VP help pls

Hi, I have a 30yrs old pt coming in today with about 12- 14 VPs of differing sizes on both feet which he has had for 2+ years and am planning to needle them today using a tibial block. He has a large (2-3cm and sticks out at least 1cm) VP on his achiles insertion point which is the one causing him the most pain/ discomfort/ problems with shoes etc.

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VP help pls

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