Diabetic Foot Checks/Diabetic Treatment
The diabetic foot requires ongoing specialist assessment and care.
Why?
People living with diabetes are more ‘at risk’ for diabetic complications. Long term diabetics or those with poor glucose control may result in…
Nerve changes resulting in loss of sensation (tingling, burning or numbness)
Impaired blood supply
Increased risk of infection that can lead to ulceration (non- healing wounds) and result in amputation
Self-care
It is imperative you are aware of the risks and make an effort to monitor and check your feet daily.
Check feet for changes
Wash and dry your feet, especially between the toes
Apply moisturizer daily
Monitor your shoes for wear and tear
Seek advice of your podiatrist or GP if any changes
Avoid over the counter treatments e.g. corn, wart treatments
Have properly fitted shoes, make sure socks are not too tight
Podiatry and you
Have feet checked annually at a minimum
3-6 monthly reviews are highly recommended.
Ask you GP about eligibility for Medicare funded visits
Call us for a podiatry assessment today on 07 3228 5700
Corns/Calluses
What is a corn or callus?
Our feet are subject to changing level of pressure throughout the day. Increased pressure from weight bearing, deformity or ill-fitting footwear may lead to corns and callus.
Our bodies respond to this pressure by thickening the skin to protect underlying structures of the foot. If the pressure is not relieved, or off loaded, this can become painful.
A corn is a focalized area of callus from excessive friction.
Because calluses are caused by other problems, it is important to have your feet assessed by a podiatrist.
Over-the-counter remedies can be harmful. They contain salicylic acid which can cause easily damage the healthy skin surrounding the corn if not used properly. Remember these will only alleviate the symptoms of pressure not the cause! Commercial preparations should only be used following professional advice.
Your podiatrist will assess your footwear to determine if it is the culprit for the problem of suitable for your foot type and activity. Insoles or orthoses may be prescribed to reduce excessive weight bearing forces on the foot and provide long-term relief.
Prevention is better than cure!
By simply paying attention to your feet, monitoring pressure or redness
Ensure your footwear is properly fitted
Use daily moisturiser to ensure skin is supple
Seek advice from our podiatrist, call us for an appointment on 07 3228 5700
Cracked Heels
What are they?
Cracked heels are often quite painful, they can bleed and become infected. Often becoming more prevalent in summer with the use of sandals and thongs. High weight bearing pressure, tight calf muscles, and dry skin can lead to the skin around the heel cracking or splitting.
What causes them?
- Dry skin is less elastic
- Being overweight
- Callus
- Tight calf muscles increasing the loading under the heel through the gait cycle
- Footwear like sandals and thongs can move away from the foot as we walk again increasing loading under the heel.
How are they treated?
- See your Podiatrist to have the heel callus removed.
- Regular treatment is recommended to identify and prevent potential problems.
- Daily use of a moisturizer will ensure the skin elasticity is maintained, the elderly should avoid greasy creams that may increase risk of falls
- An antiseptic liquid may be needed if the cracks are deep or infected.
- Footwear assessment and advice
- Adequate water intake and essential fatty acids within your diet (e.g. Omega 3 fatty acids) may assist in preventing dryness and cracking by helping to keep the skin hydrated and more supple.
Bunions
Also known as HALLUX ABDUCTO VALGUS
A bunion is progressive deformity; most obvious is the bony thickening at the base of the first toe. This thickening impacts on the toes ability to move or flex throughout the gait cycle and can be very painful.
Causes:
- Foot type: high or low arches
- Footwear: narrow shoes and high heels
- Family history
Treatment:
- Prevention is better than cure. Call your podiatrist for an assessment today
- Correct fitting footwear
- Treatment of corns or callus resulting from poor mechanics increasing weight bearing pressure under other parts of the foot
- Insoles or orthotics to correct foot mechanics
- Strengthening exercises
- Pain relief
- Surgery
Heel Pain
A common reason people present to the podiatrist. The incidence of heel pain is highest in middle aged men and women.
Plantar fasciitis
Plantar fascia is a band of connective tissue that runs from the heel into the toes. Inflammation of this structure is known as plantar fasciitis.
Signs and symptoms:
- Heel pain with weight bearing after prolonged periods of rest or the first steps in the morning
- Sharp or stabbing pain under the heel or arch
- Can be acute or chronic in duration
Causes:
- High arch or low arch
- Sudden increase in activity
- Overweight
- Prolonged standing
- Unsupportive footwear
- Pregnancy
Heel spurs
A heel spur is a boney lip that develops under the heel. May often occur with chronic plantar fasciitis.
