Watch your step: The condition of feet can indicate thyroid, poor blood flow, rheumatoid arthritis

When our feet hurt, we hurt all over — different versions of this quote are attributed to Greek philosopher Socrates. Though it’s a statement made by a man born circa 470 BC, it holds true in the 21st century as well.

Your feet have to be healthy for more reasons than one. Dr Govind Singh Bisht, principal consultant (podiatry) at New Delhi-based Max Super Specialty Hospital, compares the body to a car and says your feet are the tyres. “If the tyres are not aligned properly, they will wear off and the alignment of the whole car will be disturbed,” he said.

Our body weight is distributed between the forefoot and the back foot evenly with an optimum arch, Bisht said. Any factor that disturbs this balance can cause problems.


YOUR FEET MAY BE SPEAKING TO YOU
Dr Prabhat Ranjan Sinha, consultant (internal medicine) at Dwarka-based Aakash Healthcare Super Speciality Hospital, said that since we think our feet are sturdy and can take intense pressure (and that's true), we don't generally invest much time contemplating the throbs, agonies and cautioning signs that they may give us.

“Dry or flaking skin around your heel or on the balls of your foot may be a warning sign of a thyroid condition; if you notice that your toes are losing a little bit of hair, or if they've gone completely bald, it could be a sign of poor blood flow; morning foot pain could be a sign of rheumatoid arthritis, and bluish discoloration of fingers and toes signifies that blood supply is getting compromised — it could be because of diabetes or vasculitis, and is a common problem among smokers,” Sinha said.

READING THE PAIN
Foot pain is usually caused by mechanical problems such as poor foot biomechanics, muscle imbalances, poor training techniques and improper footwear, according to Dr Ajay Aggarwal, principal consultant and head of the department of endocrinology at Fortis Hospital, Delhi.

“A podiatrist may prescribe an insole and assess your footwear. Shin pain usually occurs because of poor biomechanics, faulty training techniques or over-training; a callus or corn can form in response to pressure or friction, usually because of poor-fitting shoes; one may also witness soft corns that develop between the toes, where the skin is moist; corns and calluses are common among elderly people, and people with flat feet, higharched feet, arthritis and those who wear ill-fitting shoes,” Aggarwal said.

Ingrown toenail is a common problem among all age groups. Bisht said it accounts for 6-9% of his patients. “This happens when the nail starts digging into the skin at the corner and sides of the nails. It could be caused due to inflammation in the corner of the nails from using narrow, tight-fitting or pointed footwear, or overenthusiastic fiddling in the corner of nails while trimming them, walking downhill or pressure sports that cause rawness in the corner of the nails,” he said.

It is not uncommon to find people having thick and discoloured nails; they may not be normal in texture and shape too. "It's called onychomycosis," Bisht explained. “Fungal infection of nails is caused by trauma to the nail bed, which allows moisture to enter. Once the nail bed is infected, it may stay that way for years,” he added.

TREATMENT OPTIONS
Taking care of your feet also means you will have better overall health. “When you have painful feet, there is restriction of movement, which can lead to weight gain, sedentary lifestyle, (and thereby) diabetes, hypertension, feeling of bloating, sleep disturbance, and even depression and behavioural issues,” said Bisht.

“The treatment options include identifying and removing the cause of friction and pressure, customised padding to redistribute pressure, shoe inserts, proper footwear and proper moisturising. One must wear shoes or chappals in public areas to avoid tinea and apply anti-fungal creams for treatment. To avoid ingrown toenails, nails should not be cut into the corners and shoes should fit properly. Some patients have toenails that are prone to ingrowth, regardless of how they cut them. In these cases, the solution is to remove the outer margins of the nail, which requires a minor surgical procedure,” said Aggarwal.

DIABETICS NEED EXTRA CARE
According to a study published in the Lancet Diabetes & Endocrinology journal, as many as 98 million people in India may have type 2 diabetes by 2030.

Diabetes can make the feet numb and even a small cut can cause serious consequences. "This can cause an infection or a non-healing wound that may lead to amputation. Patients with diabetes should see a doctor regularly as part of their foot care. Specially so if there is a change in the foot’s skin colour, swelling in the foot or ankle, persistent sores on the feet or if there's an infected ingrown toenail,” said Aggarwal.


Along with following regular foot care, those with diabetes must take care to not walk barefoot even at home, they must wear extra-wide and well-cushioned footwear as well as never use hot-water bottles, heating electric pads or have direct exposure to heaters or blowers in the winter, said Bisht.

Make Your Feet Work Well:

• Maintain a healthy and balanced diet
• Don’t smoke as smoking causes blockage in arteries and decreased blood fl ow
• Wear well-fitting footwear. Pick footwear meant for specific activities like hiking boots or football shoes for those activities
• Maintain good foot hygiene as this will prevent skin infection, plantar warts and fungal infections. Regular nail care is important too
• Indulge in physical activities and sports only after proper muscle training and strengthening programmes to avoid injuries
• Never wear brand new footwear while travelling. Get used to them 10-15 days beforehand
• Wash your feet with warm water and dry them well, specially between the toes
• Wear cotton or woollen socks. Change them often
• Those with dry feet can use a urea-based or paraffin-based moisturiser and those with sweaty feet can use dusting or anti-fungal powder to avoid infections
• If your feet have a tendency to swell, consult your doctor for compression stockings
• If you have corns, don’t use corn caps available in the market or try bathroom surgeries — see a doctor
• Buy footwear in the evening as feet are known to swell as the day progresses