Prevention and education keys to proper foot care

by Erica Peterson 

When it comes to maintaining one’s overall health, proper foot care should not be overlooked.

Podiatrists, working in concert with other health care providers, provide an important piece of the wellness puzzle. For example, diabetic foot care is one of the most popular treatments sought by Dr. Jeffrey Halpert of Podiatry of Greater Cleveland in Broadview Heights and Parma. 

That includes maintenance checkups, vascular care and treating ulcers, neuropathy and infections.

Diabetics who have neuropathy can’t feel the pain in their feet that signal an ulcer, cracked skin or other wound. That is why regular foot exams are vital for diabetics.

“What a lot of people don’t think about is that pain is a good thing; it tells us something is wrong,” said Dr. Sarah Newey of the Newey Foot Clinic in Bath. 

“Someone who can’t feel or has very little feeling in their feet could walk a hole into the bottom of their foot and would never feel it.” 

Often, by the time such a wound is noticed, it’s infected. “By the time you notice an infection, it’s too late,” Halpert said. 

Treatment can include hospitalization for IV antibiotic treatment and, if an infection gets into the bone, amputation of toes, foot, or even leg, he said.

That’s why preventative care is necessary, Newey said. “A lot of insurances want diabetics to be seen by a podiatrist for a foot exam every year even without any symptoms, because they are at such high risk,” she said. 

Regular examinations include checking for signs of infection and vascular issues, and proper foot care including debriding toenails and calluses that could lead to ulcerations and prescribing diabetic shoes and insoles, Halpert said.

Newey participates in a program that provides accommodative shoes for diabetics who qualify. She sees it as another preventative care service.

“If they have at least one pair of shoes that I know is not rubbing on their feet or causing any issues, I’ve done one part in preventative care,” she said. “I can’t be there to look at their feet every day, but I know I’ve helped them in their day-to-day life.” 

Plantar fasciitis 

Both Halpert and Newey treat many patients for plantar fasciitis, which presents as heel pain. The plantar fasciitis is the band that connects to heel to the ball of the foot, and it is painful when inflamed.
“We see a tremendous amount of plantar fasciitis, most coming from May through the fall, when people are out running,” Halpert said. 

The pain most often hits first thing in the morning, when people get out of bed, or late at night, he said. It may be relieved by stretching exercises, ice, proper arch supports and anti-inflammatories. 

“If the pain doesn’t respond to home remedies, it’s time to see a podiatrist,” Halpert said.

That’s because while plantar fasciitis is the most common cause of heel pain, it’s not the only one. Newey said other causes could be a stress fracture, a strain, referred pain from the ankle or elsewhere in the foot, bone cysts or inflammation from overuse of a ligament or tendon.

An exam is needed to determine the proper cause and course of action.

Other common ailments podiatrists treat include fungal toenails, plantar warts, bunions, hammertoes, ingrown toenails and neuromas, which are a benign growth of nerve tissue.

Whatever the diagnosis, patient education is important, Newey said. “My perspective is education is the way to prevention,” she said. “If you don’t understand what is going on, you’re just following directions. Education helps you prevent doing the same thing [that caused the problem] the next time. 

“I try to get my patients to get involved in their patient plan as well. I can tell you what to do, but it’s your body. You should have a say in what you do.”