​01384 390000
Stourbridge Podiatry/Chiropody Practice
37 High Street, Amblecote, Stourbridge DY8 4DG
OPEN ALTERNATE WEEKS:
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MONDAY 12:15pm - 4:45pm
TUESDAY 9:15am - 4:45pm
WEDNESDAY 9:15am - 4:45pm
THURSDAY 9:15am - 4:45pm
FRIDAY 9:15am - 4:45pm
SATURDAY 9:15am - 1:00pm
For bookings please telephone: 01384 390000 if you leave an answering machine message it may take an extended amount of time before I ring you back. So if you prefer for a prompt reply you are very welcome instead to: EMAIL ME at 2025@foothelp.co.uk
​Sorry my practice does not offer home visits or just a toe nail cutting service. This surgery in Stourbridge is open currently on alternate weeks to treat most common foot ailments by appointments booked in advance. My apologies for any inconvenience this may cause but after 45+ years of providing comprehensive help all of the time, at this stage in my career I prefer to work fewer days and times.
Jonathan D Lees (Podiatrist/Chiropodist)
High Standard Chiropody (Podiatry) Treatment
45 minute ‘thorough and careful’ Appointment slots
Modern ‘top of the range’ Instruments & Equipment
Exclusive Car Parking directly in front of Practice
Comfortable ‘no receptionist’ Waiting Room
Fixed price consultation ‘no hidden extra’s’
established 1979
D.Pod.M., M.R.C.Pod. HCPC fully registered
This page last edited 25th November 2024. All rights reserved.
This practice is located 13 miles west of Birmingham (England) in Amblecote, which is part of the historical town of Stourbridge. We are directly on the main road (A491).
FROM STOURBRIDGE RINGROAD - Follow the A491 sign toward Wolverhampton. Go over the lights at the Stourbridge Football Ground. Pass "Magnet" kitchen & bedroom shop then look on your right. After the long wall of Corbet Hospital on your right, you will pass about six old houses, a modern bungalow, I am the second modern looking house on your right. (If you reach The Ruby Cantonese, or Laser Quest - you have gone too far)!
FROM WORDSLEY - Follow the A491 to Stourbridge after "Lidl" supermarket you will pass "Geoff Hill" electrical superstore, carry on over the next lights past the "Ruby Cantonese" restaurant, and "Laser Quest", still heading toward Stourbridge after about 100 metres you will find us as the second driveway immediately after the pull in bus-stop on your left. (If you reach the wall of Corbet Hospital, or Magnet kitchen shop - you have gone too far)!
THE PRACTICE HAS PLENTY OF SPACE ON THE FORECOURT FOR CARS WHEN PARKED SENSIBLY.
SAT NAV ERROR - Some in-car direction aids take you to the A461 Wollaston Road rather than the A491 High Street Amblecote, please do not trust these gadgets if you only input our postcode DY8 4DG. The manufacturers of these gadgets have been told of this error which I am told confuses several local High Streets. Use the above map instead or input: (for accurate satelite navigation location) = 52° 27' 59.49" N and 2° 09' 02.92" W
(From 24th October 2023 professional fee has been £49 by card, and £47.50 by cash)
From 31st March 2025: For a normal consultation with ALL Card Payments, the standard fee is £51.00 per treatment.
(However this is discounted to £50.00 if you pay by cash or cheque)
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Ingrowing Toenail Surgery (under full sterile field) from £399.00
(only carried out if normal treatment methods are not providing a permanent solution)
We do accept cash or cheques and offer a discount to many consultations if you choose this method of payment. Card payments are available at the full standard consultation fee from summer 2014.
Yes I know there are practices that charge more, and some who charge less. I am certain that my fees however represent exceedingly good value without any compromise in standards of care. My standard appointment times are better than any other Podiatry practice I know of. I do not offer a separate toenail cutting service from full chiropody care, everything here is done by me, thoroughly, properly, and carefully, without using so called "foot-health professionals" or other dubiously trained outsiders to potentially put you in danger attempting to save costs.
Who am I
Jonathan D. Lees D.Pod.M., M.R.C.Pod. HCPC Registration Number CH07404
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General Background Information
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This Practice in Amblecote was established in 1984 initially for the purpose of Nail Surgery specifically.
