Unresolving Forefoot pain? Could it be freibergs?

FREIBERGS DISEASE

Summary

• Freiberg’s disease is a relatively uncommon disorder that affects the joints of metatarsals (the bones that extend from the arch of your foot to your toes).
• The disease is associated with the gradual collapse or disintegration of the joint surfaces between the metatarsals as well as the formation of abnormal joint tissue. Symptoms include chronic history of forefoot pain, foot stiffness, and walking with a limp.

How did I get this?

• The specific events or factors that cause Freiberg’s disease are not completely understood.
• However, there are several risk factors for the disease, which include age and gender (Freiberg’s disease occurs most often in female adolescents and young women, although the disease can occur in any person at any age), excessively long metatarsals, and foot trauma.

What can I do about it?

• Freiberg’s disease may be asymptomatic or it may heal without treatment. But if symptoms are present, the following will be beneficial:
• Rest the metatarsal joints allowing the joint Inflammation and irritation to go away.
• Nonsteroidal anti-inflammatory drugs (NSAIDS) are used commonly for pain.
• Always seek podiatry consultation if you suspect you might have it.

What help can I get for this?

• Podiatrist may advise comfort shoes with metatarsal pad to help offload the area and for protection, and a camwalker boot for protected weight bearing for a period of two to six weeks to allow the symptoms to settle.
• Foot and ankle surgeon for surgical treatment if the nonoperative intervention fails to control the symptoms.

When will it get better?

• Fortunately, the outcomes of both non-operative and operative management are good to excellent and most patients are able to return to previous activity.

Revolutionary Verucca Treatment - Swift

Swift – The Revolutionary Verucca Treatment

Most of us will have veruccas – also sometimes known as plantar warts – at some time in our lives. Veruccas are caused by the Human Papilloma Virus (HPV), as are other types of warts. Warts and veruccas can be contagious and love nothing better than damp skin. Veruccas can be uncomfortable and painful, especially when on the soles of the feet. Eventually, the body will fight off the HPV virus and the veruccas will disappear, but this can take months. 

Conventional Verucca Treatments

The problem with a lot of verucca treatments currently on the market is that they’ve been proven to be fairly ineffective. A 2014 American study looked at the three main methods used by doctors and parents to treat warts and veruccas – salicylic acid, duct tape and cryotherapy. Duct tape was found to be no more effective than doing nothing and leaving the veruccas to get better on their own. Cryotherapy – freezing the veruccas off using liquid nitrogen – is effective, but can produce a range of nasty side effects, especially in children. Treatments might have to be repeated several times to get rid of the verucca completely. Salicylic acid is effective when applied directly to the wart, but can take 12 weeks to get rid of veruccas completely and requires compliance from the patient.

How Swift Is Different?

Swift uses a different approach to treating veruccas. Swift uses the same microwave technology which has been used to treat cancer for 40 years or more, but which has only recently been applied to dermatology and podiatry. The microwaves penetrate into the tissue surrounding the verucca, destroying infected tissue quickly, painlessly and without smell or smoke. The technology has been fully tested to ensure that it conforms to the highest safety standards, and approved for use in the UK. Patients don’t need anaesthetic. It would be a lie to say that the treatment is totally painless, but it hurts no more than a quick scratch, and the pain subsides quickly. Each verucca is treated in a matter of seconds. Unlike more conventional treatments, the microwaves are concentrated in the verucca tissue only, and won’t affect the surrounding skin. The technology is safe and proven over several decades. Many patients find that they only need one treatment to see a huge improvement in their foot condition, unlike other treatments which take weeks or even months. 

Is Swift suitable for me?

At Foot Medic we’ve linked up with the makers of Swift to deliver the treatment to our patients. Most people who come to us with problem veruccas can try the Swift treatment to see whether it helps. There are a few groups such as type 1 diabetics or people with cuts on their feet who might not be suitable for the treatment, but come along to the clinic, grab a coffee and we can talk through your treatment options. We’re very excited about the results which our patients are already seeing from the Swift treatment – why not give it a try?

Getting the Right Pair of School Shoes for your child.

It’s that time of year again when the long school holidays are drawing to a close and parents all over the UK are entering into battle with their kids over what shoes are appropriate for school. Apart from the blazer, kids’ school shoes are probably the most expensive thing you’re going to have to buy and we’re well aware of that fact that what parents think are “sensible shoes” are the ones which kids will probably turn their noses up at. No parent wants to be dealing with a full-on meltdown over school shoes, but we also know there’s a lot of confusion about what sort of shoes are going to look after growing feet, but will tick the fashion boxes too.

Comfort, Support and Flexibility

When you’re dragging a reluctant child around the shops looking for that perfect pair of school shoes, keep three key concepts in mind – comfort, support and flexibility. 

Comfort – obviously a good pair of school shoes needs to be comfortable as a child will be wearing them for 7 hours a day or more. A skilled fitter will be able to suggest the right style of shoe for your child’s foot but advice can be hit or miss, especially at this time of year when shops are so busy. As a parent you can do some basic checks too. Shoes shouldn’t slip off the ankle, and you shouldn’t be able to see gaps between the shoe and your child’s foot. Press on the toe to make sure that there’s a gap between the toe and the shoe. Factoring in a little growing room is wise, but not at the expense of a properly fitting shoe.

