Details of Infections, Diseases and Conditions of the Feet and When/When Not to Treat

Details of Infections, Diseases and Conditions of the Feet and When/When Not to Treat

Whilst reflexology is a good all round treatment, there may be times when the whole foot or specific area cannot be treated. Below, is a list of various conditions and disorders of the feet together with instructions on whether the whole foot or specific area cannot be treated.

Please Note: the conditions listed below are for information purposes only. If you have any of these conditions, or suspect you have any of these conditions, please consult a doctor who can give you and official diagnosis.

Athlete’s Foot (Tinea pedis)

Athlete’s foot is a fungal infection of the foot that produces cracked, sore, itchy skin between the toes. This condition is most common in teenagers and young adults and is rare in children.

This condition is a common fungal infection of the feet that particularly affects the skin between the toes. The condition can be caused by several types of fungi that thrive in warm, humid conditions.

Athlete’s foot often affects teenagers and young adults, who tend to sweat more and wear enclosed footwear, such as trainers, for long periods. Walking barefoot in communal areas that are warm and humid, such as changing rooms and poolsides, are another way that people can pick up athlete’s foot.

Athlete’s foot occurs most commonly between the fourth and fifth toes and produces the following symptoms:

[ Cracked, sore and itchy areas of skin.

[ Flaking, white, soggy skin.

Sometimes the infection spreads on to the sole or the sides of the foot or affects the toenails, which then become yellowish, thickened and brittle. People who have athlete’s foot are more susceptible to ringworm of the groin, which is another fungal infection.

To prevent the infection from recurring, following treatment, the client should wash their feet at least once a day, more frequently if they become sweaty, and dry them thoroughly between the toes. At home, it may help to wear open-toed shoes or go barefoot.

Athlete’s foot is highly contagious, so therefore, it is advisable not to complete foot reflexology treatment over the infected area, however, hand reflexology would be acceptable over the area that cannot be treated on the foot.

Trials carried out by Dr M Walker in 1972 concluded that pure tea tree oil (Melaleuca alternifolia) is a successful treatment for athlete’s foot, therefore, this oil can be put on the skin undiluted.

Eating garlic or taking garlic capsules are also beneficial as it helps to build up the immune system and combat infection.

Bunions (Hallux valgus)

A bunion is an inflamed, thickened soft tissue and bony overgrowth found at the base of the big toe. It often becomes inflamed and painful, making walking difficult.

The underlying cause is usually a minor bone deformity called hallux valgus, in which the joint at the base of the big toe develops an abnormal projection, which forces the tip of the toe to turn towards the other toes. The actual cause of hallux valgus itself is unknown but the condition runs in some families. As a result of pressure on the deformity, the surrounding tissues thicken.

The term bunion refers to the thickened lump that is due to the combination of the bony deformity and thickening of the soft tissue around it. The condition is particularly common in young women who wear tight, pointed shoes with high heels.

In rare cases, the constant rubbing of tight shoes on the skin over a bunion may cause an abrasion, which then leads to a bacterial infection. People with diabetes mellitus are particularly susceptible to infected bunions because the sensation in their feet may be reduced.

Without attention, a bunion may gradually worsen. Pain may be alleviated by wearing comfortable shoes and a special toe pad or corrective sock that straightens the big toe. However, if a bunion causes severe discomfort, a doctor may suggest corrective surgery. A bunion increases the chance of developing osteoarthritis of the toe joint later in life

Depending on the severity of the pain and providing that recent surgery had not been completed on the bunion, foot reflexology can be carried out as long as the massage is gentle. If the area were too sore, hand reflexology over the area that cannot be treated on the foot would be advisable.

Chilblains (Perniosis)

Chilblains result from excessive narrowing of blood vessels under the skin in cold weather. The reddish-purple swellings, which most commonly affect the fingers and toes, are painful when they are exposed to cold and are intensely itchy once the skin has become warm again.

