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A dying healthcare system

A dying healthcare system

Consultants split their time between the NHS and the independent sector, although some remain loyal to the NHS alone. Surgeons often make up their salary in this system, taking away an essential NHS resource – experienced professionals. This was the deal that Bevan had to negotiate. It is true that junior consultants have found it harder to follow their senior colleagues into the independent sector but eventually they trim back their hours if they want to work this sector.

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Arthritis and the big toe

Arthritis and the big toe

I confess I am not keen on the word arthritis as it conjures up a disease of the worst kind. So let us use the phrase ‘arthrosis’ because the term means a condition associated with deterioration of any joint, not just the big toe. Severe forms of arthrosis come under a wonderful term – the arthritides (arth-rit-eedees), which sounds like a member of Jason and the Argonauts crew in Greek mythology. Rheumatoid arthritis and gout are two such conditions which are highly destructive. Already you can see Latin and Greek in our language. Medical people love to make everything sound complicated and a bit of old language helps!

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Morton’s Nerve Pain

Morton’s Nerve Pain

Nerves can recover but often start off because there is local inflammation. The symptoms of what we call neuritis can shoot back up the foot, are often short lived and occur when the foot is compressed initially. Most of the population consult someone between the ages of 40-60. However, there are some who experience the condition as early as 20-30. If caught young then recover can be encouraging. In 1995 Gordon Bennett looked at 115 patients and followed them for 2 years. Thirty-nine percent did well with insoles and footwear alterations. In other words altered their footwear.

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Tennis player loses her toenails

Tennis player loses her toenails

Good foot care should be carried out for all sportspeople. They spend huge sums on their sport so they should invest in ensuring the foot is stable and the footgear is correct for their foot shape. Shoes should be fitted with care and the constituent materials should be considered equally important. Consultingfootpain is keen to ensure the public receives good advice so here is some self-help information

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Tarsal Tunnel Pain

Tarsal Tunnel Pain

I want to introduce you to the condition called tarsal tunnel syndrome as a cause of heel pain but with the distinctive quality that the pain burns. The second feature that gives the condition away is that feeling of fullness, a sort of exploding sensation when exercising worsening with standing walking or running. Sometimes this type of problem pain is called referred. This means that the source of pain and location may not match. The pain may be in front of the foot but is related to the structures in the hind part of the foot.

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More about heel problems

More about heel problems

The most common types of heel pain problems arise from general overuse or repetitive heel pad strain but heel pain is complex and if left can resist treatment. In this article, there are four key subjects that you need to know about. The first relates to children while the other conditions are adult related. There are conditions such as rheumatoid arthritis, gout and ankylosing spondylitis that may affect the heel as well as rarer conditions and of course fractures. If the pain does not subside with self-help remedies recommended after several weeks, then seek professional medical help from a podiatrist or medical practitioner. 

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The Vascular Podiatrist

The Vascular Podiatrist

Taking a good clinical history is vital together with social history. We cover limb oedema (swelling) and changes in the skin with the effects of poor supply. The ultrasound Doppler and blood pressure tests in arms, ankles and toes are vital to match clinical findings with factual changes in pulse quality, pressures and the types of waves. All this information can make a prediction as to the risk associated with vascular disease from amputations to aneurysms to clots and thickening of the walls of blood vessels.

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Understanding ganglions in feet

Understanding ganglions in feet

The nuisance factor behind ganglia and swellings is the potential for pain associated with trapped nerves producing sharp electric shock pains that can shoot into the foot or up the leg. Infections are not common but cause ascending pain and must be investigated and managed. Deeper bursae do well from injections where they form part of normal anatomy. These are called an anatomical bursa. Tethered down with strapping can help or they can be protected by foam and gel padding.

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Biopsy in the foot

Biopsy in the foot

There are several techniques available to the surgeon. We can shave the top to acquire a sample or we can punch a section out using a small punch. The last technique is excisional biopsy, often used as part of treatment. Shave, punch and excisional biopsy are the different techniques. Biopsy is designed as a diagnostic method of test for abnormal skin cells.

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Biomechanics and the foot orthosis

Biomechanics and the foot orthosis

In the USA, from the sixties, the earlier designs were based around a popular subject called ‘biomechanics’. This was a pseudo term but became a significant part of the podiatric medicine degree course in the USA. Much of this pseudo-science involved measurements with protractors (tractographs) and in build error ‘eyesight’ assessment which led to assumptions with a predilection for the concept of wedging. The foot orthosis (F.O.), as it was called, tried to separate itself from the older insole and appliance. A google search today will still confuse the terms.

