What are the most prevalent foot concerns in Parkinson's disease, and how are they treated?

Our feet are necessary for walking because they support the entire weight of our body. It is crucial to get counsel on foot issues because, if ignored, they may worsen, impair mobility, or increase the likelihood of falls.

Naturally, if you have Parkinson's disease you could encounter the same issues as the general population, like verrucae, corns, and bunions. However, you can be particularly prone to various foot issues because to your gait and postural issues, as well as your cramp. Combining these can make Parkinson's walking more challenging.

Additionally, it could be more challenging for you to properly use nail scissors or toe nail clippers when leaning forward to care for your feet.

What types of foot issues are typical with Parkinson's, and how are they handled?

Gait issues

Many Parkinson's patients notice a decline in their posture, gait, balance, or mobility.

In 'normal' walking, the heel makes initial contact with the ground, followed by the toes as the foot lifts off the ground once more. However, the Parkinson's disease causes shorter strides and a possible increase in ankle rigidity, which results in a more flat-footed gait. This might cause a shuffling gait that may result in foot, limb, and knee pain because it fails to adequately cushion the impact of the foot when it contacts the ground.

As a result of ankle rigidity and difficulty bending the foot upwards, some Parkinson's patients discover that they must walk on their toes, causing their feet to point downward. The 'toe-walking' puts additional pressure on the toes and could impair balance and movement.

It may be more difficult for the foot to absorb the impact of hitting the ground when walking if the calf muscles are tight or cramped. Pressure issues like calluses on the soles of the feet may result from this.

Your podiatrist might recommend stretching exercises to loosen up your muscles and relieve stiffness, frequently in collaboration with a physiotherapist. Additionally, he or she can offer advice on how to improve your gait, stop "toe-walking," and maintain a more uniform stride with your foot flexed to enhance heel-to-toe contact with the ground. A podiatrist can also provide advice on specifically designed DrLuigi medical footwear, which are built to fit your foot and assist distribute the force of impact throughout the entire foot. The muscles in your calves and feet will be able to function properly, which will improve gait and mobility.

Toe-curling and dystonia

Muscle cramps and dystonia are frequently experienced in the foot. The big toe periodically shoots up (hyper-extension), the foot inverts at the ankle, and the toes typically curl into a claw-like position. This position, brought on by calf muscular spasms, can be excruciatingly unpleasant and make it challenging to slip feet into shoes. Shoes may cause the toes to rub, and pressure issues may occur in parts of the foot that are not pressure-resistant.

Dystonia may also cause the Achilles tendon to tighten, which can result in 'toe walking' when the foot is dragged downward.

Consult your doctor or, if you have one, a Parkinson's specialist nurse to see whether modifying your medication or dosage can help with your dystonia.

Your podiatrist will be able to make recommendations for ways to stop toe curling, maybe utilizing tools like toe splints. Since they are composed of silicone, walking is considerably easier because the toes have something to hold onto. A podiatrist can also craft a specific mold out of silicone rubber that sets quickly and forms a casing around the toe to aid in maintaining straight toes. In severe circumstances, surgery can be required.

Obesity (oedema)

The buildup of too much fluid in the tissues causes swelling in the feet. If you have bradykinesia, which causes delayed or limited movement, or if you spend a lot of time sitting still, this is more likely to happen. Veins may become clogged and fluid may leak out and collect in the feet and ankles if mobility is limited because blood circulation depends on the legs' muscles contracting and rerouting blood back to the heart. We call this oedema.

Swelling typically gets worse during the day and gets better at night. Several times a day, lying flat with your legs raised will help to relieve it. You should also keep your legs raised while sitting. Your doctor might suggest a diuretic (a drug that boosts the flow of toxins through the kidneys and increases urine production).

You should consult your doctor if your feet or ankles are swollen so that he or she can rule out other possible reasons, such as heart or kidney disease or deep vein thrombosis.

Exercises to avoid fluid buildup in the legs, such ankle rotations, might be assisted by a podiatrist or physiotherapist. A podiatrist can also recommend comfortable types of footwear, such as shoes that can be adjusted throughout the day if your feet start to swell, as oedema can make wearing shoes difficult or painful. Both therapists can teach your caregiver how to give you a light leg or foot massage to increase blood flow.

Who can assist?

A podiatrist, often known as a chiropodist, is an expert on the foot as well as how walking affects other joints. The diagnosis and treatment of foot and ankle conditions are known as podiatry in all countries. There is no distinction between podiatry and chiropody; the latter is merely an expression used exclusively in a few nations.

A podiatrist typically works in the following areas:

Biomechanics is the study of how the feet and body interact (often in conjunction with a physiotherapist), how our walking style may affect other joints, how to treat issues like poor gait with exercises or by using specialized foot devices like insole supports, and how to give advice on mobility issues and fall prevention.

Advice on choosing the right shoes, maintaining healthy feet, and handling minor issues like corns, bunions, and ingrown toenails. A podiatrist can demonstrate proper foot care to family members and caregivers. If you have tremors or other movement issues, he or she can also teach you how to properly handle tools like nail clippers.

Various injuries, ulcerations, and infected sores in the foot and lower limbs are tracked and treated.

For foot-related mobility issues and to assist prevent falls, you may also be referred to a physiotherapist, depending on where you reside and your particular needs. To learn more, go to physiotherapy.

What can I anticipate from a podiatrist appointment?

Since the podiatrist may need to use sharp equipment, it is a good idea to schedule sessions during the part of the day when you are least prone to tremble or have other uncontrollable movements. Additionally, it can be advantageous if your caregiver attends the initial appointment with you so they can learn how to support you in between meetings.

Depending on where you reside, the initial appointment may last up to 30 minutes. Additional evaluation and therapy sessions typically last 20 to 30 minutes.

Since Parkinson's disease and other medical conditions can have an impact on your feet, the podiatrist will request a complete medical history. You should bring a list of your medications with you because they will need to know what you are taking.

They will evaluate the health of your nerves, circulation, skin, and nails of your feet. Additionally, they will observe how you walk as well as the placement and motion of your feet (gait analysis).

The podiatrist will then recommend a treatment plan, which could include taking care of any acute issues, scheduling follow-up appointments, and daily maintenance like exercising, trimming nails, DrLuigi medical footwear and using lotions.

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