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Systemic Conditions

Learn more about the different conditions we treat.

Click the underlined treatments for more information


Diabetes and Foot Care

Diabetes can cause damage to the nerves in your feet and blood circulation, and can increase your risk of foot ulcers, infections and amputations.

Nerve Damage

Poor diabetes control can cause nerve damage to feet. Symptoms include:

  • Numbnes, tingling, pins and needles sensation in the feet

  • Burning pains in the legs and feet, usually more noticeable in bed at night.

These symptoms can result in a loss of sensation in the feet which increases the risk of accidental damage because you can’t feel any pain.

Blood Supply

Poor diabetes control can reduce the blood supply to the feet. This makes people with diabetes more prone to infection following any injury that breaks the skin. Signs of poor blood supply include:

  • Sharp leg cramps after walking short distances or up stairs

  • Pain in the feet, especially at rest, which resolves with walking or sitting in a dependant position.

  • Feet feeling cold

  • Feet looking a reddish-blue colour

  • Cuts which are slow to heal.

Looking after your feet​:

  • Daily care can prevent serious complications – wash, dry and check your feet every day. Check for redness, swelling, cuts, pus discharge, splinters or blisters, being especially careful to look between toes, around heels and nail edges and at the soles of the feet. If you have difficulty with your vision get someone to check for you

  • Moisturise your feet daily to avoid dry skin

  • Protect your feet in a shoe which fits well – the right length (a thumb width longer than your longest toe), width and depth – and has been checked for stones, pins, buttons or anything else which could cause damage

  • Keep your feet away from direct heat such as heaters, hot water bottles and electric blankets

  • Visit a podiatrist annually for a check up or more frequently if your feet are at high risk



If you find an injury including a cut, blister, sore, red area or open crack, immediately:

  • Wash and dry the area

  • Apply good antiseptic e.g. Betadine

  • Cover with a sterile dressing, available from pharmacies.​

    • If any injury does not improve within 24 hours, make an urgent appointment to see your doctor to avoid serious complications.

    • Seek urgent medical advice for even the mildest foot infection, including any sore, open wound or crack which is oozing, contains pus or any type of discharge or which does not heal within a week.


Gout is a condition where small crystals of uric acid form in and around a joint, causing inflammation at the affected joint. Gout usually comes on suddenly, often overnight, and usually affecting the big toe joint. The affected joint becomes very red, swollen, painful and tender to touch. 

Who is affected:

  • Males aged 40 to 50 years

  • Elderly people taking diuretic medication (medication that helps to rid water from the body).


  • Excessive usric acid

  • Hereditary

  • Lifestyle factors - drinking alcohol, dehydration, eating certain foods that are rich in purines e.g. red meats


  • Anti-inflammatories

  • Other medications to reduce uric acid levels

  • Appropriate footwear with appropriate width and cushioning, to protect joints and offload high pressure areas in the feet.


Osteoarthritis (OA) is the most common form of arthritis. This is when there is a presence of wear and tear in the joints caused by mechanical stress, resulting in grinding of the bones. 

It is commonly associated with old age. However, it is also seen in individuals with previous ankle or knee injuries / trauma. Symptoms include pain, tenderness, joint stiffness and mild swelling. The progression of this conditions could lead to degeneration of the joint cartilage, extra bone formation in and/or around the joint, and enlarged joint, leading to sharp pain and joint stiffness. 

Diagnosis is usually based on patient history, clinical examination and radiograph imaging. ​​

Treatment options: 

  • Lifestyle modification / changes

  • Pain management - paracetamol (first line), steroid injection 

  • Footwear modification - to accomodate and assist with foot deformity

  • Orthotic therapy - to provide cushioning and offloading painful joints in the feet 

  • Physical therapy - a tailored exercise could to improve function and pain of the condition

  • Surgery - this can be discussed with your podiatrist

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is a chronic and progressive autoimmune disease where the immune system attacks the lining of the joint capsule, resulting in inflammation and joint damage. 

RA commonly affects the smaller joints of the hands and feet, and it affects the foot in up to 90% of patients with RA. 


RA commonly causes pain, swelling and tenderness in the affected joints. People with RA may experience stiffness that takes a while to settle in the morning. They could also experience episodes of condition flaring up, leading to periods of inflammation.

It could also lead to permanent joint damage and foot deformities if left undiagnosed / untreated at an early stage. This is because the inflammatory reaction in the joints may weaken the supportive structures of the joint such as ligaments, and tendons, leading to tendon contracture and joint stiffness. 

Commonly experience symptoms on the feet includes:

  • Development of nodules in the feet - rheumatoid nodules 

  • Prominent forefoot bones leading to lesser toe deformities, bunion

  • Thickening of skin on the bottom of the forefoot

  • Flat feet

  • Swelling

Treatment options: 

While there is currently no cure for RA, there are many treatments available to treat the associated symptoms. 

Treatment for RA patients is tailored towards the goal of symptoms relief and improving functionality. 

  • Wearing supportive footwear with extra depth and width to improve function and limit disability 

  • Orthotic therapy to improve comfort, reduce pressure on the ball of the feet and reduce / delay the onset of retraction of the toes. 

  • Myofascial release 

  • Early rehabilitation on the soft tissue structure of the foot and lower limb

  • Regular screening of changes of the foot, biomechanics, skin condition, and neurovascular function of the foot.

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