Here at Good Foot Podiatry we treat a number of foot conditions from general foot check up and care to orthotics, sports related conditions and nail surgery.
Many of the conditions we see and treat are listed below for your information.
Achilles Tendonitis occurs when the Achilles tendon becomes inflamed. The Achilles tendon joins the calf muscle to the heel bone. When walking and running, the tendon helps in lifting the heel bone off the ground. Athletes are prone to this injury because excessive recurring activities -- like running -- can overuse the tendon.
Treatment can include;
- Immobilization – using a cast of removable walking.
- Ice - To reduce swelling due to inflammation.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), to help reduce pain and inflammation.
- Orthotics – when abnormal gait is a contributing factor.
- Physiotherapy/exercises to help strengthen the tendon. Also, soft-tissue massage/mobilization and ultrasound therapy can be employed in treatment of Achilles disorder.
Osteoarthritis and rheumatoid arthritis are common in the feet and ankles. Osteoarthritis occurs when the cartilage between the bones begins to degenerate. This can lead to symptoms such as:
- Joint stiffness and swelling
- Difficulties walking
- Pain in feet
- Deformity of the bones of the feet causing corns and calluses
Treatment can include use of Nonsteroidal anti-inflammatory drugs, walking casts, and steroid injections are helpful in reducing inflammation. Custom shoe orthotics to help reduce pain and alleviate discomfort in feet.
Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes.Bunions are a progressive disorder eventually developing a bump on the side of the of the great toe. Bunions are caused inherited faulty biomechanics of foot.Tight fitting and narrow toe shoes cause the bunion development to progressively worsen thus causing the symptoms to present sooner.
Symptoms can include:
- Pain or soreness in the toe joint
- Inflammation and redness around the bunion area
- A burning sensation
- Possible numbness to the toe
Some treatment practice that can alleviate bunion problems include:
- Changing footwear – wear shoes with a wide toe box., avoid pointed toe shoes and minimize high heels wearing.
- Padding – across the bunion area to reduce rubbing on the area and reduce pain.
- Activity modifications – pain with bunions can be brought on by prolonged periods of activates such as long distance walking or running. Its best to avoid activity that causes bunion pain to allow pain management and inflammation reduction.
- Nonsteroidal anti-inflammatory drugs - may be recommended to temporary reduce pain and inflammation.
- Icing – using an ice pack several times a day helps reduce inflammation and pain.
- Injection therapy - corticosteroids injections although rarely used in bunion treatment may be useful in treating the inflamed bursa sometimes seen with bunions.
- Orthotic devices - In some cases, custom orthotic can be very useful in controlling motion and function of the bunion foot to alleviate pain and help maintain mobility.
- Surgery – Bunion surgery can be necessary if pain and difficulty walking begin to affect one’s activity of daily living, especially after trying the previously mentioned nonsurgical treatments. Bunion surgery realigns bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position.
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery. The most common and problematic issues with hammertoes is the formation of corn where the joint if deform causing rubbing usually in shoes or the other toes.
Treatment – as with many biomechanics problem of the foot, nonsurgical measures should be tried first including;
- Padding corns and calluses – to reduce friction and rubbing.
- Changes in shoewear – It is very important to avoid pointy shoes, shoes too short or too tight of high heels shoes in this case.
- Orthotics – Custom Orthotics with added modifications can help control the muscle/tendon imbalance.
- Splinting/strapping – of the toes can be performed in early stages when the changes are still very flexible.
Please see our Diabetes information page
Gout is classified as a form of arthritis, and is a painful condition that affects the joints and tissues, most often the big toe. Crystallized uric acid will begin to build up in the joints and cause pain and inflammation. Individuals at high risk for developing gout are those with diabetes, high blood pressure, high levels of stress or alcohol consumption and even people who have had chemotherapy. Diet is a big contributor to the developing of Gout because foods rich in red meat, seafood/shellfish may produce high levels of uric acid that can contribute to gout.
Common symptoms include:
- Pain in the joints of the feet (big toe joint is most common)
- Joint warmth
Diagnosing and treating gout involves clinical assessment by the clinician. If this is the first time the symptoms present, blood tests may be done to check some markers in the blood. Initial treatment of gout typically includes;
- Medications/injections to treat the pain, swelling, and inflammation.
- Some medications may be prescribed by the GP for use in the initial attack, and for long term use to prevent recurrence.
- Dietary modification – avoiding foods high in purines (as mentioned earlier).
- Fluids - drink plenty of water daily to prevent dehydration.
Please see OrthoInfo for extensive information on this condition
Prolotherapy is an injection technique that stimulates tissue regeneration for chronic soft tissue injuries. The action of Prolotherapy is similar to that of PRP (platelet rich plasma) therapy, where the aim is to stimulate the body’s natural inflammatory response which in turn promotes the healing process to restore normal tissue make composition while preventing further tissue degeneration.
The solution used in Prolotherapy is glucose mixed with local anaesthetic. This solution is designed to stimulate a local influx of healing cells (white blood cells, platelets) and other important pre collagen growth factors needed for tissue repair.
Prolotherapy in podiatry is used for treatment of chronic pain in tendons, ligaments and joints. Chronic heel pain (Plantar fasciitis), Achilles tendon and tendon insertion pain, chronic ankle pain following sprains, other foot tendonitis’s and joint pain.