Since the age of 7 years old I have had the vocation of becoming a Chiropodist, and after qualifying
from the Birmingham School of Chiropody in 1979, I set up my private practice in Oldswinford, which
was the first ever ‘Stourbridge Chiropody Practice’ run by a private ‘State Registered Chiropodist’. I also worked
for the National Health Service in their Medical Centres, Clinics and Hospitals as a Senior Podiatrist Practitioner.
In addition I gained much experience working in a private clinic in Birmingham.
All instruments are sterilised to the top standards (and were years before this was expected in official guidelines). The standard appointment time given for a normal treatment is three times that which I was allowed in the NHS. I have always managed to keep
fee’s well below my contemporaries simply by being very efficient. I have never advertised and do not ‘sell’ products.
The surgery’s air is filtered, and air-conditioned when needed. The waiting room as well as the surgery is private,
although you are most welcome to have company during treatment if you wish.
What do those letters after the name mean?
D.Pod.M. Diploma in Podiatric Medicine - European Standard of Podiatry, which now includes the qualification using Local Anaesthetics
M.R.C.Pod. Member of the Royal College of Podiatry (Replaced Society of Chiropodists and Podiatrists in name - below - in 2019).
M.Ch.S. Member of the Society of Chiropodists & Podiatrists - (The only recognised body
exclusively responsible for the training of chiropodists in the United Kingdom.)
S.R.Ch. State Registered Chiropodist - (The minimum qualification required to work by the NHS, this is maintained by the
government by the independent body the ‘Health Professions Council’ a term sadly that had disappeared by July 2005).
Podiatrist Another name used meaning ‘Chiropodist’ which is becoming popular recently.
Produced by: Jonathan D. Lees D.Pod.M., M.R.C.Pod.
Telephone: Stourbridge (01384) 390000
Surgery Address: 37 High Street, Amblecote, Stourbridge, West Midlands DY8 4DG
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You are welcome to park directly on the forecourt in front of the practice. There is extra wide car access directly onto the main road. Both the comfortable Waiting Room and Air-conditioned Surgery are on the ground floor. We are on several major Bus routes. Set Fee’s are guaranteed with no extra’s. Written advice upon demand. Children are welcome. You are also welcome to be accompanied during treatment. Custom appliances are available by arrangement, extra to normal treatment costs. Sterile Field operating facilities, and On-site Local Analgesia is always available. Instruments for every single patient are Autoclave Sterilised, or Disposable for your protection (this has always been the case here, and even before I opened this surgery in 1984, many years ahead of any national codes of practice requiring so).
WHEELCHAIR ACCESS IS RESTRICTED to 25" or 64cm maximum due to the width of the front door. Also please note that there is a 7" or 18cm lip to get over at the entrance, plus a step between the waiting room and surgery of 8" or 20cm. If you need to use a wide wheelchair or one that cannot get up a step Building and Fire regulations mean that it will not be possible for you to be treated here at all.
Sorry for those addicted but this practice is a no smoking environment, and that includes "vapes".
Many problems I see have been caused by practitioners attempting to perform chiropody who have not completed the minimum qualification accepted by the National Health Service which requires at least 3 years full time intensive training at an accredited chiropody school. There are people calling themselves chiropodists, (displaying often many certificates and using lots of letters after their name) who are not trained properly - please be careful and ask at your local NHS Chiropody/Podiatry clinic for who is safe to seek private treatment from.
I look forward to seeing you, and caring for your feet soon.
MY AIMS AND OBJECTIVES AT THIS PRACTICE ARE:
1. To treat foot problems to the highest standards possible.
2. To run the most cost effective practice in this country.
3. To have available and use the most modern proven techniques.
4. To keep using former successful treatments unless superseded.
5. To never risk the safety of any patient.
6. To be the best Chiropodist in the World.
HOW SHALL I ACHIEVE THIS CHARTER:
1.
a) Allow more time for every appointment as a routine than any other Chiropody Surgery I know of.
b) Use the best instruments, equipment, and medicaments available.
c) From time to time I update my knowledge in relevant subjects.
2. Keep it simple.
a) No massive practice rent you pay indirectly to a landlord.
b) No wages for you to pay for receptionists/secretaries.
c) My time is spent efficiently - in the surgery - not travelling.
d) I never have advertised.
e) Computerised Stock Rotation controls used.
f) By using the best of everything, you get better quicker, or can go longer between appointments,
(that’s the best saving of all).
