Focus on Technology

At Dulwich Podiatry we pride ourselves in exploring new and innovative ways of treating your foot conditions.  This month we take a look at a few examples of the technology we use :

Photodynamic Antimicrobial Therapy

Photodynamic Antimicrobial Therapy (PACT) is a non-invasive, safe treatment for fungal nails.  After the affected nail plate has been thinned down, a blue photosensitising gel is applied to the affected nails for ten minutes to allow it to be absorbed by the fungal cells.  The PACT lamp then focuses beams of high wavelength light onto the infected nail, destroying the fungal cells and allowing a new healthy nail to grow through.

The PACT process kills 99.9% of fungus.  If the fungal infection has affected the nail matrix the effectiveness is reduced because the light cannot penetrate this area of infected nail as it is under the skin.

The treatment is painless and has no contraindications.

When should you consider PACT?

If you have a mild to moderate fungal nail infection and

• want a short course of treatment
• are pregnant or breastfeeding
• suffer with liver problems or any other condition that would contra-indicate oral medication
• using a paint on product weekly is becoming tedious.

Low Level Laser

Low Level Laser Therapy (LLLT) is the application of red and infrared light over an injured site to promote tissue healing.  The laser light penetrates deep into the affected tissue where it is absorbed by cells and converted into energy which stimulates the body’s natural healing processes, reducing inflammation, optimising repair and helping to restore normal cellular function. 

The primary actions of LLLT are:

• Anti-inflammatory – LLLT stimulates blood flow and lymphatic drainage, improves delivery of oxygen and removes waste products.  
• Accelerated tissue repair – as swelling is reduced, tissue healing is accelerated therefore wounds heal more quickly and scar tissue is reduced.
• Pain relief – LLLT provides this by increasing endorphin release and serotonin production.

Uses

LLLT is a very patient friendly treatment modality.  It is non-invasive and completely painless.  It can be used for both acute and chronic injuries and shortens recovery time while reducing swelling and inflammation

It is particularly useful for:

• Sprains, ligament and tendon injuries, muscle and joint pain
• Fibrous lesions and scar tissue break down
• Verrucae
• Wound Healing
• Pain management
• Plantar fasciitis, Mortons neuroma, bursitis, capsulitis
• Fracture healing

Note about LLLT as a verruca treatment – LLLT has been found to be particularly effective for deep fibrous verrucae as a precursor to cryosurgery, for superficial mosaic warts and in children.  It is slow in its effects and has lower success rates than other treatment modalities.  It is essential that the patient is aware of this prior to commencing a course of treatment.

Extracorporeal Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT) is the application of an acoustic wave that carries high energy to areas of injury or pain.  The kinetic energy produced, created by the compressed air, is transferred to the transmitter at the end of the applicator and then into the affected area.  The energy promotes regeneration and reparative processes of the soft tissues.  

Shockwave therapy works by encouraging:

• New blood vessel formation
• Reversal of chronic inflammation
• Stimulation of collagen fibre production
• Dissolution of calcified fibroblasts
• Dispersion of pain mediator – substance P, providing pain relief
• Release of trigger points

In podiatry we use shockwave therapy for treating previous injuries that have no healed back correctly and have caused chronic conditions which would most likely not heal if left untreated

With shockwave therapy there may be some discomfort during application however the intensity is adjustable and can be tailored to our patient.  There may be some initial soreness after treatment, with the results of the treatment being seen 24-48 hours later. 

We recommend a series of three ESWT applications spaced a week apart.  Shockwave therapy is used as an adjunct to other treatments, which, depending on the condition, could include stretching or strengthening exercises or orthotic therapy.

When do I need ESWT?

For a soft tissue injury which has not healed within three months, in particular:

• Plantar fasciitis
• Achilles tendinitis
• Shin splints
• Plantar fibroma

Footscan®

Gait analysis is the study of the way you walk and we can use systems and instruments to analyse this to a more detailed degree,.

At Dulwich Podiatry we use a Footscan® pressure plate to analyse each footstep and give us a detailed report of how you are distributing pressure between both both feet.  This in turn enables us to prescribe a highly specified customised orthotic device.

The Footscan® pressure pad is equipped with thousands of sensors to capture a complete gait cycle.  This enables us to see the plantar pressures of your foot but also allows us to see how you transition to your next step.  Gait analysis can help us identify any imbalances which may lead to compensations around the joints causing large muscle groups to do more or less work than they are meant to.  This helps us to determine causes for pathologies from foot and heel pain to hip and back pain.

When should I ask for a Footscan®

We will always use Footscan® as part of your full biomechanical assessment if we have decided that your foot or leg problem need customised orthotic intervention. Footscan® will also help us with diagnosis of your condition and gives us a baseline measurement before treatment commences.

At Dulwich Podiatry, our aim is to relieve your foot pain as quickly as possible and prevent recurrence.  The treatment options mentioned above, and others, will form part of your treatment plan.  If you suffer from any of the conditions mentioned, call us on 020 8693 6000 to see one of our podiatrists.