Cold Feet, Many Culprits 
- If your toes are always cold, one reason could be poor blood flow — a circulatory problem sometimes linked to smoking, high blood pressure, or heart disease. The nerve damage of uncontrolled diabetes can also make your feet feel cold to you. Other possible causes include hypothyroidism and anemia. A doctor can look for any underlying problems — or let you know that you simply have cold feet.
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Foot Pain - When your feet ache after a long day, you might just curse your shoes. After all, eight out of 10 women say their shoes hurt. But pain that’s not due to sky-high heels may come from a stress fracture, a small crack in a bone. One possible cause: Exercise that was too intense, particularly high-impact sports like basketball and distance running. The weakened bones of osteoporosis increase your risk.
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Red, White, and Blue Toes - Raynaud’s disease can cause your toes to turn white, then bluish, and then redden again and return to their natural tone. The cause is a sudden narrowing of the arteries, called vasospasms. Stress or changes in temperature can trigger vasospasms, which usually don’t lead to other health concerns. Raynaud’s may also be related to rheumatoid arthritis, Sjögren’s disease, or thyroid problems.
Heel Pain- The most common cause of heel pain is plantar fasciitis, inflammation where this long ligament attaches to the heel bone. The pain may be sharpest when you first wake up and put pressure on the foot. Arthritis, excessive exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis. Less common causes include a bone spur on the bottom of the heel, a bone infection, tumor, or fracture.
Dragging Your Feet- Sometimes the first sign of a problem is a change in the way you walk — a wider gait or slight foot dragging. The cause may be the slow loss of normal sensation in your feet, brought on by peripheral nerve damage. About 30% of these cases are linked to diabetes. Nerve damage also can be due to infection, vitamin deficiency, and alcoholism. In many cases, no one knows what caused the nerve damage.
Clubbed Toes- In clubbing, the shape of the toes (and often the fingers) changes. The nails are more rounded on top and curve downward. Lung disease is the most common underlying cause, but it also can be caused by heart disease, liver and digestive disorders, or certain infections. Sometimes, clubbing runs in families without any underlying disease.
Swollen Feet- This is usually a temporary nuisance caused by standing too long or a long flight — especially if you are pregnant. In contrast, feet that stay swollen can be a sign of a serious medical condition. The cause may be poor circulation, a problem with the lymphatic system, or a blood clot. A kidney disorder or underactive thyroid can also cause swelling. If you have persistent swelling of your feet, see a physician.
Burning Feet- A burning sensation in the feet is common among diabetics with peripheral nerve damage. It can also be caused by a vitamin B deficiency, athlete’s foot, chronic kidney disease, poor circulation in the legs and feet (peripheral arterial disease), or hypothyroidism.
Sores That Don’t Heal- Foot sores that will not heal are a major warning sign for diabetes. Diabetes can impair sensation in the feet, circulation, and normal wound healing, so even a blister can become a troublesome wound. Those sores also are prone to infection. Diabetics should wash and dry their feet and check them for any wounds every day. Slow-healing of sores also can be caused by poor circulation from conditions such as peripheral artery disease.
Pain in the Big Toe- Gout is a notorious cause of sudden pain in the big toe joint, along with redness and swelling (seen here). Osteoarthritis is another culprit that causes pain and swelling. If the joint is rigid, it may be hallux rigidus, a complication of arthritis where a bone spur develops. Finally, turf toe is an ailment of athletes, particularly those who play on hard surfaces. It’s caused by an injury to ligaments surrounding the joint.
Pain in the Smaller Toes- If you feel like you’re walking on a marble, or if pain burns in the ball of your foot and radiates to the toes, you may have Morton’s neuroma, a thickening of tissue around a nerve, usually between the third and fourth toes. It is eight to 10 times more common in women than in men. It is caused by injury or too much pressure on the toes.
Itchy Feet- Itchy, scaly skin may be athlete’s foot, a fungal infection that’s common in men between the ages of 20 and 40. A reaction to chemicals or skin care products — called contact dermatitis — can cause itching, too, along with redness and dry patches. If the skin on your itchy feet is thick and pimple-like, it may be psoriasis, an over-reaction of the immune system. Medicated creams can relieve the symptoms.
Claw Toe- This foot deformity can be caused by shoes that are tight and pinch your toes or by a disease that damages nerves, such as diabetes, alcoholism, or other neurological disorder. Your toes will be bent upward as they extend from the ball of the foot, then downward from the middle joint, resembling a claw. They may respond to stretching and exercises of the toes or you may need special shoes or even surgery.
Foot Spasms- A sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp, which can last many minutes. Overwork and muscle fatigue are common causes. Other causes include poor circulation, dehydration, or imbalances in potassium, magnesium, calcium, or vitamin D levels in the body. The changing hormone levels of pregnancy or thyroid disorders may play a role. If spasms are frequent or severe, see a doctor. Strengthening exercises can help with muscle fatigue.
Dark Spot on the Foot- We associate skin cancer with the sun, so we’re not as likely to check our feet for unusual spots. However, a melanoma, the most dangerous form of skin cancer, can develop even in areas that are not regularly exposed to the sun. Melanoma can even appear beneath the nail, where it might look like a black spot.
Yellow Toenails - Your toenails tell a lot about your overall health. A fungal infection often causes thickened yellow toenails. Thick, yellow nails also can be a sign of an underlying disease, including lymphedema (swelling related to the lymphatic system), lung problems, or rheumatoid arthritis.
