Windows to your sole

Dr. Paul B. Clayton examines Cleo Fleming’s feet in his office at McKay-Dee Hospital in Ogden....
KERA WILLIAMS/Standard-Examiner
Story by Jamie Lampros
(Standard-Examiner correspondent)
Mon, Feb 18, 2013
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Right now, your feet are probably tucked away in a pair of wool socks or warm, fuzzy house slippers or a thick pair of boots to get you through the winter snow.

But when you get a few minutes, take a good look at your naked feet. You may just end up saving your own life.

The feet are composed of 26 major bones and joints that allow us to stand upright, walk, run and jump. But they’re even more complex than we may realize. The feet are good indicators of what might be going on in the rest of our body.

Cleo Fleming of Pleasant View has been dealing with a condition called neuropathy, which includes pain and numbness in her feet. Fleming suspects the neuropathy in her feet was an indication of varicose veins in her legs, which she eventually had removed.

Then, two years ago, she was doing yardwork when she unknowingly stepped on something.

“I don’t know what I stepped on because I didn’t feel it at the time, but whatever it was, it went right through my rubber boots,” she said. “I developed an open sore on my foot, so my doctor sent me to a foot specialist.”

Dr. Paul Clayton, a podiatrist at the McKay-Dee Hospital Foot and Ankle Clinic, has been treating the wound.

“Feet can, in fact, tell you a lot about your overall health,” Clayton said. “By looking at the skin, toenails, checking pulses, looking for swelling, and checking nerve and muscle function, there is a lot that can be learned about a person’s health. I have diagnosed conditions such as diabetes, heart problems, psoriasis, hip and back problems, based on a simple foot exam.”

We asked Clayton, Ogden Clinic’s Dr. Kelly Stagg, the Davis Hospital and Medical Center’s Dr. David H. Warby, and Dr. Greg Cook of Brigham City Community Hospital to give us the lowdown on what our feet say about the state of our health.

“We see a lot of things happening in the feet and when you see some of those things you say, ‘Oh boy, this isn’t good,’ ” Stagg said.

Cook agrees.

“Our bodies are intricately connected, and issues in one location can affect other areas of your body in ways you didn’t even realize,” Cook said. “Your foot structure has a lot to do with that, since we spend so much of our day on our feet through walking or standing — and abnormal foot structure places abnormal stresses on joints further up the body, including the knee, hip, or back.”

Here are some things to look for that may indicate you need to see your physician:

• Ulcers and sores — If you notice sores that won’t heal or blemishes that develop red ulcers, you may have diabetes. Because of high glucose in the blood, not enough oxygen reaches the nerve tissue to heal sores in the feet. Diabetics also have a more difficult time fighting off infection because they are less able to produce white blood cells. As a podiatrist, Stagg said, he is able to treat those wounds, but he refers them on to a specialist to help them with their diabetes.

Ulcers and sores that don’t heal could also mean you have an undiagnosed autoimmune disease such as lupus or rheumatoid arthritis. Or, it could also mean poor nutrition.

• Red, white and blue feet — While you might think you’re being patriotic, don’t get too enthused. Warby said this is definitely a sign of a circulation disorder. You should make an appointment with a cardiologist.

Smoking can also cause a bluish color in the feet. That’s because the effects of nicotine can involve narrowing of the arteries in the legs and feet. If you don’t quit smoking with this condition, Stagg said, you could start losing some fingers and toes.

• Frequent cramping — Clayton said cramping in the feet can be caused by vitamin or nutrient deficiencies, circulation or nerve problems, overuse injuries, or inappropriate or poor-fitting shoes. A nutrition deficiency can be corrected. Changing shoes or relaxation techniques can be helpful. Even changing the way you sit or lie in bed at night can improve foot and leg cramps.

• Spots underneath your toenails — Stagg said black dots underneath the toenails can indicate heart disease. Thankfully, he said, he doesn’t see this very often, but he sees it enough to emphasize that your next stop should be the cardiologist’s office.

• Other abnormalities with the toenails — Ridged or pitted nails can mean you have eczema or psoriasis, a skin disease marked by red scaly patches, Warby said. It can also indicate specific types of arthritis.

