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Find out more about your feet with the information on this page! Our team have collated the following resources so that you receive the right information.

Ageing Feet

What is it?

As we age, we naturally develop more problems with our feet due to normal daily wear and tear of joints, but also because the skin starts to become thin and loses its elasticity, as well as being dry and much more fragile.

Who gets it?

Feet can start to show signs of ageing at any age if good routine foot care is not practiced, but generally it is most common from your fifties onwards.

How do I know I have it?

General signs of ageing feet include more regular aches and pains, developing bunions, signs of clawing of the toes along with general circulatory problems.

How do I Prevent it?

Pain and uncomfortable feet aren’t a natural part of growing old or something to ‘put up with’. A lot can be done to improve comfort, relieve pain and maintain mobility.

Exercise

Keeping active and on the move helps to keep feet healthy – it tones up muscles, helps to strengthen arches, and stimulates blood circulation.

General Foot Care and Protection

Keeping toenails cut and under control is key as nails that become too long can press against the end of the shoe and the constant pressure can cause soreness, infection and ulceration. Toenails that have been poorly cut can also become ingrown.

Additionally, checking your feet regularly, daily if necessary, and moisturising them (but not between the toes) will help them keep supple as feet start to dry out and lose their natural oils as they age. We also start to lose the fatty pads that cushion the bottom of the feet, and soles and heels become dry and nails brittle and more difficult to manage.

Keeping warm is also important, but do not warm them too close to the fire! Warm stockings or socks can help and avoid anything too tight which can restrict your circulation or cramp your toes. Wearing fleece-lined boots or shoes or even an extra pair of socks will also keep you warm but do make sure your shoes aren’t tight as a result. Bed socks are also a good idea.

Footwear

The older you get, the more important it is to wear a shoe which is comfortable, well-fitting and holds your foot firmly in place to give adequate support. Many people wear slippers if their feet are hurting but this can make things worse as slippers encourage you to shuffle rather than letting the joints work as they should. A pair of running shoes is the best option as these provide a good amount of shock absorption and stability and also support the arch.

Avoid plastic ‘easy clean’ uppers which don’t allow the foot to breath and won’t stretch to accommodate your own foot shape.
Many shoes have cushioning or shock absorbing soles to give you extra comfort while walking. When buying shoes, ensure that you can put them on and take them off easily. Check that the heel is held firmly in place, you’ll find that a lace, strap, buckle or Velcro fastening shoe will give more support and comfort than a slip-on.

Your shoes should be roomy enough, particularly if you intend to wear them every day. If you suffer with swollen feet, it’s a good idea to put your shoes on as soon as you wake up, before your feet have had a chance to swell.

Is it Serious?

Foot pain can be debilitating. As we only have one pair of feet, it’s important to take good care of them. Foot pain can also lead to issues with walking and exercising which are an important part of health and wellbeing as we age. Additionally, if we have trouble with mobility, this can impact on getting out and about and involvement in social activities which become ever more important as we get older. As long as we take routine care of our feet, serious problems can usually be avoided, however, ageing can also mean that we develop other conditions, such as diabetes and arthritis, which in some cases can affect the foot and lead to requiring treatment. Healing may also take longer.

What are the Treatments?

Treatments depend on which particular condition you are suffering from, eg. bunions, and therefore the best advice is to visit your local podiatrist if your foot care routine is not alleviating the symptoms.

When Should I see a Podiatrist About it?

As we get older, an annual foot health check is as important as a sight or hearing test. Conditions like diabetes or circulatory problems can all be picked up by looking at the feet and common problems like corns, cracked skin and ingrown toenails can be successfully treated.

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as your GP oy you should contact a podiatrist.

Athletes Foot

What is it? / How do I know I have it?

Athlete’s foot is a skin fungal infection. It can lead to intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin usually between the fourth and fifth toes initially, or on dry, flaky skin around the heels or elsewhere on the foot. Large painful fissures can also develop and the condition can also spread along all five toes and sometimes to the soles of the feet if left untreated.

What Causes the Problem?

It’s caused by a number of fungal species which you can pick up from someone else shedding affected skin (typically in communal areas such as pools, showers and changing rooms) or where you may walk around barefoot. Athlete’s foot can also be passed on directly from person to person contact, although people who sweat more are much more prone to infection.

Once your feet have been contaminated, the warm, dark and sweaty environment of feet cramped in shoes or trainers provides the ideal breeding ground for the fungus. However, athlete’s foot also occurs in dry, flaky areas. It’s quite common in summer with sandal wearers. The sun makes your skin dry out so it loses its natural protective oils. This combined with the constant trauma from sandals makes them more prone to infection.