3.
a) I scan the latest journals routinely.
b) Attend suitable beneficial relevant postgraduate courses from time to time.
c) Update surgery facilities immediately as developments occur.
d) Trawl the internet for refreshment of ideas regularly.
4. Previous techniques ought never to be forgotten.
a) I still use old-fashioned methods where indicated if it works.
b) My treatment records are kept, and reviewed for forgotten good ideas.
c) Knowing what did-not work in the past, helps me to avoid using new procedures that are old unsuccessful
treatments rediscovered.
5.
a) My knowledge is extensive in Chiropody only. Outside that I refer.
b) All instruments are sterilised or single use, to the absolute top specifications.
c) All equipment, drugs, padding & strapping used is the best available.
d) Hygiene and cleanliness is never compromised.
e) Records kept are completely confidential.
6. My experience covers every field of Chiropdy/Podiatry. I have lectured in Schools, Universities, and Hospital. I have run surgeries in Industry, Hospitals; Clinics; and Homes, both N.H.S. & private, as well as having run 3 practices of my own.
The qualifications I hold for Chiropody and associated fields are all officially recognised in the U.K. I also hold the Diploma in Podiatric Medicine which complies with the EEC reciprocal agreement for mutual qualification respect.
Experts in their fields have taught me their aspect pertaining to Chiropody/Podiatry e.g:
From England:
Medicine: Dr. Hawkins, Consultant Physician - Birmingham
Analgesia: Dr. Stewart, Consultant Anaesthetist - Birmingham
Surgery: Mr. Norcross, Consultant Orthopaedic Surgeon - Birmingham
Fabrication: Mr. Anthony, Orthotic Manufacturer - Oxford (Summer School)
From America:
Sports Medicine: Dr. Sokoloff & Dr. Kirby Podiatric Surgeons - California
Force Paradigms: Dr. Weal, & Dr. Fuller, Senior Lecturer’s California University of Podiatry
Biomechanics: Dr. Orion, World Famous Author in the field
The prosperity of my family depends entirely upon more patients seeking treatment here to replace those I cure. As it is unprofessional for a practitioner to advertise his own medical services I rely on my patients to recommend me to others. The busier I am, the longer fee’s can be kept down, & standards up.
ONLINE FREE ADVICE: Corns and Callus
CALLUS
These are protective growths of thickened skin over areas where repeated friction occurs. Unless they prove troublesome or painful they require no specialised treatment.
CORNS
These are round thickened areas of compacted hard skin with a central area called “the nucleus”
which acts like “a wedge” in the skin thus causing pain.
Corns do not have roots and are not infectious.
They may be a symptom of structural deformity in the foot and can be very painful.
They may be found on the top of toes and underneath the feet.
Those found between toes may have absorbed perspiration and become “rubbery”
which get described as “soft corns”. Sometimes we see tiny “bead like” corns occasionally found in the heels not due to obvious pressure which are called “seed corns” simply due to their appearance.
TREATMENT
(REMEMBER prevention is better than cure.)
Always have feet measured when standing before buying shoes, by a trained shoe fitter. Even when you have stopped growing, changes still occur in your feet. The measurements you require are, a)length, b)width, c)depth, d)overall shape. Not regarding c) and d) is often the only reason for foot problems.
Help yourself by looking after your feet:
Wear sensible shoes which are well fitting.
Use a rough Pumice Stone on hard skin.
Use a good moisturising cream on the dry areas.
Swab surgical spirit between toes after bathing.
AVOID treating your corns by using so-called corn cures, harsh medications or chemical compounds which may contain acids.
AVOID cutting your own corns and callus using any manufactured device.
FOR RELIEF
Always make sure that you consult a Chiropodist for treatment and advice with years of experience and training. Also try to make a visit to him part of your regular health check to prevent problems before they start.
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​Ingrowing Toenails
What are they?
A true ingrowing toenail is where a shoulder or splinter of nail pierces the skin
at the side of the nail.
Where?
The most common nail affected is the big toenail.
It is most commonly found in teenagers, especially boys.
Causes?
The main cause is poor nail cutting
- cutting the nail too short
- digging down the sides
Poor footwear - shallow, pointed shoes
What does it look like?
The toe will be tender and may throb. It will also become red, warm, swollen and, if severe,
infected, some pus discharge may be seen.
Where the piece of nail enters the skin a hole is formed which provides a good source of
infection which commonly accompanies this condition.
