Our feet contain a quarter of the body’s bones. Each foot has multiple joints, tendons, muscles, and ligaments. The nerves and blood vessels in the feet go all the way to the heart, spine, and brain.

So it’s no wonder they’re sometimes a barometer of our general health.


Vascular Disease

Pain in the calves after walking short distances or while lying flat can indicate that the lower legs are not getting enough blood and nutrients to keep up with the demand.

When someone presents with these symptoms, a podiatrist would need to rule out peripheral vascular disease.

Or if the patient has cold toes, a lack of hair growth on the feet, or dry skin, a vascular issue may be involved.



Another condition that affects the feet but is systemic is gout. A gouty attack presents as red, hot, swollen joints, mostly in the big toe. It indicates an elevated uric acid level, leading to the formation of crystals inside a joint.

The podiatrist works with a primary care doctor to treat it and prevent recurrent gout attacks, which can cause arthritic changes in the joint they continue to occur in.



Other types of arthritis can present in the foot: degenerative, post-traumatic (injury), rheumatoid, and psoriatic.

With psoriatic and rheumatoid arthritis, findings show up on the X-rays of the foot that may be indicative of early signs of a rheumatologic disease. The podiatrist would refer the patient to a rheumatologist for further workup.

Degenerative and post-traumatic arthritis are not usually associated with a systemic issue.


Plantar Fasciitis

In cases of plantar fasciitis, the thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes, becomes inflamed and causes pain.

Shoe inserts or physical therapy, which rehabilitates muscles to improve flexibility and strength, can help.



When a diabetic patient comes in, the podiatrist stratifies that person in a specific risk category based on multiple factors and the effects the illness has already had. The stratification identifies the likelihood of the person developing complications in the lower extremities.

Diabetes can cause blood flow and nerve problems. The longer the glucose is elevated, the more negative effects the diabetic may experience.

A podiatrist who sees patients with “pins and needles in their feet” can rule diabetes in or out with further testing and coordination with a primary care physician. Neuropathy (problems with the nerves, usually the peripheral nerves as opposed to the central nervous system) may also mean the person has diabetes.

In fact, since many people don’t go to a primary care doctor except when they’re sick, it may be the podiatrist who diagnoses the diabetes if, for example, a patient sees a podiatrist for an unhealed or infected foot wound.


Other foot-issue implications include:

  • Dehydration can be seen in the feet—with symptoms of muscle cramping, cracking nails, and dry skin.
  • Poor nutrition leads to poor overall health. Specifically, nerve symptoms can indicate a vitamin B deficiency. Stress fractures (inflammation inside the bone without a precipitating event) can indicate vitamin D deficiency, though this deficiency is sun- not just diet-related.
  • Numbness in the feet can be a result of many issues. Diabetes is one, but so is entrapment of the nerves, called tarsal tunnel (like carpal tunnel in the wrist).
  • Patients who have lower-back issues or who have had low-back surgery can have lower-extremity nerve pain.
  • Toenail changes can signify systemic issues—such as iron deficiency, psoriasis, or liver disease. They can also be related to cardiac disease, but not always.
  • Fungus is usually localized.
  • Muscle spasms at the end of the day might mean tight muscles, which need to be stretched.
  • Some people get pitting of nails or clubbing, in which the entire ends of the fingers and nails appear rounded from top to bottom and side to side. This may indicate a cardiac issue.
  • If experiencing charley horses, increase water intake or drink electrolyte beverages or tonic water, which contains quinine.


Don’t diagnose yourself. See your primary care doctor or a podiatrist to find out what your feet may be trying to tell you.


At-home foot exercises that can help foot flexibility:

  • Draw the alphabet with your foot to help tight muscles.
  • Place the front of your foot on a step and let the back of the foot hang off. Hold for three seconds. This improves calf flexibility.
  • Stand at a countertop, holding on, and lift your heels off the ground. This strengthens foot/ankle muscles.
  • Walk or do physical exercise for general and cardiovascular health.

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