Is it Serious?

If left untreated, the fungus can spread to the toe nails causing thickening and yellowing of the nail which is much harder to treat. Fungal infections are highly contagious and can spread to anywhere on your skin – including your scalp, hands and even your groin. This is especially likely if you use the same towel for your feet as for the rest of your body. It is always best to treat this condition as soon as symptoms are first noticed.

Who gets it?

It’s not called athlete’s foot for nothing! It’s a fairly common condition and walking barefoot around swimming pools and spending your life in trainers may make you more likely to suffer, but obviously, you do not need to be an athlete to suffer from this condition.

How do I Prevent it?

The single most important tip for preventing athlete’s foot is to ensure your feet are completely dry after washing them and before you then put your shoes and socks on. However, there are many things you can do to make your feet less hospitable to fungal infections.

Firstly, change your footwear on a regular basis. There’s no point sorting your feet out if you constantly re-infect them by putting them into damp, fungally-infected shoes. It takes 24-48 hours for shoes to dry out properly, so alternate your shoes daily.
If you really have to wear the same pair day after day (say, if you’re on holiday), dry them out by using the hairdryer on a cold setting and this will get rid of the perspiration quickly without creating more heat. To help shoes dry out more quickly, take any insoles out. Also, loosen any laces and open your shoes out fully so that air can circulate. Choose trainers with ventilation holes.
If your shoes are so tight that they squeeze your toes together, this encourages moisture to gather between your toes and encourages fungus. Let air circulate between the toes by going for a wider, deeper toebox instead and choose shoes made from natural materials. Of course, you should also be changing your socks daily.

Wear flip-flops in the bathroom and in public showers. This will not only ensure that you don’t leave your dead skin around for others to pick up, but will stop you picking up other species of fungus. Also, never wear anyone else’s shoes, trainers or slippers.

What are the Treatments?

Treatments depend on what type of Athlete’s foot you have.

For athlete’s foot where the skin conditions are dry: if the condition occurs on a dry area such as your heel, you need to restore moisture by rubbing in an anti-fungal cream or spray, sometimes combined with a steroid cream (all from your pharmacist). You must remember to wash your hands thoroughly afterwards, or use disposable gloves so you don’t get the fungus on your hands at all.
For athlete’s foot where the skin conditions are moist: this condition requires an altogether different type of treatment to that above. Wash your feet in as cold water as you can bear (as hot water only makes your feet fungus-friendly) then dry them thoroughly after washing, preferably with a separate towel or even kitchen roll. It is important to dab your feet dry rather than rub them, as rubbing tends to take away any healing skin. Although the skin may appear flaky and dry, never use moisturiser between your toes, also avoid powders as they can cake up and irritate skin. A spirit-based preparation can help such as surgical spirit (it’s cooling, soothing and antiseptic). This may sting a little but will evaporate the moisture and allow the skin to heal.
In severe cases, sometimes an anti-fungal tablet is prescribed. However, tablets are not suitable for everyone eg. pregnant women so always check with your pharmacist and follow the instructions carefully.
You should also avoid using anti-fungal powders between the toes, they’re good for dusting inside shoes and trainers.

The mistake most people make is to stop the hygiene regime, shoe rotation and/or medication once their symptoms have gone. Although symptoms may disappear after several days or weeks of treatment, the fungus can lie dormant and could eventually reappear if the environment is right. Some products require continued treatment for many weeks – always follow the instructions. Also, be alert to symptoms so that you can deal with any problems straight away.

When Should I see a Podiatrist About it?

You should be able to get rid of Athlete’s foot on your own but a podiatrist may help you pinpoint the best treatment for your particular type of Athlete’s foot. Your podiatrist can also help if the fungal infection has spread to your nails by reducing the thickness and cutting back the nails thereby exposing the infected nail bed to a lighter, cooler environment.

Nail infections do not respond to topical treatments. You need oral medication (tablets) to kill the fungus in nails. If the fungus is only in the nail and not elsewhere, it is probably caused by an injury. Injuries allow the fungus to creep in and multiply under the nail. This can affect the substance of the nail which may become crusty, discoloured and deformed. This oral medication can have side effects so if you have other medical conditions or are on other medication, your GP or podiatrist may recommend that you don’t take it.

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within days, it is recommended to seek the help of a healthcare professional or a podiatrist.

Blisters

What is it? / What Causes the Problem?

Blisters are painful, fluid-filled lesions produced by friction and pressure. They can be caused by the following:

  • Ill-Fitting Footwear
  • Stiff Shoes
  • Wrinkled Socks Against the Skin
  • Excessive Moisture
  • Foot Deformities

Is it Serious?

