Trench Foot
Written By: Chloe Wilson - BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Trench Foot is a condition caused by prolonged exposure to damp, cold, unsanitary conditions. The foot become numbs, changes colour, swells and starts to smell due to damage to the skin, blood vessels and nerves in the feet.
Trench Foot originates back to 1812 with Napoleon’s Army but is most commonly associated with the trench soldiers in the First World War where it affected approximately twenty thousand soldiers in the British Army alone in the winter of 1914-15. Numbers of casualties dropped dramatically with improved trench drainage and conditions, but the condition still affects people today.
It can take three to six months to fully recover and prompt treatment is essential to prevent gangrene and possible foot amputation.
The medical term for this condition is Non Freezing Cold Injury (NFCI) and it is also known as Immersion Foot. Here we will look at the causes, symptoms, treatment options, recovery process and how to prevent trench foot. You can also find out which celebrities have suffered from this problem!
What Causes It?
Trench Foot is caused by prolonged exposure to damp, cold conditions and poor environmental hygiene. The blood vessels constrict in an attempt to keep warm by reducing blood flow to the extremities. This reduces the amount of oxygen and nutrients to the feet which can result in tissue and nerve damage.
Unlike frostbite, it doesn’t require freezing temperatures. It can develop in temperatures up to sixteen degrees celsius (sixty degrees fahrenheit) and can even affect people indoors. Any wet environment, be it from excessive sweating to wearing damp socks and shoes can cause Immersion Foot.
It can take less than a day of exposure to poor conditions for Trench Foot to develop. Nowadays, it is most commonly seen in builders, hikers, extreme-sports enthusiasts, security guards, campers, aid-workers and festival goers. At the 1998 Glastonbury music festival, doctors were seeing approximately ninety people a day with Immersion Foot.
Symptoms of Immersion Foot
Trench Foot can affect the heels, toes or entire foot. The classic presentation is a cold, swollen,
white/grey foot that can feel numb, heavy, painful and prickly.
In the early stages, blood vessels constrict in cold, moist conditions resulting in a lack of oxygen to the tissues. The foot becomes cold, numb and mildly swollen, painful and discoloured.
If allowed to progress, tissue and nerve damage occur. Swelling increases and a constant pins and needles sensation develops. In extreme cases, blisters and ulcers develop, skin starts to peel off and tissues begin to die, resulting in gangrene.
Treatment Options
Prompt treatment is vital to prevent permanent tissue damage from Immersion Foot:
1) Thoroughly clean and dry the feet: use an anti-bacterial, anti-fungal dressing and air the feet regularly
2) Gently re-warm the feet to improve circulation: warm the feet for approximately five minutes at a time either by soaking in warm (not hot) water or using heat packs. Make sure you test the temperature first to avoid the risk of burning especially while the sensation is reduced
3) A Potassium Permanganate foot bath: can help draw fluid out of the affected area
4) Amputation: in severe cases were gangrene has set in, amputation is required
Recovery Process
As Trench Foot starts to heal, swelling reduces and the foot colour returns to normal. Blisters often form and there can be temporary severe pain as the tissues warm and feeling returns. There can be ongoing problems with itching, pins and needles, excessive sweating and cold sensitivity that can last for several months.
Prevention
As always, prevention is better than cure as Trench Foot can be extremely painful and it can take up to six months to fully recover.
1) Wear clean, dry socks: change socks daily or more frequently if in damp conditions
2) Use Polypropylene sock liners: specially designed to draw moisture away from the feet
3) Don’t wear socks in bed: allow the feet to “air”
4) Keep feet clean: wash and dry feet daily
5) Apply talcum powder or Vaseline: to the feet to keep moisture away
6) Ensure shoes fit well: avoid shoes that are too loose or too tight
7) Ensure footwear is dry: it may help to alternate shoes/boots daily to ensure they dry out fully
8) Avoid synthetic materials: e.g. rubber and vinyl
9) Control excessive perspiration: use drying agents like aluminium chloride or with extreme cases Botox may help. Always talk to your doctor before undergoing any treatment.
Celebrity Trench Foot Sufferers
1) JRR Tolkien, author of Lord of The Rings, contracted Immersion Foot during WW1
2) Actor Jeremy Irvine got Trench Foot whilst filming War Horse
3) Actress Joanna Lumley suffered from the disease when cast away on a desert island filming the TV documentary Girl Friday
You can find out about other common causes of foot pain in the foot conditions section. Alternatively, if you want some help working out what is wrong, visit the foot pain diagnosis section.
Go to Common Causes of Foot Pain or Foot Pain Guide
Page Last Updated: 14/01/19
Next Review Due: 14/01/21
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