• Skin and Nail Conditions
  • Biomechanical Conditions
  • Long term conditions Affecting the feet
Callus and Corns: Callus, also known as Hyperkeratosis, is the formation of a flattened area of thick skin predominantly found on the sole or ball of the foot. Callus if left untreated can become painful thus limiting ones mobility. Corns, also known as Helomas, form a more localised area of thick skin that has a conical shape. Corns can get very painful as the over lying skin increases pressure on the soft tissue lying underneath the hard skin.

Infections of the skin and nails: There are various infections that can cause skin problems to the feet. The most commonly known is Athelete’s foot (TinneaPedis),that is, a fungal infection of the skin that can be uncomfortable due to the itchiness it can cause and unsightly due to its presenting features. This type of infection flourishes in warm moist environments. People who are mostly prone to such infections are athletes, older people with limited movement, people who are prone to excessive sweating and people whose immune system is weak such as patients with Diabetes. Onychomycosisis the fungal infection of the nails. It is the most common disease of the nails. The most common symptom is the nail becoming thickened and discoloured. If not treated this condition can result to brittle crumbly nails with pieces breaking off or the whole nail coming off the toe completely and malodour. Furthermore the skin can get infected causing pain and discomfort.

Verrucas:
Warts on the feet are known as verrucas. They are viral infections that are most commonly found on the ball of the foot as well as on the sole, there could be just one or sometimes a number of them in the same area. They appear as areas of either flat or thickened skin, with usually a soft centre and a harder edge and black spots. They are quite uncomfortable when walking and can cause pain. They are contagious so you are advised to avoid touching the area and walking on wet grounds where other people with verrucas might have already walked i.e swimming pools. Verrucas are stubborn if left untreated.

Ingrowing toe nails: This is a very common painful toe nail condition. The medical term for this is Onychocryptosis. It occurs when a nail spike penetrates the skin around the nail, this could be due to an incorrect way of cutting the nail or due to trauma to the nail. The area where the spike pierces the skin usually gets inflamed and infected (red, hot, swollen and painful). The inflamed area can begin to grow extra tissue or drain yellow fluid known as pus.

Flat Feet: Also known as excessive pronation of the foot. It is a common condition of the lower limb, where the arch of the foot has dropped. This can strain the muscles and ligaments of the foot and eventually of the leg resulting in excessive pain mostly when walking. Common signs of flat feet include pain at the ankle in the inner side, pain within the arch of the foot, knee or hip as well as within the lower back.

Bunion: (also known as HalluxAbductoValgus) An irregular bonny prominence on the base of the big toe, causing it to shift towards the lesser toes. This in turn can eventually result in the clawing of the lesser toes. The joint at the base of the big toe and the underlying skin can become inflamed. The skin will obtain a red colour, become tender and very painful when applying forces such as pressure, friction or shearing.  The joint on movement will feel stiff and painful and eventually this can result in the formation of a bursa (fluid-filled sac) leading to additional swelling and pain.

Morton’s Neuroma: This is a condition that affects one of the nerves running between the metatarsal bones of the foot (ball). The exact causes are unknown. When a neuroma forms one experiences pain when walking. Women experience the pain when wearing high heels as the area undergoes more pressure. The pain is usually between the second to third or third to fourth metatarsal bones. Symptoms of Morton’s Neuroma may include pain, in particular burning pain, numbness, tingling of the toes or the foot.

Diabetes: A metabolic life long health condition, in which one has high levels of blood sugar (glucose) because the body can not use it correctly. This can be due to the pancreas’ inability to produce any insulin (Type 1) or not enough of it (Type 2), or due to the malfunction of the insulin produced. The high blood sugar levels if not controlled can result to peripheral neuropathy. That is, damage to one or more of the peripheral nerves resulting in loss of sensation. When this occurs one may not be aware of any damage to their feet, including minor cuts, burns or blisters. As there is no feeling one does not protect the wound and this makes the wound worse and eventually can develop into an ulcer (skin that has broken down and the underlying tissue can be seen). Another reason why an ulcer can develop in someone with Diabetes is due to peripheral vascular disease a complication of Diabetes, which is the narrowing of the arteries due to fatty deposits. This can affect the blood flow and supply to the skin at the feet, as a result any wounds present do not heal as normal becoming worse and developing into an ulcer.

diabetes
 

Rheumatoid Arthritis (RA): Is thought to be an autoimmune disease, which causes inflammation of the joints. The immune system produces antibodies that work against the synovium (the tissue that surrounds each joint). This causes inflammation in the affected joints and can damage the joints and parts of the bones near the joint. Symptoms of RA are inflammation, pain, stiffness and swelling of the joints. The most commonly affected joints are small joints such as fingers foot joints and the ankle. Damage to the joints can result to the formation of deformities, which will increase pressure to certain areas of the foot, as there will be alteration to its structure. The role of the Podiatrist is to spot early indicators of the disease, to aid maintain independence and ambulation, to minimise joint stress and reduce pain and to increase activity tolerance while trying to minimise foot joint damage.