Treatments
GuideDry needlingDry needling puts a thin, solid needle into sore spots in a muscle to ease pain and tension. It may give short-term pain relief, but it's usually no better than exercise. Side effects are mostly minor, and screening beforehand matters.GuidePainkillers and anti-inflammatory medicinesPainkillers such as paracetamol ease pain, and anti-inflammatory medicines (NSAIDs) such as ibuprofen also calm swelling. They relieve symptoms rather than cure the cause. A gel or cream is often tried first for sprains and knee arthritis, while tablets suit some people but carry more risks.GuideWound vac (negative pressure wound therapy)A wound vac, or negative pressure wound therapy (NPWT), seals a wound with a dressing connected to a small suction pump that draws fluid away. It's used for stubborn or complex wounds, such as diabetic foot ulcers, though how well it works is mostly low certainty.GuideWound dressingsA wound dressing is a covering that protects damaged skin and helps keep a wound moist but not too wet while it heals. It doesn't heal the wound by itself, and no single type suits every wound, so the right choice depends on the wound.GuideWound debridementWound debridement is the removal of dead or damaged tissue from a wound so that healthy tissue can heal. There are gentle and sharp methods, and the right one depends on your wound, your circulation and your health. It may help healing, but how much isn't certain.GuideNail matrixectomyNail matrixectomy is a procedure, done under local anaesthetic, that destroys the nail root so part or all of a toenail doesn't grow back. It's mainly used for ingrown toenails that are painful, keep coming back or haven't settled with simple care.GuideCryotherapyCryotherapy uses extreme cold, usually liquid nitrogen, to destroy small skin lesions such as warts, verrucas and sun spots. It suits sun spots best, gives mixed results for warts, and often needs several sessions.GuideCompression therapyCompression therapy uses firm, graduated pressure from bandages, stockings or devices to help blood and fluid move back up the leg. It works best for venous leg ulcers, and it should be chosen and fitted by a health professional after a circulation check.GuideAnkle bracesAn ankle brace is a support worn around the ankle, used mainly to help prevent repeat sprains and to protect the ankle after a recent one. It seems to help most if you've sprained the ankle before, and it works best alongside exercise rather than on its own.GuideHeel cups and heel liftsHeel cups and heel lifts are inserts that sit at the base of the heel inside a shoe, used for heel pain and to make up for a leg length difference. The benefit is modest and often short-term, so they work best as one part of a wider plan.GuideFootwear modificationsFootwear modification means changing an existing shoe, such as adding a raise, wedge, flare or rocker sole, to ease pain, reduce pressure or improve walking. It's best studied for preventing repeat foot ulcers in adults with diabetes. It only helps when worn, and not every shoe can be adapted.GuideNight splintsA night splint is a brace worn on the ankle and foot during sleep, holding the ankle in a neutral position. It's aimed at plantar heel pain, especially pain with the first steps in the morning. Results are mixed, and it's usually tried after stretching and taping.GuidePadding and offloadingPadding and offloading means using cushioning or devices to take pressure off a sore or vulnerable spot on the foot so it can heal. It's best supported for foot ulcers in people with diabetes, where casts or boots usually come first and padding is a lower choice.GuideStretching and flexibility programA stretching and flexibility program is a routine of gentle calf, Achilles and foot stretches done at home. It's a first-line part of care for plantar heel pain in adults, works best alongside taping and education, and can take weeks to months to help.GuideToenail removal (nail avulsion)Nail avulsion is a minor operation that removes part or all of a problem toenail, usually under local anaesthetic. It's mostly used for ingrown toenails that haven't settled with simpler care. A chemical called phenol is often added to help stop the nail growing back.GuideTotal contact castingA total contact cast is a close-fitting, non-removable cast that takes pressure off a foot ulcer. It's mostly used for ulcers on the sole of the foot in people with diabetes. It heals more ulcers than