The big toe joint (called the metatarsophalangeal joint or MPT joint) is an important joint that needs to be able to bend for the foot to work as efficiently as it should. Sometimes, for a variety of reasons, the joint can become stiff and make walking painful at this area – and sometimes it can become so bad that it results in a complete loss of movement.
Footwear is important in these cases. If the joint cannot bend, then a shoe with a stiff sole – or rocker sole like the examples pictured below- can be useful. A shoe with a decent heel height may make symptoms worse as this will ask more of the joint and so may be best avoided – or at least limited. It is also important to point out that themake and price of the shoe/trainer is not important, as long as it is fit for purpose.
If you do not see any sign of improvement after 6 – 8 weeks of following the advice and exercises in this leaflet, please phone 0141 347 8909 to see a healthcare professional who can assess your foot and potentially recommend further treatment.
An ingrown toenail occurs when the edge of the toenail grows into the surrounding skin, causing pain, swelling, and sometimes infection. It most commonly affects the big toe, but it can occur on any toe, and can make day to day activities uncomfortable.
If untreated, an ingrown toenail can become severely painful and lead to more serious complications such as infection.
Why does this happen?
There are many reasons this can occur including:
Improper Toenail Trimming: Cutting your nails too short or cutting into the corners of the nail can lead to ingrown toenails.
Excessive Sweating/Moisture: The skin surrounding the toenail(s) softens and increased the risk of toenail growing into the skin.
Tight Fitting Footwear: Shoes, socks or hosiery that is too tight can cause the toenail to grow into the surrounding skin.
Injury: Trauma to the toe, such as stubbing or pressure from our footwear can increase the risk on an ingrown toenail.
Nail Shape: Nails that are broad, curved or thickened can increase the risk of ingrown toenails.
How can I prevent this?
There are things you can do to prevent an ingrown toenail as part of your personal footcare routine. Further information and support available from our personal footcare site.
Important points to remember:
Ensure you are using the appropriate equipment and technique when cutting your nails. Cut nails straight across and avoid cutting them too short. Nail files are useful for maintaining nail length and smoothing any rough edges.
Good hygiene is essential (including hoisery). Washing and drying your feet properly can reduce risk of infection and reduce skin irritation.
It is important that your footwear is well fitting, with enough room for your toes. Avoid shoes that press your toes together. ‘Looking after your feet’ booklet
What do I do if I have an ingrown toenail?
For mild cases of ingrown toenails, the following methods may be effective:
Bathing In Salt Water: Warm water in a clean basin with ordinary table salt can sooth the symptoms of ingrown toenails and keep the affected toe(s) clean.
Correct nail cutting: Trimming your nails straight across and avoiding cutting into the edges can help the condition from worsening
Over-The-Counter Medication: Pain relief, paracetamol or ibuprofen.
Podiatry Treatment: If the ingrown toenail does not resolve, becomes more painful, persistent or infected, Podiatry treatment is advised. Details on how to make an appointment are below.
What will happen at my initial appointment?
At your initial podiatry appointment, your safety is paramount. Therefore, we will take a history of any long term health issues or medications to make sure that any management options discussed are suitable for you.
We may be able to resolve the problem at that initial appointment, however, in some cases you may need further treatment which may require a local anaesthetic. We will discuss all your treatment options and will refer you for nail surgery if agreed and appropriate. We will discuss with you the benefits, the risks and the alternative options which will give you the opportunity to voice any concerns you have so you can make an informed choice of your management plan.
We can arrange for antibiotics if they are required. You may be supplied them by the podiatrist or have them requested by you GP.
Nail Surgery
What is nail surgery?
If we have not been successful in managing your problematic nail conservatively, then we can refer you for nail surgery.
What will happen at my nail surgery appointment?
Again, you will have the chance to ask questions and voice any concerns. We will not proceed without your consent and you are free to decline treatment on the day if you change your mind.
The procedure is performed under local anaesthetic which will numb the affected toe(s). This allows us to safely remove the full nail, or part of the nail depending on what was decided during the discussions. A chemical is then applied to the nail bed to prevent a portion or full nail from regrowth. This is a permanent solution which will reduce the chances of regrowth.
A family member/friend may accompany you to your appointment for support if needed.