TREATMENT - Depends upon the severity of the case
It may simply involve the careful removal of the piece of nail which has penetrated the skin,
followed a month or more later by a packing placed between the edge of the nail and the
groove, which allows the nail to grow over the skin properly.
Sometimes the part is so sensitive the toe needs to be numbed first,
this can be done easily in the practice using a local anaesthetic
which is always available providing you have no medical contra-indications.
Been there - But it is not better!
If the area has not significantly improved by about 4 days following treatment,
you MUST return to the surgery, as probably there was more than one spike causing trouble,
this too has to be removed.
Often I see and cure patents who have been
elsewhere without success.
Done that - Fed up now
If the nail keeps ingrowing,
then a more permanent treatment is available
where we remove the offending side of the nail
(leaving the centre of the nail as it is),
& permanently kill a bit of the nail root. See below.
What else?
Often pain in the nail groove is not due to the nail
itself growing in, so ensure if you have any
problems with a toe, make sure you consult
a chiropodist.
But it feels better now!
The commonest mistake with ingrowing toenails is where treatment is postponed because the pain has gone. Unless the ‘spike’ has been removed the pain will return again, often worse. Taking antibiotics to clear any infection present is almost pointless without the cause being dealt with, and can needlessly allow delay in solving the problem.
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A Permanent and Pleasant Cure!
WEDGE RESECTION + PARTIAL AVULSION + MATRIX PHENOLISATION.
This procedure was developed originally in America in the 1950’s and became the radical treatment of choice by the 1980’s by members of the Society of Chiropodists and the Podiatry Association (the only medical bodies trained in this advanced technique of skin surgery).
Preparation
A case history is made and any medical conditions are taken into consideration before the operation is performed. This is to ensure your absolute safety, if you have had dental anaesthetics before, are reasonably fit, and have no artificial implants there should not be any problems. Queries may need to be checked with your doctor. You cannot expect to have an operation without visiting here at least once beforehand.
Surgical Treatment:
The operation is performed on an outpatient basis and is completely painless. The time taken varies with each
case and depends upon how many sides of nails are requiring treatment, (usually between 45 and 90 minutes).
A local anaesthetic is administered to the base of the toes to be treated, you will normally be lying down during
the whole procedure. The numbness will last approximately two hours. You must be accompanied home after
the operation. Do not consume alcohol for 24 hours before of after, or take any drugs without consultation with
the chiropodist. The edges should not be sore after this time anyway, depending on what is intended you
probably can continue afterwards with your normal daily routine. Elevation, rest, and an ordinary analgesic
might be needed but only in rare cases that feel uncomfortable. This operation is carried out under proper
sterile field conditions so needs to be booked at a mutually convenient time as I do need to arrange an assistant to be available.
Afterwards?
That night as the soonest, three days later at the latest, the dressing will need to be changed. You will be supplied everything you need apart from a pair of scissors. You bathe the toe, take the dressing off underwater, scrub the area well, dry with a clean towel, apply the antiseptic, non-stick gauze, and bandage as shown. Some days after the operation the groove discharges a sticky fluid, this is a healthy sign and needs to be encouraged. When this stops you no longer need to redress the part, this takes often two to nine weeks. It is sensible practice to ensure that the operation is carried out at least 3 weeks before a holiday is planned.
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Athletes Foot (Tinea Pedis)
Definition: This is a skin disease caused by a fungus.
It appears commonly in three types: Sogginess of skin and peeling in-between toes.
Eruptions of small white or red blisters on soles and sides of feet. Dry skin,
redness and scaling on soles of feet. All above may itch and therefore become sore,
if scratched will spread more rapidly.
Tinea Pedis is infectious and thrives where there is moisture and darkness, therefore,
the foot in a shoe is an ideal breeding area.
​
TREATMENT
1. Avoid nylon socks and plastic shoes. Use natural materials, e.g. leather or canvass for shoes, cotton or wool for socks. Do not wear the same pair of shoes for two days running.
2. Wash feet regularly using soap and water. Dry thoroughly using a personal towel. Swab surgical spirit between toes after bathing.
3. Use recommended products for the infection, taking the advice of a Chiropodist. However most ‘Athletes Foot’ treatments sold these days are effective in 3 out of 4 infections. (If the product chosen has not worked after 1 week, simply try another make).
4. Be aware that the infection can be picked up in swimming pools, showers, baths at home or at work. Sauna’s and Steam Rooms are particularly likely to encourage this condition.
