In this blog i have decided to write about pain in-between the toes as a few patients have presented this week with using acid patches on the sore area in an attempt to self-treat but causing more harm then good. A corn is technically keratin which is the most upper layer of the skin. It has no blood or nerve supply. When excess pressure is applied on the skin, particularly over joints, it leads to excess keratin in order to protect the site from breaking down. This extra keratin can taken different shapes and size depending on the direction and size of the pressure. A corn is simply excess keratin but it presents in the shape of a small cone with the sharp point being deepest. It can sometimes be confused with a wart due to the round shape you see on the surface. When corns occur between the toes, they can be very painful because it feels like having a splinter in your skin wedged. Inter-digital corns often present in winter due to frequent use of closed-in shoes. Read more
It is a well observed and well documented fact that poorly fitting footwear can cause foot problems to arise in people who previously had no foot troubles. Whilst fact remains, people often still persist with shoes that are either too narrow or too small for their feet and often present to podiatry clinics with a number of different problems. Some of the most common problems I have seen in patients who have presented to the clinic are listed below and have often had footwear choice as major contributing factor to the development of problems. Read more
Toe deformities are becoming more prevalent due to lifestyle and shoe characteristics. Though most people are quick to diagnose misshapen toes as ‘hammertoes’, there in fact are four different types of toe abnormalities. These include:
- Hammer toes
- Claw toes
- Mallet toes
- Retracted toes
Whilst there is an appreciable difference in the abnormal alignment of each type of deformity the causative factors and consequences are generally the same.
The hammertoe deformity is possibly the most common misalignment condition that affects the smaller toes. The condition is characterized by contraction of the toe to a position that can cause pressure spots to form due to shoe pressure whilst walking. Whilst the deformity itself is not life-threatening it can become worse and more painful altering the biomechanics of the feet in the process.
Lesser toe deformities are generally progressive and whilst they cannot be stopped, the speed of onset, progression of condition as well as symptoms caused can be controlled. Read more
Part of my job when dispensing orthotics to patients, is to educate them on the type of shoes that fit orthotics as is can be often confusing as to what to buy and what to avoid. Fitting orthotics in sport shoes, or lace-up shoes is often a straight forward process with no difficulty. However, orthotics that have to be used in work or casual footwear is often confusing as they vary so much. I have written this article as a guide to assist those who use orthotics, and need professional advise and guidance on what features to look for in a casual or work shoe to comfortably fit orthotics.
What are bunions?
Medically referred to as “hallux abducto valgus”, bunions are a relatively common deformity found in the fore foot area which is usually characterised by a prominent ‘bump’ and deviation of the big toe from its original position. The condition can lead to painful motion of the joint when walking or difficulty when wearing or fitting shoes. The condition can occur at any point of life but research does show an increased incidence rate in people over 45 with females also being more likely to develop a bunion. A patient may present to a clinic with or without pain. Those who have discomfort, generally describe a pain centralised to the big toe joint. Aching pain may also be described with irritation from footwear on the prominent bump. Patients may report that physical activity may make the bunions feel worse and thus may limit their physical activity levels. Read more
The effect of diabetes on the feet and lower limbs has been well established both in literature and in clinical studies. Changes in the body can ultimately impact both the larger and smaller arteries in the lower limbs. Calcification of arteries as well as formation of thrombi (Blood clots) may lead to further problems that can end in death. As such, ankle systolic blood pressure measurements have been an important process in evaluating and monitoring lower limb arteries for onset of diseases such as peripheral arterial disease and critical limb ischaemia. Currently the most widely accepted method of assessing this is the Ankle Brachial Pressure Index (ABPI). Though this method is effective in identifying blockages in blood flow, recent studies have shown it to be unreliable in elderly patients, those with diabetes or chronic renal failure because the peripheral arteries may be incompressible as a result of calcification or blockages in these smaller arteries.
What does the Systolic Toe Pressure Machine Detect?
The newest technologies look to assess the systolic blood pressure in the toes as well as toe pressure indices. The readings are usually taken at the hallux. The results of these studies can be used to identify or screen for a number of medical conditions including:
- Blockages in large and small blood vessels
- Arterial insufficiency
- Cardiac dysfunction
- Ischaemia/intermittent claudication
- Necrosis and amputation risks.