I have a sore on the right side of my left foot that will not heal properly

The pain is excrutiating and it shoots thru the heel of my foot right below the sore.

I have had this sore on my foot since last year, it did heal at first, then I bumped it again and this time it formed a scab, but the bandages keep pulling the scab off. I went into the hospital and was diagnosed with diabetes type 2, I also have high blood pressure which cause my feet to swell. The swelling in my foot seems to make the sore stretch, the swelling did go down but it keeps coming back. They did nothing for my foot in the hospital, other than tell me that it might be cause by poor circulation and the blood might not be flowing properly to my foot, and that I should elevate my feet, which I did. I am still experiencing this terrible pain that shoots thru my foot around the sore and the nerve pills and pain pills do not help, please tell me what to do.

RESPONSE

Hi,

It would be nice to know what country you are writing from as the quality of care for a diabetic foot ulcer will vary from country to country.
Here in the United States most metropolitan areas have wound care centers which specialize in the treatment of these types of wounds.
If you read my section on the diabetic foot you will learn that these wounds can be very difficult to close even under ideal circumstances, so if you are in an area where the best they do for you is give you dressings that stick to the wound (there are plenty of non-stick dressings out there), then you need to find better medical care.
In general there are three factors that work against most diabetics when it comes to these kinds of wounds.
First is the control of your blood sugars. If they are elevated then that enhances the chances of infection as bacteria thrive in a "sweet" environment. This not only makes it difficult for the wound to heal but greatly increases the chances of the wound becoming severely infected, so much to the point of eventually invading the underlying bone, leading to what is known as osteomyelitis which is very difficult to treat and in many instances requires surgery.
Also working against diabetics is the quality of the blood flow going into the foot and the blood flow leading out of the foot back to the heart.
Poorly controlled diabetics, over time, develop a diminishment of blood flow to the foot and without proper blood flow, a wound in the foot will have difficulty closing.
If you are experiencing chronic swelling in the foot and ankle, that means the blood is having trouble getting back to the heart. The problem here is that the blood is pooling in the foot and so there is a poor turnover of oxygen and nutrients that are necessary for wound healing. Good blood flow provides the nutrients and oxygen; poor blood flow hampers this situation.
Lastly, the quality of care of health care professionals to the wound itself will greatly affect the time it takes for the wound to close.
The wound needs to be attended to by someone familiar with diabetic wound care.
All "dead" tissue on the wound needs to be cut away as this dead tissue harbors bacteria and creates a poor environment for the wound to heal. Additionally, there are many medications out there today that actually enhance the ability of the wound to heal itself. Many of these medications are impregnated into dressing which are applied on a regular basis.
The idea behind cleaning a wound regularly and applying certain medications is to created a wound environment which is the most conducive to allowing the body to heal itself.
So, as you can see, it sounds like you are not receiving the best care available for treatment of your diabetic wound.
The only advice I can give you is to be proactive and try and find a doctor that is experienced in treating these conditions. It is not uncommon for these wounds to never heal and the longer the wound is open the more susceptible you are to wound infection.

Marc Mitnick DPM
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