Top 5 reasons we visit the podiatrist

With summer around the corner Dr Tariq Khan gives you advice on how to get your feet looking their best

An engineering miracle combining grace, durability and sensitivity – it’s an apt description of the human foot. Perhaps one of the most neglected parts of the body, generally hidden from site, the importance of feet is only fully appreciated when something goes wrong. Healthy feet in good working order give us the joy of movement. Painful, unhealthy feet makes feel tired and irritable and take the pleasure out of life.

Consider the punishment the foot absorbs in a lifetime. As we move, at a comfortable 100 steps a minute pace, each heel strikes the pavement with the equivalent of a 225lb jolt 50 times a minute. As we walk an average of 115,000 miles in a lifetime, that means tens of millions of jolts for each foot.

The five most common problems that hobble into my clinic are: Athletes foot, Corns, Cracked heels, Sore soles (plantar fasciitis), and Verrucae (plantar warts).

1. Athlete’s foot
This is a fungal infection. It can lead to intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin especially between the fourth and fifth toes, or on dry, flaky skin around the heels or elsewhere on the foot. It’s caused by a number of fungal species which you can pick up from anywhere (typically communal areas such as pools, showers and changing rooms) or anywhere where you may walk around barefooted.

“The fungus on each bit of skin that falls away from someone else’s feet can be picked up by you if you’re prone.” Once your feet have been contaminated, the warm, dark and sweaty environment of feet cramped in shoes or trainers provides the ideal breeding ground for the fungus. However, athlete’s foot also occurs in dry, flaky areas.

It’s quite common in summer sandal­wearers. The sun makes your skin dry out, so it loses its natural protective oils; this combined with the constant trauma from sandals makes them more prone to infection.For prevention change your footwear on a regular basis.

There’s no point sorting your feet out if you constantly re­infect them by putting them into damp, fungally infected shoes. It takes 24-­48 hours for shoes to dry out properly, so alternate your shoes daily. To help shoes dry out more quickly, take any insoles out. Also, loosen any laces and open your shoes out fully so that air can circulate. Go for trainers with ventilation holes.

First Aid medicines that can help:

  • Berberis vulgaris. When the skin has dry, scaly lesions with circumferential progression and healing from centre outwards.
  • Graphites. Skin oozes a thick, viscous, honey­like fluid. The itching is relieved by localised cold while the individual is sensitive to cold.
  • Psorinum. Mycosis (fungal infection) found on unhealthy, dry, wrinkled, scaly, itchy skin on the sole of the foot.
  • Sepia. Itching not relieved by scratching, ringworm­like eruption every Spring, sweaty feet, worse on toes and intolerable odour.
  • Silica. Eruptions itch only in daytime and evening, Rose­coloured blotches and coppery spots.
  • Sulphur. Skin that is dry, scaly unhealthy, pimply eruptions and pustules. Itching especially from warmth, in the evening, often recurs in springtime, in damp weather.

Medicines should be taken initially in 6c or 12c three times a day for the first two weeks.

If fungus presents for several months or years take 30c once daily up to three months.

2. Corns
Corns like calluses develop from an accumulation of dead skin cells on the foot, forming thick, hardened areas. They contain a cone-shaped core with a point that can press on a nerve below, causing pain. Corns are a very common ailment that usually forms on the tops, sides and tips of the toes. Corns can become inflamed due to constant friction and pressure from footwear. Corns that form between the toes are sometimes referred to as soft corns.

There are very simple ways to prevent and treat the corns. You should wear properly fitted footwear with extra room in the toe box (toe area). Avoid shoes that are too tight or too loose. Use an orthotic or shoe insert made with materials that will absorb shock and shear forces. Also avoid tight socks and stockings to provide a healthier environment for the foot.

Try to steer away from corn removing solutions and medicated pads. These solutions can sometimes increase irritation and discomfort. Diabetics and all other individuals with poor circulation should never use any chemical agents to remove corns.

Topical agents like Marigold ‘Tagetes’ cream or oil are found to be very effective for treatment of this condition.

First Aid medicines that can help:

  • Antimonium crudum. Skin that is hard, thickened (Hyperkeratotic) and yellow corns, often in multiple.
  • Ferrum picricum. Corn, which have a yellowish discolouration. The medicine acts best in darkhaired people.
  • Hypericum. Neurovascular corn (a corn on the end of a nerve and blood vessel), which is painful, inflamed with burning and shooting pain.
  • Nitric acidum. Golden-yellow callus, local pathogenic action of nitric acid, painful fissures which bleed, giving impression of being stuck by needles. Hyperkeratosis, where the adjacent skin has golden-yellow characteristic.
  • Rannuculus bulbosus. Corns that are sensitive, hard and thickened skin is present.

