What we treat

Signs and symptoms

• Dry, red, scaly and flaky skin
• White, soggy and cracked skin
• Itchy or sore areas, sometimes small blisters

Treatment options

Athlete’s foot is unlikely to clear on its own but usually responds to antifungal treatment without needing to see a GP. We stock a range of antifungal creams, sprays, liquids and powders. Wash and dry the area before applying, treat the affected and surrounding skin, and keep going after the rash clears — spraying inside shoes every couple of weeks reduces the chance of it returning.

Prevention

• Good foot hygiene, drying gently but thoroughly between the toes
• Cotton socks and breathable, roomy shoes in natural materials
• A fresh pair of socks each day; alternate shoes so they dry out
• Don’t walk barefoot in public showers or changing rooms; don’t share towels or shoes

Treatment options

Most blisters heal naturally within three to seven days and don’t require attention. Avoid bursting them, as this can lead to infection or slow healing. If a blister does burst, don’t peel the dead skin — let the fluid drain and cover with a dry, sterile dressing. We can release the fluid using a sterile blade and dress it to reduce infection risk, and we stock a range of blister-prevention plasters and pads.

Prevention

• Wear comfortable, well-fitting shoes and break new footwear in gradually
• Keep feet dry with thicker socks or talcum powder
• Use a little Vaseline on areas of increased pressure
• Don’t ignore any signs of pain

Callus

Hard, rough, often yellowish areas of skin — larger than corns and without a well-defined edge. They form where pressure increases, most commonly the ball of the foot, under the metatarsals, the sides of the foot and around the heel. A sterile blade is used to debride the thickened skin, or it is filed with a water-spray drill; the priority is to remove the cause of pressure and reduce reoccurrence.

Corns

Small circles of thick skin, usually on the tops and sides of toes or the sole. They differ from callus because a nucleus is still present, which makes it feel like walking on a stone and is usually more painful. We enucleate the corn with a sterile blade and/or water-spray drill and advise on prevention. We do not recommend corn plasters, due to the damage they can do to surrounding tissue.

Prevention

• Dry your feet thoroughly and apply a good-quality moisturising foot cream (not body lotion)
• Use a pumice stone or foot file regularly to remove hard skin
• Wear well-fitting footwear — shop for shoes in the afternoon, when feet have swollen

Causes

• Walking barefoot or in flip flops and open-backed sandals
• Long periods standing, especially on hard floors
• Increased weight, poorly fitting shoes or poor foot hygiene
• Dry, scaly skin from climate; poor diet or circulation
• Conditions such as diabetes, thyroid problems, psoriasis and eczema; and the ageing process

Treatment options

• Use a heel balm or oil-based moisturiser twice daily — a balm in the morning improves elasticity before you get moving
• A pumice stone or foot file to reduce thickened skin
• Wear closed-in shoes and good socks; drink plenty of water
• Essential fatty acids such as omega 3 may help; if cracks bleed, apply antiseptic and keep clean with a dressing

Causes

• Poor foot hygiene or footwear; damage to the nail
• Contagious — sharing towels or shoes can spread it
• Poor circulation, smoking, or being immunosuppressed

Symptoms

At first there are usually no symptoms. Later, nails may thicken enough to hurt against a shoe. Infected areas turn white or yellowish and become thickened and crumbly. Not all discoloured nails are fungal. We use water-spray drills to reduce the thickness, allowing pain-free trimming and helping treatment reach the nail bed.

Treatment options

• The most effective treatment is often a tablet (such as Terbinafine) from your GP, alongside a lacquer — success rates 60–80{5c66684700e3c2b698904b45f0463633f3120d22f57ca9c19461edd3455a2fbb}
• Natural products such as tea tree oil are sometimes effective
• Nail surgery under local anaesthetic with phenol prevents regrowth (97{5c66684700e3c2b698904b45f0463633f3120d22f57ca9c19461edd3455a2fbb} success), with staged dressing appointments
• Newer options include laser therapy and Clearanail

Causes

• Poor nail-cutting technique; tight footwear; sweaty feet
• Injury; naturally curved or fungal-thickened nails

Symptoms

• Pain, redness and swelling
• Fluid build-up, bleeding, or pus if infected

Treatment options

Where possible we remove the spike with specialist clippers or a water-spray drill, using local anaesthetic if needed, and advise on prevention. For recurrent or severe cases we can perform nail surgery — Partial or Total Nail Avulsion under local anaesthetic with phenol applied to prevent regrowth (around 98{5c66684700e3c2b698904b45f0463633f3120d22f57ca9c19461edd3455a2fbb} effective), followed by a course of dressing appointments over four to six weeks.

