BLOG - REGULAR BLOG BY JANET McGROGGAN - PRINCIPAL PODIATRIST 

Heel Pain… Plantar [email protected]#?* Plantar Fasciitis - Do I have it? What do I do? 
 
In this blog, I just want to give you some information about what this may feel like and the first line of treatment because I’m sure if you are reading this then you are in pain and want that to stop!!! 
 
Do I have it? 
 
Do you have heel pain like a bruised feeling or arch pain? This one is usually a sharp pain. 
 
Generally, the pain is at its worst in the morning, gets better with walking but can come back after activity. It often returns after sitting down for a while. Some mild cases may only cause problems after running. 
 
Ok, I have these symptoms, now what do I do? 
This week's blog talks about a relatively new treatment for verrucae which is great if you are busy because it's a one-off treatment with reviews roughly every two months. 
 
It's called needling and, yes, it could do with a less scary name but it is what it is!! 
 
Needling was first carried out in America in 1969 and success rates of 70 – 90% after a single treatment are common. 
 
One verrucae will be selected to treat and the surrounding area anaesthetised. 
A caustic is a substance that is destructive to living tissue. Podiatrist have access to several with different actions, my favourite is 60% Salicylic Acid.  
 
It destroys Keratin, a protein that forms part of the epidermis where the Verrucae lives. This painless treatment is usually well tolerated. 
Cryotherapy is the destruction of diseased tissue by extreme cold. 
 
Your podiatrist will remove any overlying callus and the probe will be held closely to the lesion. An application will last 10—15 seconds and may be a little uncomfortable. A second application may be used. 
 
Afterwards the treated area will be covered. This area MUST be kept dry for 24 hours. 
Can't you just cut it out? Has it got roots? What are the black spots? 
 
All valid questions, all shall be answered. 
 
What is a Verrucae? 
 
A verrucae is a virus that affects the epidermal layer of our skin. It is known as the Human Papilloma Virus (HPV) and there are more than 90 types of HPV. 
 
Viruses are microscopic. But, what you can see are the distorted skin cells that the verrucae has invaded. There may be small black dots which are capillaries (tiny blood vessels). 
 
A verrucae may be a single lesion (plantar wart) which on weight bearing areas can be quite deep and covered with hard skin. Or grouped together as multiple or mosaic warts (cutaneous warts) which are generally more superficial. 
 
Verrucae are spread by the transfer of a virally infected cell in a damp environment. 
 
So, cover it with a plaster if you are sharing a shower or bathing area. 
If I had a pound for every time someone asked me this... I'd never need to work again! No, seriously this is the enigma of the podiatrist. So here we go... 
 
The titles of Chiropodist and Podiatrist are protected in the UK and this means that only professionals qualified and registered can legally use these to define their profession. Essentially the two are interchangeable but this can still be very confusing. 
 
So, what is the difference? Well, my degree is in Podiatry but one of the things I do is chiropody. There. Cheerio. 
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