During your first appointment a medical history will be taken. This is followed by a discussion of your problem and possible treatments and then, with your agreement, the treatment will be given. Where appropriate advice will be given and discussion of follow-up appointments if necessary.
There are many reasons why people benefit from seeing a Podiatrist:
Difficulty cutting their nails
Nails often become harder, thicker and possibly brittle too. Many people find they no longer have the strength in their hands perhaps following an injury or illness. For instance the tremors associated with Parkinson’s make nail cutting tricky.
Difficulty reaching their feet
A lot of people have difficulty reaching their feet. For instance they may have injured their back or have painful hips or knees, they may have problems breathing and reaching down to their feet makes it worse. They may simply be a little rounder around the middle than they used to be. Often people feel embarrassed that they can no longer reach but there really is no need; it’s very common.
Some people suffer with cracked skin, often around the heels and these can also be very painful. Clients usually find it beneficial to return regularly to keep their feet comfortable.
Ingrowing toe nails
These are another common but painful problem. An ingrown toe nail may occur following an injury or not quite getting it right during nail cutting, or a change in the nail shape resulting in an ongoing problem of the nail edges cutting into the skin; all resulting in a very tender toe. Usually treatment at the initial appointment results in relief.
Fungal nails and athletes foot
Fungus commonly affects the foot, as within the shoe, there is an ideal environment for the fungus to thrive i.e. dark and damp. This can result in athletes foot; itchy, broken skin between the toes or generalised peeling of the skin, or fungal nails. On the nail, fungus, gradually affects the whole nail making it discoloured, thick and crumbly. Both men and women, can find affected nails embarrassing. With regular treatment from the client and Podiatrist, the nail can usually make a good recovery, but may take many months.
Trauma to nails or skin
I occasionally see clients who have torn or damaged a nail. This usually follows a trauma or sporting event. In these cases I remove as much of the nail as possible, bit by bit, slowly and gently, before applying a dressing.
Callus and corns
Hard skin (callus) can develop on the soles of the feet making them uncomfortable. In areas of very high pressure, often under the forefoot, on toes or between toes, corns can develop. These can be excruciatingly painful and have a detrimental impact on everyday activities. Clients often comment about the relief they feel once the callus is reduced or corn removed. However, as pressure is likely to remain both callus and corns tend to return so clients often find it beneficial to have regular appointments to keep feet comfortable following a first treatment. The build up of callus can sometimes be associated with conditions such as diabetes or rheumatoid arthritis. People with Down’s syndrome often develop more callus on their feet than is usual.
Verrucas are a type of virus that invades cells in the epidermis. Clients often find verrucas embarrassing or painful and difficult to get rid of. Results from a weekly treatment have been good, but it is hard to predict how many weeks of treatment will be needed and so it is useful to agree to six treatments at the outset, followed by a review at this stage.
Many systemic conditions affect the nails.
The most common are:
- Diabetes – It is important that the feet of diabetics are cared for properly. Many diabetics are seen by podiatrists in the NHS and I usually see those who are fortunate enough not to be considered high risk and those who would like to be seen more regularly.
- Rheumatoid arthritis may cause a change in foot shape which may result in a painful build up of callus over high pressure areas.
- Parkinson’s disease – Not only do tremors make the cutting of nails difficult but the change in walking pattern can lead to callus and corns developing.
- Heart disease and arterial diseases – I am happy to treat clients taking anti-coagulants such as aspirin or Warfarin. I always take care not to cut any client, but if this did occur the foot/toe would be dressed with a haemostat to stop bleeding.
- Chemotherapy can sometimes affect nails.
may be caused by capsulitis, mortons neuroma, a painful big toe joint such as a bunion.
Pain in the rearfoot
may be caused by plantar fasciitis, or an ankle sprain, among many other possibilities.
Both forefoot and rearfoot pain can be treated with either custom made insoles or exercises, or a combination of the two. The problem can then be overcome and normal life resumed.