Chilblains usually disappear without treatment but may recur. Children and the elderly or inactive people in particular should wear sufficient clothing, including gloves, socks and

a hat, to keep warm and help prevent chilblain from developing. If someone is susceptible to chilblains and is exposed to cold weather, taking exercise may encourage blood flow to the hands and feet.

Foot reflexology would not be advisable over the area affected as it may be too sore or infected. If the area is too sore/infected, then hand reflexology could be completed over the area that cannot be treated on the foot.

Claw Foot (Pes cavus)

Claw foot is a deformity of the foot in which there is an exaggerated arch and turning under of the tips of the toes.

This disorder may either be present from birth or may result from disturbance or damage to the nerve or blood supply to the muscles of the foot.

Occasionally, surgery may be performed which involves cutting the underside of the foot in order to flatten it. However, the condition can be helped by using a moulded insole to redistribute the body weight evenly over the foot.

Reflexology can be completed on the feet, providing gentle pressure is used over the arch. If the arch is painful, hand reflexology can be used on the area that cannot be massaged on the foot.

Clubfoot (Talipes)

Clubfoot is a condition in which a baby is born with one or both feet twisted out of shape or position. There are two types of clubfoot:

Positional clubfoot: in which the twisted foot is flexible and can be manipulated into a normal position. This is probably due to compression in the uterus.

Structural clubfoot: in which the deformity is rigid. This condition affects 1 in 700 babies, is more serious and is twice as common in boys and can run in families, suggesting a genetic factor.

Clubfoot is usually diagnosed during a routine examination after birth. Positional clubfoot may not need treatment, but physiotherapy may help to straighten the foot, and a cast may help to straighten the foot, and a cast may be used to move the foot into position. A normal position can usually be achieved within 3 months.

Structural clubfoot requires physiotherapy and a cast for a long period. In 6 out of 10 cases, this treatment is successful. If not, surgery may be needed at the age of 6 – 9 months. Surgery is usually successful, enabling most children to walk normally.

Foot reflexology treatment would not be advisable unless the consent of the doctor had been obtained. However, hand reflexology would be acceptable.

Corns (Clavus)

Corns are patches of thickened skin that occur on the toes. They are usually due to wearing shoes that are too tight. The patches have a hard, clear centre and can be painful and persistent. Soft corns are only found between the toes and are caused by too much pressure combined with too much sweat. A chiropodist who will reduce the size of a thickened area by paring it down with a scalpel, usually over

several sessions, can treat both types of corns. To relieve pressure on corns, it is advisable to wear shoes that do not press on the toes and corn pads (small rings of sponge that are available over the counter at a chemist). Soaking the feet daily in a bowl of warm water, drying them, then using a pumice stone is also beneficial.

Reflexology would be advisable over the area, provided it is not too sore or infected. If the area is too sore/infected, then hand reflexology could be completed over the area that cannot be treated on the foot.

Diabetes

Diabetes is any disorder of metabolism causing excessive thirst and the production of large volumes of urine.

There are two types of diabetes, one is diabetes insipidus, which is a rare metabolic disorder in which the patient produces large quantities of dilute urine and is constantly thirsty. It is due to deficiency of the pituitary hormone vasopressin, which regulates reabsorption of water in the kidneys and is treated by administration of the hormone.

The other type of diabetes is diabetes mellitus which is a disorder of carbohydrate metabolism in which sugars in the body are not oxidized to produce energy due to lack of the pancreatic hormone insulin. The accumulation of sugar leads to its appearance in the blood, then in the urine. Symptoms include thirst, loss of weight and the excessive production of urine. If left untreated, this can result in a diabetic coma.

Diabetes can affect the feet as diabetics are at more risk of infection and loss of feeling in the feet so they can be easily damaged. The feet often smell of ‘pear drop’ sweets. In order to conduct reflexology on a client with diabetes, the doctor’s permission must be obtained. Because a diabetic’s skin is relatively thin, it is inadvisable to use a foot spa and gentle pressure should be used when completing a reflexology treatment. It is also essential that a diabetic has food or insulin with them during treatment in order to prevent an attack.

