Paulton Podiatry

Common foot problems

• Diabetic foot issues
  Diabetes can sometime have a very serious effect on feet and it is recommended that everyone with diabetes is seen by a podiatrist at least once a year.
  
  It is not so much diabetes itself but the high blood sugar that comes from poor diabetic control that can effect the feet, damaging the nerves and blood vessels. The good news is that if the diabetes is well controlled the chances of having foot complications is greatly reduced.
  
  A dramatic rise in foot ulcers and amputation has been seen in the NHS since they stopped offering routine care. In private practice, if the patient can attend as and when required, they can almost entirely avoid issuses by having an ideal level of regular routine maintenance. With fast access to care, problems can be nipped in the bud and severe ulceration is almost never seen.
• Verrucae
  Click here for more information
• Corns & hard skin
  Less and less seen as a medical issue by stretched NHS services, corns can nevertheless be extremely debilitating.
  
  They are simply focused areas of dense hard skin over pressure points and have no root as many people believe. They can be removed and if skillfully done it is not a painful treatment however they will nearly always return if nothing is done to change the cause.
  
  There is a world of difference between what can be done with emery boards and creams from the pharmacy and what can be done by a good podiatrist, especially for those cracked heels. If you suffer from hard skin and have never had a podiatry treatment make an appointment for one and see what a difference it can make.
  
  Mr Thomson is genuinely committed to preventative treatment and has a number of methods for relieving the pressure with simple and inexpensive insoles, that will in most cases not only provide greater comfort but will lengthen the time between repeat visits. It is very rare that a patient needs to been seen every 3 or 4 weeks so if you are in that position give us a chance to improve your feet for the long term. With a thorough course of treatment and pressure relief many patients can double their usual time between visits.
• Elderly routine care
  Unfortunately there is now no NHS provision for elderly routine foot care unless there is a medically significant issue such as a break in the skin. For many elderly people who might have difficulty reaching their feet, simple nail cutting can present quite a problem. Toenails often thicken with age which adds to the difficulty of self care.
  
  Other foot complaints such as dry skin and callus can be addressed and Mr Thomson will aim to provide a very thorough treatment to get your feet in the best possible condition. Seeing a fully qualified Podiatrist who knows how to spot things arrising, can make all the difference for avoiding problems that can ruin people's quality of later life.
• Leg wounds & ulcers
  Click here for more information
• Ingrown toenails
  An ingrown or ingrowing toenail refers to one that has broken the skin but they can be very painful before that and seeking treatment early might prevent a much more painful infected toe.
  
  The real underlying cause of most cases of ingrown toenail is the hereditary shape of the nail. Often our teenage patients get the blame for cutting them badly but it's usually the case that the problem was going to occur at some stage anyway. The bad news is that because of the underlying cause they do usually recur and a small operation to permanently remove part of the nail might be needed. But it really is a very small operation and nothing to worry about.
  
  If struggling with an ingrown toenail it is best to see a podiatrist as soon as possible and BEFORE going to a GP. We can provide antibiotics if needed but they rarely are once we've seen it. However, people attending a GP with an inflammed toe are nearly always given them.
  
  If you have already been prescribed antibiotics by your GP you should still see a podiatrist as soon as possible as in all cases there must be a piece of nail that needs to be removed before it can heal. Antibiotics will not magically disolve a spike of nail!
  
  In most cases just the spike can be removed without anaesthetic and to every patients surprise, if skillfully done, it's not painful. That usually gives instant relief and the long term treatment of removing a small part of the nail permanently can then be planned for a suitable time if the problem recurs.
• Plantar Fasciitis
  There are a number of possible causes for heel pain but a common and very painful one is Plantar Fasciitis. The most indicative symptom is pain under the foot when first getting out of bed in the morning, or after sitting in the evening after coming home from a day standing on them for work. The pain subsiding gradually with walking. In some long term cases it is painful all day but usually people with this condition remember a stage where it was only in the morning.
  
  Many times people spend months or even years doing stretching, wearing night splints or having steroid injections that reduce the symptoms, without addressing the underlying biomechanical cause (the way your foot functions). Naturally, the problem does not fully resolve and in fact can become chronic and harder to resolve when the right treatment is eventually tried.
  
  The problem is biomechanical so the solution needs to address that, with orthotic insoles that change the way your feet move and takes the tension from the plantar fascia when you walk.
  
  Proper functional orthotics are prescription only insoles and shouldn't be confused with those you can buy over the counter in a pharmacy or sports shop even if they look similar. The good news is they needn't be expensive. In most cases if you have a fairly standard foot shape pre-made prescription insoles can be just as effective as the much more expensive custom made insoles.
  
  Again it is important to stress these are very different to the ones available in shops so if you have tried them and it didn't work please don't be put off. Bring them with you and the difference will be explained.
  
  Our orthotics cost £75 a pair plus the standard appointment fee. No extra charges are made for the biomechanical assessment or fitting appointments and you can take the orthotics with you straight away. Once we have assessed you, if you wanted more pairs later, you can simple buy some more.
• Children's feet
  By far the most common conditions effecting children are ingrown toenails and verrucae (see those sections if this applys to your child). With both of these there are benefits to seaking treatment sooner rather than later and you don't need to see your GP before coming for private treatment.
  
  Other less common conditions include biomechanical conditions caused by excessive pronation (feet rolling in at the ankles), overuse injuries caused by sport and growth spurts. If you child has any problem and you're not sure if Podiatry is what to try gives us a call to discuss it.
• Warts on hands
  Yes we do hands! Thankfully, warts on hands (or knees etc) are much easier to treat than verrucae on the soles of feet. If it is very big it might need a chemical treatment for a week, or very rarely two, and then cryo surgery. Usually one cryo treatment is enough.
• Excessive pronation
  "Excessive pronation at the subtalar joint" is the rolling inwards of the feet. The laymen's term is "flat feet" but it is a misleading term. The feet do not need to to be literally flat, having no arch, for it to cause problems. Some amount of pronation is normal but usually due to a hereditary misalignment of the feet or leg they can be so far rolled in that the muscles in the legs are unable to roll them out again during walking.
  
  An easy clue to look for is if you unevenly wear the outside rear corner of the heel on your shoes.
  
  Excessive pronation can cause a huge number of problems, from acute pain in the feet or legs to long term damage of joints including knees and hips. It is the main cause of hereditary bunions. It can cause lower back pain and sciatica. The list goes on.
  
  The good news is help is available and it is much less expensive than it used to be. Proper functional prescription orthotics are needed to change the way your foot functions. The type of insoles available in sports shops and pharmacies promise to do that but in fact are not corrective or supportive enough. If you have already tried those bring them to your appointment and the difference will be explained.
  
  Until recently the only really effective solution was custom prescription orthotics costing hundreds of pounds, requiring multiple appointments and taking a month to arrive.
  
  Fortunately recently developed pre-made prescription orthotics can be in most cases just as good for a fraction of the cost and are available to take straight away. Our orthotics cost £75 a pair plus the standard appointment fee which includes consultation and biomechanical assessment. Additional pairs can then be purchased for £75 a pair if needed.