Spoon-shaped Toenails- Sometimes an injury to the nail or frequent exposure to petroleum-based solvents can create a concave, spoon-like shape. However, iron deficiency also can cause this unusual shape.
White Nails- Injury to the nail or illness anywhere in the body can cause white areas in the nails. If part or all of a nail separates from the nail bed (shown here), it can appear white — and may be due to an injury, nail infection, or psoriasis. If the nail is intact and most of it is white, it can sometimes be a sign of a more serious condition including liver disease, congestive heart failure, or diabetes. Talk with your health care team about any concerns.
Pitting of the Nails- Pitting, or punctured-looking depressions in the surface of the nail, is caused by a disruption in the growth of the nail at the nail plate. It affects as many as half of people with psoriasis.
- By Stephanie Stephens WebMD the Magazine – Feature
- Reviewed by Brunilda Nazario, MD
- For most people, a blister, cut, or scrape on the foot is no big deal — an «ouch!» and a hurriedly applied bandage, and it’s over. Not so if you have diabetes; meticulous daily foot care is as important as monitoring blood glucose, cholesterol, and blood pressure levels.
- «Unfortunately, diabetes foot-health awareness doesn’t have a colored ribbon or national voice,» says foot care expert James Wrobel, DPM, of the University of Michigan Medical School. «If you don’t manage them early, small problems that start in the feet can cause really big ones.»
- Show your hardworking feet some love by preventing ulcers — open sores that can lead to serious complications like infection and even amputation. According to a report co-written by Wrobel, people who develop diabetic foot ulcers have a higher risk of dying within five years than people with some types of cancer, including prostate cancer, breast cancer, and Hodgkin’s lymphoma.
- Remember that what you can’t feel might really hurt you later, especially if infection sets in. Uncontrolled glucose levels can lead to nerve damage called diabetic neuropathy, a numbness or tingling that may affect balance and prevent you from feeling hot, cold, and even pain. Nerve damage can also compromise your body’s ability to sweat, which means skin on the feet can get dry and crack, opening the body’s natural infection barrier. The foot’s pressure-absorbing fat pads also harden and thin out, creating ideal conditions for foot ulcers to develop.
- When cholesterol and blood pressure levels aren’t controlled, narrowing or poor function of blood vessels in the arms and legs, called peripheral vascular disease, can reduce blood flow and circulation. Narrower vessels mean the feet get less oxygen and vital nutrients that fight infection and heal wounds. When tissue dies (a condition called gangrene), amputation may follow.
- What Your Feet Say About Your Health
- Diabetes Experts’ Tips on Foot Care
- The lifetime risk that a person with diabetes will develop a foot ulcer may be as high as 25%. To lower your chances of having this happen and to keep your feet in tiptop shape, Wrobel recommends taking these steps.
- Take care. Wash feet daily with warm water and soap, dry well, then soften with lotion, cream, or petroleum jelly, avoiding the areas between toes. Trim or file toenails into a shape that’s almost square but with no corner points to break skin or cause ingrown toenails.
- Be sure the shoe fits. Indoors or out, wear properly fitting, closed-toe shoes to protect feet from stubs and bangs. After age 40, when feet get wider, consider prescription orthopedic footwear for better balance and stability. Never go barefoot.
- Wear socks. Clean, light-colored, and lightly padded socks will show blood or draining wounds so you can easily spot problems. Avoid slow-drying, 100% cotton socks in favor of synthetic blends that wick moisture away and discourage fungus.
- Fight fungus. Fungus, which thrives in moisture, can lead to infection. Where can you pick up fungus? From carpet, showers, and gym floors. To help kill it, use medicated foot powders like Tinactin or Micatin, and spray Lysol inside your athletic shoes.
- Inspect daily. Take a good look at your feet every day. A recent study of male veterans with diabetes found that more than half couldn’t see or reach the bottom of their feet. If you aren’t flexible enough to see your soles, ask someone to help or use a magnifying mirror to scout trouble spots like redness, bruises, and tiny punctures.
- Shake things up. Give your shoes a good shake regularly. Seemingly harmless debris like coins and pebbles can fall unnoticed into shoes, injuring feet.
- Don’t go to extremes. Insensitivity to temperature means you could accidentally damage your feet, so avoid becoming too hot or too cold.
- Heat can cause feet to swell and can burn skin, so don’t soak your feet in hot water — and stay away from hot-water bottles, heaters, and fireplaces, too. Wear insulated boots and socks in very cold weather to help prevent frostbite.
- Don’t be callous. Don’t attempt any kind of «surgery» by cutting your calluses yourself. You risk getting ulcers or infections, so call your doctor for help.
- Mark the calendar. Schedule regular foot exams with your doctor — every few months, or at least once a year — to avoid emergencies later.
- Managing Stress and Diabetes
- Another critical aspect of diabetes management is staying stress-free. A little bit of stress can send your blood sugar out of control. Geralyn Spollett, NP, president of health care and education for the American Diabetes Association, offers these tips.
- Exercise. «It’s a great stress management tool. Walk on a treadmill or get out and hoof it in the fresh air.»
- Talk with a loved one. «Don’t bottle it up inside. Find someone who will be sympathetic.»
- Get enough sleep. «You can’t cope with stress very well if you’re overtired. Get checked if you think you have sleep apnea, which causes snoring and abnormal breathing during snooze time.»
- Don’t overeat. «Many times, people who are stressed like to eat because it’s a comfort for them. But overeating can cause high blood sugar, so if you must, snack on carrots or rice cakes.»