Trench foot, or immersion foot syndrome, is a serious condition caused by having your feet wet for too long. The condition was first known about during World War I, when soldiers got trench foot from fighting in cold, wet conditions in trenches without extra socks or boots to help keep their feet dry.
Since the infamous outbreak of trench foot during World War I, there is now more awareness of the benefits of keeping feet dry. However, it is still possible to have this disease even if the feet are exposed to cold and wet conditions for too long.
Trench foot is typically classified as one to four stages, including:
This stage involves restriction of blood flow due to cold tissue, symptoms may include numbness and redness of the skin, but the pain has not yet started.
This stage lasts from 6 to 24 hours. Symptoms include pale, white, cold feet with paresthesia (tingling sensation). The ankles and toes are stiff, making it difficult to walk.
Upon examination, a doctor may not be able to palpate (feel) normal pulses in the feet (indicating that normal blood flow has been impeded).
This phase lasts up to two months. Symptoms include painful feet that are hot to the touch. There is swelling that worsens with heat, movement and standing.
In severe cases, small blisters can be seen. Bruising may occur, along with petechiae (rash-like patches on the skin). When trench foot is mild, the condition usually resolves with treatment at this stage. If severe, trench foot symptoms progress.
This phase can last the entire life of the person. This is a long-term vasospastic (narrowing of the blood vessels) phase involving increased pain on heating, hyperhidrosis (extreme and excessive sweating) of the feet, and paresthesia (tingling sensation).
The affected foot or feet may develop a permanent cold sensation. Secondary Raynaud’s syndrome (a condition involving exaggerated sensitivity to cold in which the toes turn blue and/or white on exposure to cold and then turn bright red when reheated) develops as a result of constriction in the long term of the small blood vessels.
With trench foot, you will notice some visible changes in your feet, such as blisters, blotchy skin, redness, or skin tissue that dies and falls off.
In addition, trench foot can cause the following sensations:
- Pain when exposed to heat
- persistent itching
These trench foot symptoms may affect only part of the feet. But in the most severe cases, these can spread throughout the foot, including the toes.
Trench foot is caused by feet that get wet and don’t dry properly. It is also more common in temperatures from -1ºC to 4ºC. However, trench foot can occur even in desert climates.
The key is how wet your feet get, not how cold they are (as opposed to freezing). Standing in wet socks and shoes for a long period of time tends to make things worse compared to other activities, such as swimming in water shoes.
With prolonged cold and dampness, feet can lose circulation and nerve function. They are also deprived of the oxygen and nutrients normally provided by the blood. Sometimes loss of nerve function can make other symptoms, such as pain, less noticeable.
We can also be more prone to complications if we have foot injuries. As we recover from trench foot, we must watch for signs of infection, such as swelling or drainage from any wounds.
Your doctor will be able to diagnose trench foot with a physical exam. They will examine any injuries and tissue loss and determine the extent of the loss of circulation. You can also test nerve function by seeing if you can feel pressure points in your foot.
As doctors have learned more about trench foot, treatment has evolved. During World War I, trench foot was first treated with bed rest. Soldiers were also treated with lead and opium-based foot washes. As their conditions improved, massages and vegetable oils (such as olive oil) were applied. If trench foot symptoms worsened, amputation was sometimes necessary to prevent circulation problems from spreading to other areas of the body.
Today, trench foot is treated with relatively simple methods. First, we will have to rest and elevate the affected foot to stimulate circulation. This will also prevent new blisters and wounds. Ibuprofen can help relieve pain and swelling. If we can’t take ibuprofen, the doctor may recommend aspirin or acetaminophen to reduce pain, but these don’t help with swelling.
Early symptoms of trench foot can also be treated with home remedies . Some of the same techniques that we would use with freezing can be used. For example:
- remove socks
- Avoid wearing dirty socks to bed
- Clean the affected area immediately
- Dry your feet well
- Apply heat packs to the affected area for five minutes
If trench foot symptoms don’t improve after every treatment, it’s time to see a doctor to avoid complications.
When does it disappear?
As you heal, it’s a good idea to check your feet every day. Severe cases of trench foot can leave blisters, but it can also change the sensation in your feet. That means we may not even feel a cut or blister. Openings in the skin can increase the chances of infection and gangrene. With gangrene, the tissue dies. This condition requires immediate medical treatment.
It is possible to make a full recovery if it is mild and we receive treatment right away. However, we may need to treat the pain for a while. We may even need physiotherapy.
If we wear boots, we will make sure that they are not too tight. If the feet get wet, we will change the socks frequently. We should drink plenty of water and move around to help keep the blood flowing. But the best way to prevent trench foot is to keep your feet dry and warm.