Foot Care

It is crucial to speak to your doctor about any foot problems because if left untreated, they may make walking more difficult, or increase the risk of falls.

In addition to common foot issues that can affect anyone, such as corns and bunions, many people with Parkinson’s find their balance, gait, mobility or posture are affected, and this can lead to other complications, as well as cramp.

Dystonia is a movement disorder that causes contractions in various muscles. This means the muscles become tighter and shorter than normal, making them difficult to stretch.

In Parkinson’s, dystonia can cause repeated, twisting movements (spasms) which create abnormal postures in the affected body part.

You may experience spasms and muscle cramps in the feet, where the toes curl into a claw-like position, the foot turns inwards at the ankle, and occasionally the big toe sticks up. This can be very uncomfortable and make it hard to fit feet into shoes. The toes may rub on footwear and pressure problems may arise on areas of the foot not designed to withstand pressure.

Dystonia can be caused by your medications, so speak with your doctor or Parkinson’s specialist nurse if you have one, to see if switching your medications or dosage can help alleviate the spasms.

Swelling in the feet, known as oedema, results from the accumulation of excessive fluid in the tissues. This is more likely to occur if you have slow or reduced movement (bradykinesia) or spend a lot of time sitting down.

Swelling tends to get worse during the day. Lying down flat with your legs slightly raised and keeping your legs raised while sitting can alleviate swelling. Your doctor may also prescribe a diuretic (a medication which makes you urinate).

If you are experiencing swollen feet or ankles you should talk with your doctor so that he or she can rule out other causes, such as problems with your heart or kidneys or deep vein thrombosis.

There are a number of things you can do to help prevent or alleviate foot problems:

Choosing the right footwear is important, both for comfort and to prevent pressure points or changes to the foot’s shape. A podiatrist or other experienced professional such as a physiotherapist or occupational therapist should be able to help you decide what is appropriate for you..

• Footwear should be supportive, with cushioning, to help absorb the impact of your foot hitting the ground
• If you find laces difficult to tie then your physiotherapist may recommend shoes with easy fasteners or buckles
• Your toes should not be cramped in narrow-ended shoes. Wide-ended shoes in which you can wiggle your toes are preferable
• Footwear that is lightweight requires less effort when walking, while natural, breathable materials help keep feet fresher.

Stretching and exercising the feet regularly can help prevent or reduce muscle stiffness, and improve circulation and the strength of foot arches. A podiatrist will be able to suggest suitable exercises that will only take a few minutes.

Keep your feet healthy with the following simple tips:

• Wash your feet every day in warm (not hot) water and afterwards make sure you dry them thoroughly, including between the toes. If toe-curling is an issue, try using a dry flannel or baby wipe between your toes
• Avoid harsh soaps and don’t soak your feet longer than you would in a bath as this dries the natural oils in the skin
• Keep your feet warm and don’t expose them to extreme heat or cold
• Exercise your feet to improve circulation and reduce muscle stiffness
• If your feet are particularly dry, use moisturising creams, lanolin or olive oil, taking care to avoid the areas between the toes
• You can remove hard skin by using a pumice stone or foot file. Apply an emollient cream afterwards, and up to twice a day
• File your toe nails regularly using a special file with a rounded end or an emery board. Always follow the shape of your nail and don’t cut it down at the corners as this can lead to ingrowing toe nails
• If you experience tremor or involuntary movements, or have difficulty gripping small instruments, don’t use sharp scissors or nail clippers. Use a file or ask your carer or podiatrist for help
• If you suffer any cuts, burns or breaks in the skin contact your podiatrist or doctor promptly as these can lead to more serious problems if left untreated. Also seek advice if you notice any changes in the colour, smell or temperature of your feet
• Use a shoe horn to help you get your shoes on (long handled horns may be easier to use) and try to wear different shoes every day so that pressure isn’t being put on the same area of the foot every time