, narrow, high-heeled, and pointy-toed shoes can easily aggravate the condition.
While surgery is part of the conventional treatment arsenal, I advise against it, as it doesn’t really address the underlying cause, and may require weeks or even months of painful recovery.
As with plantar fasciitis, part of the long-term answer is to go barefoot more often. Bunions are virtually non-existent in barefoot populations of the world.
Granted, from a practical perspective, going barefoot all the time is not an option for most people. But you can certainly do so inside of your home or backyard.
If you decide to go barefoot, do it slowly, progressing to more and more time spent without shoes. Also, when you start going barefoot it is best to initiate on naturally softer ground like grass and sand, not cement or hardwood.


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You can also address bunions with specific foot exercises. In the video above, Daniel Fitzpatrick of Alternative Foot Solutions in Sydney, Australia, reviews 2 daily exercises that can help strengthen the muscles around the bunion, thereby helping to correct the displacement of your big toe:
  • Heel raises. Lift your heels ¾ of the way up and hold for three seconds. Lower back down. Do 10 repetitions, once per day. This exercise strengthens your medial arch muscles, which helps pull the metatarsal bones into place, correcting the position of your big toe.
  • Toe crunches. Stand with feet hip-width apart. Rotate your ankles outward, so the weight is on the outside of your foot. Then scrunch your toes together, as if you’re making a fist with your foot. Hold for three seconds, then release. Do 10 reps once a day.
Hammertoes


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Hammertoe is a bending of either one or both joints affecting the second, third, fourth, or little toe, and is the result of years of compensation from the intrinsic (small) foot muscles. Ill-fitting shoes can contribute to the problem, but in some cases it can also be a hereditary condition.
Once a hammertoe develops, the high point of the knuckle becomes prone to shoe pressure, which can lead to pain, inflammation, and the formation of hard corns and calluses. Over time, the toe or toes tend to lose flexibility. As with bunions, foot exercises can be helpful, with a focus on stretching and increasing mobility. This includes the following exercises, demonstrated in the video above:
  • Toe extensions. This is best done with assistance. Your helper will grasp your foot with both hands, and gently flex your toes toward the sole of your foot to stretch the extensor tendons at the top of your foot.
  • Plantar flexion. Similar to the toe extension, the toes are flexed so that the knuckles at the top of the foot are clearly seen. Your helper can augment the stretch by placing a thumb into the metatarsal arch, gently pushing up, while gently flexing your toes down. Hold the stretch for 20 to 30 seconds.
  • Toe flexion. Grasp the end of your hammertoe, and stretch it to elongate the flexor tendon.
Toenail Fungus


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Toenail fungus is a very common and vexing problem that can be surprisingly difficult to eradicate. The fungus typically causes thickening of the toenail that can be quite painful, along with unsightly discoloration. If left untreated, it can cause secondary infections in the surrounding tissues. Conventional treatments typically involve harsh antifungal drugs, and/or laser treatments. Less expensive and certainly less toxic alternatives include the following suggestions:
  • Begin by reducing the thickness of your nail using some sort of debridement tool, to allow any topical remedy to enter into the nail. A nail file will suffice in most cases. Topical remedies that can be helpful include tea tree oil, Thieves oil (an aromatherapy oil), Neem oil, or even Vicks VapoRub. The latter is based on hundreds of anecdotal reports noting beneficial results. So, although I can't explain why it works, it certainly seems harmless enough to give it a try.
  • Avoid wearing socks and shoes as much as possible, as they create a hot, moist environment preferred by fungi.
  • Expose your feet to sunlight as much as possible, as the UV rays have a natural “anti-fungal” effect. Keep in mind it may take three to six months of nearly daily sun exposure to work, in combination with wearing sandals most of the time so there is no moist environment for the fungus to grow. I used to struggle with this problem for many years but since moving to Florida and walking daily on the beach I have been toenail fungus free for many years now.
  • Regularly submerge your feet in saltwater. The ocean is ideal, but you can also do foot baths, using natural sea salt.
  • Reduce sugar consumption, as sugar is a preferential nourishment for fungi.
Ingrown Toenail