Causes

• Fungal infection; trauma such as dropping an object or repeated pressure from footwear
• Tight shoes or high heels; sport that repeatedly knocks the nail
• Reduced circulation or diabetes; systemic conditions such as psoriasis or arthritis

Treatment options

If a fungal infection is present it is treated first. A water-spray drill reduces the thickness painlessly, followed by professional trimming; soaking for ten minutes or more softens the nail for care at home. Nail surgery is an option if a nail is painful or persistent, and any underlying condition is addressed.

Prevention

• Good hygiene and well-fitted, properly fastened shoes
• Correct nail cutting and filing; avoid tight shoes and high heels

Prevention

• Good foot hygiene and thorough drying
• Don’t share towels, socks or shoes; wear flip-flops in communal showers
• Avoid touching or scratching to prevent spread; verrucae socks are useful for swimming

Treatment options

Ultimately the immune system must clear the virus. Where treatment is warranted — painful, unsightly or spreading verrucae — options include cryotherapy (freezing), silver nitrate or acid treatments, debridement to trigger an immune response, dry needling, laser or surgical removal, usually over a course of treatments.

Risk factors

• Diabetes and peripheral neuropathy
• Circulatory problems and Raynaud’s phenomenon
• Foot abnormalities that increase pressure

Treatment options

We debride dead skin, apply sterile and antibacterial dressings, and advise on footwear and lifestyle. Serious ulcers may need appointments up to twice weekly. Prevention is key: examine your feet daily (a mirror helps), wash, dry and moisturise, wear suitable footwear and socks, and take care with nail care.

Osteoarthritis

Often develops from the late 40s, and is more common in women and where there’s a family history. It affects the smooth cartilage lining of the joint, leading to pain and stiffness, and can cause bony spurs (osteophytes).

Rheumatoid arthritis

Occurs when the immune system targets the joints, causing pain and swelling. It often starts between 40 and 50 and affects women more than men.

Symptoms

• Joint pain, tenderness and stiffness
• Inflammation in and around the joints; restricted movement
• Warm, red skin over the joint; weakness and muscle wasting

Symptoms

• A swollen, bony bump on the outside edge of the foot
• Pain and swelling over the big-toe joint, worsened by shoe pressure
• Hard, red skin where the toes overlap; changes to the shape of the foot

Treatment options

Non-surgical treatments are tried first — painkillers, orthotic insoles and bunion pads. These ease symptoms but don’t reverse the shape. Surgery may be considered for severe cases. The best prevention is to wear shoes that fit properly and avoid high heels.

Symptoms

• Severe joint pain, heat and tenderness
• Swelling and red, shiny skin over the joint

Causes

A build-up of uric acid, from overproduction or poor filtering by the kidneys. It’s linked to obesity, diabetes, diet and alcohol. As podiatrists we treat the effects (such as corns and altered gait); your GP manages pain and prevention through weight loss, hydration and dietary changes.

Causes

• Trauma; arch disorders and excessive pronation
• Genetics, arthritis, overuse or tight footwear

Symptoms

• Pain and stiffness when moving the toe, and during weight-bearing activity
• Swelling, altered gait and pain elsewhere in the lower limb

Treatment options

Proper footwear, stretching, an anti-inflammatory diet and orthotic insoles with adaptations to offload the joint. Surgery is a last resort.

Causes

A muscle imbalance, often from poorly fitting shoes or high heels, arch disorders or arthritis.

Symptoms

• Pain at the bend of the toe; corns on the top of the joint
• Swelling, restricted movement and pain in the ball of the foot

Treatment options

Spacious, low-heeled shoes, massage, ice and painkillers, stretching, and padding or strapping. Rigid toes may require surgery. Early diagnosis improves outcomes.

Causes

Activities that load the ball of the foot — running, basketball, ballet. A higher arch increases the risk.

Symptoms

• Dull pain beneath the big-toe joint, aggravated by activity

Treatment options

• Padding, strapping or taping; rest and activity modification
• Ice therapy and anti-inflammatories; occasionally a steroid injection
• Custom orthotic insoles to balance pressure, and lifestyle changes

Causes

• Common in running, jumping, dancing and tennis, but possible in any sport
• A sudden increase in activity or intensity; poor running technique or excessive pronation
• Inadequate or worn-out footwear; certain medications

Symptoms

• Gradual pain and stiffness over the tendon, often worse first thing in the morning
• Tenderness on palpation; pain on moving the ankle

Treatment options

We treat the cause, not just the injury. A biomechanical assessment identifies contributing factors, and a programme is tailored to you — which may include bespoke orthotic insoles, made at your assessment for you to walk out wearing.

