Onychomycosis is often ignored because the infection can be present for years without causing any pain.  The disease is characterized by a progressive change in a toenail’s quality and color, which is often ugly and embarrassing.

In reality, the condition is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.  If ignored, the infection can spread and possibly impair one’s ability to work or even walk.  This happens because the resulting thicker nails are difficult to trim and make walking painful when wearing shoes.  Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers for example.  Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection.  Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails.  Other contributing factors may be a history of athlete’s foot and excessive perspiration.

Traditionally, nail fungus has been difficult to treat, with many experiencing recurring outbreaks during treatment.  Efficacy with oral therapies remains limited, and safety may be an issue, as oral medications may carry risks such as liver or kidney problems.  Topical therapies as alternatives for onychomycosis are limited by lack of nail penetration and compliance issues, as most topical treatments require 12 months and are associated with lower success rates.

New device-related topical therapies, such as laser therapy, are particularly noteworthy, as they may allow for shorter, more convenient treatments for patients, reducing issues with topical compliance, and avoid potential for drug reactions.

http://www.achillesfootclinic.com/laser-treatment.php

“My foot or ankle can’t be broken, because I can move it.”

False. This widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples:

• breaks of the thinner of the two leg bones
• small “chip” fractures of either foot or ankle bones
• the frequently neglected fracture of a toe.

“If you break a toe, immediate care isn’t necessary.”

False. A toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatrist usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatrist will help prevent improper or incomplete healing.

Many patients develop post-fracture deformity of a toe, which in turn results in formation of a painfully deformed toe with a most painful corn. A good general rule is: seek prompt treatment for injury to foot bones.

“If you have a foot or ankle injury, soak it in hot water immediately.”

False. Don’t use heat or hot water if you suspect a fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain.

An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing effect, and prevents swelling and pain. After seeing a podiatrist, warm compresses and soaks may be used.

“Applying an elastic bandage to a severely sprained ankle is adequate treatment.”

False. Ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. Imaging studies (X-ray, bone scan, CT, MRI or the like), immobilization by casting or splinting, and physiotherapy to insure a normal recovery all may be indicated. Surgery may even be necessary.

Source: B.C. Association of Podiatrists

Source: B.C. Association of Podiatrists

As always, prevention is the best medicine. A good daily foot care regimen will help keep your feet healthy.

Start by assembling a foot care kit containing nail clippers, nail file, lotion, a pumice stone and a non-breakable hand mirror. Having everything you need in one place makes it easier to follow this foot care routine every day:

• Wash your feet in warm (not hot) water, using a mild soap.
• Don’t soak your feet, as this can dry your skin.
• While your feet are still wet, use a pumice stone to keep calluses under control.
• Dry your feet carefully, especially between your toes.
• Thoroughly check your feet and between your toes to make sure there are no cuts, cracks, ingrown toenails, blisters, etc.
• Use a hand mirror to see the bottom of your feet, or ask someone else to check them for you.
• Clean cuts or scratches with mild soap and water, and cover with a dry dressing suitable for sensitive skin.
• Trim your toenails straight across and file any sharp edges. Don’t cut the nails too short.
• Apply an unperfumed lotion to your heels and soles. Wipe off excess lotion that is not absorbed. Don’t put lotion between your toes, as the excessive moisture can promote infection.
• Wear fresh clean socks and well-fitting shoes every day. Whenever possible, wear white socks – if you have a cut or sore, the drainage will be easy to see.

Healthy feet do’s and don’ts for diabetics

• Do wear well-fitting shoes. They should be supportive, have low heels (less than 5 cm high) and should not rub or pinch. Shop at a reputable store with knowledgeable staff who can professional fit your shoes.
• Do wear socks at night if your feet get cold.
• Do elevate your feet when you are sitting.
• Do wiggle your toes and move your ankles around for a few minutes several times a day to improve blood flow in your feet and legs.
• Do exercise regularly to improve circulation.
• Do inspect your feet daily and in particular, feel for skin temperature differences between your feet.
• Don’t wear high heels, pointed-toe shoes, sandals (open toe or open heel) or worn-out shoes.
• Don’t wear anything tight around your legs, such as tight socks or knee-highs, unless custom stockings are prescribed by your doctor.
• Don’t ever go barefoot, even indoors. Consider buying a pair of well-fitting shoes that are just for indoors.
• Don’t put hot water bottles or heating pads on your feet.
• Don’t cross your legs for long periods of time.
• Don’t smoke. Smoking decreases circulation and healing, and significantly increases the risks of amputation.
• Don’t have pedicures by non-healthcare professionals.

Source: B.C. Association of Podiatrists