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Smelly feet and the home truth

Smelly feet and the home truth

Poor hygiene adds to the build-up of skin squares offering greater bacterial opportunity. However, increased sweating requires increased temperature, exercise and stress affected by medical drugs and chemicals as in foods. Increased sweating may require medical intervention. One condition that is less common is pitted keratolysis; lysis means breaking down.

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Podiatry as a career choice?

Podiatry as a career choice?

Like a flying carpet from the Arabian Nights of old, I was transformed along a landscape that threw up new opportunities; it was an unchartered journey, unlike today. Like many friends and colleagues, I did not leave school knowing about podiatry. Our career’s office at school failed to mention this, and I was heading for a failed destiny. By chance, I was redirected as many have been.

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Avoiding Death by PowerPoint

Avoiding Death by PowerPoint

Well, it is simple. Good speakers feel that PowerPoint makes people lazy, leading to a lack of being prepared. I thought it was a good topic as conference season is starting to warm up for some. Preparation is everything and of course, your talk looks better for those slides. I am a strong proponent of PowerPoint, but I have to say it is poorly used more than it is used well. In preparing this short article I have adopted the term Death by PowerPoint because it really can kill what could be a good talk. A few tips might not go amiss.

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Foot cramp is there a cause?

Foot cramp is there a cause?

Salt is not just sodium chloride but calcium, potassium, magnesium. These chemicals are also known as electrolytes which are important for nerve conduction and health muscle function. One myth cramp was to eat a banana because this had potassium, a significant body salt. Athletes had their blood levels measured based on their loss of water in sweat and, hence, salt loss. The findings showed little difference between those who suffered cramp and those that don’t.

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What is a foot orthosis?

What is a foot orthosis?

A podiatric consultation is wise for medical foot problems (diabetes, rheumatoid, psoriatic arthritis, compound arch pain, or deformity). High-performance athletes are best consulting a podiatrist with a sports interest as the market is broad and confusing for laypeople.

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Urine Holds the Secrets of Health

Urine Holds the Secrets of Health

In the past, physicians would hold up a sample of urine to the light and declare all manner of diagnoses. As a podiatrist in training, colour became a prodigious indicator of so many aspects of medical assessment – the colour of the lips for oxygen exchange, the skin and blemishes for cancer, the colour of the nail bed for heart and lung as well as kidney disease. In every case, subtle colour changes might have played a part from the yellowing features created by jaundice and hence a sign of liver malfunction to the loss of pigment in black skin – vitiligo. When it came to body waste, it was easy to assume this had nothing to do with the podiatrist…

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The Fish Pedicure – good or bad?

The Fish Pedicure – good or bad?

CFP decided to look into this topic further and found some interesting facts. Yes, you can become infected from the doctor fish, as they are sometimes called, although the fish as Garra rufa fish and are found in the Middle East, such as Turkey, Syria, Iraq, Iran, the Far East – Indonesia. The Garra rufa belongs to the carp family. In their natural habitat, their suction helps them stick to rocks so they feed on plankton. In a town called Kangal, it was observed that the resident Garra rufa fed spared normal skin but ate psoriatic plaques. Let’s look at risk and potential reasons for scaremongering. Secondly, we need to feature the Garra Rufa fish.

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The Bunion Corrector.

The Bunion Corrector.

Patients often ask if this type of device is of value for their bunion, which does not mean the bump, but the deformity called hallux valgus. The splint actually has a purpose and function and could be valuable, but we have to specify some reservations because at best, it takes time for a painful joint to settle. The big toe (hallux) splint is often called a ‘night splint’ (illustrated as the main image) implying that it can only be worn at night. In reality, many designs can be used during the day but the one I intend to introduce is used as an adjunct to treatment and in some cases exercises.

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The Social-Historian

The Social-Historian

My starting point was the 1960 state registration Act, and the reason for that was because Gerry Larkin’s examination of ‘chiropody’ had basically run from the 19th century up to 1960. Thus, the sociology of podiatry had already been written up until 1960, but nothing had followed since then. I saw the opportunity, and took it upon myself to be the person to undertake an analysis of the post-1960 profession, and that’s how it happened.  There were other brief articles, mainly by the historian Colin Dagnall, which addressed certain features of the profession during those years, but nothing which specifically drew upon the sociology of the professions. 

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Delayed Big Toe Surgery!

Delayed Big Toe Surgery!