Blisters can become a more serious concern if you have diabetes and may not heal so easily. Please refer to your podiatrist for further advice.

How do I Prevent it?

As blisters are the result of friction, there are a number of simple techniques that can prevent your walking, running, or social activity being ruined by a blister:

  • Keep your feet dry and your toenails trimmed
  • Always wear socks of the right size as a cushion between your feet and footwear and change your socks daily
  • Wear comfortable, good-fitting footwear, especially on long walks or runs
  • For very sweaty feet, use products that help control excessive moisture
  • Immediately remove any foreign bodies that accumulate in socks and boots
  • Ensure the tongue and laces of your boots are arranged correctly and evenly
  • Check your feet regularly for any sign of rubbing and tenderness

It is possible to buy socks made of fibres with good ‘wicking’ properties and also special ‘dual layer’ socks where the inner layer moves with the foot, the outer layer with the shoe – eliminating friction at the skin surface.

What are the Treatments?

It is important to act immediately if you feel any friction or discomfort as blisters can form very quickly. Stop walking or running and examine your feet and if nothing has developed, consider applying some material or padding to cushion the area or even a breathable waterproof plaster.

If a blister does occur, do not pop it. Cut a hole in a piece foam or felt to form a doughnut over the blister. Tape the foam or felt in place or cover with a soft gel-type dressing. Treat an open blister with mild soap and water, cover it with an antiseptic ointment and a protective soft gel dressing to prevent infection and speed up the healing process.

Most foot blisters last between three and seven days and will normally clear up if further excessive friction is avoided.

When Should I see a Podiatrist About it?

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks.

Bunions

What is it?

More than 15% of women in the UK suffer from bunions, but what is a bunion? A bunion, also known as ‘hallux valgus’ is a deformity of the big toe in which the big toe excessively angles towards the second toe and leads to a bony lump on the side of the foot. This can also form a large sac of fluid, known as a bursa, which can then become inflamed and sore.

What Causes the Problem?

There is no one cause of having a bunion and contrary to popular opinion, bunions are not generally caused by shoes. They are most often caused by a defective mechanical structure of the foot which is genetic and these certain foot types make a person prone to development of a bunion.

Bunions can also be caused from the big toe pushing over on to the second toe which can lead to problems. Commonly, it can end up lying on top of the second toe causing crossover of the toes making it difficult to walk due to pressure on the toes from footwear. Once the big toe leans toward the second toe, the tendons no longer pull the toe in a straight line, so the problem tends to get progressively worse. This condition can also lead to corns and calluses being developed.
Poorly fitting footwear tend to aggravate the problem as they can squeeze the forefoot, crowding the toes together and exacerbate the underlying condition, causing pain and deformity of the joint (hallux valgus).

Bunions can also be caused by age, arthritis or playing sport.

Is it Serious?

Some people have large bunions that cause no pain but do cause difficulties with footwear, while others have relatively small bunions that can be very painful. Although some treatments can ease the pain of bunions, only surgery can correct the defect.

In some cases, pressure from the big toe joint can lead to a deformity in the joint of the second toe, pushing it toward the third toe and so on. However, just because you have a bunion, does not mean you’ll get a bursa as well.

Who gets it?

Although anyone can get a bunion, they tend to be more common in women, possibly due to some of the more restrictive footwear typically worn. Women also tend to have looser ligaments. If your parents or grandparents have them, you may also be more prone to developing them.

How do I Prevent it?

Wearing sensible shoes that fit well is a good preventative measure. If you notice a bump developing where your big toe joins the foot, it may be time to switch your footwear. Try to opt for wider shoes that provide your toes with room to move and keep your heel height to no more than 4cm for maximum comfort. The following also serves as a useful guide:

  • Wear backless, high-heeled shoes in moderation.Backless shoes force your toes to claw as you walk, straining the muscles if worn over a long period.
  • Vary your heel heights from day to day, one day wearing low heels and the next day slightly higher heels.
  • If you want to wear a heel every day, keep heel heights to 4cm or less.
  • Wearing a shoe with a strap or lace over the instep holds the foot secure and acts a bit like a seatbelt in a car and helps stop your foot sliding forward.
  • Calf stretches to counteract the shortening of the calf can help to keep feet supple.

What are the Treatments?

Your podiatrist may recommend the following:

  • Exercises
  • Orthoses (special devices inserted into shoes)
  • Shoe alterations or night splints which hold toes straight during sleep (helps to slow the progression of bunions in children)

However, these are conservative measures and although they may help relieve symptoms, there is no evidence they can correct the underlying deformity. Your podiatrist will be able to identify any significant deformity and/or defect and will refer you for surgery which can involve a combination of removing, realigning and pinning of the bone.