Tips and treatment:
- Avoid barefoot walking
- Increased cushioning from sports shoes
- For heel spurs shoes with a slight heel raise will offload the area
- Stretching
- Rest
- Ice
- Massage
- Pain relief
- Biomechanical assessment by your podiatrist
- Orthoses
- Cortisone injections and surgery in severe cases
In grown toe nails
Also called onchyocryptosis. A condition where the toe nails grows irregularly, causing pressure to the side of the toe.
Signs and symptoms:
- Redness
- Pain
- Discomfort to pressure e.g. footwear, socks and even bed sheets
Causes:
- Poor nail cutting technique
- Nail shape
- Incorrectly fitting shoes
- Trauma
- Sweaty feet
Treatment:
- Podiatrists are trained to treat ingrown toe nails
- Instruments are sterilized
- Often regular podiatry care will manage ingrown nails
- Chronic ingrown nails and infection may warrant a nail surgery.
Partial Nail Avulsion:
- Local anesthetic is used to numb the toe
- The offending portion of nail is removed and treated with phenol, a chemical that ‘kills’ nail growth
- There can be pain after surgery, the podiatrist will advise you about managing the post op wound with dressings and will review the toe 2 days after surgery
Deformed Nails
Changes in nail appearance and structure can often give us insight into our general health.
Causes:
- Trauma e.g. footwear, injury from stubbing the toe or dropping an object on the nail
- Poor circulation
- Diabetes
- Infection e.g. fungal or bacterial infections
- Skin conditions e.g. dermatitis or psoriasis
- Smoking
- Medications e.g. anti malarial and chemotherapy drugs
- Age related changes causing thickening and discoloration
- Arthritis e.g. Rheumatoid
- Peripheral vascular disease
- Poor self care and nail cutting technique
- Chronic in grown nails
Signs of deformed nails:
- Discoloration
- Thickening
- Lines and ridges
- Pits and grooves
- Clubbed nails
- Bruising
- Chalky appearance
- Brittle nails
- Lifted nail plate
- Splitting
- Redness
- Infection
- Pain
- Odorous discharge
Treatment:
- Consult your Podiatrist, GP or Dermatologist
- Education
- Routine management by Podiatrist
- Good self-care: hygiene, use of moisturizer etc.
- Over the counter or prescription medications
Fungal Conditions
Fungal conditions like tinea or “athlete’s foot” and fungal toe nails are causes by a microorganisms T. rubrum or T. mentagrophytes.
Causes:
- Poor immune system
- Contact to microorganism e.g.
- Diabetes
- Cancer
Fungus likes a warm moist environment, things like sweaty feet (hyperhidrosis), footwear e.g. work boots, thick socks or exposure to fungal spores at the local pool are all possible causes.
Fungal Nails
Also known as onchyomycosis.
Signs and symptoms:
- Discoloration of the nail
- Thickening
- Brittle or crumbling nails
Athletes Foot
Also known as tinea pedis.
Signs and symptoms:
- Itchy skin
- Redness
- Dry scaly spots
Avoiding tinea:
- Wear shoes whenever possible
- Wear thongs in public showers.
Treatment for fungal conditions
- Good hygiene washing feet and drying between toes, managing moisture balance skin that is too dry or too moist.
- Putting shoes in the sun to air
- Washing socks, sheets and towels to minimize the spread.
- Consult your podiatrist
- Prescription and over the counter medications may not be suitable for those with Diabetes. Please consult your Podiatrist, GP or Pharmacist.
Orthotics
Orthotics or insoles are used to support feet to maintain proper foot mechanics.
Orthotic therapy helps to realign the foot and distribute body weight evenly.
Conditions treated:
- Growth disorders in children
- Problematic high or low arches
- Plantar fasciitis
- Metatarsalgia
- Wounds
- Deformity
Biomechanical assessments are required to evaluate your body:
- Joints range/quality/symmetry/direction of motion.
- Muscle strength/weakness/tightness.
- Footwear
- Pressure patterns e.g. callus on the skin
- Gait
- Occupation
- Activity
- Weight
Orthotics can be off the shelf or custom made depending on budget and requirements.
It is advisable that you have orthotics reviewed annually