Dr Zak: Why it's important to mind your feet

We endure a love-hate relationship with our feet, from some who relish their regular pedicure, to those for whom even the thought has them in a cold sweat, or worse shouting 'put those away'.

Whatever your view, we need to be familiar with our feet, in the same way we would any intimate body part, meaning something not regularly on show to others, and hence potentially ignorable.

In the UK, over two million working days a year are lost due to lower limb complaints, and a third of GP consultations regarding musculoskeletal issues pertain to the foot and ankle. Trips and falls are the single most common cause of accidental injury and death in the over 75 age group, with many of these being due to foot related problems.

Our feet are marvellous organs so complicated that they contain 26 bones, 33 joints and more than 100 ligaments, muscles and tendons. Thankfully, the majority of what we need to be aware of can be learnt by observing them from the outside.

Podiatrists or chiropodists, these terms often being used interchangeably, advise that we pay the same attention and care to our feet, as we would any other part of our anatomy. Just 10 minutes a week may be enough to check for minor ailments that if addressed could keep us going strong.

Cracked heels and skin, though unsightly, are often nothing more than a cosmetic nuisance. However, if ignored they may become deep enough to cause pain and even bleed. Any open wound is a portal for infection to enter the body.

While there is a strong genetic component to the development of bunions, they can often be exacerbated by ill-fitting footwear. Shoes with a narrow toe box, as the name implies, may cause bunching of the toes and worsen any pre-existing condition.

Calluses represent thickening of the skin to protect the underlying structures, but they may be sign of poorly fitting footwear, or misaligned posture or gait. The feet are our foundation stones. Foot and ankle problems can affect joints all the way up the body, even to the neck.

While our hands and feet may sometimes be cold, being furthest from the heart and often not surrounded by much fat, permanently cold feet could be a sign of underlying circulatory issues. Feet and hands that change colour violently when going from warm to cold environments may signify Raynaud’s disease.

Discoloured or disfigured toenails can indicate fungal nail infection. Typically, you would need to submit nail clippings to be tested before being commenced on some of the stronger medications to tackle this.

On the subject of nails, please be wary of any bruise or change under a toe nail, especially if you cannot remember a knock or trauma. In rare instances this may be skin cancer.

Lower limb swelling (oedema) can occur if you are stood for prolonged periods, but if it does not resolve when lying flat, it could be due to heart or kidney issues. Swelling in one leg could be a sign of infection or clot, (DVT), and should never be ignored.

Podiatry and footcare services are routinely available on the NHS to those with diabetes, as high blood sugar levels not only impair circulation to the feet, but also damage the nerves which would alert the person to a potential problem in the first place. For this reason, also, anyone with diabetes is encouraged to visually inspect their feet on a daily basis.

We are living in cash strapped times, but I would urge anyone who can afford it to consider investing in a routine review with a podiatrist. Though much basic footcare can be done in the home with the aid of fairly inexpensive tools and moisturisers, many cases of ingrown toenails are caused by overly aggressive nail trimming.

Not only will a trained professional be able to assess your foot health, they will be delighted to provide a comprehensive service including removal of hard skin and verrucae, as well as advise on any complaints that may require footwear adaptations.

Loving your feet will take you a long way.

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