Once referred, your podiatric surgeon will evaluate the extent of the deformity. They can remove the bunion and realign the toe joint in a common operation known as a 1st Metatarsal Osteotomy (‘bunionectomy’). However, there are more than 130 different types of operation that fall under this title, so each individual surgery is different.
The aim of surgery is to address the underlying deformity to prevent recurrence. As with all surgery, there are risks and complications, so it is not usually advised unless your bunions are causing pain – or if it is starting to deform your other toes.

When Should I see a Podiatrist About it?

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as your GP to refer you to your local NHS trust for free treatment but if you do not qualify for this, or need urgent attention, you should contact a private podiatrist.

Corns & Callus

What is it? / What Causes the Problem?

When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker to withstand the pressure. When this pressure becomes excessive, some areas of skin thicken in the form of corns and callus, as a protective response to the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground. 

Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type. Elderly people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot.

Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core which may cause pain if it presses on a nerve. There are five different types of corns, the most common of which are ‘hard’ and ‘soft’ corns:

  • Hard corns – these are the most common and appear as a small area of concentrated hard skin up to the size of a small pea usually within a wider area of thickened skin or callus. This may be a symptom of the feet or toes not functioning properly.
  • Soft corns – these develop in a similar way to hard corns but they are whitish and rubbery in texture and appear between toes where the skin is moist from sweat or from inadequate drying.
  • Seed corns – these are tiny corns that tend to occur either singly or in clusters on the bottom of the foot and are usually painless.
  • Vascular corns – these can be very painful and can bleed profusely if cut.
  • Fibrous corns – these arise when corns have been present for a long time and are more firmly attached to the deeper tissues than any other type of corn. They may also be painful.

How do I Prevent it?

If you have corns or callus, you can treat them yourself occasionally by gently rubbing with a pumice stone or a chiropody sponge when you are in the bath and apply moisturising cream to help remove the thickened skin a little at a time or relieve pressure between the toes with a foam wedge.

What are the Treatments?

It is best not to cut corns yourself, especially if you are elderly or diabetic. A podiatrist will be able to reduce the bulk of the corn and apply astringents to cut down on sweat retention between the toes.

You should be careful about using corn plasters, as they contain acids than can burn the healthy skin around the corn and this can lead to serious problems such as infection. You should always consult a podiatrist for advice before using corn plasters. Home remedies, like lambswool around toes, are potentially dangerous. Commercially available ‘cures’ should be used only following professional advice.
If you are unsure of what to do or need special attention, consult a registered podiatrist who will be able to remove corns painlessly, apply padding or insoles to relieve pressure or fit corrective appliances for long-term relief. For callus, your podiatrist will also be able to remove hard skin, relieve pain and redistribute pressure with soft padding, strapping or corrective appliances which fit easily into your shoes. The skin should then return to its normal state.

The elderly can benefit from padding to the ball of the foot, to compensate for any loss of natural padding. Emollient creams delay callus building up and help improve the skin’s natural elasticity. Your podiatrist will be able to advise you on the most appropriate skin preparations for your needs.

Who gets it?

Although anyone can get a bunion, they tend to be more common in women, possibly due to some of the more restrictive footwear typically worn. Women also tend to have looser ligaments. If your parents or grandparents have them, you may also be more prone to developing them.

How do I Prevent it?

Wearing sensible shoes that fit well is a good preventative measure. If you notice a bump developing where your big toe joins the foot, it may be time to switch your footwear. Try to opt for wider shoes that provide your toes with room to move and keep your heel height to no more than 4cm for maximum comfort. The following also serves as a useful guide:

  • Wear backless, high-heeled shoes in moderation.Backless shoes force your toes to claw as you walk, straining the muscles if worn over a long period.
  • Vary your heel heights from day to day, one day wearing low heels and the next day slightly higher heels.
  • If you want to wear a heel every day, keep heel heights to 4cm or less.
  • Wearing a shoe with a strap or lace over the instep holds the foot secure and acts a bit like a seatbelt in a car and helps stop your foot sliding forward.
  • Calf stretches to counteract the shortening of the calf can help to keep feet supple.

What are the Treatments?

Your podiatrist may recommend the following:

  • Exercises
  • Orthoses (special devices inserted into shoes)
  • Shoe alterations or night splints which hold toes straight during sleep (helps to slow the progression of bunions in children)

However, these are conservative measures and although they may help relieve symptoms, there is no evidence they can correct the underlying deformity. Your podiatrist will be able to identify any significant deformity and/or defect and will refer you for surgery which can involve a combination of removing, realigning and pinning of the bone.