Homeopathic medicines should be taken at 6c/12c twice daily for up to two weeks for acute conditions and 30c taken daily for up to three months for chronic conditions.

If a corn is present for sometime then seek help from a homeopathic podiatrist, who can remove it and use a topical phytotherapy based treatment to prevent it returning.

3. Cracked heels
Many factors cause cracked heels such as dry skin due to wearing sandals and shoes without backs, this leads to the heel building up callus due to friction and pressure bought on by walking and further leading to fissure formation with pain and bleeding.

There are others reasons such as skin conditions like eczema and psoriasis and abnormalities of the heel structure, which lead to a biomechanical instability with the bone and fascia around the heel. Patients with poor circulation and especially diabetics often do not have enough blood supplying the skin to carry out the requirements to function normally.

To help prevent cracked heels stop wearing the shoes that caused the problem. At the end of the day soak feet in warm salt water for 10 minutes to ease them and help to take down the inflammation caused by the friction and pressure of being on your feet all day. Daily application of cream or ointment, the uses of traditional plant-base preparations along with products with neem, coca butter, shea butter and vitamin E also show promising results. Pumice cracks or dry skin, make sure the sole of the shoe is well cushioned and not rough or too hard, you can put in an insole or heel cushion. Avoid shoes like flip flops and high heel shoes, if taking long walks or walking on hard surfaces.

First Aid medicines that can help:

  • Antimonium crudum. Dry fissures often found on heels or external borders of feet. Scaly and pustular eruptions are often burning and itching, worse at night.
  • Petroleum. Skin dry, constricted, very sensitive, rough and cracked, leathery. Thick, greenish crusts, burning and itching; redness, raw; cracks bleed easily.
  • Graphites. Rough, hard, persistent dryness of portions of the skin, Eruptions, oozing out a sticky exudation. Cracks in heels and in between toes, burning and stinging pain.
  • Sulphur. Dry, scaly, unhealthy, itching, burning, worse scratching and washing.

Homeopathic medicines should be taken as 30c twice daily up to three six weeks.

4. Plantar Fasclitis
(Pain in the sole of my foot)
The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to over-pronation(flat feet), causes plantar fasciitis. The inflammation caused by the plantar fascia being stretched away from the heel often leads to pain in the heel and arch areas. The pain is often extreme in the morning when an individual first gets out of bed or after a prolonged period of rest.

If this condition is left untreated and strain on the longitudinal arch continues, a bony protrusion may develop, known as a heel spur. It is important to treat the condition promptly before it worsens.

Topical treatments that can help the following conditions:

Arnica cream – Bruising / Arthritis
Bellis perennis cream – Deep bruising
Hypericum cream – Nerve pain
Ruta cream – Bony inflammation
Rosemary tincture – Pain
Symphytum gel – Ligaments non-bony union

First Aid medicines that can help:

  • Apis meliflica. Affected joints are reddish/pink and swollen. There is stinging, burning pain improves with cold applications.
  • Arnica. Following physical effort or repeated trauma (eg badly fitting shoes). There is purplish oedema and intense pain, which improves after hot application.
  • Bellis perennis. Damaged muscular fibres of blood vessels and muscular soreness. Deep bruising, due to mechanical causes. First remedy in injuries to deeper tissues after major surgical work. Injured nerve endings, lead to intense soreness and intolerance to cold weather.
  • Bryonia. Joints are red and hot, frequently swollen and sensitive to slightest touch. There is a sensation of throbbing, acute and stinging pain, which is aggravated by the slightest movement.
  • Hypericum. Throbbing pain follows the course of the nerve from the foot to the lumbar region.
  • Kali bichromcium. Pain that is wondering along bones, soreness of heels when walking and tendo Achilles painful and sore.
  • Ledum. Joints are swollen, hot and pale. Pain is aggravated at night and by warmth of the bed and improved by cold applications. Patient immerses foot in cold water if the big toe is affected.
  • Rhododendron. Generally erratic, searing pain is aggravated by stormy weather, particularly before storm, and improved as soon as storm breaks out.
  • Rhus toxicodendron. Patient complains of painful, joint stiffness, which occurs at the start of a movement then disappears as the movement continues. Pain aggravated by damp weather, cold and rest.
  • Ruta graveolens. Pain in the joint, which is aggravated by rest and improves immediately after movement. But, without the warming up phase of Rhus tox. Ruta causes less stiffness than Rhus tox.
  • Staphysagria. Pain intense in soles of the feet and Achilles tendon.

