Care & Treatment
A small bunion may not cause problems when wearing shoes and socks that don’t rub the area. Shoe inserts like orthotics (soles specially molded to your foot) may also help. If this doesn’t work, other options are:
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, or corticosteroid (cortisone) injections may help to relieve pain.
- Surgery: Even if your bunion is severe, outpatient surgery may be all you need. The abnormal growth of the bunion is gently shaved away and tendons are adjusted. In more intensive surgery, other toe bones may have to be repositioned.
Corns and Calluses
Shoes that are fit well are the solution for corns and calluses. Open-toed sandals are very helpful in good weather. Sometimes, a shoemaker can stretch your shoes to give you more room around your toes. Thick socks also help to absorb pressure.
Simple over-the-counter products can soften and resolving corns and calluses. These include:
- Creams or petroleum jelly (Vaseline). Regular use can soften dead skin.
- Donut-shaped pads that fit around the corn and reduce pressure and friction. (Avoid medicated pads, especially with diabetes or numbness in your feet.)
- Cotton or other soft material placed between toes to prevent them from rubbing.
- Pumice stones. These are used to gently sand down the corn or callus after soaking in very warm water for at least five minutes. This will take several treatments.
Never trim corns or calluses with a razor blade or knife. The risk of injury and infection is extremely high.
- Wearing roomier shoes with mild symptoms
- Preventing corns and calluses from rigid hammertoes by using soft padding between the affected toes
- Wearing wide shoes or custom-made orthotic inserts or footwear
- Exercising and using splints may help
- Having surgery to release the tendon if the deformity is severe
Wearing open-toed shoes or sandals may prevent painful friction.
For ingrown toenails that are not infected, your podiatrist or other trained healthcare professional can
- Trim the side of the nail or shave it down to resolve the pain.
- Use a chemical to remove the skin around an ingrown nail. The skin may also be removed with a laser or by cauterizing (burning it away).
Surgery: If the nail is completely ingrown, or has a significant infection, more of the nail may have to be removed. Local anesthesia works for these procedures. If the infection is causing swelling, the podiatrist may drill a hole in the nail to allow drainage, which will relieve the pain. Soaking or icing the area may also be prescribed.
If the toenail is infected by a bacteria or fungus antibiotics may be needed by mouth or ointments on the toe. Cautions are:
- Treatment is expensive and may need to continue for 6 to 12 months
- Cure for the infection happens n fewer than half of cases
- Oral antifungal therapy generally works, but can takes months
- Medicines can have adverse effects
Diabetic Foot Problems
Minor Foot Infections
A healthcare professional will clean the infected area and prescribe antibiotics to get rid of the infection. Make sure to take all the pills prescribed and have the professional check to make sure the infection has cleared up.
Serious Foot Infections
People with diabetes can have serious sores develop from a small cut or abrasion. The infection can then spread into foot bones and even into the leg. Foot ulcers must be treated carefully and their healing monitored by trained specialists.
If the infection cannot be controlled, surgery may be needed with intravenous (IV) antibiotics for at least a few days. After the surgery, a healthcare professional needs to change your wound dressings regularly. Follow up appointments with your health care professional are important because infections can come back if not completely cured.
Arthritis Foot Problems
Arthritis foot pain may be controlled with:
- Warm footbaths
- Heating pads (if you do not have nerve damage or numbness).
- Custom-made footwear
If the pain is severe and prevents you from walking well, your healthcare provider or podiatrist may suggest surgery.
Steps to relieve pain from plantar fasciitis include:
- Exercise to stretch the plantar tendons
- Painkillers such as aspirin or ibuprofen
- Cold compresses
- Taping the foot or shoe inserts (such as orthotics) to cushion the soles of your feet
- Slightly elevated heels if symptoms are mild
The most important step is doing regular foot stretches and icing. It may take several months or more to see full results.
Moderate, gentle walking, swimming, or bicycling are good activities, but avoid overdoing it. You may have some relief from slightly elevated heels if your symptoms are mild.
For severe cases of plantar fasciitis, night splints, leg supports, corticosteroids (cortisone shots) or local anesthesia may be needed.
For stubborn, disabling heel pain that has been going on for many months, surgery may help. An operation called “instep plantar fasciotomy” removes tissue that has been pressing on irritated nerves.
Non-surgical approaches are always preferred, and include:
- Pain medications and anti-inflammatory pills (aspirin, ibuprofen)
- Taping the foot
- Shoes that fit well with low heels and arch support
- Calf stretches
- Massage and warm-water foot baths
- Icing the arch
- Over the counter or custom-made orthotic insoles
Surgery to lengthen the Achilles tendon or reshape the foot is rarely done in older people, and then only in very severe cases.
Overly High Arches
Depending on how severe the deformity and the pain, your healthcare professional may prescribe non-surgical treatments like those for flat feet, exercise, or surgery.
Tarsal Tunnel Syndrome
Treatment approaches include:
- Special shoes and custom-made insoles (orthotics)
- Cortisone shots help
- Surgical removal of a cyst or tumor.
Surgery may not be beneficial if no cause for the Syndrome is clear. Surgery only happens if the problem has persisted for at least a year with no relief. Recovery takes several months.
Various approaches are used to treat Achilles tendonitis but scientists are still uncertain which work best.
- Exercise: Keep the leg elevated as much as possible while there is swelling in the calf or heel. When swelling is gone, try gentle calf stretches, but stop if the pain increases.
- Medications: NSAIDs (aspirin, ibuprofen) often lessen the pain and swelling. Cortisone injections may also help but are not used often because of the risk of tendon damage.
- Non-drug approaches: Icing the area up to five times per day for about half an hour may bring some relief, but be careful not to overdo it. If the tendon ruptures, you will probably need a cast over the calf and foot.
- Surgery: A surgical approach for a ruptured Achilles tendon is sometimes done. However, surgery is usually not recommended for older people.
The following approaches, alone or combined, may help:
- Massage of the painful area
- Wider shoes
- Cushioning pads
- Corticosteroid (cortisone) injections
- Ultrasound-guided alcohol injections
Surgery: If your symptoms have not improved with these treatments, surgery to remove the painful area is usually effective.
Your podiatrist or other healthcare provider may prescribe orthotic inserts for you to wear at all times. These insoles are molded from a cast of your foot. They may be rigid, semi-rigid, or soft.
Your healthcare provider will decide which type is right for you depending on your condition. They are often expensive. Cheaper over-the-counter insoles available at any drug store may be sufficient.
You should inspect your feet regularly, checking for changes in skin color or temperature, thickened or discolored nails, and any sign of a break in the skin or abrasion.
Older people with diabetes make up the greatest number of older adults with serious foot problems. They need a thorough foot evaluation at least once a year. Many older people—particularly those with diabetes—have impaired vision. This can make it harder to find small changes or skin problems.
People who have diabetes, poor circulation in the feet or foot problems likely need to see a podiatrist approximately every 3 months.
Last Updated February 2023
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