Category Archives: Uncategorized

Patient -L5 S1 Radiculopathy

Summary

  • Bulging discs in your lower spine can press on the nerves that supply your feet, causing you to feel pain in your heels.

 

How did I get this?

  • A previous back injury or wear and tear arthritis or bone spurs in the lower back.
  • It is more common in the 40-60 age group, golfers and dancers.

 

What can I do about it?

  • Avoid activities or movements which cause the pain.

 

What help can I get for this?

  • Your doctor may arrange scans of your lower spine, and pain relief medication
  • Exercises for postural correction
  • A Pain clinic may help with epidural injections.
  • Surgery may be required to attend to the spinal problem.

 

When will it get better?

  • Pain relief medication should give fast relief.
  • Exercises and postural correction may take some weeks to improve.

Patient -Reactive Arthritis

Summary

  • Inflammation, heel pain and bone spurs are found in patients with Reactive Arthritis.

 

How did I get this?

  • Reactive Arthritis is caused by an infection which may also affect the eyes and urinary tract.

 

What can I do about it?

  • Anti – inflammatory pain medication will give some relief, but you will require medical attention

 

What help can I get for this?

  • Your doctor may order blood tests and prescribe antibiotics, anti-inflammatories and immunosuppressants.
  • Your podiatrist will help with footwear advice and modification, insoles and orthotics to reduce load on the painful areas.

 

When will it get better?

  • Managing the symptoms may provide fast relief, but treatment may take weeks to eradicate the infection and settle inflammation.

Patient – Inflammatory Bowel Disease

Summary

  • Heel pain is often associated with Chron’s Disease and Ulcerative Colitis.

 

How did I get this?

  • There is a higher incidence of inflammation in the heel where the achilles tendon and the plantar fascia attach.

 

What can I do about it?

  • Rest
  • Use immunosuppressant and pain relief if prescrib

 

What help can I get for this?

  • Scans may identify inflammatory hot spots.
  • A Podiatrist will provide splinting or immobilisation, orthotics, footwear advice and strengthening exercises.
  • Your doctor may advise blood tests and medication, and possibly referral to a rheumatologist.

 

When will it get better?

  • Managing the symptoms may provide fast relief, but treatment will be long term and involve appropriate footwear and support to reduce load on the painful areas.

Patient – Osteomalacia

Summary

  • Heel pain caused by a weakness in the bone structure, leading to fractures.

 

How did I get this?

  • Deficiencies in Vitamin D, Phosphate, and Calcium.
  • Osteomalacia may be associated with Coeliac Disease, Liver and Kidney problems.

 

What can I do about it?

  • Rest
  • Dietary advice and supplements

 

What help can I get for this?

  • Xrays or scans may identify fractures.
  • A Podiatrist will provide splinting or immobilisation, footwear advice and strengthening exercises.
  • Your doctor may advise blood tests and medication, along with referral for dietary advice.

 

When will it get better?

  • Appropriate dietary supplements will help strengthen bones.
  • Fractures may take 3 months to stabilise.

Patient – Lateral Plantar (Baxter) Nerve entrapment

Summary

  • Heel pain that often shoots under the outside of the heel and travels up the leg

 

How did I get this?

  • The nerve under your heel becomes pinched by a muscle connecting your big toe and your heel bone.
  • You may have a low arch foot type, or the area could be irritated by footwear.

 

What can I do about it?

  • Wear supportive cushioning footwear.
  • Avoid going barefoot.
  • Modify your activity to stop doing the things that cause pain.
  • Short term use of pain killers can give relief.

 

What help can I get for this?

  • A Podiatrist will provide padding, cushioning or orthotics to reduce load in the painful area.
  • Xrays or scans may identify bony lumps or soft tissue abnormalities.
  • If other treatment is not successful surgery may be required to release tissue around the nerve.

 

When will it get better?

  • Activity modification plus appropriate footwear and orthotics should see an improvement in 6-8 weeks.

Patient – Heel Fat Pad Atrophy

Summary

  • Damage or wasting of the fat pad under your heel makes it painful to stand or walk.
  • Loss of fat pad can put more pressure on nerves and bloodvessels.

 

How did I get this?

  • Often associated with ageing, but may also be associated with diabetes, rheumatoid arthritis, peripheral vascular disease, trauma and long term corticosteroid use

 

What can I do about it?

  • Wear supportive cushioning footwear.
  • Avoid going barefoot.
  • Short term use of pain killers can relieve the pain.

 

What help can I get for this?

