If you want to take a step towards better health, consult a dentist. You may learn something about a completely different (and seemingly unrelated) part of your body.
Sometimes, “your feet are the first place you might see warning signs of diseases like diabetes, vascular disease or even skin cancer,” says Hira Mirza, a podiatrist at CLS Health in Houston. “If you look closely enough, it really is a window into the rest of your health.”
We asked experts about the foot symptoms you should never ignore and what some of these problems can tell you about your health.
Hair that stops growing on your toes
When Anne Sharkey examines patients' feet, she always checks the hair on the toes, which causes a puzzled reaction. “They were like, 'Why are you looking at my hair?' And I tell them, 'Because if it stops growing, we're going to have a problem,'” says Sharkey, a podiatrist in Cedar Park, Texas. This may indicate vascular insufficiency, meaning the body's veins are not working properly, resulting in poor blood flow back to the heart. “I tell my patients that skin is like grass,” she says. “Skin needs blood to grow, grass needs water to grow, and if we don’t have enough blood down here, we won’t grow hair.”
Lost toe hairs aren't the only foot-related sign of a potential vascular problem. Sharkey also looks for changes in color, such as if your toes look very pale or shiny, as well as changes in temperature. “People come to us and say, ‘My feet are really cold,’” she says. This is a red flag for circulatory problems, which are especially common among people with diabetes, and her office helps patients make an appointment with a vascular specialist as soon as possible.
Sudden changes in arch height or foot shape.
Women over 40 often come to Sharkey's office complaining of swelling and pain in one of their legs. They tell her that it feels like they sprained their ankle, but they didn't do anything to cause that injury. When she examines them standing, one leg appears normal, but the swollen arch appears flat.
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Many of these patients deal with insufficiency of the posterior tibial tendon, which provides support to the arch of the foot during movement. Menopause may increase risk: “We're seeing an association between decreased estrogen levels and tendon dysfunction,” Sharkey says. Patients feel better when they seek help immediately; This usually means a combination of physical therapy, a cast or boot, and orthotics. However, “sometimes we notice it very late because people just didn't realize it or thought it was a sprain and went through it for years,” she says. “Then there are surgeries and reconstructions to get that tendon back to where it was.”
Red or irritated ingrown toenail.
Ingrown toenails are one of the most common reasons for visiting a podiatrist. However, they often wait too long. “If you have an ingrown toenail that is red and irritated, don't ignore it because it will only get worse,” says Mirza. “These infections can go very wrong, very quickly.”
In addition to redness, watch for soreness, pain when walking, discharge, or dried blood. Don't try to fix the problem at home: “Unfortunately, people try to ruin their toenail with an unsterile tool or tool,” she says. “It makes the infection worse, and that's when people end up coming in.” She usually prescribes antibiotics and performs a procedure to remove the nail growing under the skin, which turns “a three-day problem into a two- to three-week problem.”
Swelling of the legs that does not go away with standing up
Sudden unilateral swelling of the foot or leg is an emergency that may indicate deep vein thrombosis (blood clot in the leg). “We need to evaluate this immediately,” Sharkey says. “I've had people come into my office and think they've torn their Achilles tendon because their leg is swollen, and I'll say, 'Well, your Achilles tendon is fine, but we need to get an ultrasound.'
People at particularly high risk of developing blood clots include those who have recently been bedridden after surgery and people who have traveled long distances by car or plane. If Sharkey suspects a patient has a blood clot, she sends them to the emergency room for an ultrasound and immediate treatment with clot-busting drugs.
Sudden pain in the big toe
If you wake up at night with severe pain in your toes, it could be a sign of gout, which Sharkey is seeing more and more often in his office. Characteristic symptom: red, hot, swollen big toe, very sensitive and painful. “You don't even want the sheet to touch it,” she says. “Patients call the office in the morning in desperation and say, 'I didn't do anything and woke up in the middle of the night with excruciating pain in my leg.' They often come to appointments barefoot, she adds, unable to bear the sensation of something touching their foot.
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Gout is diagnosed through a physical examination and laboratory tests, and patients require steroids or oral anti-inflammatory drugs to control the pain, in addition to ongoing medication and diet changes.