PRODUCTS
What type you choose will be dictated by the site of infection and your convenience. Bear in mind that the product will normally need to be applied twice a day, for ten days!
Creams - ideal on soles, arches and heels, only if you can reach. Some creams may cause clamminess between toes, so do check first before purchasing.
Liquids - suitable to be directly painted anywhere on unbroken skin, economical, but very fiddle to use, and you need to be able to reach your feet quite well.
Powders - messy, can cause ‘mud pies’ in between toes. Useful though for those who cannot reach their feet easily.
Sprays - smelly and wasteful, however so easy to use this type is the treatment of choice by many people.
PREVENTION IS BETTER THAN CURE
DIAGNOSIS
Many nail and skin conditions that appear on first inspection to be caused by a fungus, may be a symptom of another condition.
Laboratory tests are required to specifically ascertain which organism (if any) is the problem. This can take weeks and is expensive. Treating ‘Athletes Foot’ usually clears the problem before we know specifically the cause!
Referral to a Dermatologist by your G.P. can be advisable in rare cases.
Complications :- Athletes Foot should always be treated as the fungus can spread causing unsightly discoloration and thickening of the toenails. This is very difficult to deal with.
Toenail Fungal Infection (Onychomycosis)
Fungi are often present in low numbers within nails as a harmless resident.
Sometimes conditions within our shoes are so favourable to fungi (dark warm and moist),
that numbers increases to the point where this becomes unwelcome.
Affected Nail Appearance :- Usually brown, crumbly, thick, and uneven. Has a dank odour.
Treatment for a Big Toenail :- Either paint a liquid fungicide onto the nail twice daily for 18 months
until appearance is normal. Or daily for 3 months using terbinafine* take a fungal antibiotic tablet
(18 months daily using Griseofulvin).
The liquids are far from guaranteed to be successful, particularly as it is easy to miss one days treatment. The tablets have medical contraindications associated with them, and are ‘Prescription only’ you will need to discuss this option with your own G.P.
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Verrucae Pedis
(Click Here for Latest Excellent Idea)
What are they?
Verruca is the Latin term for ‘Plantar Wart’.
Simply a lump of hard skin which DOES NOT
grow inwards but is “flattened” by the action
of walking.
How are they spread?
The verruca is caused by a virus infecting the skin.
It is not understood exactly how they are spread.
In the past it was argued that, there was more
chance of getting a verruca where barefoot activities
are taking place (however this has never been
scientifically proven).
This DOES NOT mean that everyone going
swimming will eventually get a verruca, and
thankfully many pools have put signs up stating
that it is acceptable to enter the pool even if you
have a verruca.
This will help remove some common myths surrounding the verruca.
Treatment
Most verruca are NOT painful, and if left alone will eventually disappear. There is plenty of evidence to show that, once they have cleared ‘naturally’ an increased immunity to further infection is conferred. Those which are painful, often are only so due to being “messed with”, or being pinched by footwear. If it is felt the discomfort is too much to bear, or the verruca is taking much too long to disappear naturally, it can be treated effectively by a chiropodist. Zinc Tablets have been shown since 2017 to be a worthwhile remedy to try - Click here
Commonly treatments usually involve the use of chemicals, and/or machines to freeze or burn the part. Although the method used will be adapted by all practitioners to be as kind and quick as is possible, removing a verruca is often lengthy, expensive, and painful. HOME TREATMENT is dangerous and inadvisable. Most verrucae that I have actually had to treat, had been damaged by some product sold over a chemist counter (a situation that has got worse since the mid 1990’s when the restrictions on television advertising of these weak toxins were lifted).
What does one usually look and feel like?
A slightly raised hard round yellow lump with a crusty white middle containing black dots. If pressed upon no discomfort is felt, but it is very painful if pinched. Usually there is only one or two ‘blobs’ and most people are unaware of them until pointed out. They can be more sensitive first thing in the morning, when hot, and after exercise, when a sharp twinge is noticed as the heart pounds. Sometimes a few centimetres of skin is affected by a different verruca virus causing a ‘Mosaic Wart’, this type is particularly resistant to treatments.
Private Swimming Pools, and Children
Sometimes owners of premises outside state control insist that “verruca socks” are worn. Whilst there is no evidence these work, they can alley the prejudice of others. (Care should be taken as they can cause slipping - if only one foot is affected only wear one sock).
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Reasons For Treatment.
