Why is there a risk to my feet?

There are various medical conditions which can cause serious foot problems which may become life or limb-threatening conditions. Some of these problems can occur because the nerves and blood vessels, including those supplying your legs and feet, are damaged.

This can change the feeling in your feet (peripheral neuropathy) and the circulation in your feet (ischaemia/ peripheral arterial disease)

These changes can be very gradual and you may not notice them. This is why it is essential that every year you have your feet assessed by a member of the foot protection team. You can then agree a treatment plan to suit your needs.

What is my foot risk?

Your assessment has shown that there is a HIGH RISK of developing wounds that may be slow to or may not heal and may lead to an amputation due to the following risk factors:

You have lost some feeling in your feet (peripheral neuropathy).

The circulation in your feet is reduced (ischaemia/ peripheral arterial disease).

You have developed problems with the shape of your toes or feet.

You have hard skin on your feet.

You have a compromised immune system.

• Good management of your cholesterol and blood pressure, stopping smoking, increasing cardiovascular exercise and controlling your weight will help reduce the risk of these life and limb threatening problems.
• If you smoke, you are strongly advised to stop. Smoking affects your circulation and can lead to amputation.
• As your feet are now at high risk of developing wounds and complications which may be slow to or will not heal and could lead to an amputation, you will need to take extra care of them and may need regular reviews and treatment by a member of the foot protection team experienced in the high risk foot.

The advice and information in this leaflet will help you to take care of your feet. This will help you to reduce the risk of developing life-and limb-threatening problems.

What should I do if I have a concern or problem?

If you develop any of the following problems, it is important that you contact your local Podiatry Department or GP for advice as soon as possible (within 24 hours).

A red, hot, swollen toe or foot

A new break or wound in the skin.

New redness or discolouration of your toe or foot

New or unexplained pain in your foot

If they are not available, go to your nearest accident and emergency department. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.

What can I do to reduce my risk of developing problems?

Check your feet every day

• You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness.
• If you cannot check your feet yourself, ask your partner or carer to help you.
• If you discover any breaks in the skin or blisters, cover them with a sterile dressing. Do not burst blisters.

Wash your feet every day

• You should wash your feet every day in warm water and with a mild soap. Rinse them thoroughly and dry them carefully, especially between the toes.
• Do not soak your feet as this can damage your skin.
• If you have lost some feeling in your feet, you may not be able to feel hot and cold very well. You should test the temperature of the water with your elbow or ask someone else to test the temperature for you, if you have reduced feeling in your feet.

Moisturise your feet every day

• If your skin is dry, apply a moisturising cream, avoiding the areas between your toes.
• If your skin is dry and cracks, you can apply cream with high urea content. Your foot protection team or local pharmacist will be able to advise.

Socks, stocking and tights

• Change your socks, stockings or tights regularly. They should not have bulky seams and the tops should not be elasticated.

Toenail care

• Cut or file your toenails regularly, following the curve of the end of your toe.
• Use a nail file to make sure that there are no sharp edges which could press into the next toe.
• Do not cut down the sides of your nails as you may create a ‘spike’ of nail which could result in an ingrown toenail.

Please note podiatry do not provide routine nail cutting service.

Avoid walking barefoot

• If you walk barefoot, you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.

Check your shoes

• Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole.
• Run your hand inside each shoe to check that no small objects such as small stones have fallen in , as you may not feel it.

Poorly fitting shoes

• Poorly fitting shoes are a common cause of irritation or damage to feet.

The foot protection team who assessed your feet may give you advice about the shoes you already own and about buying new shoes.

Prescription shoes

Depending on your need, you may be assessed and referred for prescription footwear, insoles or both.

• If you have been supplied with shoes, these should be the only shoes you wear.
• Prescription footwear and insoles can reduce the risk of ulcers but cannot remove the risk altogether.

Hard skin and corns

• Do not try to remove hard skin or corns yourself.
• You can gently reduce callus using a foot file but not a “cheese grater type”. Your foot protection team will provide treatment and advice where necessary.

Over-the-counter corn remedies

• Do not use over-the-counter corn remedies such as corn plasters. They are not recommended as they can be highly dangerous and can lead to new wounds and infections.

Avoid high or low temperatures

• If your feet are cold, wear socks.
• Always remove hot-water bottles or heating pads from your bed before getting in.
• Never sit with your feet in front of the fire to warm them up.
• Avoid walking on hot sands or pool sides surfaces on holiday. Always apply sunscreen on your legs and the top of your feet.

A history of ulcers

If you have had an ulcer before, or an amputation, you are at high risk of developing more ulcers. If you look after your feet carefully, with the help of a podiatrist, you will reduce the risk of more problems.

Appointments

It is important that you attend all of your medical review appointments and podiatry appointments where necessary. This reduces the risk of problems developing.