Often ignored, feet can  cause or indicate health problems that need to be addressed. Dr Wanjiku Njongo gives tips on how to keep yours healthy.

Every foot tells a story — a story of miles walked, soccer games played, trails jogged, shifts worked on your feet, and hard work put in. But feet can also tell stories of underlying health issues. 

 For Nancy Khisa, an ex-banker and currently an entrepreneur, it all started with a fracture on her right ankle as a result of an accident in 2002.

“After the accident, I sought medical attention. They  put a cast on my right ankle to rectify the fracture. After eight months, the cast was removed and I had to use crutches,” she starts.

“However, I had lots of pain in my foot and had to undergo physiotherapy for some time. The pain persisted and I had to rely on painkillers,” she adds.

Today, she occasionally experiences pain and slight swelling especially when she stands for long.

 “The condition affected my lifestyle in a big way. After the accident, I had to be away from work for some time. I am no longer as swift as I used to be.

I was a good badminton player, but now I cannot play as before. I used to represent my organisation during the inter-banks games.

Due to pain, I self-medicate by taking pain killers and hope to find a lasting solution for my problem,” she says.

Constant nightmare

Just like Nancy, Trufena Nakhungu, 59, currently experiences challenges with her feet that have rendered her unproductive.

The widow and mother of four, who resides in Kakamega, cannot work nor perform duties that need her to exert herself.

“The problem started 10 years ago when I was 48. I went to hospital after hospital trying to find a solution. I first went to Kakamega General Hospital, where the doctor told me I had arthritis.

They prescribed some medication, which didn’t help much because I still experienced too much pain in my legs,” says Nakhungu.

She went to a different health centre within Kakamega and the doctor prescribed pain relief medication, which also didn’t help.

“I had to go to St Mary’s Mission Hospital in Mumias to seek further advice. However, the situation has never changed. To date, my feet still ache,” she adds.

Due to the condition, Nakhungu cannot walk straight and not for a long time. She says even bending to wash clothes is a nightmare because of the pain.  

She offers: “It’s a world I never expected to enter and is often times lonely. With each hospital I visit where the medic tells me they don’t have a viable solution, I lose hope. The situation has greatly affected and stressed me up so much that I have developed ulcers which are also a pain,” she says.

Nakhungu adds that  often she has to rely on well-wishers for support. 

“I carry out menial jobs such as planting people’s farms to get some money for food. Since my husband died long time ago, my children did not study well and have no jobs hence they cannot support me. My wish is that I may get some lasting solution to this problem so that am able to get back on my feet,” she says.

Nancy and Nakhungu are among many people who have presented foot problems without any viable solution. 

Dr Wanjiku Njongo, an orthopaedic surgeon and a clinical partner at the Nairobi Spine and Orthopaedic Centre, says foot and ankle problems are quite common.

“As orthopaedic surgeons, we most frequently deal with complications of fractures, congenital conditions such as flat feet and high arches, sports-related injuries, arthritis, bunions, and complications of diabetes,” she says.

Different conditions will affect different groups of people. Those conditions associated with previous fractures, arthritis, diabetes and bunions most commonly occur in adults. Congenital conditions on the other hand tend to occur in childhood but in some cases may persist into adulthood. 

 “The effect of age on the feet and ankles depends on a number of factors including a person’s individual anatomy, lifestyle, occupation and shoewear. Because the foot has many joints, aging may result in arthritis,” she says.

Dr Njongo, who started working on foot and ankle cases with Dr Ezekiel Oburu, about five years ago, says they  discovered  there was a large number of patients who needed foot care, but were not able to access it. 

“We needed a way to reach out to Kenyans, not only to help those with foot and ankle problems, but also to spread awareness on the solutions to these problems,” says Dr Njongo whose main area of focus is foot and ankle surgery.

It is in this regard that Dr Njongo organised a free foot and ankle last month. 

