Right Steps

Most corporate employees make it a point to be well shod - in dress shoes, heels, pumps and even espadrilles depending on the occasion. But not even the most expensive footwear could help if you are suffering from conditions that may require corrective footwear, medication and surgery.

"A normal foot is one where the toes are aligned and straight, there is no deviation and the arch below the foot is normally maintained. But either due to trauma or weakness in foot muscles, the arch under the foot could collapse, leading to what is called a flat foot. Some are also born with them," says Dr G. Shashi Kanth, Consultant Orthopaedic Surgeon and a specialist in joint replacement and sports injuries at CARE Hospitals, Hyderabad.

Women tend to suffer from hallux valgus or bunion as the big toe bends to one side due to bone or tissue enlargement, arthritis or hormonal changes leading to loosening of ligaments. It can be hereditary as well. In eight out of 10 cases, people suffering from bunion are women, especially those whose work involves a lot of standing or walking around or severe repetitive stress (doctors, nurses, teachers, dancers and so on) and who mostly wear close-fitting shoes. The treatment starts with wearing comfortable shoes along with a bunion shield or pad and a toe spacer placed between the big toe and the next one. If the condition persists, surgery might be required.

People with diabetes could end up with diabetic neuropathy (small nerve damage in feet) and diabetic charcot arthropathy (damages bones, joints and soft tissues in feet and ankles). They also run the risk of developing gangrene (a condition when a body tissue dies due to lack of blood supply). In some cases, people could develop, what doctors call a rocker bottom foot, characterised by a convex, rounded bottom of the foot.

You may also feel a piercing pain in the heel when you put your foot down in the morning, points out Dr Shashi Kanth. It is another common problem called plantar fasciitis. The plantar fascia is a thick band of tissues attached to the heel bone to support the arch in the foot and the pain is usually caused by irritation or inflammation of tissues. The treatment is usually non-surgical and involves physiotherapy, use of silicon heel gel pads (costs Rs 500-1,000 a pair) and anti-inflammatory medications.

Therapies for foot health

Treating foot/heel pain (plantar fasciitis) takes time, but help is at hand. The use of platelet-rich plasma therapy for soft-tissue healing has become quite popular over the past four-five years, says Dr Shashi Kanth. In this procedure, a patient's own blood platelets are injected into the affected area and the healing process is faster, compared to steroids. As for treating bunion, open surgery is a standard procedure where the bone gets realigned. In cases where the big toe is both deformed and arthritic, the joint is fused completely with minimal invasive surgery. It helps correct the deformity and ensures pain relief although there will be no movement in that joint. Stem cell therapy is also useful for those suffering from non-healing ulcers caused by diabetes.