Once referred, your podiatric surgeon will evaluate the extent of the deformity. They can remove the bunion and realign the toe joint in a common operation known as a 1st Metatarsal Osteotomy (‘bunionectomy’). However, there are more than 130 different types of operation that fall under this title, so each individual surgery is different.
The aim of surgery is to address the underlying deformity to prevent recurrence. As with all surgery, there are risks and complications, so it is not usually advised unless your bunions are causing pain – or if it is starting to deform your other toes.

When Should I see a Podiatrist About it?

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as your GP to refer you to your local NHS trust for free treatment but if you do not qualify for this, or need urgent attention, you should contact a private podiatrist.

Heel Pain

What is it?

The heel is a specialised part of the body designed to absorb the impact of your body weight when walking, running or undertaking any other form of physical exertion or weight bearing exercise. When pain does develop, it can be very disabling, making every step a problem which in turn affects your overall posture

There are various types of heel pain and the more common ones include:

  • Heel Spurs (Plantar Fasciitis)
  • Heel Bursitis (Subcalcaneal Bursitis)
  • Heel Bumps

What Causes the Problem?

Heel pain is a common occurrence and in most cases the pain is caused by some form of mechanical injury caused by small repetitive injuries that occur at a rate faster than the body can heal them. 

Heel pain can also be caused by lower back problems or inflammatory joint conditions.

The following types of heel pain are not exhaustive but may help you appreciate the complexity of heel pain and why specialist advice can be helpful.

Heel Spurs (Plantar Fasciitis or Fasciosis)

This is the most common caused by inflammation to the fascia ‘band’ (similar to a ligament) which connects the heel bone to the base of the toes. This condition can be caused in various ways including extensive running/walking/standing for long periods of time, especially when you are not used to it as well as a sedentary lifestyle. In particular, a change of surface (eg. road to track), poor shoe support, being overweight, overuse or sudden stretching of your sole as well as a tight Achilles tendon can lead to this condition.

Heel Bursitis (Subcalcaneal Bursitis)

This is an inflammation of a bursa (a fluid filled fibrous sac) under the heel bone where the pain is typically more in the centre of the heel than that experienced with plantar fasciitis (heel spur) and significantly worsens during the day. This condition can be caused following a fall from a height on to the heel.

Heel Bumps

These are firm bumps on the back of the heel.

Tarsal Tunnel Syndrome

This can feel like a burning or tingling sensation under the heel within the arch of the foot with occasional loss of sensation on the bottom of the foot. This is caused by compression of the tibial nerve as it passes the inside of the ankle and tapping of the nerve will stimulate the symptoms known as Tinel’s sign.

Chronic Inflammation of the Heel Pad

This is caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad which can give rise to a dull ache in the heel which increases during the day.

Stress Fracture

Often caused following injuries such as falling from a height or landing on an uneven surface.

Severs disease (Calcaneal Apophysitis, and Osteochondrosis)

This condition affects young children, usually between the ages of 8-12 and occurs when part of the heel bone suffers a temporary loss of blood supply. The bone dies only to reform when the blood supply is later restored and is also known as osteochondrosis where this condition occurs in active growing bones.

Achilles Tendonosis

This condition occurs when the Achilles tendon is placed under more pressure than it can cope with and small tears develop along with inflammation and in some cases can lead to tendon rupture. These tears become a source of further injury which can lead to swelling within the tendon, hence the name ‘tendonosis’ (sometimes referred to in error as ‘tendonitis’).

Is it Serious?

Heel pain is a common condition and in most cases will diminish following some routine self-care measures but if the pain persists longer than three weeks, it is best to seek professional advice from someone who specialises in heel pain, such as a podiatrist or chiropodist. This is necessary as there are many types of heel pain, each with their own different causes and separate forms of treatment.

Who gets it?

Heel pain can affect everyone, whatever your age, but those more commonly affected include those in middle age (over 40’s age group) as well as athletes.

How do I know I have it?

With heel spurs, there are no visible features on the heel but a deep localised painful spot found in or around the middle of the sole of the heel and is usually worse on standing after long periods of rest, particularly first thing in the morning. Although the name implies a spur of bone sticking out of the heel bone (heel spur syndrome), around 10% of the population have heel spurs without any pain whatsoever.

With bursitis, pain can be felt at the back of the heel when the ankle joint is moved and there may be a swelling on both sides of the Achilles tendon. Or you may feel pain deep inside the heel when it makes contact with the ground.

