WHAT IS ARTHRITIS?

Arthritis is a general term used to describe any type of joint pain. It is usually associated with pain, stiffness, inflammation and joint damage.

There are many different types of arthritis, with the most common being Osteoarthritis and Rheumatoid Arthritis. Gout is also a form of arthritis. These three forms of arthritis account for 95% of arthritis cases in Australia. However there are around 100 different types of arthritis and they can affect any age group. Arthritis generally becomes more prevalent with age, particularly after the age of 45 years.[1]

Just about any joint in the body can be affected by arthritis, and with 33 joints in each foot, it isn’t surprising that arthritis in the feet is pretty common. In fact, about 1 in 6 older people had painful arthritis affecting their feet according to a recent study.[2]

Knees, hips and spine are also quite susceptible to developing arthritis. Being overweight places more stress on the bones and joints and has been shown to increase foot and lower limb pain in arthritis.

HOW IS ARTHRITIS TREATED?

Treatment for arthritis depends on the exact type of arthritis and the joints affected.

Generally speaking though, when treating arthritis associated with your feet and legs, treatment usually involves:

• Stretches and exercises to maintain joint mobility
• Supportive, well cushioned footwear, fitted well to protect painful joints
• Arch supports or prescription orthoses to stabilise the foot, reduce abnormal joint loading and help prevent deformity
• Advice for maintaining healthy lifestyle and reducing stress on the affected joints 

WHAT ARE PLANTAR WARTS?

Plantar Warts (or verrucae) are warts that occur on the bottom of your feet. They generally appear as hard lumps in the skin with thick skin surrounding it. They are often mistaken for corns but can be differentiated by the appearance of small black dots in the middle of the wart and with the lack of skin striations (skin lines on the feet, like fingerprint lines) through the wart.

Plantar Warts can occur at any age but are particularly common in school-aged children. [1] They are contagious and can be spread when using communal facilities such as change rooms and showers.

Plantar Warts are sometimes painful, depending on their location on your foot and how big or how deep they are. The decision to treat them is usually dependent on whether they are painful.

WHAT CAUSES PLANTAR WARTS?

Plantar warts, like any wart, are caused by the Human Papilloma Virus (HPV). There are over 100 different strains of HPV, with only a few causing warts on your feet. The virus enters the body through a small break in the skin surface [2], however, the virus can remain dormant in the body and become evident months, if not years later.

Pain associated with warts is due to the pressure applied to the soft tissue underneath the wart, as the wart and surrounding callus gets thicker.

HOW CAN PLANTAR WARTS BE TREATED?

Often warts will resolve on their own without any treatment, but this may take years to do so. Treatment options for Plantar Warts are quite varied. They range from doing nothing at all, to home remedies such as ‘over the counter’ wart treatments and duct tape, to more advanced treatments such as salicylic acid and cryotherapy (freezing). Surgical removal is also an option. Whatever the treatment, care must be taken to avoid scarring which can sometimes lead to long term painful callus formation.

Research has suggested the best form of treatment for warts is the use of salicylic acid and/or cryotherapy.

Salicylic acid, as the name suggests, is an acid which softens the wart tissue, and with the aid of manual removal of dead skin, will gradually reduce the wart tissue. It is also thought that partially-damaged cells expose the immune system to HPV to stimulate your body’s immune system into reacting to the wart too.[1] Care must be taken only to apply the acid to the wart tissue, hence this is often done by your Podiatrist or doctor who may also mask the surrounding area with tape or dressings to protect the healthy skin.

Cryotherapy utilises liquid nitrogen to freeze the wart tissue, and like salicylic acid, will eventually decrease the wart size as well as stimulating your body’s immune system to respond. It can be painful and also requires care taken to ensure only wart tissue is treated.

Silver nitrate has also been shown to have some good results for treating warts. It is also a topical treatment which is painted on to the wart.

All of these non-surgical wart treatments require several applications, and may take weeks or months to resolve, so patience and persistence is key. As they all cause tissue damage, these treatments must be used with great caution in people who have poor circulation or sensation e.g. diabetes or those who have poor immunity. In some of these cases no treatment may be the best option.

At FootMotion, we use our extensive clinical experience and state-of the-art technology to properly diagnose your skin condition, carry out a thorough vascular and neurological examination to accurately assess your foot health and create an evidence-based treatment plan to effectively manage your condition.

WHAT IS HEEL PAIN?

Your heel bone (calcaneus) is the largest bone in your foot. It takes the bulk of the foot’s forces during heel strike when you are walking, leaving it prone to injury. There are many different conditions which cause of heel pain, including:

• Plantar fasciitis
• Heel spurs
• Achilles tendonitis
• Fractures
• Sever’s disease (in children)
• Plantarfibromatosis
• Nerve entrapments

WHAT CAUSES HEEL PAIN?