Toenails with slightly sunken, spoon-shaped indentations may indicate iron deficiency, anemia or chronic internal bleeding.

Raised strips running across the nail could mean you have Raynaud’s syndrome, a circulatory problem that can make your toes feel icy cold.

• An enlarged big toe — This can mean several things, said the four physicians. The most common is gout, a painful arthritic condition that can affect the joints, particularly the big toe. Other symptoms include a burning sensation in the toe, swelling, shiny red or purplish skin, and pain so severe it hurts to even have a sheet touching the toe.

If you have toes that burn and sting, you could have Morton’s neuroma, a common condition that Stagg said is easily treated. Trauma, bunions and Gigantism can also cause an enlarged big toe.

• Numbness and tingling — This can be an indication of diabetes or peripheral neuropathy. Peripheral neuropathy can be caused by diabetes, but it can also be caused by varicose veins, alcohol abuse, chemotherapy treatment, lumbar spine problems, or tarsal tunnel syndrome, a condition that occurs from abnormal pressure on a nerve in the foot.

• Stinky feet — Ah, the junior high favorite, Stagg observed. Kids in this age group have feet that sweat like crazy, but it’s not the feet causing the foul aroma. It’s bacteria in their shoes. Thankfully, there are some topical medications that will help dry out the feet.

Stagg also recommends changing your shoes and socks a couple of times a day, washing with an antibacterial soap, keeping feet dry, and wearing natural materials such as cotton socks and leather shoes, which wick away moisture better than manmade materials.

• Loss of hair on toes and feet —Hairy feet may not look pretty, but they’re a sign of good health. If your feet and toes are hairless, Clayton said, you could have poor circulation. The small blood vessels feed the hair follicles; when the circulation diminishes, the hair stops growing. For this, you will need a vascular workup.

• Shooting pain in the heel — Clayton said heel pain is one of the most common complaints in his practice. The most obvious reason could be plantar fasciitis, a condition caused by abnormal straining on a band of connective tissue running along the bottom of the foot.

It could also mean tendonitis, heel spurs or nerve entrapment. Rest your foot, apply ice, get rid of your old shoes — and if that doesn’t help, go to the doctor.

• Flat feet — If you walk barefoot on the beach and look back at your footprints, Cook said, do you see your whole foot from toe to heel and inside to outside edge, or do you see just your toes to the outside edge of your foot to your heel? The first description is called a flat foot. The second is a high arch. People often have varying foot structures between these two extremes.

High arches can cause arthritis in the knees, hips and back. Flat feet can cause shin splints, plantar fasciitis, achilles tendonitis, a tendency toward bunion formation, and a predisposition for ACL (anterior cruciate ligament) injuries.

• Ingrown toenails — Just thinking about this one can cause pain. The majority of ingrown toenails are from injuries such as dropping things on the feet or having them stepped on. Sometimes, it takes a foot doctor with a dose of anethesthesia to remove the ingrown toenail.

• Fungus — This condition is common, Stagg said. Thick, yellow, dry, flaky feet and toenails can be downright miserable. See your foot doctor for this one. There are several treatment options, but keeping your feet dry is key. Fungus in the toenails can grow so thick that it can tear up your shoes and socks and will most likely have to be professionally removed.

Fleming said she had been having pain in two of her toes, which turned out to be a fungal infection. “I had Dr. Clayton remove two of my toenails,” she said. “I am so careful about my feet now. Every night, I sit down by the side of the tub and exam my feet.”

• Toes that bump upward at the tips — This is called digital clubbing, Warby said, and can mean insufficient oxygen is being carried throughout the body. If this happens, it could be a lung disorder or even lung cancer.

• Blisters and bunions — Blisters can mean your shoes are too tight. Bunions can mean your shoes are too narrow. And flip-flops? Stick to good old-fashioned tennis shoes: Stagg says it’s amazing how many people actually fall off the side of their flip-flops, not to mention the shoes provide zero support for your feet.

So, while the feet can indicate other health issues, you can solve a lot of common everyday problems by keeping your tootsies washed and dried, wearing good-quality shoes and changing your socks a couple of times each day.

Oh, and get yourself a good foot doctor.


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