Flat Feet (Pes planus)

This is a condition that usually affects both feet and is the absence of the arching of the foot, so that the sole lies flat upon the ground.

It may be present in infancy until gradually the supportive ligaments and muscles in the soles of the feet develop. This process can starts from birth until approximately 6 years of age.

In adult life, the condition is usually acquired usually either from prolonged standing or from excessive weight, both of which initiate the arches to fall.

Most flat feet are painless and require no treatment. In adults, treatment consists of wearing arch supports.

Providing the arches are not too painful, reflexology treatment would not be contra-indicated. Appropriate pressure must be used over the affected area.

Foot Drop

Foot drop is a condition in which the foot cannot be raised properly and it hangs limp from the ankle join, causing it to catch on the ground when walking.

A common cause for this condition is neuritis (inflammation of a nerve), which can affect the nerve supplying muscles that move

the foot. Other causes, which can initiate the condition, are diabetes or MS (Multiple Sclerosis). Weakness in the foot muscles can also result from pressure on a nerve root as it leaves the spinal cord, perhaps due to a slipped disc or, rarely, to a tumour.

Reflexology would not be contra-indicated here unless the client had diabetes. Reflexology would help with circulation and inflammation.

Fungal Infection of the Nailplate (Onychomycosis)

This is an abnormal thickening, hardening and curving of the nail, which occurs mainly in the elderly. Whilst the cause is unknown, it is associated with 2 types of fungal infection;

Dermatophyte: a fungus belonging to any one of the 3 genera (Microsporum, Trichophyton, and Epidermophyton) that can feed on keratin and cause ringworm (tinea).

Candida: a genus of yeasts (formerly called Monilia) that usually inhabit the vagina and alimentary tract.

It is also associated with poor circulation.

Onychomycosis is highly contagious, so therefore, it is advisable not to complete foot reflexology treatment over the infected area, however, hand reflexology would be acceptable over the area that cannot be treated on the foot.

The aromatherapy oil, Tea tree (Melaleuca alternifolia) can be applied neat on the affected area.

Gout

Gout is most commonly found in people between the ages of 30 and 60. It is 20 times more likely to occur in males than females. It often runs in families.

Gout causes sudden pain and inflammation usually in a single joint. The base of the big toe is the most common site, but any joint may be affected. The disorder affects many more men than women. In women, gout rarely appears before the menopause.

An attack of gout is usually caused by raised blood levels of uric acid (a waste product of the breakdown of cells and proteins). An excess of uric acid may be caused by the over production and/or decreased excretion or uric acid and may lead to uric acid crystals being deposited in a joint. The underlying cause of gout is unknown, but he condition is often inherited. A few people with gout also develop kidney stones formed from excess uric acid.

Gout may occur spontaneously or be triggered by:

[ Surgery.

[ Being overweight.

[ Drinking alcohol.

[ Treatment with diuretics.

[ Excess cell destruction associated with chemotherapy.

The symptoms of gout usually flare up suddenly. They may include:

[ Redness, tenderness, swelling and warmth around the affected area.

[ Pain, which may be severe, in the affected joint or joints.

[ Mild fever.

In long-standing gout, deposits of uric acid crystals may collect in the earlobes and soft tissue of the ands or feet, forming small lumps called tophi.

Gout is usually treated with anti-inflammatory drugs but can also be controlled with an anti-acidic diet.

Providing the area is not too painful, reflexology treatment would not be contra-indicated. Appropriate pressure must be used over the affected area. However, if the area were too painful, hand reflexology would be advisable over the affected area.

Ingrowing Toe Nails

An ingrown toenail curves under on one or both sides and cuts into the surrounding skin, causing inflammation and sometimes infection. The condition, which most commonly affects the big toe, is often due to ill-fitting shoes pressing on an incorrectly cut nail. In some cases, injury can cause the skin around the nail to overgrow and engulf part of the nail. Poor foot hygiene can also increase the risk of infection, leading to inflammation.

