Bunions, ingrown toe nails, plantar warts, corns and calluses... So many ailments can affect your foot health, you don't have enough of 10 toes to count them!

Ms Marabelle Heng, Principal Podiatrist from the Department of Podiatry at Singapore General Hospital, gives detailed answers to your questions.

Question by zarchi

What cause bunions, tight covered shoe or high heel?

Can bunion be cured by no surgical treatment?

How to prevent bunion from growing bigger?

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

Bunions usually occur in the 1st toe joint. It may also occur at the 5th toe joint. It is usually a result of poor biomechanics around the joint or poor choice of shoes – usually shoes that are too narrow around the toe area. Sometimes it could also be due to arthritis.

People with bunions are advised to wear comfortable supportive shoes with wider toe box so as not to exacerbate the problem.

If the condition is due to a biomechanical problem, insoles prescribed by your podiatrist would control and reduce progression of the bunion.

Question by jasteo

Hi,

i would like to ask about painful heels.

I got painful heels in the past, but only last few days.

Now both of my back heels are painful, especially when walking after waking up in the morning. Also painful when standing up after sitting or resting for some time during the day. Also wil be painful if massaging the spot.

This recent pain came after a day of long walking two weeks ago, (3times my normal walking activities.) (im female, overweight, and i only wear flat shoes)

Now, is this pain cause by poor blood circulation or inflammation of the heels?

How to distinguish between these two?

How to prevent or relieve the pain?

Thanks

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

Pain from poor circulation usually presents as a burning or shooting pain which is relieved by standing or bending knee so that feet is below knee level.

Pain from inflammation in heels commonly presents as you have described – pain first thing in morning or when standing up after a period of rest.

The good news for acute inflammation in the heels is that it can usually heal with time, rest and good supportive footwear (some may require insoles). Depending on the individual’s biomechanics, some may also require stretching exercises. Others may find relieve in icing the foot or application of anti-inflammatory creams to manage the inflammation.

Thin soled shoes may aggravate the problem now so do stay away from these during this period.

Question by jes

Hi Doctor

I need yr advice. My niece (aged 15) complains of pain on both her feet (in the center of sole nearer to the toes). This pain is ongoing since she was seven. But now the pain is getting worse.

We have consulted gp and also tailored made special insoles for her but pain did not go away.

May I know what is the problem and what should we do.

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

It is difficult to assess this chronic situation without clinical examination. It sounds like your niece will require a full biomechanical assessment to ascertain the root cause(s).

I suggest you book your niece into any Podiatry clinic for an assessment. A listing of podiatry clinics in Singapore can be found at http://www.podiatryassociationsingapore.com/pages/members.php

Question by rachel

I have rather large bunions on both my feet. What type of shoes should I wear? I am a working exectuive, so hope to have shoes that are good for my feet but also still look good!

Is there any way to reduce it without surgery? Plus, if with surgery, what is involved please.

thanks

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

Pain around the bunion is mostly due to direct pressure of shoe on bony prominence of the joint. Most people find relieve with pressure is redistributed from the area with bunion shields or silicon gel pads. There are some shoes with stretchable material around the bunion area to provide pressure relieve too.

Open toed sandals with supportive insoles and backstraps are sometimes recommended to people with bunions as closed in shoes cause too much discomfort.

Shoes with raised heel result in increase pressure in the forefoot/toe joint area which can cause further progression of the bunion.

Question by p1071663

Hello,

I have a problem with a recurrent fungal infection of my L-big toenail. Please, Help!

Thank you.
Rafeeda

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

Fungal infections are hard to diagnose with certainty as about 30% nail scraping/clippings microscopy lab tests come back as false negative.

However, fungal nails do commonly present with white chalky appearance. Sometimes it presents as a yellowish spot. In chronic cases, the nail may thicken, become brittle or have discolouration.

Do see medical professional for diagnosis and treatment options. You may wish to try over-the-counter nail fungal medication. A pharmacist would be able to point you to the right medication.

Fungal nail infections may take months to clear, so do be patient and keep up with the application of medication as directed.

Question by ilove20stars

Hi,

I need help!

I am a female at 25yo, overweight and usually wear flat sandals and slippers.

Recently, my heels/ankle are very painful especially when walking after waking up in the morning. Also painful when standing up after sitting or resting for some time during the day. Also wil be painful if massaging the spot.

I had try to walk quite a lot (at least 30mins), does it trigger the problem?

How and what can i do to prevent or relieve the pain?

Thanks
Stars

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

From your presentation, it sounds like you are likely to be experiencing some inflammation in the heels. However, I am unable to diagnose the problem without clinical examination.

Pain from poor circulation usually presents as a burning or shooting pain which is relieved by standing or bending knee so that feet is below knee level.

Pain from inflammation in heels commonly presents as you have described – pain first thing in morning or when standing up after a period of rest.

The good news for acute inflammation in the heels is that it can usually heal with time, rest and good supportive footwear (some may require insoles). Depending on the individual’s biomechanics, some may also require stretching exercises. Others may find relieve in icing the foot or application of anti-inflammatory creams to manage the inflammation.

Thin soled shoes may aggravate the problem now so do stay away from these during this period.

​Question by ​janey

I have large bunions on both my feet, so have resorted to wearing only open toed shoes/sandals, without any covering on the toe front and heels. However, I noticed that my heels and tips of my toes seems to have been getting drier by the week. Is this caused by being constantly exposed?

Any alternative shoes for ladies like us?

I also tend to wear those sandals/shoes which has a wedge in the middle to hold the large toe versus the other toes. However, my calves seem to ache more, and the masseuse ( yeah), told me its because I am wearing such shoes/sandals. So, what should I wear instead? I can't seem to find any shoes which does not hurt my bunions within 30 mins of wear.

Help!!!
thank you

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

Pain around the bunion is mostly due to direct pressure of shoe on bony prominence of the joint. Most people find relieve with pressure is redistributed from the area with bunion shields or silicon gel pads. There are some shoes with stretchable material around the bunion area to provide pressure relieve too.

Open toed sandals with supportive insoles and backstraps are sometimes recommended to people with bunions as closed in shoes cause too much discomfort.

Shoes with raised heel result in increase pressure in the forefoot/toe joint area which can cause further progression of the bunion.

Question by owmio6464

Hi,

I have Bunions on both of my feet, how do I treat it? I had gone to one of the shoe shop specialise on certain type of shoes and the sales recommend me a shoe at SGD170, special for bunions user and I bought it, but till now I don't see any improvement.

Kindly adv is there any treatment to it? By the way, out of curiosity, how do bunions come about it?

Awaiting your reply.

Thanks/Michelle

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

It is difficult to assess this chronic situation without clinical examination.

Bunions usually occur in the 1st toe joint. It may also occur at the 5th toe joint. It is usually a result of poor biomechanics around the joint or poor choice of shoes – usually shoes that are too narrow around the toe area. Sometimes it could also be due to arthritis.

Question by priya77

Hello doctor,

I have a very painful heel, but only on my left leg. The pain is unbearable. Even if I don't walk much, the pain is unbearable. Due to this, I hesistate to go shopping or any long distance walking.Please advise and I am SGH staff.

Answered by Ms. Marabelle Heng, Podiatrist Dept of Podiatry Singapore General Hospital

It is difficult to assess this chronic situation without clinical examination. It sounds like you will require a full biomechanical assessment to ascertain the root cause(s).

I suggest you book yourself into any Podiatry clinic for an assessment. A listing of podiatry clinics in Singapore can be found at http://www.podiatryassociationsingapore.com/pages/members.php

Ref: U11