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Ingrown toenails are preventable by making sure you cut your toenails correctly. You want to make sure you cut them straight across. Avoid angling the nail at the edges. Also, avoid cutting them too short. Proper trimming helps prevent the nail from curving and growing into the tissue of your toe on one or both sides, which can cause pain and infection. Excessive pressure from tight shoes can also contribute to ingrown toenails, so avoid too tight fitting shoes.
The video above, narrated by a podiatrist, explains how an ingrown toenail typically develops, and how to best address it. In the early stages, you may be able to free the ingrown toenail from the skin by soaking your foot in warm, soapy water. This can help prevent it from getting ingrown. AVOID trying to cut out the nail yourself, as this oftentimes will only worsen the problem, as explained in the video.
When it comes to ingrown toenails, your best option is to see a good podiatrist who can surgically address it. It’s one of the very few occasions when surgery is actually advisable. The podiatrist will numb the toe, and then remove the border of the nail to allow the tissue to heal.
It can in some cases be done in as little as 15 minutes, and relief and recuperation is typically swift. I actually had to have this done on both of my great toes about 10 years ago. It was the only surgery I have had and one that I am most grateful for, as the problem never returned.
Plantar Warts
Warts are caused by the human papillomavirus (HPV), and appear when the HPV virus infects the top layer of the skin, often in an area where the skin has been broken.
Plantar warts, also called verruca plantaris, are common warts that grow on the bottom of the feet. Plantar warts can occur as a single wart, but more frequently in a pattern grouped closely together. They often feel like small stones under your feet when walking, and can cause swelling and tenderness. The discomfort can also change the way you walk, which increases your risk of knee, hip, and back pain.
In more than 90 percent of cases, your immune system can clear up an HPV infection within two years on its own, so keeping your immune system strong is an important part of the equation. However, while most warts have the potential to resolve spontaneously over a number of years, many want the warts treated and removed as quickly as possible.
Alternatives range from over-the-counter treatments, such as a salicylic acid-based compound that removes a few layers of the wart at a time, to treatments available only in a physician’s office, such as cryotherapy and laser treatment.  
When using salicylic acid, you should first thin the wart by using a pumice stone or nail file across the top until all the white, dead skin is removed. Stop before the wart is bleeding or when you feel discomfort. Do not share this pumice stone or nail file with others or use on other parts of your body, as you can transmit the wart virus and develop more warts.
Soaking the wart in warm water will help to soften it before filing it down. Apply the solution, gel, or pads to the wart and use as directed on the packaging.
Interestingly, there’s also evidence that using nothing more than duct tape may do the trick! In fact, research3 shows duct tape is more effective than cryotherapy (cold therapy or freezing) applied in the physician’s office. The treatment was tested by applying a piece of duct tape over the wart for six days. The tape was then removed, the wart soaked in warm water, and filed. The tape remained off overnight and reapplied the next day for another six days.
This treatment protocol was compared against freezing therapy done in a physician’s office with liquid nitrogen applied for 10 seconds every two to three weeks for a maximum of 6 treatments. The researchers found that the individuals who received the cryotherapy had a 60 percent success rate with complete resolution of the wart, while those who used the duct tape enjoyed an 85 percent success rate with complete resolution.
Addressing Pain with EFT


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Last but not least, the Emotional Freedom Techniques (EFT) may also be helpful here, as a wide variety of pain can be rooted in emotional trauma. The method involves tapping specific points on your head and chest with your fingertips while thinking about your pain and voicing positive affirmations.

The combination of tapping the energy meridians and voicing positive affirmation works to clear the emotional block from your body's bioenergy system, thus restoring your mind and body's balance. For a demonstration of how to perform EFT for pain relief, please see the video above, featuring EFT practitioner Julie Schiffman.

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