Our renowned medical team provides a range of treatments, from the traditional to the innovative:
This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Treatment is administered via an injection and depending on the injury two to six injections may be required, performed at weekly intervals. Patients usually see their symptoms improve within four to six weeks of having the injections. PRP is a safe treatment option which, because your own blood is used, carries no risk of allergic reaction. Read more clinical evidence supporting PRP here.
This day case treatment is exclusively offered to our patients. It combines the benefits of Platelet-Rich Plasma (PRP) therapy with Lipogems®, a pioneering procedure that uses your body’s own adipose (fat) cells to treat pain and inflammation. AMPP® injections are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time of around three hours. As well as being a potential alternative to surgery, AMPP® can also aid post-surgery recovery.
Around one in five people will suffer from foot pain at some point in their life. Your feet bear your full body weight and cushion the impact as you walk, run and jump, which makes foot and ankle injuries quite common, especially if you’re keen on sport. Around one in 10 will suffer with heel pain called plantar fasciitis during their lifetime.
There are a number of places in your feet and ankle where you might feel pain, including the ankle joint, heel, toes, sole and ball of your foot. Possible symptoms include swelling, bruising, sharp pain between the heel and arch of your foot and discomfort when standing on tiptoes.
Sometimes an injury in one part of your foot might cause issues in another – for example if you sprain your ankle and damage the ligaments holding the bones of the joint together, it can change how you walk and put stress on other joints in your foot.
Your feet are very complex – each one is made up of 26 bones and 33 joints as well as many muscles, tendons and nerves. If any of these get injured, overused or affected by underlying health issues, it can result in foot and ankle pain.
Common causes include:
Arthritis damages the surfaces of your joints, including your ankles and any of the joints in either foot. In many cases – around 70 per cent ¬– arthritis in the feet and ankles is caused by a previous injury. As well as fractures and ligament damage, other conditions such as gout and inflammatory arthritis can result in arthritis in these joints. The most common form of arthritis is osteoarthritis – the slow wearing away of the cartilage that protects the bones in your joints.
• Ankle instability
If your ankle often gives way when you’re walking, particularly on uneven surfaces, or even simply standing still, you may be experiencing chronic ankle instability. The causes can be complex, and could be due to ligaments in the joint or the muscles controlling your ankle not working correctly. This might be because a sprained ankle hasn’t healed properly, and additional sprains can make the problem worse.
• Plantar fasciitis
One of the most common sources of heel pain, plantar fasciitis happens when the thick ligament running across the bottom of your foot between your heel and toes becomes inflamed. It results in a stabbing pain, most often first thing in the morning. While anyone can suffer from plantar fasciitis, it’s most common if you’re aged between 40 and 60, and women are twice as likely to be affected.
• Achilles tendinopathy/tendonitis
The Achilles tendon is the thick cord running down the back of your lower leg that connect its muscles to your heel. If it becomes painful, stiff or swollen, you might have Achilles tendinopathy, also called tendonitis. It can make it hard to run, jump or even walk and can be caused by putting too much strain on the area through activity – particularly if your body isn’t used to it.
• Other types of heel pain
As your heel acts as a cushion for your body weight when you walk, run or jump, pain there is quite common and can have a big impact on your everyday life. As well as plantar fasciitis (see above), other conditions include:
– bursitis, when fluid-filled sacs in various places around your feet become inflamed
– tarsal tunnel syndrome, when the nerve passing through the ankle joint gets compressed
– a possible fracture.
• Peroneal tendon pain or injury
Your peroneal tendons are a pair of thick cord-like bands that run side by side down your leg and behind the outside of your ankle. Pain may come on either suddenly or slowly over time and could be due to tendonitis, where the tendons become swollen and tender. The discomfort could also be down to small tears caused by injury or overuse, or if the tendons have slipped out of position, known as subluxation.
• Ligament pain or injury
There are many ligaments in your ankle, helping to hold the bones together. If you fall or trip, you can cause a sprain, which can cause a partial or full tear of these ligaments. Sprains vary from minor to severe, and symptoms include pain, tenderness, swelling and bruising. A bad sprain may mean you can’t put weight on the affected foot – if this happens, you should see a doctor as soon as possible in case you require urgent treatment.
• Subtalar arthritis or instability
The subtalar joint is at the back of your feet, below the ankle. Arthritis to this joint is most often the result of injury, and can lead to swelling and stiffness on one or both sides of your foot. It can also cause pain in the back of your heel, especially when walking on uneven surfaces.
A painful, bony lump at the base of the big toe that makes it painful to walk, a bunion can take years to develop. It happens when pressure is put on your big toe so that it leans towards the toe next to it. Tight shoes that pinch your toes together can cause bunions or make them worse, as can arthritis.
For some causes of foot and ankle pain, particularly injury or overuse, simply resting, applying ice and taking over-the-counter pain relief may be all that’s needed. However, you should see your GP or a specialist if the discomfort persists – or more urgently if you have any of the following symptoms:
• severe pain
• it makes you feel faint, dizzy or nauseous
• you can’t walk or put any weight on the foot
• the injury caused a snapping or popping sound
• the shape of your foot or ankle has changed
• the injured area looks infected – red, warm and tender to the touch – and you have a fever.
If the first-step approaches of rest, ice and over-the-counter pain medication don’t help, or a specialist has advised your condition requires more in-depth treatment, there are several options that don’t involve surgery.
We offer a variety of biological therapies that harness your body’s natural ability to repair itself – Platelet Rich Plasma (PRP) treatment and Activated Mesenchymal Pericyte Plasma (AMPP®) injections.
They are minimally invasive, can decrease inflammation, stop the progression of arthritic damage and may repair joint cartilage. The recovery time is also much shorter than with surgery.
Following these treatments, you are often encouraged to walk the same day and quickly return to normal activity without having to go through the risks associated with surgery.
Depending on what’s causing your foot or ankle pain, there are several different ways to try to relieve it through surgery. Operations include:
• keyhole surgery, known as ankle arthroscopy, to remove tissues inflamed by arthritis
• joint fusion, where the ends of bones that meet in the ankle joint are removed and the remaining ends fixed together with pins or screws
• tendon grafts
• distraction arthrolysis, where a special device is fitted to promote bone healing and growth.
As with any surgery there are risks associated with these procedures, which you can discuss with your doctor if you require surgical intervention.
Our innovative range of treatments goes beyond what’s available on the NHS. As well as providing a full opinion on your condition that includes all the traditional non-surgical and surgical options, our experienced consultants will also assess your suitability for our alternative biological therapies, Platelet Rich Plasma (PRP) and Activated Mesenchymal Pericyte Plasma (AMPP®).
During the consultation, our specialist will:
• discuss your medical history to find out more about your symptoms
• examine the joint and identify the source of the pain and any mobility issues
• arrange for a diagnostic investigation, usually an MRI scan
• discuss all the treatment options with you, along with their potential benefits and any risks.
Autologous means ‘from the same person’ rather than from a donor. Essentially, your own cells are used to encourage healing. With this type of treatment, there’s a dramatic reduction in the risks of the rejection, infection or contamination that come with using material from someone else. The innovative therapies we offer are based on this idea. If you’ve found traditional treatments aren’t helping your pain, of if you’re looking for a possible alternative to surgery, then this approach is one to consider.
Biological treatments are pioneering procedures and we’re continuously monitoring and recording its effectiveness. Patients undertaking these treatments are asked to complete pre-operative and post-operative questionnaires.
The information obtained from these questionnaires allows us to monitor your progress and it also contributes to our evidence-based database and other global studies on biological treatments. All information gathered is anonymised.