The UWA Podiatry Clinic

Common foot disorders

• Ingrown toenail
  The initial podiatric treatment often includes a course of oral antibiotics and the simple removal of the ingrowing section of nail under local anaesthetic. If necessary, permanent correction of the condition may be performed as a minor clinic procedure once the infection has settled.
• Hammer toe
  Hammer toes are usually the result of tendon imbalances and often develop painful corns. These may be treated conservatively by paring down the thickened skin over the bony prominences, or surgically by straightening the involved toes. Hammer toes are often associated with bunion deformities.
• Bunions
  Bunion deformities are common conditions affecting the big toe joint of the foot. Often they are familial in nature and apart from being cosmetically undesirable, they often cause difficulty in wearing shoes in comfort and eventually cause considerable pain as the joint becomes more and more arthritic. The definitive treatment for a bunion deformity is surgery. Modern surgical procedures produce minimal post-operative discomfort and provide a good opportunity for lasting correction of the deformity. Although bunions are best treated in the earlier stages of their development, effective treatment for advanced cases is still possible. If necessary, patients can usually have both feet corrected at the same time and are normally able to walk in reasonable comfort in post-operative shoes.
• Neuromas
  Neuromas are painful thickenings of sensory nerves, usually present between the third and fourth toes of the foot. Patients often report early symptoms of numbness and as the lesions develop, sharp, burning pain between the toes is common. The conservative treatment of neuromas, including injections or foot orthoses, is usually effective. However the surgical removal of the thickened nerve section is often necessary.
• Heel pain
  There are a number of possible causes of heel pain, including injury, infection, arthritis and soft tissue inflammation of tendons or ligamentous-like structures around the heel. The most common causes include plantar fasciitis/heel spurs, achilles tendonitis in adults, and osteochondritis (Sever’s disease) of the heel in children. Each condition needs to be accurately diagnosed and treated appropriately. Early diagnosis and treatment is important to avoid the condition from developing into a chronic disabling one. Treatment is usually very successful and usually consists of rest, foot strapping, gentle stretching exercises, anti-inflammatories and the use of prescription foot orthoses. On rare occasions, surgery may be indicated when the heel pain fails to respond to conservative care.
• Warts
  Warts are a viral infection in the epidermal layers of the skin and are thought to be transmissible through direct contact or by walking barefooted in communal pools or showers. Warts may spread and grow in size to press on nerve endings in the skin to become quite painful. Their removal may be facilitated by the use of ‘wart-paints’ available from any pharmacy, or may be frozen off or surgically curetted as an office procedure.
• Fungal nails
  Toenails infected with fungi appear thickened, discoloured and are often a source of embarrassment to the patient. Such conditions may be associated with athlete’s foot ortinea and may be treated by removal of the affected nail section/s and the application of topical or oral anti-fungal medication.
• Flat feet
  Flat feet are normal in children but by the time a child reaches school age their feet should look and function normally. Flat or ‘pronated’ feet for the most part should be considered abnormal and are the cause of a great many foot and leg complaints, including bunions, hammer-toes, plantar fasciitis and shin pain. If you are concerned about your children’s feet or your own, a podiatric examination is recommended. Postural foot problems can often be helped with prescription foot orthoses.
• Foot orthoses
  Foot orthoses, often referred to as ‘arch supports’ are frequently used in podiatry to manage a variety of structural abnormalities and/or mechanically induced foot, leg, knee and even low-back symptoms. After a thorough medical and podiatric history, biomechanical and gait examination, if required, orthoses are prescribed according to the individual’s foot structure and function.