Trench Foot: What are the Causes & Origins in World War I?

Trench warfare was a bloody horrendous form of war, described as “the bloodiest, wildest, most brutal of all.” Mud, shit piss, the reak of death together with long cold nights waiting for the enemy, and the sounds of battle made the 10-foot-deep trenches a living nightmare.

Trench foot, also known as immersion foot, became most commonly known and associated with the trenches of World War I. Soldiers who were often caught in the trenches for months on end in putrid conditions were left wearing wet boots and dirty socks, literally causing their feet to rot.

Let’s get into the trenches.

Trench Warfare

Men had to live in bleak unsanitary conditions for weeks and months, where they were plagued with bouts of fever, typhoid, and trench foot. The trenches of the Western Front went through Belgium and northern France and were one long windy hole of damp, dreary conditions. During rainy months the trenches would become cesspools of bacteria due to all the stagnant water that would collect from the runoff. Morale in such conditions was low, and during winter months, the war became a miserable slog, where both sides waited for the enemy in long drawn-out periods known as trench warfare.

The soldiers were faced with many health risks, including respiratory infections such as pneumonia or bronchitis, dysentery, fever, and trench foot.

US military trench feet
US governments attempt to educate the military about dry feet

Investigating the Causes of Trench foot in World War 1

Trent foot is most often caused by prorogued exposure to wet conditions and usually occurs in moist, humid environments. Trench foot can also be caused by standing in water or walking in wet conditions for extended periods of time. Poorly fitting shoes or boots can also contribute to it as can tight socks or clothing that doesn’t allow the feet to breathe.

According to the Microbiology Society in reaching the trenches:

“[soldiers] had to wade through semi-liquid mud and water, often at a temperature only a few degrees above freezing point, and remain motionless at their posts for many hours…the consensus emerged that trench foot stemmed from a compromise to the circulation of the lower limb, with factors such as cold, wet, pressure, immobility, poor nutrition and lack of exercise being contributing factors…In addition, the disease could also be exacerbated by the soldiers’ trench equipment, with the standard-issue boot being blamed.”

Trench Foot Symptoms

The symptoms of trench foot depend on the severity of the condition. In mild cases, trench foot may cause a tingling or numb sensation in the feet as well as blanching or mottled skin.

The condition damages the tiny blood vessels and tissues when it progresses and gets worse. In more severe cases, trench foot can lead to swelling, blistering, and tissue death. In extreme cases, trench foot can lead to rotting tissue, gangrene and amputation.

Trench Foot Treatment

The best way to treat trench foot is to prevent it from happening in the first place. This can be done by keeping the feet clean and dry, wearing well-fitting shoes or boots, and avoiding tight socks or clothing.

Mild cases of trench foot can be treated with over-the-counter medicines and home remedies, but more severe cases may require hospitalization and aggressive treatment.

You can prevent this from happening by:

  • keeping your feet clean
  • changing socks often
  • make sure your feet stay dry
  • clean the affected area

If your skin becomes black, it indicates that the tissue is dying. If at all possible, see a doctor. If you can’t, begin antibiotics if you have them. Treat it as an infection like a wound so to minimize further damage and tissue loss.

severe case of trench feet
A severe case of trench feet

The Treatment for Trench Foot in WWI

In Wild War I, trench foot was treated with bed rest; soldiers were also treated with lead and opium foot washes and oil massages.

The Microbiology Society states that there were “a number of conventional, tried-and-tested methods, including deep cleansing, the application of ointments, fomentations, exercise, massage, galvanic baths, and electrotherapeutics.”

In severe cases, oftentimes, soldiers had to have their toes and feet amputated due to the decay of the tissue in their feet which often resulted in gangrene.

Not much has changed, though today, trench foot is treated with rest and foot elevation, and medication for the swelling.

There is no real cure for trench foot, so prevention is critical.

Trench Foot Prevention

If you have no choice and have to go for long periods with wet feet, the following will help prevent trench foot:

  • Lie down and remove your socks often and let your feet air dry for as much as possible and through the night.
  • Wipe and clean your shoes and keep them dry.
  • Change into dry socks a few times a day.
  • Keep the rest of your body warm.
  • Raise your legs, and get some blood circulating if possible. Swing them around, clench and release your toes (anything to get the blood flowing).

Trench Foot Facts of WWI

Many soldiers were maimed and died from trench foot during World War I. Over 75,00 British soldiers and 2,000 American soldiers died as well as many Canadians and French soldiers.

Surprisingly, though bacteria and disease played a major role in WWI it was actually better than in previous wars, due to a better understanding of bacteria. WWI was the first war in which more soldiers died in combat than of diseases. In wars prior, most soldiers died from illnesses associated with living in cramped and filthy conditions.

For example, in the Crimean War of 1854–1856 there were 34,000 British, French, and Russian soldiers were killed in action, with 26,000 from wounds and 130,000 died from diseases.

For years, typhoid was the greatest scourge of mobilized armies. In the Spanish–American war in 1898, 2192 US soldiers died from typhoid compared while only 379 died in combat.

The reason as explained by the study published in Future Microbiology was that:

“In 1914, bacteriology had matured as a science. There were no antibiotics, but the majority of important pathogens had been discovered and made amenable to laboratory investigation.”


Luckily we are not in a World War nor stuck in 1914. Today we are more aware of sanitation, have access to antibiotics, and have a more thorough grasp of bacteria so that the trench foot of today will likely be nothing more than wrinkly feet.

Photo credit: Patient Dinosaur

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