ASTRA FOOT CLINIC 
Oldham AND SADDLEWORTH
 

Diabetic foot 
Diabetes is a common cause of foot problems. Diabetes-related foot issues are frequently more severe than those in healthy people.


The Diabetic Foot 

Long-term high blood glucose levels can impair the body's processes. Diabetes can have a detrimental effect on the nerves and blood supply in the foot. Nerve injury in the feet and legs can result in a lack of sensation. Any trauma or damage to the foot, such as standing on a sharp object, may go undetected and result in more serious problems, such as an ulcer. Diabetes can cause a reduced blood flow to the feet and legs, affecting the capacity to heal if the foot is injured. 

If circulation is inadequate, the feet may appear cold and the pulses weak. 

A specialist can advise a diabetic on a variety of steps they might take to prevent foot issues. These include: 

Examine the feet daily for cuts, swelling, scrapes, and discolouration. 
Every day, wash your feet and gently dry them. 
Avoid scorching your feet. Burns from hot water, for example, may go undetected because of diminished sensation. 
Take care when trimming toenails. If your vision, feeling, or circulation are affected, you should have your toenails clipped by a health care professional.. 
 
Footwear should fit properly, and shoes should be checked before each wear to ensure that there is nothing that could cause irritation to the foot, such as a stone. 

Stopping smoking can be beneficial since smoking impairs circulation. 

A foot health professional should monitor any worsening in your feet's nerves or circulation. This enables you to take the required precautions to prevent any issues.
 

Rheumatic foot

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease that affects a variety of tissues and organs, but mostly attacks the joints. 

Foot difficulties are frequent in patients with rheumatoid arthritis. These issues can frequently be more problematic than in a healthy person. 

Rheumatoid arthritis can damage tissues, organs, and joints in the body. Rheumatoid arthritis affects many people's feet. This can cause discomfort, oedema, deformity, and structural collapse of the foot. Deformity in the foot can cause a variety of problems. Corns and calluses may form over areas of intense pressure, producing pain. Swelling may prevent a person from wearing their typical style of footwear. The collapse of the foot structure can result in a 'flat foot' that does not function properly and makes it difficult to walk efficiently. 

In our clinic the aim is to improve the comfort of your rheumatic feet by recommending appropriate footwear and addressing painful pressure points with callus and corn removal. Orthotics (shoe inserts) can be used to support and improve foot function. Each of these options will help you to be as mobile as possible.
 

Metatarsalgia

What is metatarsalgia?

Metatarsalgia is a common overuse injury characterised by pain in the forefoot. It is associated with increased stress on the metatarsal bone heads (the ball of the foot). Metatarsalgia is commonly found where the second, third, and fourth toes meet the ball of the foot (the metatarsal heads). 


What are the symptoms of metatarsalgia? 

Metatarsalgia causes pain in the ball of your foot, which can worsen with walking or running. Some people describe a burning or aching sensation in the ball of the foot as 'walking on pebbles'. The pain intensity varies greatly, ranging from mild to severe. Common symptoms of metatarsalgia include shooting pains in the toes, tingling or numbness around the toes, and worsening pain when standing or moving. Symptoms typically appear gradually over several months rather than suddenly. 

What is the cause of metatarsalgia? 

Metatarsalgia can be caused by a variety of factors; anything that puts additional strain or pressure on the ball of the foot can cause issues. Poorly fitting footwear, such as narrow, high-heeled shoes that force the foot into a small space, can lead to the condition. Certain foot shapes, such as a narrow, high arched foot with a lot of pressure on the front, are more likely to develop metatarsalgia. Athletes who participate in high-impact sports such as running or jumping have a higher risk of developing forefoot problems. Being overweight puts more pressure on the foot. As we age, the protective 'fat pad' that sits over our metatarsal heads thins and displaces, exposing the bones to more pressure. Metatarsalgia is frequently associated with and symptomatic of hammer toes, Mortons' neuroma, and foot osteoarthritis. 

What should I do if I've got metatarsalgia? 

If you have metatarsalgia, you should consult with a podiatrist/ Foot Health Professional. The appropriate treatment will be determined by how quickly the symptoms appeared. Reducing pressure over the area is critical, and sometimes avoiding certain types of activity for an extended period of time is required. 

What should I not do if I have metatarsalgia? 