With heel bumps, these are usually caused by excessive shoe rubbing in the heel area.

How do I Prevent it?

Follow the self-care measures below in the first instance.

What are the Treatments?

If you experience heel pain, some simple self-care measures include:

  • Avoid wearing ill-fitting or uncomfortable shoes
  • Wear shoes with good heel cushioning and effective arch support
  • Avoid walking or exercising on hard ground
  • Rest regularly and try not to walk or run too fast
  • Wear a raised heel (no more than 6-10 mm higher than normal)
  • Losing weight if you are overweight

More specialist treatments include:

Heel Spurs (Plantar Fasciitis or Fasciosis)

Treatment can take many forms from resting your foot as much as possible, stretching exercises and deep heat therapy to steroid injections and even medication or surgery to release the tight tissue ‘band’. In some cases, padding and strapping is applied to alter the direction of stretch of the ligament to alleviate symptoms in the short-term. However, for the long-term, special insoles (orthoses) are prescribed to help the feet to function more effectively and help to make any possible recurrence less likely.

Heel Bursitis (Calcaneal Bursitis)

Medication and ultrasound can give relief but for the long-term, a shoe insert may be necessary. In addition, attention to the cause of any rubbing and appropriate padding and strapping will allow inflammation to settle.

Heel Bumps

Adjustments to footwear is usually enough to make them comfortable, although a leather heel counter and wearing boots may help. In more serious, recurring cases, surgery may be necessary.

Tarsal Tunnel Syndrome

Special shoe inserts can reduce the pressures on the nerve and may be appropriate for certain foot types whereas, on other occasions, local injections of medication to the area where the tibial nerve is inflamed may be necessary.

Chronic Inflammation of the Heel Pad

A soft heel cushion can help this condition.

Stress Fracture

If this is suspected, an X-ray is required to confirm final diagnosis and to determine the extent of the injury and a follow-on treatment plan.

Severs Disease (Osteochondrosis)

This condition is temporary and self-limiting but can be painful at the time.

Achilles Tendonosis

Treatment involves special exercises that strengthen the tendon and increasing the height of the heel with an insole on a temporary basis.

Sweaty Feet

What is it?

Most of us have suffered from foot perspiration and odour from time to time, yet for some people, sweaty feet (along with sweaty palms and armpits) are a persistent problem which can be embarrassing and uncomfortable. For some people, this can affect their day-to-day life considerably resulting in decreased social contact with others but the condition is treatable.

Sweaty feet is a complaint known as Hyperhidrosis (or excessive sweating) and has a lot to do with how the sweat glands in this part of the body work. With 250,000 sweat glands, feet do tend to sweat more than other parts of the body but with a daily hygiene routine, few people should suffer from the embarrassment that it may cause.
There are more sweat glands per inch in our feet than anywhere else in the body and their function is to keep the skin moist and therefore supple and regulate temperature when the weather is hot, if you have an unnaturally high temperature or while exercising. They secrete all the time, not just in response to heat or exercise, like elsewhere in the body.

What causes the Problem?

Sweaty feet (along with palms and armpits and the face/scalp) tends to be symmetrical. The exact cause is unknown but due mainly to overactive sweat glands. In some cases, the cause can be genetic.

Possible other causes include stress on the foot sometimes caused by a structural problem or because the foot is under strain or tired, for example, when you have been standing on your feet all day.

Is it Serious?

Although hot weather can make matters worse, sweaty feet is both a summer and a winter problem as well as an inherited condition. It also tends to be a long-term condition which may require treatment over a sustained period of time.

In some cases, sweaty feet can lead to athlete’s foot or blisters.

Who gets it?

In adolescents and people generally under 25, sweaty feet is probably caused by overactive sweat glands triggered by changing hormone levels in the body. As the sweat glands on the soles of the feet (and palms of the hand) respond mostly to emotions, both mental and emotional stress is a common cause.

How do I know I have it?

An added problem that often accompanies sweaty feet and signifies its presence is foot odour caused by bacteria on the skin breaking down the sweat and releasing an offensive smell.

How do I Prevent it?

Following a simple daily foot hygiene routine is usually effective in dealing with sweaty feet. This may include washing your feet with anti-bacterial soap, applying cream and/or using an absorbent foot powder and not wearing the same footwear everyday but rotating what you wear so shoes have a chance to dry out.

Wearing socks is also considered essential especially those that absorb moisture like wool, cotton or a wool/cotton mixture often helps. In addition, detachable insoles (and medicated insoles which have a deodorising effect) are recommended as a lot of sweat is absorbed by insoles or the uppers of shoes.