In acute cases, low potency (6c) is more effective as a single remedy three times a day for three days and thereafter 30 potency once daily for a week. In chronic cases 30c twice daily for up to four weeks.

5. Verrucae
(Plantar Warts)
A common viral infection of the skin, verrucae (warts on the foot or hand) are a problem for more and more people who use communal areas such as swimming baths, sports and health clubs. Some stubborn verrucae do not respond well to conventional medication. Surgical treatment can be painful and often causes scarring.

First Aid medicines that can help:

  • Antimonium crudum. Frequently seen in the 5-15 year age group. Verruca that, has a rough horny surface projecting slightly above skin, and is surrounded by horny collar. Usually single, but can be multiple. Present on palms, soles, fingers, and toes, under nails. Rarely on face, scalp or body.
  • Calcarea carbonica. Round, solitary, isolated, hard warts.
  • Causticum. Warts underneath the nails and located at the end of nose or lips on flat plane, which bleed easily. Whitish-yellow in colour.
  • Dulcamara. Transparent plane warts, which are more visible in low-angled rather than direct light and are located on the backs of the hands or on the face. Also seborrheic, wide and soft, brownish warts most often located on the back.
  • Ferrum picrum. Indicated in small, pointed warts occurring in large groups especially finger and toes.
  • Graphites. Orifices of the face & beard regions. Present as skin tags, and are found under the nail bed Greyish, brown, or fleshcoloured.
  • Natrum mur. Seen on the soles of the feet. Superficial, slightly raised, hard, multiple, with a crazy paving pattern present. They are painless, with only one plaque with several small warts. Notorious for longevity and resistance to treatment.
  • Natrum sulphuricum. Raised, smaller than common warts, flatter smoother surfaces & irregular outlines. A multiple number of verrucae, ranging from two to several hundreds. Present at the tops of feet, red circular in shape and colour. Seem to be common in children, young women and immuno-compromised patients.
  • Nitric acid. Small, punctuate lesions, horny wall surrounding central depression. Golden yellow in colour, Warts having painful fissures which bleed, giving the impression of being stuck with a needle or splinter.
  • Thuja. Warts that are hardened lumps, Fig-warts, and warts that appear in the form of cauliflowershaped lesion. An excellent first line remedy for all verrucae.

Take Thuja 30c twice daily for eight weeks. All other remedies 12c twice daily up to six weeks. Long-standing lesions Thuja 200c/1M stat dose with 30c doses twice weekly one month.

General Footcare

  • Wash your feet every day in warm soapy water (don’t soak them, as this might destroy the natural oils) and dry thoroughly, especially between the toes.
  • If your skin is dry, apply moisturising (calendula) cream all over the foot, except for between the toes.
  • Lightly apply a foot powder.
  • Remove hard skin gently with a pumice stone, but not if it is over a bony area or joint. If this is the case, or if the hard skin is painful, consult a registered chiropodist/podiatrist.
  • Trim your toe nails regularly, using proper nail clippers. Cut straight across, not too short, and not down at the corners as this can lead to in-growing nails.
  • Keep feet warm, and exercise to improve circulation.
  • Always wear the right shoe for the job.
  • Seek prompt treatment for burns, cuts and breaks in the skin, and for any unusual changes in colour or temperature. This is particularly important if you have diabetes. If your feet hurt, something is wrong!
  • You can also prevent foot problems before they occur by visiting a registered chiropodist/podiatrist for advice on how to keep your feet healthy.

Finding a homeopathic podiatrist…

Homeopathic podiatrists are health care professionals who specialise in the medical treatment of the feet and lower limbs. They were once known as chiropodists but are now generally known as podiatrists. Homeopathic podiatrists are able to diagnose and treat most foot pathologies. Homeopathic podiatry is a term used for a podiatrist who uses oral homeopathic medicines, topical phytotherapy (Marigold Therapy) in podiatric management.

The Homeopathic podiatrist is someone who has carried out specialist training in homeopathy related to the treat ment of podiatric conditions. They will normally have LFHom (Pod), DFHom (Pod) or MFHom (Pod) earned from the Faculty of Homeopathy after their names. These denote their depth of homeopathic knowledge.Dr Tariq Khan, PhD (Lond), BSc (Hons), BSc (Pod Med), MChS, FFHom(Pod), is a Consultant Podiatrist and Specialist in Homeopathic Podiatry and director of the Marigold Clinic at the Royal London Hospital for Integrated Medicine.