Dr Bernadette Carr answers your questions on plantar fasciitis and moles/lesions
I have recently started walking in an attempt to shed some baby weight.
However, over the last month, I have begun experiencing very bad pains in the soles of my feet. Why is this?
This sounds like plantar fasciitis — a common condition which results from repetitive trauma to the underside of the foot.
It occurs when the fascia (a thick band of fibres which support the underside of the foot) becomes inflamed.
This may occur as a result of overuse or excessive exercise.
It may commonly appear at the heel in conjunction with calcaneal spurs, which are deposits of calcium, again as a result of damage to the foot. Calcaneal spurs can be seen on x-ray of the foot.
However, this is generally not necessary.
Pain commonly will appear after periods of inactivity — often first thing in the morning or after sitting for long periods.
Many athletes suffer from this condition as well as people who are new to exercise or suddenly begin a new regime after a period of inactivity.
Overweight individuals may be more at risk, as well as people with flat feet.
Changes to the body after pregnancy may make you more likely to develop the condition.
Treatment includes rest and stretching exercises for the feet (especially the calves and Achilles tendons) as well as orthotic inserts for shoes.
Anti-inflammatory painkillers such as ibuprofen may be helpful temporarily, as will ensuring footwear is appropriately cushioned, with adequate arch support for any physical activity.
It is important to avoid walking barefoot or in flat shoes or flip flops as these can all aggravate the condition.
It is also important to stretch before and after exercise and to give the body adequate rest periods when engaging in any new exercise regime.
If symptoms are not relieved with these measures, physiotherapy sessions may be helpful.
There is also the option of steroid injections into the fascia for pain relief.
With time and rest, most cases of plantar fasciitis improve completely within one year.
I am a fair skinned woman in her 30s who burns easily. I am going on a sun holiday next month and have some moles on my back and arms. How should I check my moles?
Pigmented skin lesions and freckles can be normal in adults and children.
It is common to acquire more freckles or pigmented moles up to the age of 40, after which it is rare to develop a new common mole.
If you have a new lesion which is itching, bleeding, or causing pain this should also prompt review by your doctor.
It is useful to use the ABCDE checklist when examining moles.
Five features are considered here which, if present should prompt examination by a doctor.
A: Asymmetry (moles which are not regular in shape);
B: Border irregularity;
C: Colour irregularity (moles which are not a uniform colour);
D: Diameter (moles greater than 7mm across);
E: Evolving (moles that are progressing or changing).
Any or all of these features may indicate a lesion suspicious for cancerous change.
If your doctor feels it is appropriate, he may take a skin biopsy or refer to a specialist service.
A biopsy involves either removing or taking a sample from the mole and examining it under a microscope to see if there are any suspicious changes.
The most common risk factor for developing malignant skin change is sun exposure and exposure to UVA and UVB rays.
It is very important to use a high sun factor (factor 30 is ideal) with both UVA and UVB filtering to afford maximum protection.
Children’s skin may be particularly vulnerable and it is important to cover up with a hat and reapply SPF regularly throughout the day, especially after swimming or showering.
All of the main types of skin cancer are curable if they are detected early.
In most cases, surgery to remove the affected area will be sufficient.
It is a good idea to become familiar with your moles and examine regularly for any change, along with the use of adequate sun protection.
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