Chiropody & Podiatry

Specific Treatments

Swift Microwave Therapy:

Swift microwave therapy is a new, very effective treatment for verrucas, designed to prompt a local immune response for the body to heal itself

How Swift Works:

1. Swift verruca treatment uses microwave energy delivered through a special probe applied to the skin to treat the affected tissue.

Microwaves work by generating heat in the wart/verruca, focused under the probe, to a maximum depth of 5mm.

The heat dosage is controlled so as not to cause a burn.

Treatment is applied in timed bursts of two to five seconds with short pause in between, using multiple sites to cover the whole verruca if necessary. In a single session cost, all verrucas can be treated.

Swift treatment results in a degree of localised tissue damage prompting a healing response part of which is antibody recruitment.

It is also thought to stimulate heat stress protein production which is known to prompt a strong healing response.

2. What will the wart/verruca look like after it has been treated and how quickly will it work?

Immediately after the treatment there will be no change to the appearance of the wart/verruca. After a few days it starts to change colour and in time may even appear black.

Swift works by prompting an immune response and time is needed for the process to gather pace.

As regression is established the verruca will reduce in thickness, slowly be pushed upwards and outwards in its entirety. Sometimes the size doesn’t change but is said to “debulk”, that is to say reduce in volume.

The dermal ridges or ‘fingerprint’ of the underlying tissue will gradually re-establish itself as the verruca resolves.

Review is usually after 4-6 weeks to monitor progress so far. The changes can be evaluated and a decision on whether or not you require another Swift application can be made based on the presentation.

3. How many Swift verruca treatments will I need?

This depends on how you respond to treatment.

Some resolve within three treatments but more may be needed particularly with large or multiple lesions.

4. Does Swift verruca treatment hurt?

As with many treatments for skin lesions, some discomfort, even pain may be experienced during treatment.

Sensation varies from person to person but pain can be intense for 1-2 seconds of every burst and quickly subsides. The dose can be adjusted to suit your pain threshold but may affect the full efficacy of the treatment.

In rare cases some minor discomfort or tingling may be experienced for 24hrs before dissipating completely.

5. How does it feel after Swift verruca treatment?

Normally any pain or discomfort ends as soon as the treatment is finished but it is possible there may be some minor discomfort for which paracetamaol totally is effective.

However one of the great things about Swift is there is no broken skin, also no dressings and no need to keep it dry.

Therefore you can continue with all your desired activities throughout the course of the treatment.

6. Does using swift verruca treatment mean that the verruca won’t come back?

Once the wart/verruca has gone, it is usually gone for good.

However, even though Swift works by prompting an immune response and production of the appropriate antibodies communicating a degree of immunity but there can never be a guarantee due the virus mutating or infection with a different virus.

Diabetic Foot Care

Diabetes can cause:

1. Reduced circulation (ischaemia)
2. Damage to nerves resulting in loss of sensation (neuropathy)
3. Increased risk of infection
4. Decreased ability to fight infection

Therefore, people with diabetes are more prone to frequent severe foot problems, and a relatively high risk of infection and ulcers.
All these changes can put their feet at risk - so it is vitally important to ensure all diabetic patients understand the importance of looking after their feet.

How do I look after my feet if I am diabetic?

• Check feet daily and look out for any open sores or cuts.

•Cover any cuts with a clean dressing and monitor healing - seek advice from a podiatrist or a diabetic nurse immediately if you notice redness, swelling or discharge

• Never soak your feet for long periods of time.

• Never cut corns or calluses with a razor blade.

• Do not use any form of chemical treatment for corns, calluses or verrucas.

• Never allow a lesion to go untreated.

• Never ignore any foot pain.

• Avoid extremes of temperature, very warm and very cold conditions can lead to skin complaints.

• Cover any cuts with a clean dressing and monitor progress. If redness, swelling, or discharge is noticed, seek advice from a podiatrist immediately.

With regular visits to a podiatrist, routine foot care, patient education and appropriate footwear advice, healthy feet can be maintained. All diabetics are advised to have annual foot assessments to monitor these complications and prevent serious problems.

In-growing Toe Nails

There are two types of in growing toenails:

ACUTE – where a piece of nail actually pierces the skin, often resulting in infection and overgrowth of reactive tissue. It often affects younger patients and it can be the result of trauma, poor nail cutting techniques or skin changes due to hormones.

CHRONIC – where the nail shape gradually changes over the years, often associated with thickening and increased curvature (involution) of the nail. The nail edges press into the soft tissues, which can cause pain even with the lightest of pressures, and wearing shoes can become extremely painful.

What causes them?

There are multiple causes, some them simultaneously.

1. Poor nail cutting. Cutting the nail too short or digging into the sides can leave a jagged edge in the side of the nail, leading to an in-growing toe nail as the nail tries to grow forward.

2. Age. With age, the nail can become deformed and have irregular growth and texture - usually caused by repeated trauma due to continual wearing of enclosed shoes.

3. Previous injury/trauma. If the injury to the toe affects the base of the nail where the matrix (root) is, the direction of the growth of the nail can change - the nail can be deformed and thickened.