In terms of footwear, well-fitting shoes made of leather, which allow your feet to breathe, are considered best.

What are the Treatments?

For more serious cases where normal foot care is not effective and more longer term conditions, your doctor may refer you for Iontophoresis (electrical stimulation) and Botulinum toxin injections (botox).

Verrucae

What is it?

Verrucae are plantar warts that commonly occur on the soles of the feet or around the toe area. They are caused by the Human Papilloma Virus (HPV) which is highly contagious through direct person to person contact. There are various forms of HPV which all relate to various parts of the human body.

What causes the Problem?

The virus is thought to thrive in moist, damp environments such as swimming pools, changing room floors and communal shower areas. It is possible to contract verrucae simply by walking across the same floor area as someone with a verruca, especially if you have any small or invisible cuts or abrasions that make it easier for the virus to penetrate.

Is it Serious?

Verrucae are harmless but can be uncomfortable and painful if they develop on a weight bearing part of the foot. In addition, callus can form over the top of the verruca increasing the discomfort in this area. There are also some strains of the virus that spread very quickly and can look unsightly.

Who gets it?

Verrucae are most commonly seen in children, teenagers and young adults, largely those who use communal changing rooms. It is possible to develop an immunity against the virus over time but most people remain susceptible, although some more than others.

How do I know I have it?

The most common appearance is that of a small cauliflower type growth on the soles of your feet with tiny black dots. If when you pinch the area (like when you squeeze a spot) it is painful, you are likely to have a verruca. They can grow to half an inch in diameter and may spread into a cluster of small warts. If you are unsure, seek advice from your local pharmacist or visit a podiatrist.

How do I Prevent it?

To avoid catching verrucae, keep your feel in a regular healthy condition. Always dry them thoroughly after washing and if your feet are sweaty, treat them with surgical spirit; if they are dry, moisturise them with suitable creams and lotions.

Other tips include wearing flip-flops in communal areas, not sharing towels, shoes and socks, and treating conditions such as Athlete’s Foot with specialist treatment from a pharmacist.

If you do have a verruca and want to go swimming, special verrucae socks should be worn to avoid passing on the virus and can also be worn generally as a preventative measure.

What are the Treatments?

In the first instance, avoid touching or scratching it as it may spread into a cluster of warts. Instead, cover it up with a plaster and this may cure it. In many cases, evidence suggests that verrucae will disappear of their own accord within six months for children but longer for adults (up to two years). This is because the body’s immune system recognises the presence of the virus and fights the infection naturally but it can take many months for this to happen. If it is painless, no treatment may be required as some treatments can be painful especially for children and can cause side-effects.

For painful and/or unsightly verrucae or ones which are spreading, you can self-treat using ointments and gels from your local pharmacist following the instructions carefully. Evidence suggests the most effective ones contain salicylic acid which when applied to the wart, helps to disintegrate the viral cells. Sometimes, merely by rubbing away the dry skin over a verrucae and applying a plaster helps to stimulate the body’s immune system to fight the infection. However, if your verruca becomes unusually painful or the surrounding skin area goes red, stop treatment immediately and see a podiatrist. This is because if the healthy tissue around a verruca is damaged, you could hamper further treatment

Treatments provided by a podiatrist involve an assessment of your general well-being and foot health before deciding on a treatment plan. These may include:

  • Acid based treatments which are stronger than regular ‘over the counter’ (OTC) treatments from your local pharmacy
  • Cryotherapy which involves freezing the verruca with liquid nitrogen or nitrous oxide gas.
  • Electrosurgery which requires a local anaesthetic to be given
  • Excisional surgery which is similar to the above
  • Laser surgery, particularly for larger areas of verrucae

When Should I see a Podiatrist about it?

If you are worried about your verrucae and/or self-treatment is not working and/or the verrucae appears to be getting larger or more painful, you should seek the help of a HCPC registered podiatrist. Additionally, if you have diabetes, poor circulation, are pregnant or any other condition affecting your feet (or your immune system), it is important never to treat verrucae yourself and visit a podiatrist instead.

Ingrowing Toenail

What is it?

An ingrowing toenail is one that pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too. Whereas a nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn't an ingrowing toenail but can feel very painful and also appear red and inflamed as well.

What Causes it?

There are many genetic factors that can make you prone to ingrowing toenails including your posture (the way you stand), your gait (the way you walk) and any foot deformity such as a bunion, hammer toes or excessive pronation of the feet (when your foot rolls inward excessively). Your nails may also have a natural tendency to splay or curl out instead of growing straight, encouraging your nail to grow outwards or inwards into the flesh.