Usually the reason a Chiropodist will agree to treat a verruca is:
1) The verruca has been “messed with” already, either by the application of ‘wart cures’ in the home, or unqualified practitioners having damaged the skin, and it is felt the bodies defences consequently have been compromised.
2) Social pressures upsetting the patient, commonly in the form of victimisation, often hearsay & the prejudice of other people stops the person following a ‘normal’ lifestyle, i.e. believing they are prevented from swimming.
3) If the verruca is on a part of the foot that means it regularly gets pinched, and the discomfort is constant.
4) Systemic medical problems that mean the patient is unable to deal with this minor infection naturally.
5) The infection appears to be seriously spreading (although this is usually due to one or more of the reasons above).
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IDEALLY LEAVE THE VERRUCA ALONE! THIS CANNOT BE EMPHASISED ENOUGH
However if a more radical method actually is requested, there are several factors to be taken into consideration:
a) How quickly the verruca needs to be cleared up. b) The medical history and current health of the patient. c) Whether a scar left afterwards would be a problem. d) If previous treatment attempts prevent hope of success now. e) How sensitive is - the patient/that part of the foot. f) Cost.
Inescapable Consequences of Treatment
If you are trying to kill a bit of skin containing a verruca it will hurt! Our skin is full of nerves which will be extra sensitive, especially if the part is or has been cut away or damaged by a chemical.
The only trade off we can do is cause a little pain over several weeks, or cause a great deal of pain for a day or two. Analgesics, and anaesthetics may only be helpful in reducing suffering.
There is no treatment guaranteed to work, and having a verruca treated once unsuccessfully makes it considerably more difficult to get any other method to work in the future, so if treatment must be done choosing the right one first time is critically important.
Very Common Treatment Procedures in the UK
Cryotherapy The verruca is frozen twice, a pad made to keep the pressure off afterwards. (I sometimes will still offer this old-fashioned treatment when clinically indicated). Each treatment is finished the day you come, but may need repeating not sooner than 6 weeks again.
Strong Acid Based Ointments Put inside a pad onto the verruca, kept in place and dry for one or more weeks, when you return to the surgery I remove the pad and wart or repeat the treatment. Pain at home during this treatment is often much relieved by elevating the part and taking an analgesic, but rarely is there discomfort in the surgery. This commonly used method always requires you return to the practice on the appointment day booked. Often it will take two to six weeks of treatments to work.
Liquid Caustics Applied to the verruca directly. This is an accurate but lengthy, therefore expensive, treatment. It is usually painful during applications at the surgery, but less of a problem at home and work. It can easily take several months of applications twice a week.
Surgical and Electrical Sometimes an ideal treatment for adults, although it does require a local anaesthetic, and can leave scar’s.
Home (Bought from Chemist) Acid Treatments Every patient I have seen try these has had no success, found they caused harm, or if the wart went, success is easily attributed to the body having cured itself (which happens all of the time and almost always it would be better to let the body cure these themselves anyway).
Less Common Treatment Procedures in the UK
Herbal Remedies A simple application of a concentrated plant extract after removal of the overlying hard skin can be an ideal treatment especially for a very nervous patient, or someone who does not mind waiting a little longer for a resolution.
Immune Response Triggering This procedure I seem to be using more and more, it does involve a little discomfort in the surgery but has such clear benefits above most other treatments that often make it a first choice where a professional intervention is indicated.
SUMMARY:
I hope you have not been frightened by this leaflet, but I aim to answer most questions people are reluctant to ask. The trends have changed over the years, in 1979 I treated over half of the patients seen with verrucae, from 1993 until 2004 I treated on average just two verrucae each year, so the prejudice making people want to treat them has been slowly disappearing against them. By 2011 (when I last updated this page) I appear to be treating about one in eight verrucae that I see, most often using an "Immune Response Trigger" method rather than any other choice. Seven out of eight people I see choose to let the verrucae eventually go themselves untreated.
KNOWN FACT - 75% of all verrucae clear themselves in under 2 years.
KNOWN FACT - 33% of warts tested also had the virus in tissue 5-10cm away from the hard skin lump (coincidentally KNOWN FACT - 33% of all independent researched “successful” treatments had new re-growths 1 year later).
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Bunions are what ?
Definition
Everyone appears to have their own unique understanding of what the term “bunion” means.
Naturally this causes much confusion, and is of real concern to practitioners when asked “Should
I have my bunions done”. As the answer will depend on what the patient thinks they mean.
