Chilblains – a winter blight that can affect us at any age…a blog by UK podiatrist Martine Abrahams

The other day I was asked by one of my patients about chilblains – not something one hears much about these days, so I decided to jot down some info on this bone fide medical condition

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Chilblains, otherwise known as ‘pernio’, are small, itchy, painful lumps that can develop on the skin.  Found on eithers hands or feet, they are caused by local poor circulation when the skin is exposed to cold.

Not a prolonged condition, these irritating lumps settle after about 7 – 14 days but if you are susceptible to this abnormal response to the cold, you should try your best to keep your extremities warm in winter.

Who suffers the most from chilblains? – Chilblains can strike at any age and both men and women suffer in equal number.  It’s thought that around 1 in 10 people in the UK suffer from chilblains, not only hands and feet they can also occur on the nose and earlobes – anywhere that becomes cold quite quickly, for example, horse riders might have problems with their lower legs and thighs….

Causes of chilblains  – The reasons why some people are susceptible and others not is unclear, but we do know that the small blood vessel lying under the skin constrict when cold, which in turn reduces the amount of blood supply getting to the area.  As the skin warms there is some leakage of fluid from the blood vessels into the local tissues.  Inflammation and swelling result, leading to the symptom of chilblains.

Prevention is better than cure with this uncomfortable complaint:

  • One of the key ways to help avoid the chilblain taking hold is to avoid warming your self up too quickly after exposure to cold – avoid hot water bottles, sitting next to direct heat etc
  • Keep head, ears, hands, feet warm when outside in cold weather (heated glove and sock inserts can be a real help)
  • Keep the body as warm as possible – loose layers are best to trap body heat
  • Keep body and extremities as dry as possible
  • Some medication can constrict the blood vessels which leads to chilblain susceptibility – beta-blockers are one example

Chilblains are uncomfortable but do not tend to leave lasting damage. If they become a real issue your doctor might consider a drug to help dilate the small blood vessels, but this is rarely indicated.

So, condolences if you are a chilblain sufferer!  Also, apologies for the lack of really constructive solutions for this sometimes debilitating problem.  The good news is that you only have another 4 or so months to avoid the cold – spring will be here before you know it!

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One New York fashion editor swaps heels for flats – your feet will thank you says Martine Abrahams, UK leading podiatrist

American Elle’s fashion editor, Lauren Sherman declares that she’s fed up of the constant pain and discomfort caused by the heels that have gained almost ‘uniform’ status for fashion industry set.

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As  demonstrated in this amazing 3D xray, heels push the foot forward, causing the toes to bend in an unnatural way.  Pressure also builds up on the soft pad under the toes, referring pain back to other structures of the foot, i.e. ankle and metatarsals.

I have explored the blight of bunions in previous blogs, these common deformities are another uncomfortable result of wearing heels.

With my podiatrist hat on, I applaud the actions of Ms Sherman and hope that others will follow where she leads.  Is now the right time to warn her of the foot arch damage potentially caused by flat shoes? Maybe another time…!

Leading UK Podiatrist and nail laser specialist, Martine Abrahams to talk at 2013 UK Society of Chiropodists and Podiatrists’ annual conference

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ACC Liverpool 13 – 16th November 2013

The UK’s leading nail laser specialist, Martine Abrahams of the London Nail Laser Clinic, will be presenting at this year’s conference.  She will be showcasing the state-of-art low level Lunula Laser – the only PAINLESS, bone fide treatment on the market for treatment of nail fungal infections.  As the clinic director of a successful, growing business, part of her talk will also incorporate some business development advice.

As seen on ITV’s This Morning: http://www.lunulasuccess.com/media.aspx

Lunula Low Level Laser explained:

Until now, treatments for fungal nail infections have been rather hit and miss, with oral medication causing side effects, topical treatments unable to penetrate the nail bed and surgical options limited to complete removal of the nail.  The PinPointe Foot Laser proved a useful (but uncomfortable) remedy.  In 2012, the Rolls Royce of foot lasers launched – the ‘cold’ laser or Lunula Low Level Laser – and is now in the UK, revolutionising fungal treatments.  Not only PAIN FREE, this innovative technology tackles the underlying cause of the infection, rather than just the symptoms.

