Foot Ulcers and Preventative Care

Foot deformities are common among diabetic patients suffering from chronic complications of the disease such as neuropathy (decreased neural sensation). The atrophy of muscles in the foot (due to neuropathy and poor circulation) makes it difficult for these muscles to hold the toes in their proper position.  Unable to feel unhealthy friction or rubbing on their feet, diabetics are more likely to suffer from blisters, corns, calluses, bunions and hammertoe.

These various foot injuries and foot deformities are painful in their own right; but in the case of a diabetic, they have more serious implications.  Foot ulcers (open wounds on the foot) tend to develop over these bony protrusions.  A bunion, for example, can be rubbed raw by the side of a shoe.  Foot ulcers are most common on the balls of the feet and the pads of the toes (where the foot bears the weight of the body) and on the tops of the toes (where the knuckle bones of the foot are likely to come into contact with the top of the toe box).  Rigid foot deformities such as bunions and hammertoe only increase the likelihood of a foot ulcer developing.   

Foot ulcers are dangerous for diabetics because they are so difficult to detect.  Even if the ulcer is highly infected, a diabetic with neuropathy will not be able to sense the pain usually generated by an infection and therefore will not realize that something is wrong.  The infection can be quite advanced and still provide virtually no sensorial indicators.  Foot ulcers must be diagnosed visually.  Foot washings and inspections should become a crucial part of a diabetic’s daily routine.  If the patient is not able to successfully carry out these foot inspections whether due to impaired vision or limited mobility, a family member or doctor will need to inspect the foot for the patient.  

Preventative care is the best care when it comes to preventing foot ulcers.  The goal is to stop foot injuries at their most minor level.  Be vigilant when it comes to preventing and caring for blisters, calluses and corns.  A doctor should be able to inspect a patient’s shoes and inform the patient whether they fit well enough to prevent unnecessary friction or pressure on the foot.  Orthotics (orthopedic insoles) may be necessary to ensure a proper foot; other diabetics find that well-fitted athletic shoes are adequate when it comes to keep their foot callus, corn, blister, bunion and hammertoe free.