removable options, but it isn't suitable for everyone and needs regular checks.GuideOffloading devicesOffloading devices are casts, boots and shoes that take pressure off a sore area of the foot. They're best proven for helping ulcers on the sole heal in adults with diabetes, and for lowering the chance of ulcers coming back. Wearing the device as directed matters most.GuideBunion surgeryBunion surgery realigns the big toe, usually with cuts in the bone and releases of tight tissue, to ease the pain of a bunion (hallux valgus). It's usually considered when shoe changes and other non-surgical care haven't helped, and it brings risks and a recovery of weeks to months.GuideShockwave therapyShockwave therapy (ESWT) passes sound waves through the skin to treat long-standing heel and tendon pain, without injections or surgery. It has the best support for plantar heel pain, and results vary by condition. It's usually tried after other treatments haven't been enough.GuideOff-the-shelf orthoticsOff-the-shelf orthotics (prefabricated orthoses) are ready-made insoles, usually foam, that a podiatrist can adjust to your foot. For adult heel pain they may help a little, and custom insoles give similar results. Mild aching at first is normal.GuideVerruca treatmentA verruca (plantar wart) is a viral wart on the sole of the foot, and many clear on their own without treatment. When treatment is chosen, acid-based paints or gels and freezing are the main options. Neither works for everyone, and it can take months.GuideCorn and callus removalCorn and callus removal means taking off thick, hard skin, usually with a sterile scalpel, and a podiatrist does it. It can ease pain for a while, but corns often return unless the cause of the pressure is dealt with. People with diabetes or poor circulation shouldn't treat them at home.GuideCortisone injectionsA cortisone (corticosteroid) injection places anti-inflammatory medicine into or around a sore joint or tendon to ease pain, swelling and stiffness. Relief usually lasts weeks to months, and it works better for some problems than others. Exercise and physiotherapy often still matter.GuideMoon boots and CAM walkersA moon boot, or CAM walker, is a removable, supportive boot used after some foot and ankle injuries or surgery. It protects the area while letting you put weight on it. It suits stable injuries best, and your clinician decides how long you wear it.GuideTherapeutic footwearTherapeutic footwear is footwear built for at-risk or changed-shape feet, mainly in people with diabetes and numb feet. It aims to ease pressure under the foot. It may help prevent foot sores, though the evidence is less certain than the guidelines suggest, and it needs proper fitting and follow-up.GuideStrengthening exercisesStrengthening exercises build muscle strength in the foot and ankle using simple moves such as towel scrunches, calf raises and the short foot exercise. They help most with an ankle that keeps giving way, and may help flat feet and balance. Build up gradually.GuideStrapping and tapingStrapping and taping means applying adhesive tape to the foot or ankle to support a joint or limit its movement. It can lower the risk of ankle sprains and ease heel pain in the short term, usually alongside exercise and stretching, but it isn't a cure.GuideFootwear adviceFootwear advice is guidance on choosing and wearing shoes that fit and suit your feet, so they support your feet rather than strain them. It matters most for people with diabetes or rheumatoid arthritis, and it's a sensible, practical step rather than a proven treatment on its own.GuideAntifungal medicinesAntifungal therapy means using medicines, as creams, paints or tablets, to treat fungal infections of the skin and nails. Tablets clear toenail infections more often than topical treatments but carry more risks, and nail treatment takes months. A pharmacist or GP can advise which suits you.GuidePhenol nail surgeryPhenol nail surgery (phenolic nail ablation) removes part or all of a problem toenail, then uses a chemical to stop it growing back. It's mainly used for ingrown toenails that haven't settled with simple care, and regrowth is uncommon. Healing takes several weeks.GuideCustom orthoticsCustom orthotics are shoe inserts made for one person's foot, from a cast, scan or mould, to support the foot or ease pressure on sore spots. Guidelines favour them for adults with diabetes at risk of foot ulcers; for other problems, results are mixed.