How does it work? Unlike conventional solutions, the Lunula Low Level Laser is the first treatment to tackle the root cause of nail fungus – not just the symptoms.  Known as the ‘COLD’ laser – this new device does not rely on heat to treat, instead utilises two light wavelengths, 635nm and 405nm, to tackle differing cell membranes.  The light is passed over the whole foot, which has a four-fold benefit:

  1. stimulates and improves nail bed blood supply (great news for diabetic patients)
  2. improves immune response
  3. breaks down the fungal cells walls by disturbing their oxygen content, killing spores
  4. can also improve Athlete’s Foot

BEFORE Lunula Laser:

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AFTER 8 MONTHS:

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Course of treatment: 4 x 12 minute sessions required. Results are seen over a few months, with a fabulous new nail growing through in around 12 months

Contact details:

London Nail Laser Clinics:

  • London (Harley Street & Moorgate)
  • Bristol
  • Chester
  • Hertfordshire (Radlett)
  • Worcester (Bromsgrove)

t: 02074678542   w: www.thelondonnaillaserclinic.co.uk

For more information or to interview Martine Abrahams please contact Philippa at Urban Fox Communications 07970056694 / philippa@urbanfoxcomms.com

The London Nail Laser Clinic opened in 2009 by podiatrist team, Martine and Michael Abrahams. With more than 16 years clinical experience, Martine Abrahams has become widely accepted amongst peers as THE UK expert in laser foot therapies.  UK pioneers of the PinPointe Foot Laser, Martine and Michael recognised the improved benefits offered by the Lunula Laser system, and were the first to bring it to the UK in the autumn of 2012.  Now housing 8 laser units, the London Nail Laser Clinic is recognised as THE leading UK nail laser clinic, as well as being a centre of excellence for all foot related issues.

As the sportsman’s injury, plantar fasciitis makes sports headlines in the USA, UK podiatrist, Martine Abrahams sheds some light on this common, often debilitating condition

Image Albert Pujols, player for Los Angeles Angels of Anaheim, the latest elite athlete left sitting on the bench, thanks to plantar fasciitis

High profile athletes might create headlines, but this painful condition can affect us all.

The plantar tendon and its function:

The plantar tendon runs the length of the bottom of your foot, spanning the area from the base of the toes to the front of your heel. The two ends of the tendon attach at the base of the toes and at the front of the heel bone by means of fascia, a strong fibrous membrane. The plantar tendon keeps the arch of the foot from flattening completely when the foot bears weight, providing cushioning and shock absorption during walking, running or standing. This tendon also allows you to point your toes.

What is Plantar Fasciitits?

When the plantar fascia tissue is stressed, small tears can occur, which in turn, causes extreme pain during movement or even weight bearing – or any movement that creates a pull on the tendon.

Stressors can be varied in nature and include: regular exercise/sport, heel striking during striding, tight calves, inflexible Achilles tendon and wearing high heels.

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Other common causes of plantar fasciitis include:

  • Wearing inflexible or worn out shoes
  • Very low or high arches
  • Being overweight
  • Spending long hours on your feet
  • Tight calf muscles or tight/stiff ankle muscles
  • Walking barefoot in soft sand for long distances
  • Those with natural flat feet (hyper-pronation) seem to suffer this condition more than others

Symptoms of Plantar Fasciitis:

Pain can be extreme and is often felt on the underside of the heel and more intense at the start of the day:  “You almost want to pee in your bed rather than go to the bathroom,” Pujols told USA TODAY Sports. “It’s really painful in the morning.”

Treatment:

This condition can be difficult to treat and, perhaps most annoying for those who enjoy exercise, is that the main solution is rest, combined with physiotherapy, anti-inflammatory medications, corticosteroid injections and/or night splints to stretch the injured fascia.

As a short-term pain relief measure, you can roll the bottom of the foot back and forth over a tennis ball or cold bottle of water, to gently stretch out the tendon and disperse the fluid that pools there.

Stretching exercises can also help:

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Orthotics can be worn to help support the foot arch:

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Ultimately, prevention is probably better than cure where plantar fasciitis is concerned.  Wear good shoes with adequate arch support; stretch the area well before and after exercise and regular foot massages will all help.

Watch out pregnant women – it’s not only your bump that gets bigger – often feet do too! Laser expert podiatrist Martine Abrahams talks feet and pregnancy

Image  Watch out pregnant women – it’s not only your bump that gets bigger – often feet do too!

As if the hot summer months weren’t enough to bear, try adding a 7lb bump and swollen feet into the bargain – not much fun!

Why do feet get bigger?

The obvious reason is fluid retention.  Gravity pulls fluid down to the lower extremities resulting in ballooning ankles and.

A lesser-known cause of enlarging feet during pregnancy is due to the secretion of hormone ‘relaxin’  during the 2nd trimester of pregnancy.  This aptly named hormone helps to keep pelvic joints loose and ligaments soft, offering the baby a smoother journey down the birth canal.

Sadly, it’s not just the abdominal ligaments that loosen – those in the feet can too, resulting in toes spreading and feet seeming to get bigger.

Are the changes permanent?

Thankfully any fluid build up will subside after the baby is born, however for those of you who have suffered negative effects of softening ligaments, this could well be permanent.

Some women claim their feet have grown up to one size post pregnancy!

What can you do?

I advise if you can, to wear larger shoes that sit comfortably for the duration of your pregnancy. Try not to invest in anything too expensive, as you may need to revert to your old shoes around one month after the birth.  Wearing tight shoes can cause or aggravate bunions or other painful foot issues such as ingrowing toenails, corns and calluses.