• Training modifications; rest and ice therapy
• Stretching and strengthening; footwear advice; orthotic insoles
• Kinesiology taping; an anti-inflammatory diet

Symptoms

• Swelling, tenderness and bruising
• Pain and stiffness; difficulty bearing weight

Imaging such as an X-ray may be ordered to rule out a fracture.

Treatment options

• Elastic bandages or a brace; crutches if needed
• Elevation and ice therapy; plenty of rest
• Stretching and strengthening once inflammation settles; strapping to support stability

Common issues

• Excessive inward rolling (pronation) or outward rolling (supination)
• Internal rotation of the lower leg and knee; strain on the lower back

Associated injuries

Low back, hip, knee and ankle pain · bunions · shin splints · plantar fasciitis · metatarsalgia · Morton’s neuroma.

Treatment options

We treat the root problem — stretching and strengthening, footwear changes and, where needed, orthotic insoles to realign the rear foot and support the arch. We make and fit high-performance bespoke insoles the same day. If an arch disorder isn’t corrected, injuries are likely to return.

Types

• Tendonitis — inflammation from repetitive use or trauma
• Acute or degenerative tears; subluxation, where the tendon slips out of position

Symptoms

• Pain, swelling and heat behind the outer ankle
• Instability and recurrent sprains

Treatment options

Rest and, if needed, immobilisation; ice, heat or ultrasound; strapping and strengthening exercises; and orthotic insoles to improve stability and alignment.

Causes

• Being overweight; high-impact sport; occupations that involve standing
• Arch disorders with excessive pronation

Symptoms

• Dull, sharp or burning pain in the bottom of the heel or mid-foot
• Worse first thing in the morning or after rest, and on stairs

Treatment options

A biomechanical assessment addresses the root cause. Treatment may include ice therapy, stretching and strengthening, rest from aggravating activity, footwear advice, same-day custom orthotic insoles, weight management, medication or injections, and — rarely — surgery.

Causes

• Increased exercise; hard surfaces or slopes; worn trainers
• Being overweight; arch disorders and foot rolling; weak ankles or tight calves

Treatment options

• Stop the aggravating activity for at least two weeks; ice therapy 2–3 times daily
• Active rest with low-impact alternatives; footwear advice (a neutral shoe)
• Same-day custom orthotic insoles; a stretching and strengthening programme; an anti-inflammatory diet

The injuries

• Ligament tears or ruptures — damage can be lasting where blood supply is poor or the injury recurs
• Tendon damage from overstraining; partial tears swell but heal, while a clean break may need surgery

Treatment options

• RICE — rest, ice, compression, elevation; medication
• Stretching and strengthening once swelling settles; a gradual return to activity
• Strapping or taping; orthotic insoles for support; immobilisation or surgery in severe cases

If nerves are damaged

Tingling or pins and needles · numbness · pain · sweating less · red, hot feet · changes in the shape of the feet · hard skin.

If blood supply is affected

Cramp in the calves · shiny, smooth skin · loss of hair · thickened toenails · cold, pale feet · wounds or sores.

Preventing complications

It starts with managing your diabetes well and keeping blood glucose controlled. An annual NHS diabetic foot assessment is advisable; we also carry these out and can fit them around your NHS appointments so your feet are checked twice a year. Wash, moisturise and check your feet daily, keep footwear suitable and clean, never walk barefoot, and try to stop smoking.

Causes

• Diabetes (the most common cause)
• Obesity, smoking and alcohol

Symptoms

• Numbness or tingling in the feet and hands
• Burning, stabbing or shooting pain; loss of balance and muscle weakness

Symptoms

• Tingling that progresses to sharp or burning pain in the ball of the foot
• Numbness; worse when walking or in tight shoes

Treatment options

• Wider footwear and a metatarsal dome to offload the nerve
• Painkillers, rest, massage, ice and kinesiology taping
• Orthotic insoles; injections; surgery only for severe, unresponsive cases

Causes

• Sports involving running, jumping and twisting
• Tight muscles and tendons; flat feet or pronation

Symptoms

• Pain brought on by exercise and relieved by rest
• Swelling and tenderness below the knee; limping and muscle tightness

Treatment options

• Rest from the aggravating activity; ice or heat
• Stretching and strengthening; training modifications
• Custom or off-the-shelf orthotic insoles; kinesiology taping; an anti-inflammatory diet

Causes

• A growth spurt; excessive pronation; high-impact sport on hard surfaces
• Flat or high arches; poor footwear; being overweight

Symptoms

• Heel pain and tenderness; swelling or redness
• Difficulty walking or playing sport; stiffness on waking; altered gait

Treatment options

Rest is key. Ice or heat, stretching and strengthening, and custom or off-the-shelf orthotic insoles for growing feet. Medication or a period of immobilisation may be needed in severe cases. It usually resolves within 2–12 weeks with full compliance.