Podology: diseases — симптомы, диагностика и лечение

An ingrown toenail is a condition in which the edge of the nail plate cuts into the side of the finger, causing pain, swelling, and then inflammation and suppuration. The big toe is most often affected. The reason, contrary to popular belief, is usually not in “wrong nails” or heredity, but in habit - in the way a person cuts his nails. Cutting the corners “deeper” so that the edge does not interfere, creates a sharp thorn under the roller, which, as it grows, rests on the skin and pierces it. Then tight shoes and humidity come into play, and a vicious circle results: the more it hurts, the more you want to cut off a corner, and each such cut makes the next episode inevitable.

Diabetic foot syndrome is damage to the tissues of the foot in a person with diabetes that occurs due to a combination of two processes: nerve damage and poor blood supply. The most insidious thing here is the absence of pain. With diabetic neuropathy, the foot loses sensation, and a callus, abrasion from a new shoe, a burn from a heating pad, or a pebble in a shoe goes unnoticed until an ulcer forms in its place. People are accustomed to trusting pain as an alarm signal, but with diabetes this signal is turned off - and that is why examining the feet with one’s own eyes every evening becomes not a hygienic habit, but a full-fledged medical procedure. The vast majority of amputations due to diabetes are preceded by an ulcer, which could be noticed in time.

The foot consists of twenty-six bones, many joints, ligaments and tendons and bears the body's weight thousands of times every day. Therefore, pain in it is very common and has dozens of causes. The key to diagnosis is precise location: pain in the heel when taking the first steps in the morning is typical for plantar fasciitis, pain at the base of the big toe with redness is for gout, a burning sensation between the toes is typical for Morton's neuroma. Pain in the foot requires special attention in people with diabetes, who have reduced sensitivity and any wound may go unnoticed.

Fungal infections of the skin and nails are one of the most common dermatological problems and at the same time the one where the wrong treatment is most often made. A damaged nail is not always affected by fungus: trauma, psoriasis, eczema and circulatory disorders give a similar picture. Therefore, the rule is simple: before starting treatment, you need to confirm the diagnosis in a laboratory. Therapy for onychomycosis lasts for months, costs money and requires liver monitoring - spending all this on a non-fungal problem is pointless.

Calluses and corns are areas of compacted, keratinized skin that form in places of constant pressure and friction. A corn is a wide, flat thickening on the sole, often under the base of the toes or on the heel. The callus is smaller in area, has clear boundaries and sometimes a dense core that goes deep, which is why it hurts a lot when walking. The main reasons are tight or uncomfortable shoes, high heels, flat feet and toe deformities. Calluses and corns are not dangerous for a healthy person, but in people with diabetes and circulatory problems they can lead to ulcers. Treatment always begins with eliminating the pressure.

Hammer toe is a persistent flexion of the toe at the middle joint that causes it to lift upward and push into the shoe. Most often the second finger is affected, less often the third and fourth. The deformity develops gradually: at first the finger can be straightened by hand, then the joint becomes rigid. A painful corn or callus forms at the top of the bent joint, and pain appears under the ball of the foot. The main reasons are imbalance of the muscles and tendons of the foot, narrow high-heeled shoes and concomitant transverse flatfoot with hallux valgus. At an early stage, correct shoes, insoles and exercises help; in case of severe deformation, surgery is needed.

Morton's neuroma is a painful thickening of the common plantar digital nerve, most often between the third and fourth metatarsals. This is not a tumor, but a growth of fibrous tissue around the nerve, which is constantly compressed between the heads of the bones and the ligament. The person describes the sensation of a pebble or crease in the shoe, burning and stabbing sensations in the fingers, and numbness. The pain intensifies in narrow shoes with heels and when walking, subsides if you take off your shoes and massage your foot. Middle-aged women are more often affected. With early treatment, changing shoes, insoles, and offloading the forefoot is usually sufficient; in persistent cases, injections or removal of the nerve are used.

A flatfoot is a condition in which the longitudinal arch is flattened and the heel is deviated outward, causing the foot to roll inward. In children, this is most often a developmental option, and not a disease: until the age of three to five, the arch is not formed in almost everyone, it is covered by a fatty pad, and the ligaments remain soft. As muscles grow, strengthen, and coordination develops, the arch forms independently in most children. It is not flat feet themselves that require treatment, but those cases where there is pain, fatigue, the foot is rigid and does not change shape when rising on the toes, or there are neurological disorders.

Cracked heels are tears in the thickened and dry skin in the heel area. First, the skin becomes rough and yellow, a hard rim appears along the edge of the heel, then under load it cracks. Shallow cracks cause cosmetic discomfort, while deep cracks hurt when walking, bleed and become entry points for infection. Most often, the reasons are domestic: open shoes, walking barefoot, dry hot climate, excess weight, long standing and insufficient care. However, cracks can be associated with foot fungus, diabetes, hypothyroidism, psoriasis and eczema. With proper care, the skin recovers within a few weeks, and people with diabetes need especially careful monitoring of their feet.