Wearing inappropriate footwear and participating in high-impact sports will exacerbate symptoms. Avoiding activities that put a lot of pressure on the forefoot is critical. 

Are there any long-term consequences from metatarsalgia? 

Continued high pressure on the forefoot may result in metatarsal stress fractures. 

Treatment for metatarsalgia: 

Orthotics can be used to improve foot function and redistribute pressure, thereby protecting the ball of the foot. Cushioning silicone gel insoles may also offer relief. Advice on appropriate footwear with good shock absorption is essential.

Hammer toes 

What are hammer toes? 

Hammer toe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, giving it the appearance of a hammer. Over time, the toe will stiffen and become fixed in its bent position. 

What are the symptoms of hammertoes? 

A hammer toe is usually higher than your other toes and has a distinct 'hammer' shape. A corn or callus may form on the top or tip of a toe as a result of it not sitting in alignment with the other toes and thus being vulnerable to additional shoe pressure. Pain is frequently experienced as a result of hard skin buildup. 

What are the causes of hammertoes? 

Hammer toes can occur due to tendons inside the foot or when the toes are squashed by poorly fitting shoes and/or socks. Hammer toes are most commonly found in bunions and high-arched feet. 

What do I do if I have a hammer toe? 

Seeking advice from a podiatrist is beneficial. Your podiatrist can recommend appropriate footwear and determine whether conservative treatment is sufficient or if surgical intervention is required. 

What should I not do if I have hammer toe? 

Wearing footwear that exposes the awkwardly lying toe to even more pressure is not recommended; a deep toe box and wide fitting are required to maintain comfort. 

Are there any long-term effects of hammer toes? 

The affected toe frequently does not have an attractive appearance. If conservative treatment fails to correct and straighten a hammer toe, surgery may be required. 

Treatment for Hammertoes 

Splints made of rubber or silicone may be useful in mild cases. OUR SPECIALIST can remove corns and calluses with a scalpel blade to alleviate any pain caused by them. It is best to choose shoes with a looser fit or uppers made of soft materials. We will provide a protective pad over the affected area to help alleviate symptoms.

Flat feet.  

What exactly is meant by 'flat feet'? 

In a standing position, raise the inside of the foot slightly; this is known as the arch of the foot. The height of this arch varies by individual. Flat feet, fallen arches, or 'pronated' feet are terms used to describe people who have very low or no arch at all. When someone with flat feet stands, their inner foot or arch flattens and the foot frequently rolls over to the inner side, resulting in the sole of the foot fully touching the ground. Some people have no issues with this foot shape, but it can cause problems in the feet, ankles, knees, hips, and back due to ligament and muscle overstrain. 

What are the signs of flat feet? 

Symptoms vary greatly according to the severity of the condition. People frequently report that their foot is 'rolling inwards' or collapsing (known as over-pronating). Pain is most commonly felt on the inner side of the ankle, the arch of the foot, and in the heel, calf, knee, hip, and back. 

What is the cause of flat feet? 
Flat feet are often passed down through families. When sitting, you may notice an arch, but when standing, the arch may flatten completely, giving the leg the sensation of rolling inwards. Injury, arthritis, a ruptured tendon, and nervous system diseases are all possible causes of flat feet in later life. 

What should I do if my feet are flat? 
If the condition causes no pain, nothing needs to be done. Certain treatment options exist if pain occurs during activity, such as sports, or in everyday life. A consultation with your podiatrist is required to determine the severity of the condition and the appropriate treatment. 

What should I not do if I have flat feet? 
Higher levels of activity, such as running on hard ground, can exacerbate this condition. Continuing with this activity may cause excessive stress on ligaments, tendons, and muscles and should be avoided until treatment is sought. High heels should be avoided because they place additional strain on the foot. 

Are there any long-term effects of flat feet? 
If painful flat feet are not treated, other complaints in the feet and legs may develop, depending on the severity of the condition. Flat feet can lead to inefficient walking and running, straining ligaments and muscles. If this is repeated over a long period of time, tears in these structures may develop. 

Treatment for Flat Feet 
Wearing supportive, well-fitted shoes can help alleviate arch pain. This, however, may not be sufficient, and you may need an insole or orthotic to support the arch and reduce collapsing (pronating). An orthotic is placed in the shoe. There are two types of orthotics: casted and non-casted. Casted orthotics are custom-made for your foot, whereas non-casted models are off-the-shelf. Your health provider will recommend the best type of orthotics for you.

