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Chilblains are a very common problem on the foot in colder climates. They are nearly unheard of in hotter environments. They are a painful reaction of the circulation in the toes after the feet are cold and are heated up too fast. Due to this problem with the blood circulation not responding, there's an inflamation related reaction leading to small reddish and itchy lesions on the toes. If the problem becomes more chronic the skin takes on a painful dark discolouration because waste products develop.

The most effective management of chilblains is prevention. Firstly, wear good hosiery and shoes so that the feet do not get too cold. If the foot does get cold don't stick it in from of a heat source so that it warms up too fast. The feet must be allowed to warm up gradually so the blood circulation has time to adapt to the alterations in temperature. Once a chilblain does develop it must be protected in order that it can get better, especially if the skin is broken. Keep it covered to shield it from trauma from the shoe. Soothing chilblain creams may be used to stimulate the blood circulation and help eliminate the harmful toxins which have accumulated in the skin that are causing the inflammation and congestion. Care should also be taken to prevent further chilblains developing, so the methods that needs to be used to protect against them should be used even more. It is easy to develop another one before the first one has healed up transforming this into a chronic problem. If the local measures to look after the chilblains don't help, there are some drugs a doctor may prescribe which you can use to open up the blood circulation. The medicine is not specific to the foot and work everywhere, so may be reserved for the more severe conditions. In the very worst cases, it is not uncommon that they be given advice to move and live in warmer climates.

Flat foot is a pretty common condition of the foot, but most of the time simply having a lower arch or flatter foot is not necessarily a problem. What is a problem is if it is progressive and becomes painful, then it is known as posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes progressivly lower and the heel rolls inwards. This is usually accompanied with pain in the arch of the foot and in the ankle region. Those with this also find walking is a lot harder and walking consumes a lot of energy leading to a lot of fatigue.

The cause of posterior tibial tendon dysfunction is not totally clear, but it is a problem in which the posterior tibial tendon and muscle can not just do the job that it is designed for. The primary role of the posterior tibial tendon is to hold up the arch of the foot and stop the heel rolling inwards. For some reason the muscle and tendon complex can not just do their job any more, leading to the progressive nature of this problem.

The treatment of posterior tibial tendon dysfunction is somewhat urgent and needs to be addressed as early as it possibly can. This is because the condition is progressive and it will reach a stage where conservative measures do not work and surgery is the only option. While the surgical outcomes are generally satisfactory, they do involve the fusion of some joints to prevent the condition getting worse, that does have some long term limitations on gait and function, so is best avoided. To avoid the surgical intervention, treatments needs to be started early. This will involve foot orthotics that are very supportive and angle the foot back in the right direction. Exercises are also recommended, but should never be used instead of foot orthotics, as they are crucial to stop this problem from progressing.

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Tag: pain

What are chilblains and what can be done about them?

What is posterior tibial tendon dysfunction?