Image     The good news is that your pregnancy will only last 9months (if you’re lucky!) The bad news is that your feet could grow with each pregnancy, so maybe hold off that Blahnik treat until after your family is complete!

Festival goers BEWARE – fungal spores lurk in dark, damp conditions, waiting to take hold in those vulnerable nail beds!

Glastonbury Festival 2013 is upon us and I hope all you intrepid campers have fun in the sun…Image

…but, JUST in case the British summer does what it does best, please remember to take good care of your feet Image

Clearly foot care will not be your number one priority, but maybe it should move up the list – at least a little!  

Why? Fungal spores love dark, damp and dirty conditions and the fields of the Glastonbury Festival provide the perfect breeding ground – especially when the heavens open!

During the summer months I see an increasing number of holidaymakers who made the brave decision to camp in the UK, only to come home with fungal nail infections and Athlete’s Foot.  

Fungal spores enter via any small break in the skin integrity and soon take hold.  Once established, the infections can be difficult to eradicate.

 Here are some practical tips to help avoid nail fungal infections during the long weekend:

Trim your nail short before you go

Dry feet thoroughly after bathing – try to keep your towel clean and dry (!)

Wear 100% cotton or wool socks – helps absorb the sweat and moisture 

Wear shoes that have wide space for your toes to ‘breathe’

In wet and moist areas, avoid walking in barefoot

If possible, wear shower shoes, sandals or flip flops when going to public areas

Before going to bed, try to thoroughly dry your feet

NEVER share shoes and sandals with others

Avoid injury to nails, nail beds, and nail plates 

If you do suspect a fungal nail infection has taken hold, then book in to see your local podiatrist.  Over-the-counter solutions are not particularly effective and you may well need a more sophisticated treatment such as state-of-the-art Lunula Laser. 

Symptoms of nail fungus:

  • Thickened nails
  • Crumbly or brittle nails
  • Nail distorted in shape or separated
  • Nail with no lustre or shine
  • White, yellow or brown coloured nail

How does it work? Unlike conventional solutions, the Lunula Low Level Laser is the first treatment to tackle the root cause of nail fungus – not just the symptoms.  Known as the ‘COLD’ laser – this new device does not rely on heat to treat, instead utilises two light wavelengths, 635nm and 405nm, to tackle differing cell membranes. 

Have a fabulous time – if nothing else, keep your feet happy by avoiding walking barefoot around the venue, and let’s hope you will all be basking in sunshine. (I’ll save my sunscreen lecture for next year!)

UK’s leading laser Podiatrist Martine Abrahams talks GOUT – “the disease of kings”

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The topic for my blog this month is gout – an unpleasant and often debilitating disease, which can put you out of action for several weeks.  There have been a number of high profile sufferers throughout history – Henry VIII, Pavarotti, Jim Belushi and more recently, Jared Leto, who contracted gout symptoms after piling on 60lbs for a film role.

The incidence of gout has increased over the past few decades and now an estimated 1-2% of the Western population are affected by it at some time during their lives.  The main reasons for this trend seem to be the Western lifestyle/diet and longer life expectancy.

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Gout is a type of arthritis, in which crystals of uric acid produced by the body, can form inside joints.

The most common symptom is sudden and severe pain in the joint, along with swelling and redness. The joint of the big toe is usually affected, but it can develop in any joint.

Symptoms can develop rapidly to their worst point in 6-24 hours and usually last for 3-10 days (this is sometimes known as a gout attack). After this time, the joint will start to feel normal again and any pain or discomfort should eventually disappear completely.

Most people with gout will have further attacks in the future.

The crystals may cause two problems:

  • Some may spill over into the soft lining of the joint (synovium), which causes the pain and inflammation associated with gout
  • Some pack together to form hard, slowly expanding lumps of crystals (“tophi”) which can cause progressive damage to the joint and nearby bone; this eventually leads to irreversible joint damage which causes pain and stiffness when the joint is being used

Factors that increase your risk of gout include:

  • age and gender
  • being overweight or obese
  • high blood pressure or diabetes
  • close relatives with gout (gout often runs in families)
  • long-term kidney problems that reduce the elimination of uric acid
  • a diet rich in purines; such as frequently eating sardines and liver
  • drinking too much beer or spirits – these types of alcoholic drinks contain relatively high levels of purines

There are two main goals in treating gout, relieving the symptoms with painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) and preventing future attacks with Allopurinol which can help lower levels if uric acid.  Lifestyle changes can also help – reducing weight and alcohol intake.

Some good news for us women – men are more likely to suffer gout, as oestrogen reduces a woman’s levels of uric acid by increasing excretion of uric acid via the kidneys.  Sadly however, we catch up with men after menopause!

Gout can be very painful and distressing, but if you do suffer from acute episodes don’t despair, as attacks are usually short lived and lifestyle changes combined with anti-inflammatories can help a great deal.