Hello.
Thank you for your query at DoctorSpring.com.
I understand your concern. From the picture, your foot appears to be normal, although a flat foot cannot be ruled out. However, this should not cause any unsteadiness.
I would require additional details in order to provide my best opinion.
-Since how long do you have the unsteadiness?
-Do you have any weakness of the lower limbs such as difficulty climbing up and down the stairs/ standing up from a sitting position/ inability to hold slippers / tripping over curbs/ difficulty walking on uneven ground ?
-Have you had any falls due to the unsteadiness?
-Do you have any medical illness?
-Any other symptoms like pain in the foot etc?
Please reply to the above questions in the follow-up. In addition, you can do the "wet footprint" test for diagnosing flat foot, by wetting your feet in water and then standing on a smooth, level surface such as smooth concrete or a thin cardboard or heavy paper. You can take a photograph of the resulting footprint and upload it in the follow up.
Feel free to voice your concerns.
Thank you.
Patient replied :
Don't the toes look squished/gripped??
-Since how long do you have the unsteadiness?
several months
-Do you have any weakness of the lower limbs such as difficulty climbing up and down the stairs/ standing up from a sitting position/ inability to hold slippers / tripping over curbs/ difficulty walking on uneven ground ? Sometimes not weakness ever but sometimes some unsteadiness
-Have you had any falls due to the unsteadiness? No
-Do you have any medical illness? No
-Any other symptoms like pain in the foot etc? Stiffness and tingling in feet
Hello.
Your toes do look like they are flat and pressed on the ground. This could be due to a Flat Foot, also called Pes Planus. Flat foot is a normal anatomical variation in some individuals. It usually causes pain. Unsteadiness is rare. It is basically benign or harmless and shouldn't be cause for worry.
Pes Planus is a condition where there is a decrease or loss of the longitudinal arch of the foot. It can be either rigid or flexible. This distinction is made by testing the mobility of the tarsal and subtalar joints (ankle joints). Some studies have found that people with flat feet are prone to foot and ankle injuries. This is significant in athletes with flat feet. Flexible flat foot can be corrected by measures such as foot stretching exercises and special orthotic footwear.
Treatment depends on the exact type of flat foot which can be determined by examination.
I suggest you try out stretching exercises of the foot along with a trial of over the counter arch supports, for 2-3 weeks. This should relieve the stiffness and reduce the "squishiness" of your feet.
In case your symptoms persist, kindly consult a Podiatrist or an Orthopedic for examination and further management.
I hope this was helpful.
Let me know if you have any queries.
Thank you.
Patient replied :
What's the problem with the feeling unsteady and like I'm going to fall forward? You asked some questions related to that- what could that be?
Hello.
Your symptom of unsteadiness could be due to the shape of your feet.
If you had additional symptoms like muscle weakness which is manifested by trouble while using stairs, naviagting curbs, standing from sitting etc; or any problem with maintaining balance, it would indicate a muscle or nervous system pathology for the unsteadiness. I asked those questions to rule out such a cause of your unsteadiness.
Since you do not have any of those symptoms, you do not have anything to worry.
Thank you.
Patient replied :
I do have some test results tha came back with a high level of Aldolase/CPK and ALT, would that be related? There is nothing to the toes scrunching, someone mentioned to me once that could be a neruological issue?
Hello. Thank you for writing to us again.
High Aldolase/CPK levels can indicate muscle weakness/ myositis and it definitely points towards a neurological issue. I will advise you to ger in touch with your neurologist soon who can do a proper physical examination, check the strength of your muscles and then diagnose.
For your toe scrunch, as i told you before, it looks like Pes Planus, and it is not related to your high aldolase/CPK levels. High ALT levels also indicate a damage to liver. I will advise you to take oily/ fatty food for the next one month, avoid alcohol, and also take Silymarin syrup. It is hepatoprotective and will help in healing your liver.