As mentioned above, there are several different conditions that can cause your heel pain. Other contributing factors include:

• Flat feet
• High arch feet
• Excessive weight
• Standing or walking for prolonged periods on hard surfaces
• Non-supportive footwear
• Tight Achilles tendon and foot muscles
• Some inflammatory conditions

At FootMotion, we use our extensive clinical experience and state-of the-art technology to properly diagnose your foot pain, carry out a biomechanical assessment to accurately assess your foot function and create an evidence-based treatment plan to effectively manage your condition.

HOW CAN HEEL PAIN BE TREATED?

Treating your pain involves making a clear diagnosis of the cause of your pain and then developing a tailored treatment programme to effectively reduce your pain.

This may include:

• Icing, massage and rest
• Stretching and strengthening exercises
• Strapping
• Supportive, well-cushioned footwear
• Arch supports or prescription orthoses

Fractured Toes are quite common, and can result from a direct blow to the foot, for example, the accidentally kicking something hard or dropping a heavy object on your toes.

They can also result from the overuse and repetitive stress that comes with participating in high-impact sports like running and rugby. Toe and forefoot fractures often result from trauma or direct injury to the bone.

Fractures can also develop after repetitive activity, rather than a single injury. This is called a “stress fracture.” Fractures may either be “non-displaced,” where the bone is cracked but the ends of the bone are together, or “displaced,” where the end of the broken bones have partially or completely separated.

Although fracturing a bone in your toe or forefoot can be quite painful, it rarely requires surgery. In most cases, a toe fracture will heal with rest and a change in footwear.

WHAT IS AN INGROWN TOENAIL?

An ingrown nail is a common condition affecting the toes, most often the big toes. It occurs when the side or corner of the nail digs into the skin alongside your nail and causes pain and irritation with the potential for the skin to become inflamed and infected. An involuted (excessively curved) nail can cause similar problems with pain, inflammation and infection. The curved nail presses on the tissues of the nail bed or the sulci (grooves) along the edges of the nail plate or both.

WHAT CAUSES AN INGROWN NAIL?

The main causes of ingrown toenails include:

• Incorrect cutting of nails, such as cutting them too short, not cutting straight across to remove the sharp corner, or tearing or picking them
• Injuring your toe
• Wearing shoes that are too tight or short
• Having nails that naturally curve more than usual
• Pressure between the toes due to bunions or toe deformities

Left untreated, an ingrown toenail can become infected which may lead to deeper infection in the tissue and bones if it is neglected or in people who have certain medical conditions such as diabetes. Even if an ingrown toenail becomes infected and you are given antibiotics by your doctor, it is important to have the problematic section of nail is removed to allow the toe to heal and prevent its recurrence.

At FootMotion, we use our extensive clinical experience and state-of the-art technology to properly diagnose your skin and nail condition, carry out a thorough vascular and neurological examination to accurately assess their foot health and create an evidence-based treatment plan to effectively manage your condition.

HOW CAN AN INGROWN TOENAIL BE TREATED?

In many cases, the troublesome toenail can be conservatively managed by removing just the small section of the nail that is causing the problem. Antiseptics and in some cases antibiotics may be needed in the case of an infection. Our Podiatrists have techniques to minimise your discomfort while treating your ingrown toenail. In some cases, we can administer a local anaesthetic to temporarily numb the area being treated.

Surgical Intervention
When there are recurring ingrown toenails or if the ingrown toenail is severe, we may suggest surgery to permanently remove part of the nail that is causing the problems. This procedure, called a nail wedge resection, involves removing a small section along the edge of the nail, narrowing the nail width slightly. The nail root or ‘matrix’ is then cauterised with a chemical to prevent the regrowth of the nail. It is a relatively simple procedure, performed by our Podiatrists in our clinic rooms with strict infection control procedures followed. According to a large clinical study, this particular technique is very effective at correcting the problem permanently. [1] It does require a local anaesthetic, however you will be able to walk out of the clinic room and generally won’t require an extended time recovery time.

Nail Bracing – a non-surgical intervention
Where a non-surgical correction is medically advisable or a personal preference, Footmotion Podiatry offers nail bracing as an effective alternative for nail surgery. Nail bracing can alleviate discomfort quickly and painlessly. As no local anaesthetic is used nail bracing is suitable for children and people with diabetes. Where the treatment aim is to re-shape a curved nail plate the bracing may be removed and reapplied at regular intervals over a period between 3 to 12 months.

GENERAL ADVICE AND HOME CARE

To help avoid the ingrown toenails in future, you will be shown ways to reduce the risk of them returning. This may include:

• Advice on how to cut and care for your nails
• Footwear review and advice to ensure proper fit and support
• Ongoing nail care by our Podiatrists to help with difficult nail shapes
• Treatment for foot conditions such as bunions and toe deformities