I look at why there is a discrepancy between being admitted to a private hospital through the NHS. In this case we need to get to the ‘heart’ of the problem. Additionally revision surgery and expectations are discussed with Tom in my conclusion.

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Selling & Misselling Orthoses

Selling & Misselling Orthoses

At ConsultingFootPain my colleagues and I try to take the mystique out of foot health science and recognise it is easy to confuse patients. For example, pronation is yet another word based around anatomical movement.

Sports magazines and journals, podiatrists and others use the word pronation all the time. However, do we know or understand the importance of the term, which can be used to confuse? In addition, there is another angle to this word and one that is often attributed to flat feet.

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Threats to Rafael Nadal’s Future?

Threats to Rafael Nadal’s Future?

For you or I, who are low key in our activity, relative to athletes in peak condition, this condition may settle and you can live with the condition adequately. However, the types of forces Nadal creates with tennis foot and ankle contact on the court are akin to the problems beset by Andy Murray with his hip joint. Murray’s hip was more amenable to surgery than Nadal’s foot will be. The reason athletes can push themselves is their competitive streak, motivation, and extreme fitness, long training and ethics to be better than everyone else –  this allows them to compensate for the type of problems the regular person would give up on a long time ago.

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Musings about corns and callus

Musings about corns and callus

My favourite story comes from space

Scott and Don had been in space for 300 and 365 days respectively. Their blogs recorded interesting experiences. Because astronauts are not walking around on the ground under the force of gravity they don’t have to wear shoes in space.

 “The calluses on your feet in space will eventually fall off so, the bottoms of your feet become very soft like newborn baby feet. But the top of my feet develop rough alligator skin because I use the top of my feet to get around here on space station when using foot rails.” Scott Kelly

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Contact dermatitis and plants

Contact dermatitis and plants

Summer certainly attracts more plants and visitor activity than other seasons. Yet, even as I write this article, I feel itchy. We need to know what to avoid and if we are unfortunate to have a contact rash, we should know what to do. One point about the 10 plants I have picked is that many originate outside the UK while others remain in North America. Given the serious concerns with Japanese Knotweed for example, demonstrates that boundaries do not guarantee that you will come across something that has a kick in its leaf, stem or sap. Skin and respiratory problems arise in some but not all.

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A dying healthcare system

A dying healthcare system

Consultants split their time between the NHS and the independent sector, although some remain loyal to the NHS alone. Surgeons often make up their salary in this system, taking away an essential NHS resource – experienced professionals. This was the deal that Bevan had to negotiate. It is true that junior consultants have found it harder to follow their senior colleagues into the independent sector but eventually they trim back their hours if they want to work this sector.

read more
Arthritis and the big toe

Arthritis and the big toe

I confess I am not keen on the word arthritis as it conjures up a disease of the worst kind. So let us use the phrase ‘arthrosis’ because the term means a condition associated with deterioration of any joint, not just the big toe. Severe forms of arthrosis come under a wonderful term – the arthritides (arth-rit-eedees), which sounds like a member of Jason and the Argonauts crew in Greek mythology. Rheumatoid arthritis and gout are two such conditions which are highly destructive. Already you can see Latin and Greek in our language. Medical people love to make everything sound complicated and a bit of old language helps!

read more

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A common foot treatment device

A common foot treatment device

This brief article covers orthotics or orthoses providing tips about what you might expect when this form of treatment for your foot is recommended. Can you buy your own for example and what is a prescription? Who should you avoid when being sold an orthosis. Read this article by podiatrist and a former orthotic director without adverts and sales pitch.

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What is a podiatric surgeon

What is a podiatric surgeon

What does a podiatric surgeon do and how do we distinguish this profession that is now over 40 years old in the UK. This brief article helps enquirers in the UK make that distinction with links to relevant sites. Further enquiries to the official bodies are recommended for those wishing to seek a career in podiatric surgery.

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Foot injury & self-help

Foot injury & self-help

Had an accident to the foot? Well podiatrist David did. Fixing the problem was easy but then a good article was worthwhile and what better than a bit of self-advice from this former podiatric foot surgeon. He will take you through some pointers as how to manage and even prepare for that event you may never have happen – hopefully!

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Blisters and Pathology in the foot

Blisters and Pathology in the foot

Blisters occur in vigorously active populations and result from frictional forces that mechanically separate epidermal cells at level of the stratum spinosum. Moist skin increases the frictional force, but very dry or very wet skin decreases friction force. Read more by Mike who has made a study of this common problem in this two part article for Reflective Podiatric Practice.

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