Support – this is the main issue with a lot of fashion shoe brands, especially for girls. Ballet flat style shoes are the main culprits as they have no built-in support for the foot at all. Walking for extended periods in ballet flats is known to contribute to foot pain problems and conditions such as plantar fasciitis. Look for a style of shoe which has adequate cushioning and shaping under the sole of the foot rather than being completely flat. Keep the ballet flats for weekends and nights out – not as everyday wear for school. 

Flexibility – this is especially important in younger kids, whose feet are still developing quickly. Shoes should have soles which are bendy and flexible enough to let their feet move in a natural manner when running or jumping. Don’t be afraid to pick up shoes in the shop and bend the soles! Leather’s also more flexible than synthetic alternatives, and has the added benefit of keeping your child’s feet fresher during a long day at school. 

Are great school shoes going to cost a fortune?

They don’t have to. It’s easy to stick to the tried and tested big brands which specialise in school shoes, but if you keep in mind the mantra of “comfort, support, flexibility” you can use this to evaluate supermarket and high street shoes too.

Global recognition for quality of care and advancing industry

Foot Medic Awarded Global Health and Pharma - Podiatrists of the year 2018 

Everyone here at Foot Medic is delighted to announce that we’ve won a Global Health & Pharma Award for service excellence. We usually don’t like blowing our own trumpet but we’re so thrilled to have been nominated for this prestigious award , we can’t wait to let everyone know about it.

Global Health & Pharma is a health industry portal, bringing together all sorts of medical and healthcare organisations to share information, best practice and provide news about what’s going on in the industry. It looks at healthcare issues worldwide, rather than just focusing on the UK. The website and magazine cover core medical services delivered by the NHS as well as allied services such as social care, physiotherapy, dentistry or pharmaceuticals. They highlight organisations and clinics across the globe who are going above and beyond to deliver superior service to their patients, or who have taken on a campaigning role to change the public perception of a condition or healthcare provision.

We’ve been awarded in the Private Healthcare section of the Awards, which covers all healthcare providers from dentists and Harley Street clinics to physiotherapists and hearing specialists. The Global Health and Pharma Award goes a long way in recognising that Foot Medic is doing something just a little bit different from many other podiatrists not just in the UK, but across the world. 

We're Transforming Podiatry

One of the most heard comments as patients leave after treatment is “I didn’t think podiatry was like this!” Let’s be honest. Podiatry has a bit of an image problem, associated with dingy clinics and old-fashioned treatments. Foot Medic is so far from that image that our patients are amazed by the light, airy clinic, freshly-brewed coffee and homemade tablet – and that’s just the reception area! 

The range of conditions which we treat is also extensive and expanding all of the time. We’re excited about modern developments in technology which make diagnosis quicker and clinical outcomes better! 

We provide truly comprehensive medical services relating to the foot and ankle, catering for all age groups, ranging from what we would term as routine problems, like skin pathologies to advanced musculoskeletal services like biomechanics, gait and blood analysis, medical imaging, joint injection and orthoses manufacture.

Fundamentally, as dramatic as it may sound, our mission is to improve the lives of those we treat. We encourage our clients to see beyond the physical tasks of podiatry and focus on the effect of podiatry. In essence we remove and reduce pain from patients’ lives. We improve the quality of their lives and increase and improve mobility. Everyone’s goals are different, one person’s goal might be to walk pain free, another to move more to lose weight, improve health or the athlete who might need to repair and rehab an injury or get better, faster times. Podiatry has a role to play in each of these scenarios and the Foot Medic aims to ensure excellence for everyone it treats.

That’s just scratching the surface of what we’re about at Foot Medic – we could also mention our friendly team, each member of which brings different skills and experience into the clinic, or the fact we’ve got a video-appointment system which lets us help you wherever you’re based in the world. We could be looking at plantar fasciitis in Glasgow on a Monday, and helping a hiker who’s injured his foot in Geneva on a Tuesday.  

Introduction to Foot Anatomy

Introduction to Foot Anatomy

The future of healthcare - its all about connecting people

When I was a student I spent a year or so working for Scotland’s telephone contact centre, NHS 24. We would take calls from all over the country. The system was operated on a triangular principle of call centres, in Glasgow, Edinburgh and Aberdeen. Due to the geographical nature of Scotland, the highlands and islands specifically, getting medical help and advice could be difficult. 

Sometimes when taking calls where we would have to lead the caller through a set of processes, the outcome being determined by the answers they would give. We would rely heavily on the their descriptions of themselves or the person they were calling about. They would say things like ‘its a bit swollen’ or ‘the rash is red and raised’ and a million other variations of those types of things. Often I would sit there on the phone thinking, what if we could see this. Wouldn’t that be so much easier

I was an undergraduate podiatry student then. Fast forward six years, I am the director of a company, an employer and yet still a podiatrist above all. I enjoy being a podiatrist. And my standard answer to those who say ‘how can you do this job’ has become something along the lines of ‘ I enjoy helping people. I take away pain and advise people on improving their health’. Wanting to help people comes from somewhere deep within care givers, whatever form that might take, the doctor, the nurse or indeed the podiatrist. 

