Feet are essential for walking, offering both length and stability while standing. Additionally, changes in the feet can indicate serious health issues, making it important to stay aware of their condition. Swelling in the feet signals an underlying issue in the body. One-sided swelling may result from a broken bone or soft tissue injury, diagnosed through X-rays or CT scans. Treatment involves splinting the injured leg or surgery. Accompanying redness and tenderness indicate infection or inflammation, requiring prompt medical attention. Two-sided foot swelling with pitting upon finger pressure can result from heart, kidney, or liver failure and protein or thyroid hormone deficiency. A precise diagnosis is made based on the patient's history and clinical features such as breathlessness, palpitations, and reduced urination. Confirmation comes from relevant investigations, and treatment is tailored to the underlying condition. Discolouration of the feet can point to various health issues. Blue or purple feet are often a sign of being cold. However, it can also indicate poor circulation or cardiovascular problems. Peripheral vascular disease, caused by conditions such as diabetes, hypertension, and smoking, can lead to reduced blood circulation due to blockages in the blood vessels of the legs and feet. This causes discolouration of the feet, as well as pain when walking. Treatment is by medicines that dilate the blood vessels and improve blood circulation. “Red feet” may indicate an allergic reaction, particularly if accompanied by itching, swelling, or a rash. It typically resolves with anti-allergy treatment or removal of the allergen. The sensation of numbness or tingling in the feet from staying in one position too long is known as 'pins and needles.' Frequent tingling or numbness in the feet may indicate peripheral neuropathy, a type of nerve damage. It can be due to uncontrolled diabetes, vitamin B complex deficiency, deficiency of thyroid hormones, alcohol, tobacco abuse, etc. Sometimes it is the only feature of diabetes, and testing of blood sugar confirms diabetes. Early treatment of the underlying condition, or stopping the causative substance, can reverse neuropathy. Some drugs like some anti-TB drugs, some antibiotics, and anti-HIV drugs, also cause peripheral neuropathy. This is reversible if the drug is withdrawn early. Dry, cracked heels can be a result of being on the feet for long periods, especially on hard floors and wearing unsupportive footwear. It is also common in dry weather and or exposure to dust as it happens in people who walk barefoot or use poorly fitting footwear. In some cases, dry, cracked heels can be a sign of an underactive thyroid. Dry cracked heels can become a source of infection and subsequent inflammation, as germs can enter the skin through the cracks. Hence, this needs to be avoided by wearing properly fitting shoes, and keeping the feet clean, dry, and well-lubricated. Scrubbing the heels daily helps to remove any dry or cracked skin. Swelling and pain in the big toe, possibly accompanied by discomfort in other toes, the ankle, or occasionally the knee, especially at night, suggest gout, a condition caused by excess uric acid in the blood. It is a curable condition diagnosed through blood uric acid levels, treatable with dietary changes and medications that lower uric acid. Many diseases can be diagnosed early through the condition of the feet, so it’s important to seek medical attention if any abnormalities are noticed in one or both feet. Dr Rachna Pande is a specialist in internal medicine. rachna212002@yahoo.co.uk