  • A Podiatrist will provide padding, cushioning or offloading pads, and advise appropriate footwear.
  • Xrays or scans may identify bony lumps or soft tissue abnormalities.

 

When will it get better?

  • A bruised fat pad should recover in 4-6 weeks with appropriate cushioning and footwear.
  • Wasting (atrophy) of the fat pad will require constant protection from footwear and padding

Patient – Neoplasm Bone Tumour

Summary

  • Bone tumours in the foot account for less than 2% of all bone tumours, and approximately 80% are benign. They can become painful if they cause enlargement of the bone or fractures.

 

How did I get this?

  • Previous breast, bladder, lung, kidney or colorectal cancer most frequently metastasize to the foot.
  • Most heel bone tumours are discovered on xray for other unrelated conditions.

 

What can I do about it?

  • Rest or non-weightbearing activity may help in preventing fractures.

 

What help can I get for this?

  • Your doctor will arrange scans and specialist treatment.
  • Your podiatrist may be able to assist with cam walker immobilisation.

 

When will it get better?

  • Benign tumours may require surgical excision and a period of recovery for bone strengthening.
  • Malignant tumours will need advice from an oncologist and orthopaedic specialist

Patient – Ingrowing Toenail

Summary

  • Ingrowing toenails occur when the hard nail plate causes a wound in the soft flesh around the nail.
  • They can be very painful and become infected.
  • There may be an overgrowth of tissue around the nail due to irritation of the wound.

How did I get this?

  • Direct trauma from tight footwear or stubbing your toe
  • Long term pressure from a thickened or curved toenail
  • Poor nail cutting leaving a sharp corner on the nail
  • Swollen toes and sweaty feet can weaken the skin around the nail.

What can I do about it?

  • Avoid footwear which presses on the toe.
  • Bathe the foot in salt water and apply an antiseptic dressing.
  • Trim the toenail as short as possible but do not cut into the painful side

What help can I get for this?

  • A podiatrist can remove the part of the nail that is causing the problem. This may be done under local anaesthetic if necessary.
  • A Podiatrist can advise on appropriate footwear and how to avoid further problems.
  • A doctor may prescribe antibiotics if the toe is infected, however the nail will still need treatment to prevent further infection
  • A Podiatrist can permanently remove the problem piece of nail and prevent regrowth. This procedure is performed under local anaesthetic and is a lasting solution

When will it get better?

  • Without treatment the nail will continue to grow and penetrate the wound.
  • Removal of the piece of nail provides immediate relief.
  • Careful nail care and the right shoes can prevent recurring problems

Ingrown toenail

Patient – Tinea Pedis

Summary

Fungal infection can affect people of all ages. It will cause a rash or blisters with itching, dryness, redness, flaking, and sometimes moist white skin between the toes.

How did I get this?

You can pick up a fungal infection anywhere, however they are more common in warm moist environments where there are communal barefoot areas. Care should be taken when using foot spas if they are shared with other people.

What can I do about it?

Various treatments are available from the pharmacy. Most require an application of an antifungal cream or spray as often as twice a day. Use footwear that will allow your feet to “breathe” and moisture “Wicking” socks or natural fibres are next best.

Wear thongs or water shoes in the shower to prevent infecting others.

What help can I get for this?

Your Doctor or Podiatrist will be able to help if you are not sure of the cause of your rash, or if it has not cleared up after 4 weeks. Sometimes a skin sample can be sent to the lab for testing.

Your podiatrist can advise you about disinfection of your footwear and hosiery.

When will it get better?

With the right treatment, fungal infections will usually clear up in a few weeks. More stubborn infections can keep coming back and may require further investigation.

Patient – Subungual Haematoma

Summary

Often very painful, a blood blister under your toenail will cause swelling and bruising under and around your toenail.

How did I get this?

Usually a result of trauma, you may have stubbed your toe, dropped something on it, or been stood on.

You may also see this condition after endurance events e.g. running or hiking, or after wearing shoes that sre too small.

If you are taking anticoagulant medication you should take extra care.

What can I do about it?

Painkillers may help, but avoid those containing anti-inflammatories such as ibuprofen.

Piercing the toenail to release the pressure will give immediate relief, but this should be carried out by a medical professional if possible.

What help can I get for this?

Your Doctor or Podiatrist will carefully release the pressure and fluid from beneath the toenail, and advise you on appropriate dressings.

Your podiatrist can help if the toenail comes loose, or is not growing properly.

When will it get better?

Releasing the fluid from beneath the toenail usually gives immediate relief. Sometimes you will lose the toenail, but it should grow back again.