SA1 Foot Nurse - Swansea Chiropody - Foot Health Problems

Let’s be honest, most of us ignore our feet until something happens to them that causes pain or discomfort. We ask a lot of them and on average they have to carry us around 75,000 miles during our lifetime! Little wonder that many people suffer with their feet when they get older, though foot health problems are certainly not limited to the older generation. This page aims to examine the most common complaints and explain what I can do to treat them.

Calluses: 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 the skin thicken, in the form of corns and callus, as a protective response.
A callus is an extended area of thickened skin on the soles of the feet, and occurs on areas of pressure. It is the body's reaction to pressure or friction, and can appear anywhere the skin rubs against a bone, a shoe, or the ground.

Treatment: Removal of hard skin, relieving pain, and redistributing 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. I can advise you on the most appropriate skin preparations for your needs.

Corns: Much like calluses, corns are simply evidence of the body’s reaction to pressure on the foot – usually by ill-fitting footwear but this isn’t always the case. The body reacts by building up hard skin as a defensive measure and corns are the result. Corns are essentially a cone of hard skin that presses on the nerves beneath, often causing pain.

Treatment: There are many different types of corns. Treatment involves the excision of the hard skin (it’s called ‘enucleation’) using a scalpel. Sometimes a sterile antiseptic dressing is then applied depending on depth.

Bunions: A bone deformity caused by an enlargement of the joint at the base and side of the big toe Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe.

Treatment: Because they are bone deformities, bunions do not resolve by themselves and are usually are treated by surgery. The goal for bunion treatment by a foot health practitioner is to relieve the pressure and pain caused by irritations. Protective padding, often made from felt material, eliminates the friction against shoes and helps alleviate inflammation and skin problems. I can also recommend a night-time splint if necessary.

Ingrowing Toenails: A toenail that pierces the flesh of the toe. It can feel as if you have a splinter, and can be extremely painful. 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. The quicker it’s treated the better as they can become very painful and result in serious infection.

Treatment: Foot Health practitioners can diagnose this painful condition, and if in the early stages treatment applied and advice given on further prevention. However, fully developed and established ingrowing toenails will usually require a referral to a medical practitioner and this will often result in surgical removal of the toenail. If this happens to my clients I can apply dressings post-surgery.

Thickened Toenails: Can be discoloured and that sometimes leads to a misdiagnosis by some as an infection. Often caused by poor circulation to the feet (especially so in diabetics) but can also be caused by trauma, the nail bed builds up causing thickening that can be uncomfortable.

Treatment: Thickened nails are easily treated by filing and/ or drilling. Don’t worry, it’s pain-free!

Infections: These are either caused through bacteria or a virus and are numerous. The most common, of course. Is athlete’s foot which is a fungal infection between the toes that can spread to other parts of the foot if left untreated. It’s irritating and sometimes painful but easily dealt with.

Treatment: Diagnosis and appropriate advice/ treatment given, often by using anti-fungal or antibacterial creams. Follow-up care if necessary and referral to GP if the problems persist.

Verrucae: A verruca is a viral infection, whereas corns and calluses are simply layers of dead skin. In the early stages, a verruca looks like a small, dark, puncture mark but later turns grey or brown. It may develop a black spot in the middle, which is caused by bleeding. They are harmless but they can cause a sharp, burning pain if you get one on a weight-bearing area such as the ball or the heel of the foot.

Treatment: I can treat these with a medicinal cream and in most cases I expose the verruca using a scalpel to remove the skin around the infection to expose the blood vessels of the verruca. This allows the cream to take effect. However, verrucae often need more than one treatment to be completely removed.

Diabetes: People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy. If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet.

Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much. With diabetes, you may not be able to properly sense minor injuries such as cuts, scrapes and blisters-all signs of abnormal wear, tear, and foot strain.

Treatment: A diabetic foot care assessment applicable for the diabetic patient. Depending on that assessment a decision is then taken on diagnosis and treatment and/ or prevention. This includes:

Testing for peripheral neuropathy using a tuning fork/microfilament.
Referral for a Doppler test if necessary.
Referral to diabetic clinic/ GP if necessary.
Advice re frequent and correct professional nail cutting.