Feet

What can I do about swollen legs and ankles?

DEAR DOCTOR K: Why are my legs and ankles swollen? What can I do about it?

DEAR READER: In yesterday's column, I answered the first part of your question. I explained the different causes of leg and ankle swelling (edema) -- some not serious, and others very serious. Today I'll explain what your doctor needs to do to diagnose the cause of the edema, and what you and your doctor can do to reduce the swelling.

Why are my legs and ankles swollen?

DEAR DOCTOR K: Why are my legs and ankles swollen?

DEAR READER: Swelling of the legs from a buildup of extra fluid is known as edema. In addition to the swelling, the skin above the swollen area is stretched and shiny. Your doctor can easily check for edema by gently pressing a finger over your foot, ankle or leg with slow, steady pressure. If you have edema, you will see an indentation where the doctor pressed.

What is the best way to treat blisters?

DEAR DOCTOR K: I wore a new pair of hiking boots on my vacation and now have several painful blisters on my feet. What's the best way to treat them?

DEAR READER: It sounds like you have friction blisters. A friction blister is a soft pocket of raised skin filled with clear fluid, caused by irritation from continuous rubbing or pressure. The irritation -- in your case caused by new hiking boots -- slightly damages the skin. The uppermost layer of skin separates from the layer beneath, and fluid accumulates in the space that's left.

What causes gout?

DEAR DOCTOR K: What caused my gout? Will avoiding certain foods prevent flare-ups?

DEAR READER: Gout is a painful joint condition. I know, because I've suffered from it. I spoke to my Harvard Medical School colleague, rheumatologist Dr. Robert Shmerling, to get the latest information. Gout attacks come on suddenly, with sharp pain, often in a single joint. The big toe is a common target.

What is the best treatment for a painful bunion?

DEAR DOCTOR K: I have a painful bunion. What is the best way to treat it?

DEAR READER: A bunion occurs when two bones in your foot no longer line up properly. Normally, a bone in the foot lines up straight with the first bone in your big toe. With a bunion, the joint where those two bones meet no longer is straight. Instead, there's knobby bone bulging outward at the base of your big toe. And the big toe itself turns inward, bending toward, or even under, the other toes. As a result, the knobby bone at the base of your big toe points outward.

How can I treat athlete’s foot?

DEAR DOCTOR K: I have athlete's foot. How can I get rid of it? And how can I make sure I don't get it again?

DEAR READER: Athlete's foot is a common fungal infection. It got its name because walking around barefoot in a locker room is a good way to become infected. You can also pick up the fungus from improperly cleaned instruments used in a pedicure, in the dressing rooms of clothing stores, in swimming pool changing areas, or anyplace that combines dampness and a lot of foot traffic.

How do I treat an ingrown toenail?

DEAR DOCTOR K: I have a very painful ingrown toenail. What can I do?

DEAR READER: It's been my experience that toenails get a little unruly as we get older. They seem to fit the toes perfectly well for decades, and then they start doing funny things -- the sides start to curl, for instance, and suddenly the nail is pressing against the skin of the toe.

I have a patch of hard skin on my foot — What is it and how should I treat it?

DEAR DOCTOR K: I have a patch of hard skin on my foot. Is it a corn or a callus? How should I treat it?

DEAR READER: I can't answer your question without seeing it. But I can tell you what to look for, and when it requires a visit to your doctor. Corns and calluses are areas of hardened skin. They develop to protect the foot from the damage that can be caused by friction from poorly fitting shoes.

My doctor thinks the pain in the ball of my foot is caused by a Morton’s neuroma– How did I get this?

DEAR DOCTOR K: I have pain in the ball of my foot. My doctor thinks it is caused by a Morton's neuroma. How did I get this, and what can I do about it?

DEAR READER: Morton's neuroma is a swelling of the nerve between the bones at the base of the toes in the ball of the foot. The pain it causes usually is in one spot. It can feel like you have a pebble in your shoe. Once the nerve starts to swell, the nearby bones and ligaments put pressure on the nerve, worsening the irritation and inflammation.

I have Achilles tendinitis — what can I do to ease the pain in my foot?

DEAR DOCTOR K: I have Achilles tendinitis. What can I do to ease the pain in my foot?

DEAR READER: Your Achilles tendon -- a rope of sturdy tissue that connects muscle to bone -- runs up the back of your heel. Achilles tendinitis occurs when the tendon becomes inflamed. This causes pain and sometimes tenderness and swelling in the back of the heel.