Foot conditions

An ingrowing toenail is where a piece of nail pierces the flesh of the toe.

• It can be extremely painful and inflamed with pus or blood discharge noted.
• Most common causes are not cutting the toenails properly, or not filing the toenails and leaving sharp corners.
• You can ease the discomfort by bathing your foot in a warm salty footbath which helps to prevent infection and will reduce inflammation in the area. Then apply a clean sterile dressing, especially if you have noticed discharge. To continue the salty foot bath until the inflammation subsides.

We provide:

• Corrective nail surgery under local anaesthetic. 

If you have a foot ulcer, this needs specialist care which may include working with other services such as the diabetes team, vascular team or other hospital based foot services, to get you the right care, in a suitable time frame and avoid further foot complications from arising.

If you have a chronic ulcer, this will require regular dressings, and the care may be shared with the diabetes foot team, your local community Podiatry team, district nurses and /or GP practice nurse.

Individuals with diabetes are at risk of developing foot ulcers.

A regular foot health review should be carried out by your GP practice every 12 months, even if there have been no foot health problems reported.

If the foot check highlights any foot problems e.g corns/callous, or your foot risk is assessed to be moderate/high or you have an active ulcer/wound then a referral should be made to the Podiatry service via the referral hub.

Find more information on the Know Diabetes website.

If vascular disease is diagnosed, then more specific foot care treatment will be needed. This can be reviewed at the assessment and further referrals to the relevant departments will be done if required, for example, vascular team.

Arthritic conditions including Rheumatology, Psoriatic and some Osteoarthritis can put you at risk of developing foot problems, including foot deformities, foot ulcers and infections. Our Podiatry team can help you by putting a care plan in place after assessing you, so to avoid foot problems.

• Pain is under the foot, around the heel and arch
• Pain on walking after sleeping or after rest
• Often difficult to raise the toes off the floor
• Often pain eases during exercise and returns after resting.

Causes:

• Often occurs after extended periods of walking on hard surfaces or in different flip flops/sliders.
• Sometimes no apparent reason.
• Being overweight.
• Loss of range of movement in the ankle – this can be either due to joint stiffness or tight calf muscles
• Very high foot arches or the opposite – flat feet. Both of these can put strain on the plantar fascia 
• Poorly fitting shoes  
• Often diabetics get this condition
• Bony spurs commonly seen on x-rays are NOT a common cause of plantar fascia pain. You do not need an x-ray to diagnose plantar fascia pain.

Treatment: 

• Footwear to wear all the time, walking in socks or barefoot will exacerbate the pain. Closed in back shoes are important to control the heel
• A gradual build up to new activities is recommended
• Exercises and stretches
• Weight loss
• Medication – anti-inflammatory consult your GP
• Keep active to doing exercises to prevent flare ups
• Insoles e.g slimflex insoles which have an arch support.
• Pedi roller
• Stretch board to help with stretching, or paste the link below into the search bar: 
• Keep a pain diary so rate the pain on a scale of 0—10; describe the pain; duration of the pain and what helps.

For more information visit the NHS Heel Pain webpage.

Presentation:

• Pain is at the ends of the metatarsal bones of the foot, at the ball of the foot
• Pain can be in one area or across the width of the whole foot
• Often described as an aching or burning sensation
• Sometimes the pain can be sharp or feeling like there is a pebble under the foot
• Commonly worse if walking or running
• Often a gradual onset of symptoms

Treatment:

There are a number of things you can do/change:

• Footwear: wide; deep with fastening avoid slip on shoes
• A gradual build up to new activities is recommended
• Exercises and stretches
• Massage the foot
• Weight loss
• Medication – anti-inflammatory consult your GP
• Modifying activities to prevent flare ups
• Simple Insoles over the counter e.g slimflex insoles with an arch support
• Rest  

For more information visit the NHS Foot Pain webpage.

Presentation:

• Displacement of 1^st metatarsal bone
• Pain on the side of the big toe
• Pain when wearing narrow shoes or high heels
• Pain on walking
• Bumps on the side of the big toe
• Big toe can start to point towards the other toes on the same foot
• Corns or calluses can form where there is rubbing against another toe or footwear
• Swelling and redness can occur around the big toe
• Restricted movement of the toe

Causes:

• Hereditary
• Ill-fitting footwear
• Foot shape
• Pressure from walking
• Hypermobility
• Inflammatory disease (Rheumatoid)
• Foot injury

Treatment:

Bunions don’t go away. Treatment often focuses on relieving symptoms and may include:

• Bunion pads. 
• Footwear needs to be round or include a square toe box; wide; deep with fastenings.
• Simple insoles over the counter for example slimfex insoles with an arch support.
• Pain reliever - consult your GP
• Surgery TO BE CONSIDERED as a LAST resort.

For more information visit the NHS Bunions webpage.

If there is a neurological condition, for example, a stroke, Parkinsons, multiple sclerosis or paralysis, then you will need care from the Podiatry team, to avoid foot problems. We offer a range of treatments from treating corns and callous, to issuing insoles/ or orthotics and give footwear advice.

• Podiatric biomechanics is an area of podiatry that links assessment and diagnosis of musculoskeletal (MSK) conditions in adults and children.
• There are many different MSK conditions that affect the foot and ankle.
• Common causes of musculoskeletal related pains tend to originate from bones, ligaments, tendons and muscles.
• They tend to settle with time and good self-management.
• Insoles or orthotics may be issued after an assessment to help the pain.