Preparing for the appointment
Ensure you have breakfast/lunch depending on the time of your appointment
Bring open toe shoes (sandals, flip flops etc.) to accommodate the dressing that will be applied
Ask of family member/friend to drive you or consider public transport. If this is not possible you may drive
Ensure you are able to rest the foot following the procedure. The Local anaesthetic will wear off in approximately 2-3 hours, take care not to damage it while it is numb.
Aftercare and what to expect
We will discuss with you how best to look after your toe after your nail surgery procedure and provide written advice. You will be provided with a small supply of dressing and advised where you can source more dressings.
We will discuss expected healing times at the appointment. This can vary depending on any underlying health issues which may affect the rate of healing but could be anything up to 12 weeks.
It is important to monitor the are for sign signs and symptoms of infection -such as redness, increased swell or pain- and again, we will go through all this at the end of your appointment and allow you to ask any questions you may have
You can self-refer to NHS Greater Glasgow & Clyde podiatry by contacting NHSGGC Podiatry Referral Management Centre:
You will initially be given a telephone triage appointment, where you will have a consultation with one of our highly skilled podiatrists. Depending on the severity of your problem, they make any appropriate referrals or appointments as required.
Podiatry provide assessment, management and foot health education to individuals with conditions affecting the lower limb, enabling self-care and self management where possible. We have highlighted some of the most common problems below and created resources which you might find helpful in supporting your foot and lower limb health issue.
Please note: NHS Inform is also a helpful resource.
Making an appointment
If you feel you need to speak to a podiatrist, then the details on how to do this are outlined below. It is likely that your first contact will be by telephone so we can triage you appropriately to best support your needs. Our consultations are delivered in various ways, including telephone, video, group education as well as face to face.
Podiatry does not provide personal footcare. Please refer to the ‘Personal Footcare’ resource above.
At the Specialist Weight Management Service (SWMS), patients are encouraged to take a realistic approach to weight loss. We want to challenge the notion of ‘going on a diet’. Unlike some fad diets, SWMS is based on current expert opinion and research evidence. Patients are asked to explore not only what they eat, but also when they eat, why they eat and how they eat.
SWMS encourage dietary and lifestyle changes that are realistic, achievable and that can be sustained in the long-term. The focus is improvement in health, through healthy eating and realistic weight loss, rather than striving for the perfect figure or an ideal bodyweight.
Lifestyle Intervention
The 12 week programme made up of 7 fortnightly sessions. Each session lasts 1.5 hours which covers information and support on diet, activity, and behaviour change strategies.
A Personalised Dietary Prescription (PDP,) is calculated based on height, gender, age, weight and level of physical activity. The Eatwell Guide outlines a healthy, nutritionally balanced diet that allows for personal food choices.
The minimum target weight loss in the lifestyle intervention phase is 5-10kg (11.5 lbs to 1.5 stone). This equates to a steady weight loss of 0.5-1kg (1-2 lbs) a week.
All About Obesity provides education, information, support and advocate for those living with obesity.
Better Health
Better Health offers information to kickstart better health for you.
PCOS (Polycystic Ovary Syndrome)
Polycystic Ovary Syndrome (PCOS) is a common complex hormonal condition which affects how the ovaries work. Lifestyle choices such as the type and amount of food you eat, as well as the activity you do, can improve symptoms.
Self monitoring using online apps are becoming more popular. They are a quick and convenient way to assess and track dietary intake. You can download apps on your smart phone – some of which are free and very easy to use. Some commonly used dietary apps are listed below.
Nutracheck (calorie counter +)
Nutracheck (calorie counter +) provides food and exercise tracking, UK food database with over 250,000 products with photos (verified data), scans barcodes, links with Apple Health. This app has a fee and is approved by ORCHA.
MyFitnessPal
MyFitnessPal provides food and exercise tracking, barcode scanner, large food database with over 6 million foods including restaurants menus. The app can connect with popular apps and devices such as – Garmin, Strava, Runkeeper, Fitbit. The app allows you to share your progress with friends and is free.
Lifesum
Lifesum is a food and exercise tracking app. The ‘basic’ plan (food and activity diary,) is free, however, you would need to pay a monthly subscription fee to access healthy recipes, sync the app with health apps, etc.
LIVA
LIVA is an integrated digital platform for disease management and lifestyle change. The app allows you to monitor physical activity, sleep, mood and dietary intake. Users can also record biometric parameters e.g. blood sugar levels, blood pressure, lung function.
Designed to provide support and guidance for people at risk or living with chronic diseases such as Obesity, pre and type 2 diabetes, hypertension. This app is free and approved by ORCHA.