I can hear the phone at reception from my office. Sometimes we are unable to offer patients appointments. Victims of our own success some might say. Its true to say that my team of podiatrists are proud of providing very good care to patients. That can mean from time to time we struggle to help everyone who asks for it, when they need it most. I thought on the solution for around a year. I knew if I could connect with patients remotely, just like I thought of when I was at NHS 24, I could help more people, faster. 

It wasn’t until a dinner with friend and colleague Damien Gough, who was well versed in the application of technology in healthcare that the notion started to become a reality. Damien and I had shared our motivations and passion for helping people on a larger scale than we were already able to do. Across our meatballs and pasta we returned suggestions like, Skype, Facebook messenger, and various others. All these would be discounted for a number of reasons including data security, encryption and what we thought was a trusted, serious platform for patients to engage with. After a few months of exchanges we finally developed a system that would work. It was secure, private, reputable. It was easy to use and reliable. Finally, we had done it. So after a year in the planning, in the end, it took only a matter of weeks to finalise once we had something tangible to work with. 

The system is simple. From the outset I wanted to have the fewest number of clicks required to connect, ensuring it was uncomplicated for the user. Now we have a care portal which 

 user through 3 clicks of a mouse can be face to face with an expert. No waiting times, no busy waiting rooms, transport or parking issues to worry about. The future of healthcare provision has arrived. I predict that virtual consultations will become routine. Change takes time and Im sure it wont be without resistance from those who fear it but it still feels good to be at the front end of it.

You can watch our short video explaining how our tele-medicine portal works here

Or if you would like to use the service right now click here

The awkward conversation

We need to talk.....about fees.....

 My first blog entry for a year, or over a year and its an awkward one. It's one that we need to discuss and one which I know frustrates a lot of my peers in the profession. 

Every couple of weeks or thereabouts I deliver a short talk to various community groups about podiatry, how it has changed and how it might differ from a pre-existing perception. Its fair to say that the feedback from the talks, which are generally to church guilds and woman institute groups, is good. They find it interesting and educational and perhaps even a little tiny bit entertaining. I demonstrate to them how things have changed and that podiatry has moved on. I show them some of the modalities at our disposal and the investment that a modern, forward thinking podiatrist will make. Shockwave therapy and ultrasound for example represent significant financial investment in order to bring services to the client or patient group. To frame that more clearly, a reasonable diagnostic ultrasound machine will set you back in the region of about £25, 000 and a decent patient chair to sit on.... anywhere between 2 - 5 thousand pounds. 

It wasn't until I read a facebook post a few days ago where someone talked about going to see a podiatrist for her heel pain which was so bad she could 'barely walk'. She went on to say.....'but its £36 for a 30 minute appointment and insoles on top of that at £45......that's pretty expensive". 

Of course 'expense' is a subjective thing. But therein lies the real problem. Its not the price, or the expense of an item or service. Whats is wrong with this statement is that the lady completely misunderstands the difference between 'price' and 'value'. What is the cost of pain relief in any case? What is the limit that a person is prepared to pay? And scratching further beneath the surface, what price do we place on the skill of the clinician. And now, were getting down to brass tax. 

Think for a moment, if you will, about your washing machine at home, just as an example. It breaks down, but you need it! How will you wash your laundry. It's a household essential. You go online and start looking for the engineer in your area. They agree to come out to see it but you have to pay a call out fee. Typically anywhere between £50 - 90. Once he gets there you'll be billed for the parts he needs and the time spent to fix it. So where are we, £120 - 150? 

Fees for podiatry treatment remain among some 

of the most modist private healthcare fees with 

a national average of around £40. 

Now just hold that thought, and add to it the statement ' I can barely walk. I am in so much pain - but the podiatrist is ...well pretty expensive'. 

Podiatry forms one of our greatest yet most unsung allied health professions. I admit we have a massive identity crisis facing us. One which we are desperately trying to move away with the perceptions of old. Having to justify the clinical skills and re-enforce daily, hourly perhaps in some cases our entitlement to charge fees for our skills and the services we deliver. We are often asked or expected to do work for free, albeit mundane, simple foot care tasks. But how insulting is that. Would any other professional person, whose invested time and money in a university education be expected to work for free?  

There are many examples and parallels that can be drawn, much like the washing machine engineer, the hairdresser being another favorite that springs to mind. But I will resist, because this was never supposed to be some kind of rant. It is, however,  important to talk about the difference between 'price' and 'value' and the overall attitude that we have towards our health and well being. When the skills of the tradesmen (no disrespect to them of course they too, are skilled), are valued greater than those of the health care professional who, within their armory can remove pain, prevent falls, educate and ultimately improve the quality of your life, I suppose in much the same way clean clothes do.