“A free clinic felt like a good step towards this goal for several reasons. It removes the barrier often created by a lack of financial access. It also provides an opportunity to educate those who do not necessarily have symptoms, but are looking for advice on how to avoid foot and ankle problems,” says the medic who is also a lecturer at the Jomo Kenyatta University of Agriculture and Technology. 

“So far, we have held a few foot and ankle-themed events, including symposiums and workshops for doctors. We have also conducted surgeries for patients in need, working in partnership with our colleagues from around the world,” she exoplains.

In the most recent clinic, they hoped to reach people with pain and/ or impaired function that may have resulted from previous injuries, degenerative diseases and congenital conditions.  

 She says, the most common symptom of foot and ankle conditions is pain. 

“This pain could be persistent or only experienced with certain activities such as prolonged standing, walking or running. Patients also present with stiffness of the joints, numbness and instability,” she says.

Fitting shoes 

Foot and ankle conditions affect a number of areas of life. The resultant discomfort may make it difficult to work, restrict one’s ability to engage in sport or keep you from doing things that bring joy like dancing. Chronic pain also has an impact on one’s mental well-being. 

“The foot may seem like a small area, but putting all these factors together, it has a large impact on life” says Dr Njongo.

One of the main causes of foot pain is wearing shoes that don’t fit properly. Wearing high-heeled shoes can often cause foot pain because they place a great deal of pressure on the toes.

Dr Njongo says an individual needs to include some lifestyle tips in their routine to keep their feet in good condition.

“It is important to keep your feet clean and dry all the time. That way you will be able to keep at bay some health conditions,” she says.

If you go for a run or hit the gym, it is important to carry extra socks and change during the day. You should also avoid wearing socks and shoes for long periods. 

Wash your feet thoroughly each day, and dry between your toes. Avoid wearing tight socks and instead choose socks with loose elastic tops. Doing so ensures that you don’t restrict blood flow.

“The foot problems that don’t occur due to accidents and deformities are mostly skin problems and infections,” she says.

You can also develop foot pain if you get injured during high-impact exercise or sports activities, such as jogging or intense aerobics.

Various medical issues are closely associated with foot pain.

Your feet are, especially susceptible to the pain caused by arthritis. There are 33 joints in the foot, and arthritis can affect any of them.

Diabetes mellitus can also cause complications and several disorders of the feet. People with diabetes are more prone to have nerve damage in the feet, clogged or hardened arteries in the legs and feet, foot ulcers or sores.

One is also more at risk for having foot pain if they are overweight or have obesity, are pregnant, have a foot injury such as a sprain, fracture or tendinitis.

Broadly, foot and ankle conditions can be treated through non-surgical or surgical means. Non-surgical treatments include education on foot care, shoewear modification, physiotherapy, medication and use of supports or braces.

At home treatment options for the feet will vary depending on the pain and its cause. Some tips that may help relieve your discomfort include, applying ice to the affected area, taking pain relievers, using foot pads to prevent rubbing on the affected area, elevating the affected foot and resting it as much as possible.

Improve circulation 

Medics advise against walking barefoot as it comes with the risk of cuts or other injuries. The recommend wearing comfortable footwear for both outdooors and indoors. Shoes protect your feet from sharp objects, toenail fungus and other infections. 

To have healthy feet, it is also important to observe a proper diet and exercise. Your feet depend on vital nutrients such as Vitamin D and calcium for strong bones and water for healthy skin. A diet rich in fresh fruits and vegetables and an active lifestyle helps one to maintain their weight.

Exercise helps improve circulation in the legs and feet, hence individuals should consider walking, which is the simplest form of exercise. 

“Surgical treatment is used in a variety of situations. In some cases, the condition is progressive- the problem becomes worse over time.

In such situations surgery can limit this progression and prevent future complications. In other cases, non-surgical treatments fail to relieve symptoms making surgery the most viable option to restore function,” explains the expert.