An ankle that keeps rolling
Most ankle sprains heal without causing any long-term problems. However, 10 to 15 percent of people who suffer a sprain develop ankle instability, which means their foot rolls under their ankle when doing certain activities, says Dr. Travis Hanson, an orthopedic foot and ankle surgeon at Houston Methodist Western Clinic. “If you were to see someone walking down the street who had an episode of ankle instability, they would probably be jumping around and—depending on how bad it was—maybe limping,” he says. Many continue to hobble anywhere but to the doctor, convinced that the situation will eventually resolve itself.
This is a bad idea: Constantly rolling your ankle can lead to serious problems, such as torn tendons or damaged cartilage. Hanson prefers to see people as soon as possible and can often help them strengthen their ankle through physical therapy and improving their balance. A small percentage end up needing surgery, he adds.
Inability to lift leg.
If you can push down on your ankle, as if you were laying it on the floor of a car, but you can't pull it up, you may have foot drop. When this happens, “you have zero strength,” Hanson says. People tend to limp and their feet splat so hard on the ground that “you can hear them as they walk down the hallway.”
Foot drop is often caused by a pinched nerve in the lower back, but it can may also be associated with damage caused by knee, hip, or spine surgery.. It could even be a result of the position in which you slept, in which case the problem usually goes away on its own within a few hours. Otherwise, after imaging studies, doctors usually recommend treatments such as physical therapy and the use of braces, splints, or shoe inserts.
Dark line under the nail
Mirza recently diagnosed a patient with subungual melanoma, a rare type of skin cancer that develops under the nail bed. The telltale sign is a dark vertical line, which can also lead to other discoloration in or around the nail. Get into the habit of checking in with yourself regularly, she urges; If you usually wear nail polish that hides discoloration, check your toes before applying a new coat. If anything looks different than usual, make an appointment with your doctor.
Subungual melanoma is curable if detected early. Although treatment depends on the stage of the cancer, in some cases it may include nail removal or toe amputation. “The goal is not to remove the entire finger, but it depends on how quickly you catch it,” Mirza says.
Numbness or tingling in the legs
Sharkey's patients sometimes develop symptoms that indicate metabolic problems, such as numbness, tingling or burning in the legs that worsens at night. “Our body processes a lot of external feedback throughout the day,” she says. “At night, when everything is quiet, your body suddenly becomes much more aware.” What your body might be saying: “My toes tingle or feel like they're on fire,” Sharkey says.
While people in this situation can suffer from any type of neuropathy, the most common is diabetes-related, Sharkey adds, which often comes as a surprise to the patient. According to her, foot problems are the first clue to their final diagnosis and treatment.
The sudden onset of painless swelling, warmth, and redness in the ankle or midfoot.
It's an often missed symptom among people with diabetes who have lost sensation in their feet and ankles, says Damian Roussel, a podiatrist at Advanced Orthopedic Centers in Maryland. This indicates a condition called Charcot neuroarthropathy, or Charcot foot, which occurs when minor trauma or infection leads to bone and joint destruction that people go unnoticed for a long time due to a decreased ability to feel pain.
When they finally notice redness or swelling, “they usually go to their primary care doctor, and the primary care doctor sometimes assumes it's an infection because they have diabetes and prescribes them antibiotics,” he says. “Then the patient will not get better, and they will come to me in a month, but no one did an x-ray.”
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Roussel's imaging tests usually show that the bones in the midfoot have begun to soften and break down. According to him, patients with Charcot neuroarthropathy need to stand up completely, sometimes for the sake of several months– to give the bones a chance to heal.
Inability to bear weight on the injured leg after a few days.
If you twist your ankle while playing pickleball or wearing high heels, you can assume that you can shake off the injury and be back to normal soon. This may be true. But Roussel's patients often ask him what is considered serious pain and swelling and how to know if they should make an appointment with a doctor. “I usually tell them that if three or four days after the injury you still can't put weight on your leg, it needs to be seen,” he says. “This indicates a more serious injury than they probably expected,” such as a fracture or dislocation, or damage to a tendon or ligament that requires special care.
