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CORNS

Corns are caused by continued pressure or friction of ill fitting shoes, too pointed or too short, contraction of tendons or muscles or by weak arches when the foot elongates and the toes rub on the shoes. Pressure of ill-fitting shoes on bony parts of the foot or flattening of the foot all lead to the formation of corns. Corns are more common in the elderly. Pressure causes the increased formation of skin cells as protection but because of the pressure there is not enough nutrient for all the new cells. Many cells die off and create more pressure and a horny layer, which gets thicker and thicker as the process continues. The process starts locally and radiates outwards forming a raised pyramidal structure. Nerve endings and tiny blood vessels become trapped within the dead cells and cause pain. Corns take different forms. The most common corns are: - Heloma durum hard corns Heloma molle soft corns Heloma miliares seed corns Heloma vasculare vascular corns Heloma neurovascular neurovascular corns

TREATMENT: Corns can be removed completely but they will recur if padding is not applied to relieve the pressure. Any necessary dressing or device for pressure and pain relief and realignment of bones is custom made or supplied in silicon form and applied to help prevent the problems recurring.

Diabetes

Diabetic patients are at risk from damage to their feet because of poor circulation and resistance to infection, and therefore need to be seen by a chiropodist at regular intervals.

In-growing toe nails (onychocryptosis)

In-growing toenails or an involuted nail are caused by ill fitting shoes, where the shoe is too narrow or too short, or by stubbing a toe etc. Cutting toe nails too short or cutting down at the side can cause problems as the nail grows into the skin rather that up and out of the nail groove. This may be the result of cutting one's own toenails badly.

TREATMENT: The nail sides are carefully filed or a tapered piece of nail removed and then the nail side is packed underneath to encourage the nail to grow up and out of the nail groove. This relieves the immediate painful symptoms and prevents any further recurrence of the problem.

Thick nails (onychauxis)

Thick nails can be caused by fungal infections or by nail damage or pressure on the nail from shoes etc. They are thinned down to make them more comfortable and less unsightly. If they are neglected they can form into rams horn nails (onychogryphosis).

TREATMENT: The nails are trimmed, filed and reduced in thickness. Fungal tincture is then applied to any infected nails. Any necessary dressing or device for pressure and pain relief and realignment of bones is custom made or supplied in silicon form and applied to help prevent the problems recurring.

Verrucas or warts

Verrucas are benign vascular growths in the skin usually appearing on the sole of the foot. They look like rather a cauliflower with visible growth of thickened skin. Verrucas are usually round and raised and narrower at the surface than at the base. They can vary from pinhead to the size of a small nut and may be soft or spongy, dry or moist, raised or flat. Verrucas are caused by a fungal infection which is often caught in shower trays, at swimming pools, on the beach or pavements when another suffer has been walking. They are painful, tender (especially to sideways squeezing) and often feel like a pricking sensation which is usually worse in the morning.

TREATMENT: Verrucas can be cut out leaving scar tissue which may continue to be painful. They can be burn off with liquid nitrogen which is very painful and they may recur. At the Gillingham Physio Centre they are treated by burning them out slowly, over several treatments, until they disappear. This process causes little or no discomfort. Treatment is usually weekly. In order to speed up the process the patient is advised to adhere to certain strict rules in the care of the verruca at home.