What was once a major medical issue for soldiers during World War I is still causing problems today for hikers, campers, festival-goers, construction workers, and security guards. Trench foot affects the feet after long exposures to cold, wet, and unsanitary conditions. While the best treatment is prevention, there are steps to take to treat the feet before gangrene sets in. Let’s examine the signs to look for, treatments, and ways to prevent trench foot from occurring.
Trench foot first became a common problem among troops as they stood in muddy trenches for long hours in water-soaked socks and boots. The trenches were not surprisingly unsanitary and often cold. Infection would eventually set in, and thousands of solders suffered from gangrene and subsequent amputations due to this condition. The widespread issue among armed forces resulted in modifications of the government-issued footwear, and soldiers were given a grease product to protect against moisture.
What Are the Causes and Symptoms of Trench Foot?
The conditions of warfare that produced trench foot more than 100 years ago may have changed, but the basic underlying factors still hold true today in certain situations. Back then, combatants had the improper footwear and living environment working against them during their time in the trenches. Today, civilian men and women in various job fields face risk factors. The following are factors that alone or together can be responsible for trench foot causes.
- Standing for prolonged periods of time, as the pressure hinders blood flow to lower extremities
- Long-term exposure to cold temperatures, which can prevent an adequate supply of nutrients and oxygen to feet
- Improper footwear or foot protection
- Poor foot hygiene
- Exposure to wetness as wet extremities lose heat 25 times more quickly than dry ones
- Unhealthy diet and poor sleeping habits
Trench foot symptoms can be experienced in the toes, heels, or the entire foot. The condition has three distinct stages, each with its own signs and symptoms.
1. Stage One
In this early stage, the wet and cold environment constricts the blood vessels, producing symptoms of coldness to the touch, swelling, numbness, tenderness, and a slight change in color. At this stage, the foot can be restored to normal temperature with discomfort that only lasts up to a few days.
2. Stage Two
Damage to the tissues begins to set in as improper circulation increases and the blood vessels expand. The foot begins to have increased swelling, tingling, and pain usually begins. If the foot is warmed at this stage, blisters appear, and once they burst, ulcers develop. This is when gangrene can set in. This stage can last from two to six weeks.
3. Stage Three
This final stage occurs once the damage is done. The foot has increased sweating episodes, sensitivity to the cold temperature, itching, tingling, and pain. Over the following weeks and months, the foot begins to return to its normal appearance as the swelling decreases.
In addition to the specific symptoms outlined in the three stages, there are other signs you may want to watch for with trench foot. This may include odor, bleeding under skin surface, burning sensation, and a sense of heaviness of the foot.
Treatment of Trench Foot
In this day and age, we are fortunately able to treat this condition before it advances to the point of no return, as many soldiers experienced during World War I. The treatment is similar to that of frostbite. For successful trench foot treatment, you should:
- Remove wet shoes and socks
- Clean and dry feet
- Elevate feet and avoid applying pressure
- Slowly warm feet with heat packs or in warm water for no more than five minutes
- Maintain dryness and warmth by covering feet with a blanket; avoid socks to prevent moisture buildup from sweating
During the time of healing, watch for any changes to the feet such as a dark or greenish hue as this indicates the tissue is dying. This and any worsening of symptoms needs medical attention. Amputation is a rare treatment.
Preventing Trench Foot
Any time your feet are going to be exposed to cold, wet conditions, it is wise to have extra pairs of dry socks and dry footwear handy. This is a common trick campers, hikers, builders, and avid festival-goers use. In unfortunate incidents, such as with natural disasters, there is a high risk of your feet remaining wet and cold for a prolonged time. Trench foot prevention in these times begins with:
- Vacating water-logged areas for dry ground, if possible
- Taking breaks every few hours for disaster relief workers or military personnel
- Removing wet socks and cleaning and air-drying your feet
- Lying down flat to encourage proper blood circulation
- Absorbing wetness from shoes with a cloth; changing to dry shoes once available
- Changing socks three times each day
- Keeping warm
- Wiggling toes and walking around to promote blood circulation
- Using talcum powder or other drying agents to prevent moisture from accumulating
Trench foot was once the leading factor in foot amputations for many soldiers during the First World War. Today, we have the knowledge and means to prevent the condition from occurring to defense forces and the general public. However, there are environmental conditions and outdoor activities that can put your feet at an increased risk of prolonged exposure to cold, wet grounds. If trench foot does occur, there are precautions to take for treatment before it develops into serious infections like gangrene.
Sources:
Dutra, T., “Trench Foot – Symptoms, Treatment, and Prevention,” Foot Vitals; http://www.footvitals.com/injuries/trench-foot.html, last accessed May 16, 2017.
Dr. Mary, “Trench Foot – Pictures, Symptoms, Causes, Treatment, Cure,” Bye Bye Doctor; http://byebyedoctor.com/trench-foot/, last accessed May 16, 2017.
“How to Treat Trench Foot,” WikiHow; http://www.wikihow.com/Treat-Trench-Foot, last accessed May 16, 2017.