Strong base for the whole body.
The importance of keeping our feet in good working order is becoming more and more popular and important for the bigger amount of people. But still quite a lot should be to be done to communicate this message – FOOT HEALTH: Strong base for the whole body -to the public.
Healthy feet are vital for mobility. In their lifetime, the average person walks approximately 610,000 km. But all too often, we do not place the same emphasis on looking after our feet as we do on other parts of our body. “Keeping your feet healthy should be part of your daily routine,” says Sarah Curran, principal lecturer in podiatry at Cardiff Metropolitan University. “Just because they are furthest away from your eyes should not mean you neglect them!”
Prevention is better than cure. Once trouble sets in, “a painful foot or leg can be totally debilitating,” warns Richard Leigh, head of podiatry at London’s Royal Free Hospital and a specialist in diabetic foot problems. And because our feet are so essential for keeping mobile and independent, when something goes wrong it can be a psychological strain too.
“Loss of mobility can have a major psychological impact on an individual,” says Jim Bolton, a fellow of the Royal College of Psychiatrists who helps people deal with the psychological consequences of physical illness. “[This] may include loss of independence, loss of normal roles such as parenting or employment, and loss of confidence.” Indeed, psychiatric disorders, especially anxiety and depression, are more than twice as common in people with long-term physical illnesses compared with the general population.
Given how much we rely on our feet, perhaps it is unsurprising that, as Curran points out, “many of us at some point in our lives will experience foot problems”. Almost a third of consultations for musculoskeletal problems relate to pain in the foot and ankle!
Better education about foot care is important, especially for people with specific conditions that can affect the feet. For example, those, who have diabetes. These people should check their feet and to be warned not to buy over-the-counter corn plasters, “because of the lack of sensation the acid within the plaster can do damage that we won’t be aware of”.
“Diabetes affects the feet in several ways,” says Rachel Berrington, a specialist diabetes nurse based in Leicester. She explains that high sugar levels can damage both sensory and motor nerves (neuropathy) and blood vessels (peripheral arterial disease). This means that not only can people with diabetes be at greater risk of injuring themselves because they are less sensitive to pain, heat and cold, and where their joints are in space, they can also be slower to heal because of a poor blood supply.
Leigh says that not everyone with diabetes suffers from nerve and blood vessel damage. “In those cases it’s a matter of getting their feet checked annually,” he says. But those who do have damage or who have previously suffered from ulceration should be seen in a high-risk clinic and have easy access to specialist foot care. “There should be a pathway in place that says if the patient has a problem, they can get to the hospital multidisciplinary team and that should be within 24 hours.”
He thinks it is worth pharmacists being aware of relative risk in people with diabetes. “They should be asking whether the patient knows their risk stratification,” he suggests.
“Pharmacists, like every healthcare professional, have a role when advising about good foot health for people with diabetes, as they are often the first port of call,” says Berrington. She has some specific suggestions for how people with diabetes should care for their feet. “Checking their feet every day is essential,” she says. She also suggests that people “never walk barefoot to prevent standing on anything that could traumatise the foot”. From a similar perspective, Curran adds that it is important to “always check inside the footwear before putting it on”.
LloydsPharmacy offers a free foot check service, where people with diabetes are advised to have their toenails cut by a podiatrist and to have regular check-up appointments; “almost like how you have a hygienist appointment once every six months,” says Muorah. This is made easier for her patients because there is an integrated podiatry clinic within the pharmacy.