A foot virus

verrucae

A foot virus is commonly known as verrucae or warts. Verrucae or warts are known by health professionals as the human papilloma virus (HPV).  There are over 100 HPV subtypes which can look slightly different on the skin.

What is a virus?

A virus is a tiny agent which can infect living organisms (host). The virus can copy itself inside our cells, it takes over the cell machinery and reproduces itself. The cell then bursts open, spreading the virus. There is a barrier around them making it hard for our body’s defence mechanism to locate them. Viruses infect a variety of living organisms, including bacteria, plants, and animals. 

The HPV (human papilloma virus)  

The HPV infects the skin cells in the outer layer of skin (epidermis) where it can stay undetected. They are harmless in that they don’t invade the body any deeper than the top layer of skin. They can however spread to other parts of the foot or onto the hands.

The virus causes an excess amount of keratin to develop in the top skin layer (epidermis). The extra keratin produces the unsightly and rough texture of the verrucae and wart. 

Are you sure it is a verrucae?

It is common for people to misdiagnosis a verruca, with a corn or a foreign body. If you are unsure do contact a podiatrist for confirmation as these conditions would require very different treatments.

How does it spread?

A foot virus / HPV is picked up by barefoot contact on floors and surfaces. This is most common in wet changing room floors and shower areas. The HPV can survive for up to 3 weeks without a host. The virus can lie dormant in the skin cell for up to 8 months after exposure.

The virus is passed from one person to another by infected skin cells falling off. When someone walks over the skin cells if their skin is vulnerable they may contract the virus.

Vulnerable skin can be:

  • very dry skin
  • very wet/damp skin
  • skin that has by microscopically abraded ie scuff in skin

Who gets verrucae and warts?

The HPV is so common that it is thought most people will have them at some point in their life. They are commonly seen in children, teenagers and young adults. Patients whose immune system is suppressed by drugs or a medical condition as well. 

There is an estimate that it occurs in between 5 – 30% of children and young adults. 

How does our body fight this virus?

Our immune system is designed to do this job (own immune response). It will monitor, recognise, and even remember the virus. Recognition of the virus is through the viral proteins within the skin cell around the virus. The immune system will take action to eliminate it when the virus invades healthy cells. 

The immune system does this by releasing chemicals that trigger virus-fighting cells. These cells are then sent to wipe out the enemy. Most resolve naturally in adults on average within 8 years and in children within 2 years.

However the viral proteins can inhibit the body’s reaction to the virus and as such the body remains ‘ignorant’.This means no action is taken and the virus remains.

Treatments for HPV (a foot virus)

The aim of all treatments for HPV is to destroy the virus infected skin cells and provoke the body’s own immune response. As described above our immune response should take action and eliminate, thus kill the virus from within.

There are a number of treatment options. All have success variations. 

  • No treatment – rely on body’s own immune response
  • Salicylic acids – destroy skin and burn out viral infected skin tissue, provoke an immune response
  • Cryotherapy – destroy skin cells and provokes an immune response
  • Microwave therapy – destroy tissue and provokes an immune response
  • Removal – aims to remove all viral skin cells

If you would like to come and see us for a verrucae treatment, please contact us direct or book online.

Interdigital neuroma

interdigit neuroma

More commonly called Morton’s neuroma people often describe a feeling of like having a stone in their shoe or that their sock is wrinkled up under the foot. They can get pain and numbness with tingling or burning sensation occurring in the toes or cross the ball of the foot. Shooting pains can occur in extreme cases. The pain is more noticeable on walking or in wearing particularly tight or closed in shoes.

An interdigital neuroma is an irritation of the nerve that runs to the toes in between the long metatarsal bones of the foot. For instance whilst walking or where footwear issues are particularly tight the nerve can get pinched. After that the nerve becomes enlarged due to this repeated compressed by the bones of the foot. The condition can occur gradually over time getting worse and worse and causing more pain and discomfort.

Treatment

Your podiatrist will be able to examine the area and using some diagnostic tests therefore being able to tell you whether a neuroma is suspected. The specialist podiatrist here at Zest will often use a diagnostic ultrasound scan to identify the site and size of the enlarged nerve.

Treatment options include

  • footwear changes into wide deep shoes with a lace or strap
  • insoles to help widen the space in between the bones of the foot
  • ultrasound guided corticosteroid injection to help reduce the size of the nerve

The guided injection is by far the most successful treatment for this. In addition and in extreme cases the neuroma may have to be removed by surgical team.

Plantar fasciitis

plantar fasciitis

We use the term Plantar fasciitis to describe a type heel pain. Which results from the deterioration of your plantar fascia. However, today we prefer to call it plantar heel pain syndrome or plantar fasciopathy.

Plantar fasciitis symptoms.

Plantar fasciitis is characterised either firstly by initial step pain or secondly by a pain on weight-bearing after rest. It is a very common condition, for instance around 10% of the population will suffer at some point in their lives.

The pain is usually felt anywhere along the bottom of the foot is typically located underneath the heel. As mentioned previously it is worse first thing in the morning or after long periods of rest once the foot starts moving the pain normally decreases. Plantar fasciitis can occur in people of any age but is usually in adults.

Causes

It is usually as a result of a sudden change in the loading of the heel and its associated structures this can be due to:

  • changes in activity
  • poor footwear
  • sports injury
  • imbalance in the muscles of the legs or hips
  • tight calf muscles

Often other structures than just the plantar fascia can be involved such as the nerves or tendons around the inside of the ankle. Furthermore this can often give subtle changes to the type of pain felt in the heel. Your podiatrist will ask you about this during consultation.

Treatments

The specialist podiatrist here at Zest Podiatry will then have a look at the thickness of the plantar fascia and the integrity of the structures around the area using a diagnostic ultrasound imaging. If this confirms the diagnosis of plantar fasciitis then treatment options can be discussed.

These plantar fasciitis treatment options could include:

The Zest team here will take you through the pros and cons of each treatment option so you can make decision that is right for you.

Why shockwave?

shockwave

Extracorporeal shockwave therapy (ECSWT)

Shockwave therapy is used in the treatment of heel pain and tendon injuries.

The latest research in shockwave reveals it to be as effective for plantar fasciitis as a corticosteroid injection and is very helpful for achilles tendonitis. Its use is supported by the National Institute of Clinical Health and Excellence (NICE).

At Zest we use the best machine on the market the ‘Swiss Dolarclast’. The Swiss Dolarcast is the same type that is used in the NICE research. The machine sends waves of pressure into the tissue encouraging it to heal.

Why does it work?

The machine sends shockwaves from a compressor into a special probe. The probe sends the waves into the damaged area. The waves encourage the damaged tissue to heal at a quicker rate than is normally would.

Does it hurt?

Shockwave is a non-invasive treatment so no skin is broken or damaged. It can be a bit tender during the treatment but this eases in a few seconds.

You can return to normal activity immediately as there is no damage to the area,. We may encourage you to rest and have a cup of tea after.

How many sessions will I need?

We recommend 3 shockwave sessions, a week apart. This gives you the best chance for resolution of pain. Occasionally further sessions are required, although not common we can accommodate this.

How will I know it is better?

Your pain should be gone or much less. But we will have a look with an Ultrasound scanner to see how well the damage tissue is healing.

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