4. Hereditary. Nail shape is inherited. Fan shaped nails, where the nail is wider at the furthest part of the toe, and involuted nails are prone to in-growing if not cut correctly.

5. Secondary causes. Some foot deformities, particularly toe deformities, such as hammered toes and hyper extended toe can cause continued increased pressure over the nail which can alter the direction of the nail growth in a similar way to an injured nail.

How do we treat them?

Treatment comprises of cutting the nail to remove the offending section and allows the nail to grow clear of the sides. This can be helped by clearing the sides of compact debris and callus. This conservative treatment can resolve the in growing nail as painlessly as possible and give you complete relief.

Advice on toenail cutting, self-management and footwear advice are also vital part of treatment.

Some acute cases however, may require more complex intervention such as a partial nail avulsion/ablation (nail surgery) or surgical nail edge excision. These are simple surgical procedures carried out at Premier Foot Clinic under local anaesthetic to make it pain free.

A Permanent Solution - Nail Surgery at Premier foot clinic:

This is a minor surgical procedure carried out under local anaesthetic to remove part of or the whole of the nail. It is useful if you have a frequently occurring pain from your in-growing toe nail.

Where a small section of nail is removed, phenol is used over the root/matrix of the nail to stop this section of re-growing. Effectively, you have reshaped the nail so that it does not press in the soft tissues. Where the whole nail is removed, no nail will grow in the future.

It takes 6-10 weeks to heal fully and does not require you to rest completely during the healing phase.

The procedure has a 95% success rate which means 5% of the people will have a regrowth. This is usually only partial and may be totally asymptomatic but if needed a further procedure can be carried out.

At Premier Foot Clinic, the nail surgery package consists of the surgery with 4 follow up dressings appointments. This ensures the healing is monitored throughout and any problems are dealt with promptly for the best outcome, with minimal discomfort and in the shortest time.

Morton’s Neuroma

What is a Morton’s Neuroma?

A Morton’s Neuroma is essentially an intermittently trapped nerve in the foot where it becomes enlarged due to the irritation to the nerve tissue. In the early stage it is referred to as metatarsalgia as often there is no change to the nerve. It is history of the pain that helps with the diagnosis. It feels like pins and needle, burning or a stone but during activity may progress to a sharp pain, often relieved just by taking the shoes off.

What causes Morton’s Neuroma?

A Morton’s Neuroma develops as a result of compression/irritation of the nerve. It is often associated with bunions and other foot function problems.

How do you treat a Morton’s Neuroma?

Treatment depends on the stage of the condition. At early stages, it can be improved with only foot wear advice. At Premier Foot Clinic, I use acupuncture with excellent results and it offers instant relief with lasting results. The nerve irritation starts as a result of overload of this area, so it is important to ascertain what aspect of foot function is causing this overload. This can be done using digital gait analysis. At this stage, orthotics to tackle the foot function can be effective. At a more advanced stage, steroid injections and surgery are options to explore.

​MLS Laser Treatment, a form of light therapy, can be effective at any stage to accelerate healing, resolve inflammation, and offer fast pain relief. Suitability will be discussed at your appointment with us.

Gait Analysis/Orthotics

What is Gait Analysis /Orthotics ?

Gait Analysis identifies the underlying mechanical causes of common foot and lower limb problems. At Premier Foot Clinic, a computerised force plate is used to record a dynamic “step”. In the M.O.D, this system was used to screen the feet of all new recruits with non symptomatic feet. The information given through the analysis was used to prescribe custom made orthotic for those that showed abnormalities. Due to this intervention, the injury rate was reduced by a third.

It is a useful piece of equipment to help detect underlying problems. Biomechanical problems attributed to the foot, include heel and arch pain, ankle pain, leg cramps, knee pain, hip pain, lower back pain can increase the likelihood of being injured.

Alongside, many other important observations and measurements are done, assessing the range of joint motion, muscle strength and flexibility, looking for misalignments in the feet, legs, pelvis and shoulders. The assessment also involves looking at the way you stand and walk, assessing your footwear and lifestyle.

Orthotics are used to restore the alignment along with advice on exercises.

Foot orthoses are prescribed for many biomechanical foot disorders such as High Arches, Pronation (flat feet), Bunions, Arch pain, Morton’s Neuromas and Plantar Fasciitis (Heel Pain).

They improve foot function, support the foot and redistribute forces acting on the foot and lower limb.

What is a Custom Orthotic and how could this help me?

Orthotics are special insoles that help stabilise and correct poor foot posture. They correct the dysfunctional movements and allow joints to be aligned correctly to promote efficient transmission of forces.

Orthotics can be used to:

- reduce pain;

- provide support;

- relieve pressure on a specific part of the foot;

- improve alignment of joints above the foot;

- reduce knee stress;

- prevent foot deformities;

- improve collective functioning of the lower-limb.

At Premier Foot Clinic, we provide off the shelf, semi-bespoke and custom-made orthotics to suit all budgets .Custom-made orthotics can be accommodated comfortably in the footwear of your choice and be adapted for your chosen activity.