“Bunion” is simply the Latin word for a lump. It is not a medical term, and is sometimes quite
rightly used to describe any lump located anywhere. Typically a home dictionary says it’s an
“inflamed swelling on the big toe”. However the picture here is of one of my patients who says
she has a bunion, but the big toe itself is not inflamed, nor does this foot cause pain or require surgery.
Indeed if the ‘lump’ on the inside of the foot was taken off here the whole structure would collapse as
her bunions are rather useful “props” that have been formed naturally over the years as a defence
against the internal forces of an unsteady ankle joint which has resulted in the end of the first and fifth
metatarsals (the bones which connect the big and little toe to the rest of our skeleton) moving outward,
as a compensation preventing the foot rolling excessively from side to side.
When is an Operation needed ?
If any part of a foot is actually causing pain, then something will need to be done. Sometimes padding, sometimes exercise, and in addition to this sometimes an operation. The sensible approach will depend on what the bunion actually is, and where it is. Below assumes it is the first metatarsal head area that is affected (the part behind the big toe).
​
Is the lump soft ?
Sometimes we grow a “buffer” made of fat,
this easily can be removed by a simple operation if it annoys.
Sometimes the lump is a ‘bursa’ (a natural bag of grease) that we form
over prominence’s that rub, this too is simple to remove if causes
annoyance. Although both of these tend to occur only because we
needed some protection from shoes rubbing, so they actually are a
friend.
Is the lump hard, and the First
Metatarsal still straight ?
Then the problem is an “exostosis” or extra bone grown on the side
additional to what is needed, this is simple to remove with surgery,
but often re-grows again, as it formed because of injury to that part.
Is the First Metatarsal curved ?
This is an intrinsic change within the natural design of the foot to
compensate for stresses that make you unstable. Often due to an ankle
joint misalignment from birth, making your foot once it has stopped
growing, unsteady when on level ground, (this is what is happening in
photograph above). This can happen to people who have never worn
shoes, so it is unlikely ill-fitting footwear are to blame.
The curvature can be prevented from beginning using “ORTHOSES”
(custom made insoles prescribed by a Podiatrist who is an expert in
biomechanics), if caught in time. Children of those with a family history
of bunions should always be checked over for their ankle alignment by
their School Chiropodist. In adults with existing bunions surgery can be unsatisfactory unless they too had the alignment of the heel and forefoot corrected using orthoses.
Exercises
Wiggle the big toe from side to side on it’s own. Many people find this takes about 3 weeks of ‘mind over matter’ before they remember how to do this at will.
Complications
Any lump is likely to catch footwear, which is likely to result in corns, blisters, ulcers, abscess and/or chilblains. All can be treated by a Chiropodist.
Devices sold claiming to straighten an existing bunion are simply a con and should be avoided.
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INFORMATION SHEET
FOOT CARE FOR DIABETICS
HOW DOES DIABETES AFFECT YOUR FEET?
In diabetes changes occur that make you more prone to serious foot problems. Changes take place in the blood vessels in the legs and feet which result in a less efficient circulation of blood than in a non-diabetic of similar age. Also damage to nerves occur which may cause a reduction of sensation in the feet. Because of this lack of feeling you may not be aware of injuries to the feet, and damage to the skin or underlying tissues may go unnoticed. Small injuries to the feet even if painless will take longer to heal and provide an opening for infection which may spread rapidly because of the poor circulation. It is important therefore to examine your feet regularly and treat them with great care. Your perception of hot and cold may also be affected so try to avoid direct heat from fires or hot water bottles, (remove hot water bottles before getting into bed).
FOOT HYGIENE
Do not soak your feet, but try to wash them daily or less. Use lukewarm water, NOT hot water (purchase a bath thermometer and use it), and dry carefully especially between the toes, but avoid rubbing the skin or forcing the toes apart (cotton buds may be helpful).
FOOTWEAR
Wear good fitting lace-up shoes that do not pinch the toes. It is important to check that your shoes are deep enough in the toe box as well as wide enough. Only wear slippers for short periods, consider ‘trainers’ (sneakers) instead especially during a day when you are likely to be standing or walking. Never do barefoot. Remember that tight socks or stockings can be just as damaging as tight shoes. Do not darn or mend socks as this cause seams. Never use garters which can restrict your circulation.
