Diabetes

Diabetes is a condition where the body has difficulty in managing and maintaining blood glucose levels to provide a stable HbA1c test result. Diabetes can manifest as either type 1 or type 2.

A common phrase I hear is “I have a touch of sugar” or “I’ve only got type 2”. The effects of long term increase blood glucose levels on the cells of the body are the same for type1 and type2 in as much as for example a blood glucose level of 60 mm/mol over a 10 year period will generate the same cellular damage if it were as a result of type1 or type2 diabetes, one is therefore no better or worse than the other.

A number of complaints and conditions can result if you develop one or either, ranging from neuropathy either painful or insensate change in sensation of the nerves, and ischemia where the blood supply to the lower limbs is insufficient.

A Podiatrist can help to look after your feet, either by routine regular care, by offering you footwear and general advice, as well as testing you neuropathic and vascular status annual in the form of the diabetic foot check.

Joint Stiffness

Joint pain is a very common problem with many possible causes, but it's usually a result of injury or arthritis. In older people, joint pain that gets steadily worse is usually a sign of osteoarthritis. It may affect just 1 joint or many.

Painful Legs and Feet

There are many conditions that affect the lower limbs and feet that can manifest as aches pain or discomfort in the lower limb. A good history take and a full biomechanical examination is often required to provide a full range of treatments from exercises, therapeutic orthotic insoles, footwear advice, lifestyle changes, or anti-inflammatory/analgesic medicaments.

Thickened Nails

Thick nails (onchogryphosis) present with a yellow-brown thickening of the nail plate. It is usually caused by trauma the nail plate, either long term repetitive micro trauma as a result of ill-fitting shoes including amongst others, football boots, or a single or multiple episodes of high levels of trauma/trapping. Other causes in Psoriasis Fungal infection, peripheral vascular disease, and less commonly Ichtyosis and Tuberous Sclerosis complex.

Involuted nails

Involuted nails can be hereditary, the cause of abnormal gait, or as a result of ill-fitting footwear. It is characterised when the nail plate becomes more curved than usual, ranging to a complete involuted nail plate that presents like a tube rather than a flat nail plate. Due to the curvature of the nail plate dead skin will accumulate in the sulci (edge of the nail) causing pain and discomfort or even corns. It is very common for an involuted nail to become an ingrowing toe nail through either trauma or inappropriate nail cutting.

In Growing Toe Nails

In Growing toe nails, not to be confused with an involuted nail plate, is a specific condition where the nail has a sharp or jagged edge that irritates, abrades or pierces the surrounding skin causing bleeding inflammation and possible infection. This trauma will continue and deteriorate while ever the nail plate remains in contact with the traumatised skin. If left untreated, hyper-granulation tissue will develop, a red grapelike structure, which is painful and highly vascularised meaning it will bleed very easily and frequently.

A podiatrist has a variety of ways to deal with an ingrowing toenail, depending on what stage you present to the Podiatrist. In the early stages, simply removing the offending piece of nail maybe all that is required. In the mid stages, removing the nail and applying a mild caustic can help retract hyper-granulation tissue and treating any infection may yield the desired results. However if left untreated, and allowed to develop, nail surgery will be the final cause of treatment left available to rectify the problem.

Fungal Nail Infection

Fungal Nail infection this is when your nail will become brittle with a yellow-brown colouration, not too dissimilar and therefore readily misdiagnosed as Onychogryphosis. Fungal Nail infection occurs when the nail plate becomes infected by a dermatophyte fungus, most commonly Tinea Pedis, usually after a prolonged episode or episodes of Athletes foot. There are various treatments available which the Podiatrist can discuss with you.

Athletes Foot

Athletes foot is an infection of the skin by a dermatophyte fungus, most commonly Tinea pedis. Fungal spores can be transmitted in areas where your bare feet come into contact with surfaces previous touched by an infected foot, i.e. swimming pools, indoor and outdoor, bathrooms and showers including in the home hotels holiday apartments etc. or shared footwear or socks. The fungal spores are very partial to a damp warm dark environment. The cleft between your toes is a perfect nursery for them thrive. You may notice flaky red skin possible cracked in the base of the cleft which will almost certainly be accompanied with an insatiable itch. Tinea pedis is not confined to in between the toes, it can occur wherever the environment is conducive for the fungus to germinate, the whole of the bottom of the feet can become infected crated what is know as a slipper rash.

Verrucae

Verrucae are a hard lump of skin that are usually but not confined to the bottom of the feet. They can be of various size and will over time heal on their own accord. A verrucae is caused by the human papilloma virus which can occur where ever there is a break in the skin. Contracting a Verrucae form contaminated surface, either skin to skin contact or swimming pool changing or showering area, is very easily accomplished. Spreading the virus to other parts of yourself whilst treating a verrucae is therefore also very common, causing warts.

There are various over the counter treatment and holistic therapies that are available, all of which have varied success rates, and don’t always work. Some of which included caustics such as salicylic acid, which burn the skin it is applied to. In my experience I have witnessed numerous occasions where ulcerations have been caused by inappropriate use of Salicylic acid and would therefore caution it use if unsupervised by a qualified clinician.

Plantar Fasciitis

Plantar Fasciitis is the inflammation of the plantar fascia, a tendon that starts at the heel bone (calcaneus) and attached to the ball of the foot (the metatarsal heads). It is vital in propelling you forward when you walk or run and helps to maintain the arch of your foot. Plantar fasciitis is one of the most common causes of foot pain, if treated early a course of therapy can in most cases see the complete resolution to your symptoms.

There are many factors which when combined can increases the abnormal forces acting on the plantar fascia beyond what the tendon can cope with. Small tears or ruptures in the tendon occur causing a stabbing like pain. As the causation is multifactorial, the solution and subsequent treatment also must be multifactorial, address each and all contributing factors in conjunction. These may include orthotic insoles, stretching exercises, topical analgesia, massage cold compress and possibly strapping, depending on the results of a biomechanical examination conducted by your Podiatrist.

Chilblains

Chilblains a painful itchy condition that can affect the toes, but also other extremities such as the ears nose and fingers, following periods of exposure to cold conditions. Its is more common in people who are vascularly compromised for whatever reason, and is caused when the blood supply in affected area is restricted to the small capillaries in the surface of the skin to conserve body temperature.

If the area is warmed too quickly the returning blood flow can rupture the capillaries causing blistering redness and itchy bruise like lesions. If the skin breaks or the blisters burst, it is important to prevent infection from developing by consulting a Podiatrist.

The best form of treatment for Chilblains, is prevention. If you keep warm by wearing long johns or woollen tights to maintain body an limb temperature, you can head off the onset of chilblains in most cases.