What is Podiatry?
Podiatry is an area of healthcare that specialise in the foot, ankle and leg. Podiatrists are trained in the prevention, diagnosis, treatment and rehabilitation of the foot & lower limbs. A Podiatrist’s primary aim is to improve the mobility, independence and quality of life for their patients.
At Central Podiatry we work closely with our colleagues in other medical specialties in order to provide the best treatments and outcomes for patients. We believe in a mutli-disciplinary holistic approach to healthcare.
Foot Conditions
Corns & Callus
Bunions
Warts
Ingrown
Corns & Callus
Callus (or callosity) is an extended area of thickened, hard skin on the sole of the foot. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear.
Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core which may cause pain. There are five different types of 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 the 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/neurovascular corns – these are corns that have both nerve fibres and blood vessels in them. They 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
Be careful about using corn plasters, as they contain acids than can burn the healthy skin around the corn, leading to serious problems such as infection.
Our Podiatrist will be able to remove corns and callus painlessly, apply padding or insoles to relieve pressure or fit corrective appliances for long-term relief.
RCoPod 2021
https://rcpod.org.uk/common-foot-problems/corns-callus
Bunion
A bunion, also known as ‘hallux valgus’, is a common deformity of the big toe in which the big toe angles excessively towards the second toe and leads to a bony lump on the side of the foot. Although it looks like extra bone is growing from the side of the foot, this is actually the head of the metatarsal (long bone in the foot) that has become exposure due to the deviation of the big toe. A large sac of fluid, known as a bursa, may also appear, and this may become inflamed and sore.
Bunions are most often caused by a defective mechanical structure of the foot, which is genetic; these foot types make a person more prone to development of a bunion.
Our podiatrist will be able to provide conservative (non-surgical) treatment for Bunions, which may include:
- Exercises
- Custom made interdigital wedges
- Orthotics (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)
- Footwear advice
These are all conservative measures and they may help relieve symptoms but there is no evidence that they can correct the underlying deformity. Our Podiatrist will be able to screen for any significant deformity and/or defect that will not respond to conservative treatment, they will then refer you to a Specialist Foot & Ankle Orthopaedic Surgeon for surgery, which can involve a combination of removing, realigning and pinning of the bone.
If you require surgery, we will help to ensure the best outcome by providing:
- Post-op exercises
- Specialist scar dressings
- Scar and soft tissue release
- Orthotics – facilitate recovery and prevent reoccurrence
RCoPod 2021
https://rcpod.org.uk/common-foot-problems/what-are-bunions
Warts
Warts are a growth in the skin caused by the human papilloma virus (HPV infection). They can cause pain when walking due to the lesion being pushed into the foot by the pressure of walking. They are contagious, with the virus liking a nice warm moist environment to grow. They do spontaneously resolve however sometimes they become persistent or spread and it is necessary to treat.
There are many treatments available for warts and many home remedies can be found on the Internet. The majority of these have poor research behind them. The treatments offered by our Podiatrists have strong evidence-based research.
Treatments available:
Acids, such as silver nitrate and salicyclic acid (Central Health & London Medical Clinic Only)
Cantharidin (Central Health only)
Cryotherapy with liquid nitrogen (Central Health & London Medical Clinic Only)
Falknor Needling Method
Ingrowing Toenail
An ingrowing toenail is where a piece of nail pierces the flesh of the toe. In more severe cases, it can cause pus and bleeding. Ingrowing toenails affect the big toenail, but can affect the other toes too. 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 can also appear red and inflamed.
Our 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.
- 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 required to manage the infection as well as having the offending spike removed
- For those particularly prone to ingrowing toenails a partial nail avulsion (PNA), also known as a wedge resection may be recommended along with finding a more permanent solution to the underlying cause. This procedure can be done in clinic, no need for hospital admission. It is done under a local anaesthetic where part of the nail is removed (including the root), leaving a permanently narrower nail. In some cases a total nail avulsion (TNA) may be performed, where the entire nail plate and root are removed. In either case, the chemical phenol is used to cauterise the nail and prevent it regrowing. This is over 95% successful.
Information according to the RCoPod 2021