Morton’s neuroma 

What is Morton's neuroma? 

A neuroma is a thickening or enlargement of nerve tissue that is most commonly caused by nerve irritation or compression. This type of neuroma typically develops at the base of the third and fourth toes. 

What are the symptoms of Morton's neuroma? 

Morton's neuroma causes sharp or dull pain between the third and fourth toes. Wearing tight shoes and walking can exacerbate the problem. You may experience numbness, tingling, or burning sensations in the area. Symptoms can appear suddenly or gradually over time, and they typically worsen. 

What is the cause of a Morton's neuroma? 

Several factors can contribute to the formation of a neuroma. High-heeled shoes with a constricted toe box can compress the nerve. Women are more likely to develop the condition as a result of wearing these shoes. A neuroma can be caused by a high or low arch foot, as well as a hammer toe. This is due to the instability of the structures surrounding the toe. Sports involving repetitive force on the front part of the foot (forefoot) can also result in a neuroma. 

What can I do if I have a Morton's neuroma? 

A visit to a podiatrist is recommended to diagnose the problem and determine its cause. Questions about pain levels and what activities exacerbate it will be asked. Meanwhile, wearing supportive footwear with adequate width is recommended. 

What should I not do if I have Morton's neuroma? 

This condition can worsen with time. Wearing unsuitable footwear will exacerbate the problem, as will participating in sports that place significant stress on the forefoot. Treating any other issues that may be causing the neuroma is critical; for example, a low arched foot may necessitate an insole or orthotic. 

Are there any long-term consequences of a Morton's neuroma? 

Early conservative treatment is preferred for this condition, but if that is not possible, some people may require surgical removal of the enlarged nerve. 

Treatment for Morton's neuroma 

The treatment for Morton's neuroma aims to reduce and relieve pressure on the nerve. This can be accomplished in a variety of ways, beginning with wearing a flat, wide-laced-up shoe. Orthotics are the next choice. Orthotics are shoe inserts that improve foot function and thus relieve pressure on the nerves. Padding can be used under the forefoot to provide comfort and relief.

Arthritis in the feet. 

Osteoarthritis (OA) is also known as 'wear and tear'. It usually appears in people over the age of 40 when the cartilage between bones wears down and no longer cushions the joint as well as it once did. 

Osteoarthritis affects pressured joints and is common in the feet, particularly at the base of the big toe. 

What are the signs of osteoarthritis in the feet? 

Osteoarthritis can affect any of your foot's joints, but the big toe is the most commonly affected. As people age, they often notice changes in their feet's arch structure, and mild arthritis in the arch area is common. Osteoarthritis of the ankle is less common. Osteoarthritis symptoms include pain, stiffness, and reduced movement. 

What causes osteoarthritis in the feet? 

The exact cause of osteoarthritis is unknown, but most experts believe that some people are genetically predisposed to the disease. Obesity (which puts additional strain on the foot's joints), activities involving repetitive movements of a specific joint, and previous joint damage, such as a sports injury, are all factors that contribute to the disease's onset in the foot. 

What should I do if I have osteoarthritis in my feet? 

A physical examination by a podiatrist is recommended to determine the severity of the condition and any conservative treatments that may be beneficial. A referral for surgery is sometimes necessary. Recognising activities that exacerbate the condition is critical, and it may be prudent to avoid them. 

What should I not do if I have osteoarthritis? 

This condition worsens over time, so steps must be taken to avoid things that aggravate the problem. For example, being overweight puts excessive strain on the joints, as does intense physical activity. High heeled, narrow footwear should be avoided because they put significant strain on joints. 

Are there any long-term effects of osteoarthritis? 

In the long run, osteoarthritis in the feet can cause worsening pain, loss of mobility, and even make walking difficult. If conservative treatment fails to alleviate the condition, surgery may be required. 

Treatment for osteoarthritis. 

A foot health professional can treat corns and calluses on your feet. Orthotics (shoe inserts) can be provided to help the foot function more efficiently and relieve pressure on specific 'at risk' areas. Cushioning shoe insoles can be used to provide additional comfort to the affected joints. Advice on the most appropriate footwear can also be provided.