The symptoms of an ingrown toenail may include the following:

[ Pain, redness and swelling around the toenail.

[ Broken skin at the nail edge, which oozes clear fluid, pus, or blood.

Pain can be alleviated by bathing the foot in warm salt water on a daily basis and taking painkillers. The area should be protected with clean, dry gauze.

Minor surgery may be needed for an ingrown toenail. This procedure involves making a vertical cut along the toenail. The ingrown part is removed and the nail bed treated to prevent regrowth.

Tea tree (Melaleuca alternifolia) and Lavender (Lavandula angustifolia) oils can be applied directly to the infected area and covered with clean, dry gauze.

It is advisable not to complete foot reflexology over the affected area as this may cause more damage, however, hand reflexology can be completed on the area that cannot be treated on the foot.

Sweaty Feet (Hyperhidrosis) or Sweaty and Smelly Feet (Bromhidrosis)

Having feet that smell less than sweet is by no means an entirely male problem, but men do seem to be more prone to it. This embarrassing and inhibiting problem can be caused by a number of fungal disorders as well as by bad dietary habits such as over-indulgence in pints of beer and take-away curries over a period of time. It can also be caused by emotional stress or a disorder of the nervous system. It may also occur in menopausal women. Hyperhidrosis can be an indication of an underlying problem such as an overactive thyroid gland (hyperthyroidism) or diabetes mellitus.

It is most common between the ages of 15 and 30 and sometimes this condition runs in families.

The condition can be helped by washing away sweat regularly and wearing socks made from natural fibres that absorb sweat. Also, foot powder may help alleviate the sweating.

A zinc supplement can help enormously as can a homemade recipe for foot powder, which is as follows:

1 Tablespoon baking powder

2 drops of Tea Tree (Melaleuca alternifolia) if odour is caused by a fungal infection.

Put the baking powder in a plastic bag, add the sage/tea tree oil, and shake the bag well.

Allow to dry, and separate mixture by running a rolling pin over the bag.

The feet should be dusted regularly with the powder and half a teaspoon should be left in the shoes overnight – this will provide good bacterial protection.

Reflexology treatment can be given, however, it is advisable to wash the feet before treatment. During treatment an extra towel should be used to wipe off sweat coming from the feet during treatment.

Verrucas (Papilloma Virus – Plantar Warts)

Verrucas are small growths caused by human papilloma viruses. The viruses invade skin cells and encourage them to multiply, thus creating thickened areas of skin.

Veruccas occur on the soles of the feet. Although verrucas are the same as common warts, they grow into the skin because they are continually under pressure from the weight of the body. A group of verrucas that have joined together is called a mosaic wart. Verrucas are:

[ Flattened into the sole of the foot.

[ Firm, with a thickened surface.

[ Usually painful to walk on.

[ Dotted with tiny black spots.

The virus that causes verrucas is usually picked up from walking barefoot in communal areas, such as changing rooms and swimming pools.

Most verrucas disappear without treatment, but this can take months or years. Many over-the-counter wart treatments are available. If the verruca is very painful, then it can be removed by a doctor or chiropodist, who will either freeze or scrape the verruca so that it can be removed.

Aromatherapy can help the condition by using the following treatments:

Prior to removal: Cover the verruca with tea tree (Melaleuca alternifolia) Then place a plaster over the area. After a few days, the black roots of the verruca should be ready to come out. Treatment should be continued for about 6 weeks until the skin has healed over.

Post removal: Apply wheat germ or calendula cream or oil with a few drops of lavender (Lavandula angustifolia) to encourage healing and prevent re-infection.

Garlic can be used to build up the immune system.

Reflexology can be completed around the area, but not over the area. The infected area should be covered with a plaster to prevent cross-infection. Hand reflexology can be used on the area that cannot be treated on the foot.