Easy Meals
The Easy Meals app is free and provides over 150 easy, calorie counted recipes across breakfast, lunch and evening meals and puddings. The app also has a handy shopping list to make planning and shopping easier.
Change4life Smart Recipes
Change4life Smart Recipes allows you to search over 160 easy, calorie-counted recipes, easy to follow instructions and all the ingredients you’ll need to feed a family of 4 for around £5, create a shopping list, tips on how to make healthier choices.
Change4life Food Scanner
Change4life Food Scanner is an easy to use food scanner designed to help you make healthier food and drink choices. Barcode scanner will show you the total sugar and saturated fat contents of foods.
Carbs and Cals app
The Carbs and Cals app helps people control their diabetes and weight. The app contains over 3,500 food photos to help you manage your calorie intake and portions. The Carbs and Cals app also provides useful nutritional information such a carbohydrate, fat and fibre content of foods. This app has a fee.
The prevention and control of infection throughout healthcare is everyone’s responsibility and is a major component in the drive towards a safer NHSScotland.
These Standards are one part of the drive for a safer NHSScotland, so should be seen as complementary to HAI and patient safety work undertaken by other bodies, e.g. Scottish Patient Safety Programme (SPSP). These Standards for HAI apply to all healthcare environments in which patients are treated.
GIRFEC – Getting It Right For Every Child is the national approach in Scotland to improving outcomes and supporting the wellbeing of our children and young people by offering the right help at the right time from the right people. It supports them and their parent(s) to work in partnership with the services that can help them.
At NHSGGC we have a key role to play, whenever we come into contact with children and young people – whether we are caring directly for them, or other members of their family or household. Where extra support is needed, the GIRFEC approach aims to make that support easy to access and seamless, with the child at the centre.
GIRFEC Frequently Asked Questions – start here for answers to the most commonly asked questions about Getting it right for every child
Please read the following information and then use the links at the bottom of the page if you are looking for further information or exercise.
Important information to read if you have any concerns about your foot/ ankle pain
Please click below to expand relevant section; these sections outline some of the main issues that we would advise you get checked by a health professional before commencing self-management exercises. These are called Red Flags and may indicate a more serious problem that requires medical assessment.
Symptoms that are present After Trauma
If your symptoms are caused by a recent traumatic incident (e.g. a fall, football tackle) and you have any of the following symptoms:
Extensive bruising and/ or swelling
Discolouration e.g. your foot looks pale, blue or red
Severe pain and very limited movement
Joint deformity eg foot looks like it is in the wrong place
New lumps and bumps that appear after the trauma
Great difficulty putting weight through your leg
Numbness/ tingling into your foot after trauma
Feeling of instability
Please Note: If you have a known diagnosis of osteoporosis (low bone density) a small amount of force may cause problems that require medical assessment.
Symptoms where No Trauma was Involved
Sudden loss of active movement with or without pain
Redness, heat and swelling of the joint/ surrounding area
Increasing numbers of joints that are painful and/or stiff
Fever or generally feeling unwell at same time as your foot pain developed
Unexplained numbness/ tingling into your foot
Constant pain which does not change with rest or activity
Significant worsening pain at night
Unexplained weight loss and/ or a previous history of cancer
Unexplained lumps and bumps that appear or are changing/ growing
Difficulty lifting the front part of your foot/ catching or dragging your foot when walking
Please Note: Special attention should be taken if you have a history of long-term steroid or immunosuppressive drug use, recent joint replacement, recent steroid injection, rheumatoid arthritis or other joint disease, recent infection, Intravenous drug use or alcohol misuse.
Our colleagues in the NHS Greater Glasgow and Clyde Podiatry team have developed a range of information resources for specific foot conditions – see what resources are available.
Foot and Ankle Exercises
Please make sure you have read through the important information about foot pain before proceeding.
Here are some beginner-to-progressive exercises to help you get your foot/ankle moving better. You may need to build these exercises up gradually.
You may be uncomfortable when you start doing these exercises – make sure the level of discomfort feels acceptable to you and that it doesn’t take too long to settle once you are finished.
The exercises should get easier the more consistently you manage to practice them and this may allow you to progress to more difficult exercises.
These are self help exercises:
Try to enjoy the exercises and work at a pace and level that feels safe.
Please use a common sense approach when deciding which ones to try.
The exercises listed are not designed as an alternative to professional advice.
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