FOOT CARE
If your skin is very dry, use a plain moisturising cream, but use it sparingly, and do not use between the toes. If your skin is often moist it can help to wipe with surgical spirit especially between the toes (seek medical advice if there is any splitting between toes before however).
If you must cut your nails yourself; cut them straight across. Do not cut them short, and do not cut into the corners. Avoid clearing the edges of your nails with anything other than a soft brush as instruments might easily injure the skin irreversibly.
FOOT PROBLEMS
If you have painful or troublesome nails, corns, hard skin, or indeed any foot problem do not try to treat them yourself. NEVER USE CORN PLASTERS or solvents as these contain acid and are extremely dangerous. For routine treatment always ensure you consult a Chiropodist privately who is recommended by your local N.H.S. clinic. Although your feet will be regularly monitored at the nearest designated Hospital Diabetic clinic this often is only adequate if you have no lesions.
If you experience pain or throbbing or colour changes or notice discharge from your toes or any part of your feet or leg, you should seek advice from your practitioner immediately.
FOOT NOTES
Remember that with diabetes if you have a foot problem, you may not feel a lot of pain, it is important to inspect your feet at least once a day to look for possible problems. Correctly fitting footwear and good chiropody care often means you can avoid serious complications.
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INFORMATION SHEET
CHILBLAINS
This is a skin problem caused by an extremity becoming frozen, then thawed out incorrectly.
It affects children and the elderly more commonly than anyone else, often with the tendency
running in families. It usually goes through three stages, the duration of each varies
considerably.
1. The part is white and numb due to being exposed to cold and inactivity.
2. The area becomes red, tender, hot, and swollen, often in patches.
3. The skin is dry and peeling, sometimes warm but blue.
During any stage the part is very delicate and often intensely itching. If scratched or damaged the skin may break open allowing an entry for infection.
TREATMENT
a) Prevention is the best approach. If you know you are prone to chilblains; early autumn (September-October) ask you Doctor if you are able to take a course of tablets to prevent chilblains before the cold weather arrives.
b) If you are going out in the cold; wrap up warm all over, wear thick roomy shoes or proper hiking boots (yes this is worth it) and thick socks (tights and thermal socks are excellent), gloves on your hands, AND A HAT (25-33% of body heat is lost through your head). Also keep moving.
c) When you get cold; do something active to get your blood circulating before going into a warm room. Perform vigorous exercise to thaw out before taking a hot bath.
d) Gently massage affected parts with a proprietary chilblain ointment regularly and avoid the part getting squeezed or scuffed by tight or sloppy footwear. Protect the area with a lint bandage and cotton wool.
e) If the chilblain breaks it may not necessarily bleed but treat it as though it is an open wound. Clean the part, apply a mild antiseptic (i.e. Savlon ointment) and bandage the part with sterile gauze, then seek professional medical attention.
The condition is a form of frost bite, and great care must be taken to prevent further damage. The easiest way to cause a chilblain, is stand at a bus queue for a while in winter, then sit with your feet in front of the bus heater.
TIP
Warm the middle of your body up before your hands and feet to allow the blood inside you to thaw them out rather than an external source like a hot bath or a fire.
N.B. Not all skin anomalies are chilblains. If you have any problems with your feet, always ensure that you see a Chiropodist
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Training to be a Chiropodist/Podiatrist
Only carried out as a degree at an accredited training school. It is still possible to complete the basic full-time study course in 3 years.
Please contact the ‘Royal College of Podiatry’ for full details. Careers In Podiatry
College of Podiaty - Contact Tel: 020 7234 8620
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Existing colleagues and Podiatry students please do email me
Due to poor changes in the law you may find Chiropodists who are currently working quite legally who
have only carried out a correspondence course of training.
Ask yourself - would you let yourself be treated by a Dentist, Optician, or Doctor who claimed they learned
their profession doing a postal course?
Before July 2005 if a Practitioner was not a STATE REGISTERED CHIROPODIST he or she could not work in any N.H.S. Clinic or Hospital or work for them on the Community as a Chiropodist or Podiatrist - After 2005 all someone had to do was prove they had worked privately as a Chiropodist for two of the preceding five years to be able to continue calling themselves a Chiropodist or Podiatrist regardless of what if any training they had.
Eventually the above position will not be an issue providing the new regulatory body: The Health Care Professions Council (HCPC) does their job properly. It may take another 55 years of course!
This page last edited 25.11.2024 by Jonathan Lees. All rights reserved.