Please see here for further information
A Neuroma is an enlarged nerve that usually occurs between two structures in the foot that press or rub on each other. In the foot it occurs commonly in the third interspace, but can also occur in the 2nd and 4th webspaces.
In the webspaces are soft tissue, and below the nerve is a ligament that hold the long bones of the foot together. Due to walking the ligament is pushed up to and rubs on the nerve with with enlarge over time taking up space in the webspace. As we walk, the compression in the space causes pain.
High heel shoes cause forward pressure on the ball of the feet, compressing the toe bones leading to pain.
- Wearing shoes with a wide toe-box
- Avoiding high heel shoes, and flats
- Padding of shoes may be necessary to spread to toes apart to alleviate the compression mechanism when walking.
- Orthotics can be used in most shoes for athletes with appropriate modifications.
- Injection therapy are also used in the treatment of this condition, the idea being to shrink the enlarge nerve, or completely destroy the tissue.
- Surgery is an option when all conservative treatments have failed long term.
Peripheral neuropathy is nerve damage to the Peripheral Nervous System. And Diabetic neuropathy is nerve damage caused by diabetes. Other conditions can lead to peripheral neuropathy of the feet such as slipped disc, arthritis of the lower back, chemo or radiation therapy, traumatic injury of the spine. Peripheral neuropathy can present with the following symptoms:
- Numbness, tightness, tingling, burning or pins-and-needles sensation in the feet.
- Shooting pain through the foot
- Loss of balance due to muscle weakness
- Foot deformities
- Dry feet
The danger of peripheral neuropathy especially in a person with diabetes in not perceiving pain from an injury or tight shoes as painful. Unfortunately, wound in a person with diabetes can quickly become infected, and if there is poor circulation associated with it and is not treated in a timely manner, can lead to loss of limb. This combination is the reason there are so many amputations being performed on people with diabetes. Please see here for more info. Care for Diabetic foot.
Custom-made orthotics are medical grade inserts that support and gently reposition the heel, arch, muscles, ligaments, tendons, and bones in the feet. Orthotics enable the structures in the foot to work together in a pattern that alleviates the pain or discomfort from various foot pathology.
Unlike prefabricated shoe inserts, custom-made orthotics are created from weight-bearing or non-weight bearing mold of your feet. These devices are designed to meet your specific needs. These devices are typically made with comfortable materials that are very durable, and they can be designed to fit in any type of shoe.
At Good Food podiatry, our orthotics are made using the most advanced technology in thermoplastics, and the highest quality soft foam material, Ethylene-vinyl acetate (EVA) depending on your specific needs.
We can make orthotics for;
- Everyday use such as work boots, nurse’s shoes etc.
- Sports shoes such as skiing, skating, football, running, golf, court etc.
- Special condition like in-toeing, out-toeing, diabetic feet.
- High heel shoes and dress shoes.
Orthotics are used treat/manage conditions such as:
- Plantar fasciitis
- Arch pain
- Diabetes-related pain
- Hammer toe
- Corns & calluses
- Arthritis pain
Peripheral vascular disease (PVD) are diseases that affect the veins, arteries, and lymph system.
Peripheral Artery Disease (PAD) is a condition that presents with plaque build-up in the arteries (atherosclerosis) leading to blockage in the arteries. When the arteries are clogged or narrowed this causes poor circulation to the arms, legs, brain or kidneys. It occurs most often in the lower extremities, causing decreased blood flow to the legs and feet. Just like build-up in the heart, clogged arteries in the lower extremities can cause stroke or heart attack. Pain throughout the leg and sometimes the foot. When the condition is not treated early it can lead to tissue damage especially in the legs and feet which can result in amputation.
Symptoms often can include:
- Pain while walking
- Achy pain in the feet or toes while at rest
- Sores on feet that do not heal
- Pale, bluish, or dark reddish foot colour.
Chronic Venous Insufficiency (CVI) is a progressive condition in which the valves that push blood from the legs toward the heart no longer function properly, causing blood to pool in the legs and the veins to swell. Varicose veins, which are often misunderstood as a purely cosmetic issue, can progress to this more serious condition if left untreated.
Sypmtoms of CVI include:
- Leg heaviness and fatigue
- Leg or ankle swelling
- Leg pain, aching or cramping
- Skin changes
- Ulcers, open wounds or sores
Treatment of these condition starts with early identification if signs and detection symptoms through non-invasive testing.
Our PADnet® in-office non-invasive vascular testing device is the only one of its kind that enables earlier PAD detection and accurate risk assessment by measuring:
- Pulse Volume Recording (PVR) measurements
Segmental blood pressures used to calculate:
- Ankle-Brachial Index (ABI)
- Toe-Brachial Index (TBI)
- Segmental-Brachial Index (SBI)
And CVI detection through measuring:
- Venous Refill Measurements
- Venous Outflow Measurements
All in a single 30 min session.
Please see here for further information
Tarsal tunnel syndrome is caused by the entrapment of the tibial nerve. The tibial nerve follows a curving route down the back of the leg to the ankle, where it turns and curls below the inside of the ankle.
When entrapment compresses the nerve, it causes pain, a burning sensation, and tingling on the sole of the foot. This pain usually worsens as the day progresses and can usually be relieved by rest, elevation, or massage.
Heel pain and ingrown toenails are the most common problems people research