Tight footwear, hosiery and socks can also push your toe flesh onto the nail so that it pierces the skin. Also, if you sweat excessively or don’t rotate your footwear, this makes the skin moist and weak so that it is easily penetrated by the nail. If you have brittle nails with sharp edges or are in the habit of breaking off bits of nail that are sticking out, you are also more likely to get an ingrowing toenail. In addition, the wearing of support hose that is ill-fitting and squeezes the toes or likewise, the wearing of shoes with tight toe boxes.

However, one of the most common causes is not cutting your toenails properly such as cutting nails too low in order to relieve the pressure and discomfort of an involuted nail.

Less common is a fungal infection or in some cases particular types of medication, eg. isotretinoin.

Is it Serious?

If left untreated, the infection can spread to the rest of the toe and foot and could lead to surgery. The quicker you treat it, the less painful the treatment.

Who gets it?

Active, sporty people are particularly prone, because they sweat more. Younger people are more likely to get it (as they pick their nails more, compared to older people who may not reach their toes!).

How do I know I have it?

The most common symptom is pain followed by some form of inflammation in the surrounding nail area.


However, not everyone identifies an ingrowing toenail correctly. Sometimes, they have a curly nail which has a lot of debris (dirt or fluff) underneath it or a corn or callus down the side of the nail, which can be nearly as painful. However, if it’s a corn, the pain tends to be throbbing as opposed to the sharp pain you get with an ingrowing toenail. If this is the case, your podiatrist will remove the debris, and if necessary, thin the nail.

How do I Prevent it?

Firstly, learn to cut your nails properly. Nail cutters aren’t a good idea because the curved cutting edge can cut the flesh and nail scissors can slip. It’s best to use nail nippers (available from chemists) because they have a smaller cutting blade but a longer handle. Cut your nails straight across and don’t cut too low at the edge or down the side. The corner of the nail should be visible above the skin. Also, cut them after a bath or shower when the nail is much softer.

Good hygiene can go a long way to preventing ingrowing toenails. Avoid moist, soggy feet by letting rotating your footwear so each pair has a chance to dry out thoroughly. Avoid man-made materials (synthetics) and choose socks and shoes of natural fibre and which fit properly. Keep your feet clean and dry and in the summer and wear open-toed sandals to let air get to your toes as much as possible.

If you have diabetes, are taking steroids or are on anti-coagulants, don’t attempt to cut your nails or remove the ingrowing spike of nail yourself.

When Should I see a Podiatrist about it?

Visit a podiatrist if you experience any:

  • Persistent pain in your toe from the ingrowing nail
  • Symptoms of infection, especially if you have Diabetes or a poor immune system
  • Condition which affects the nerves and/or feeling in your foot.

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as your GP to refer you to your local NHS trust for free treatment but if you do not qualify for this, or need urgent attention, you should contact a private podiatrist.

To talk to a podiatrist (also known as a chiropodist) about the options available regarding treatment, you can contact an NHS podiatrist or a private practice podiatrist. In both cases, always ensure that any practitioners you visit are registered with the Health Professionals Council (HPC) and describe themselves as a podiatrist (or chiropodist).

To contact an NHS podiatrist, please contact your GP practice for information on an NHS referral (in some areas you can self-refer).

What are the Treatments?

Before you are seen by a podiatrist, you can relieve the discomfort by bathing your foot in a salty footbath which helps to prevent infection and reduces inflammation. Then apply a clean sterile dressing, especially if you have a discharge and rest your foot as much as possible.
How a podiatrist will treat you will depend largely on the severity of your condition:

  • For the most basic painful and irritable ingrowing toenail, the offending spike of nail will be removed and covered with an antiseptic dressing.
  • For toes too painful to touch, a local anaesthetic will be injected before removing the offending portion of nail.
  • For involuted nails, part of the nail that is curling into the flesh is removed and then the edges of the nail are filed to a smooth surface.
  • For any bleeding or discharge from an infection, or even excessive healing flesh (hypergranulation tissue) around the nail, antibiotics will be prescribed to beat the infection as well as having the offending spike removed.
  • For those particularly prone to ingrowing toenails from underlying problems such as poor gait, partial nail avulsion (PNA) may be recommended along with finding a more permanent solution to the underlying condition. This procedure is done under a local anaesthetic where 8-10% of the nail is removed (including the root) so that the nail permanently becomes slightly narrower. The chemical phenol cauterises the nail and prevents it regrowing in the corners. This is over 95% successful. You will, however, have to go back to your podiatrist for a number of re-dressings. After surgery, the overall appearance of the nail looks normal – to the extent that some people even forget which nail they’ve had done!