Trench foot is brought on by extended exposure to chilly temperatures that are often above freezing, moist, and occasionally filthy conditions. In the end, the condition results in skin and tissue breakdown, raising the risk of infection and associated morbidity and mortality.
There are three classes of immersion foot and trench foot is one of them. It is a non-freezing cold injury. Unlike frostbite, which is caused due to constant exposure to freezing temperatures, trench foot can occur even in temperatures that are just cold and non-freezing. The temperature of 16°C is just adequate to affect the feet and exposure of up to 10 to 14 hours can result in damage.
Symptoms of Trench Foot
The symptoms of trench foot can start after 10 to 14 hours of exposure to cold and wet conditions, though it may normally appear after continuous exposure to dampness for a day or two. Sometimes, it may take weeks of exposure to cold and damp conditions before the symptoms appear. Some of the symptoms of trench foot are:
- Itching
- Red and blotchy skin
- Numbness
- Tingling pain
- The heaviness of the foot
- Cramps in the legs
- Oedema
- Blisters filled with liquid
- Bleeding beneath the skin
- Ulcers
- Shedding of skin
- Gangrene (this is in extreme cases where the skin turns grey, dark blue, or purple due to tissue death)
The symptoms of trench foot can surface on the toes, heel, or entire foot. In severe conditions, there can be swelling of the legs that spread up to the knee. Initially, the skin will appear blotchy and as the disease develops, there can be open sores and blisters that can lead to bacterial and fungal infections. If the disease develops beyond this stage, the sloughing of skin and tissue begins. If not treated even at this stage, then gangrene can set in. Once the gangrene sets in, amputation of the leg may become necessary to avoid further progress of the disease and further conditions like sepsis and death.
Trench foot treatment in the initial stages is very important for complete recovery. The return of sensation to the affected area can cause considerable pain.
Stages of Trench Foot
The trench foot progresses in stages, giving ample opportunity for immediate treatment. There are four stages:
First Stage: On continuous exposure to cold and damp conditions, the blood flow to the feet will be restricted and you will experience numbness and redness of the skin. This is the initial stage and you will not feel the pain.
Second Stage: This is the pre-hyperaemic phase. This stage continues for 6 to 24 hours. The feet will turn pale and will be cold with a prickly sensation. The toes and ankles will become stiff and mobility will be restricted.
The health provider examining the condition will not feel the normal pulse in the affected area, indicating the impeding of blood flow.
Third Stage: This is the hyperaemic phase. This will last for up to 2 months. In addition to swelling that gets worse with movement, heat, and standing, the feet will be hot and painful. In extreme circumstances, the skin will develop rash-like spots and blisters. If the trench foot is mild, the conditions can be brought to normal with treatment. But if it is severe, then the condition may worsen.
Fourth Stage: This is the post-hyperaemic phase. The person may experience this phase for the rest of his/her life. This is a protracted vasospastic phase that includes hyperhidrosis, intense and excessive foot sweating, paresthesia (a prickly sensation), and greater discomfort with heat.
The affected foot or feet may start to feel cold all the time. Long-term constriction of small blood vessels leads to the development of secondary Raynaud’s syndrome, a disorder characterised by an increased sensitivity to cold in which the toes turn blue and/or white when exposed to cold and deep red upon rewarming.
According to past studies, trench foot typically begins with tingling and itching before progressing to numbness. Blood flow restrictions might result in flushed skin and a bluish colour (called cyanosis). Hyperesthesia (excessive physical sensation) may happen in the later phases as the foot is rewarmed.
With continued exposure, odour, decomposition, and necrosis (death of tissue) could develop. The feet can swell greatly in some cases; in fact, some interpretations claim that oedema caused the feet to double in size (swelling).
Complications That May Occur with Trench Foot
The complications that occur as a result of trench foot can be one of the causes for foot pain. Some of the complications reported are:
- Infections of soft tissues (such as cellulitis or gangrene)
- Fairly severe subacute or chronic neuropathic pain (nerve pain)
- May cause permanent sensory changes if the treatment is not carried out timely
- Internal skin layers can be infected by a condition called cellulitis
- Inflammation of the blood vessel lining, also known as thrombophlebitis
- Muscle atrophy or loss of muscle mass
- Injury to skin tissue, muscles, blood vessels, and peripheral nerves
- Osteoporosis or softening of the bones
- Amputation will be necessary if the trench foot is left untreated and becomes severe and unmanageable
Treatment for Trench Foot
As health providers have now got a better understanding of the condition, effective treatment for trench foot has been developed. Here are a few steps you can follow:
- Rest and keep the foot elevated to improve circulation. This will inhibit the formation of blisters and wounds.
- Consumption of painkillers like ibuprofen to reduce swelling and as a foot pain treatment. If you are intolerant to ibuprofen, you will be administered aspirin, which may be a foot pain treatment but will not help reduce the swelling.
If you identify the symptoms in their early stages, home remedies can also help. Some of the precautionary techniques suggested are:
- Avoid wearing soiled socks to bed.
- Do not continue to keep the socks for a prolonged period of time. Take off your socks to air-dry your feet.
- Clean the affected area immediately.
- Keep your feet dry.
- Give heat packs to the affected area at least for 5 minutes.
If the above techniques do not help, then see a medical practitioner to get timely treatment and avoid further complications.
Conclusion
Though trench foot may not be prevalent in a city environment, it cannot be ruled out. You may be susceptible to trench foot if you indulge in outdoor activities like camping, hiking, fishing, and other hobbies. You should necessarily be aware of the dangers of trench foot, particularly, if you spend a lot of time outside in the rain or any damp condition. You should also be aware of the precautionary measures.
Trench foot can be treated without resulting in any additional issues if discovered early. Trench foot can be prevented entirely, which is one of the greatest methods to avoid its symptoms and potential health hazards. If you plan to spend a lot of time outdoors, make sure to have additional socks and shoes on hand. Even if you don’t see the possibility of your feet getting wet, it’s still a good idea to let your feet air dry after wearing socks and shoes.
