Foot Care: Podiatry Treatments, Services & When to See a Specialist

What Is Podiatry and What Does a Podiatrist Do?

Podiatry is a specialized branch of medicine focused on diagnosing, treating, and preventing conditions of the feet and lower limbs. Podiatrists (also called chiropodists in some countries) are trained healthcare professionals who treat nail disorders, skin conditions, biomechanical problems, and complications from conditions like diabetes and arthritis.

The feet are complex structures containing 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments each. Despite their importance in our daily mobility, feet are often neglected until problems become serious. Podiatrists provide essential care that ranges from routine nail trimming and callus removal to managing complex diabetic foot ulcers and prescribing custom orthotics for biomechanical issues.

Professional foot care encompasses both preventive maintenance and treatment of existing conditions. For many people, regular visits to a podiatrist help maintain foot health and prevent minor issues from developing into serious problems. This is particularly important for certain groups who are at higher risk of foot complications or who have difficulty caring for their own feet due to limited mobility, vision problems, or inability to reach their feet.

Podiatrists work as part of the broader healthcare system and often collaborate with other specialists including diabetologists, orthopedic surgeons, vascular specialists, and wound care teams. In many countries, podiatrists can prescribe medications, perform minor surgical procedures, and order diagnostic tests such as X-rays and blood tests. The scope of practice varies by country and the individual practitioner's training and qualifications.

The Role of Preventive Foot Care

Preventive foot care is the cornerstone of podiatric practice. By identifying and addressing potential problems early, podiatrists help patients avoid more serious complications that could affect their mobility and quality of life. Regular foot assessments allow early detection of circulation problems, nerve damage, and structural changes that might indicate underlying health conditions.

Prevention also includes patient education about proper foot hygiene, appropriate footwear selection, and self-examination techniques. Podiatrists teach patients how to recognize warning signs that require professional attention, empowering them to take an active role in maintaining their foot health.

What Conditions Do Podiatrists Treat?

Podiatrists treat a wide range of foot conditions including ingrown toenails, fungal nail infections (onychomycosis), corns, calluses, plantar warts, diabetic foot problems, heel pain (plantar fasciitis), bunions, flat feet, foot ulcers, athlete's foot, and biomechanical issues affecting walking and posture.

Foot problems can be broadly categorized into several groups: nail disorders, skin conditions, structural and biomechanical issues, systemic disease complications, and infections. Understanding these categories helps illustrate the breadth of conditions that podiatrists manage and why their expertise is valuable across different patient populations.

Nail Disorders

Nail problems are among the most common reasons people seek podiatric care. The toenails are susceptible to various conditions that can cause pain, discomfort, and potential complications if not properly treated. Podiatrists have specialized training and tools to safely manage nail conditions that might be difficult or dangerous to treat at home.

Ingrown toenails (onychocryptosis) occur when the nail edge grows into the surrounding skin, causing pain, redness, swelling, and sometimes infection. While mild cases may respond to conservative treatment, persistent or severe ingrown toenails often require professional intervention. Podiatrists can carefully trim the offending nail edge, and in recurrent cases, may perform minor procedures to permanently narrow the nail.

Fungal nail infections (onychomycosis) affect approximately 10% of the general population and become more common with age. These infections cause nails to become thickened, discolored, brittle, and sometimes painful. Treatment may involve topical antifungal medications, oral antifungals for severe cases, or specialized nail debridement to reduce fungal load and allow topical treatments to penetrate more effectively.

Thickened nails can result from trauma, fungal infection, poor circulation, or simply aging. Thick nails are difficult to cut at home and may cause pressure pain in shoes. Podiatrists use specialized equipment to safely reduce nail thickness, improving comfort and appearance.

Skin Conditions

The skin of the feet faces unique challenges including pressure, friction, moisture, and exposure to fungi and bacteria. Various skin conditions can develop that benefit from professional treatment.

Corns and calluses are areas of thickened skin that develop in response to repeated pressure or friction. While they serve as a protective mechanism, they can become painful and may hide underlying problems. Corns are smaller and usually develop on or between toes, while calluses are larger and typically form on weight-bearing areas of the sole. Podiatrists can safely remove excess tissue and identify the underlying cause to prevent recurrence.

Plantar warts (verrucae) are caused by the human papillomavirus (HPV) and appear as hard, grainy growths on the soles of the feet. They can be painful when walking and may spread to other areas. Treatment options include chemical treatments, cryotherapy (freezing), or minor surgical removal.

Athlete's foot (tinea pedis) is a fungal infection causing itching, scaling, redness, and sometimes blistering between the toes or on the soles. While mild cases often respond to over-the-counter treatments, persistent or severe infections may require prescription-strength medications.

Structural and Biomechanical Issues

The complex structure of the foot means that even small abnormalities in alignment or function can cause significant problems. Podiatrists assess how the feet function during standing and walking, identifying issues that may contribute to foot pain or affect other parts of the body.

Plantar fasciitis is one of the most common causes of heel pain, affecting the thick band of tissue running across the bottom of the foot. Podiatrists can recommend stretching exercises, footwear modifications, custom orthotics, and other treatments to relieve symptoms and address underlying causes.

Bunions (hallux valgus) are bony bumps that form at the base of the big toe when the joint becomes misaligned. While bunions often have a genetic component, footwear plays a significant role in their progression. Podiatrists can recommend appropriate footwear, padding, orthotics, and in some cases, refer for surgical correction.

Flat feet (pes planus) and high arches (pes cavus) can both cause problems with walking, standing, and weight distribution. Custom orthotics can help redistribute pressure and improve foot function for people with these conditions.

Why Is Foot Care Especially Important for People With Diabetes?

Diabetes can cause nerve damage (neuropathy) reducing foot sensation, and poor circulation slowing wound healing. This combination means small injuries can go unnoticed and quickly develop into serious infections or ulcers. Regular professional foot care and daily self-examination can prevent up to 85% of diabetes-related amputations.

Diabetic foot complications represent one of the most serious consequences of diabetes and a leading cause of hospitalization and limb amputation worldwide. The International Diabetes Federation estimates that 15-25% of people with diabetes will develop a foot ulcer at some point in their lives, and diabetes-related lower limb amputations occur every 30 seconds globally. However, the vast majority of these amputations are preventable with proper foot care and early intervention.

Understanding why diabetes affects the feet requires knowledge of two key complications: diabetic neuropathy and peripheral arterial disease. These conditions often occur together and create a dangerous situation where injuries may not be felt and cannot heal properly.

Diabetic Neuropathy and Reduced Sensation

Diabetic peripheral neuropathy affects the nerves in the feet and legs, often causing numbness, tingling, or burning sensations. As neuropathy progresses, protective sensation is lost, meaning cuts, blisters, burns, or pressure injuries may go completely unnoticed. A person with severe neuropathy might walk on a nail, develop a blister from ill-fitting shoes, or sustain a burn without feeling any pain.

This loss of sensation fundamentally changes the relationship between injury and awareness. In healthy individuals, pain serves as a warning system that prompts action – removing a stone from a shoe, changing uncomfortable footwear, or seeking treatment for an injury. Without this warning system, minor injuries can progress to serious wounds before they are discovered.

Neuropathy can also affect the motor nerves controlling foot muscles, leading to muscle weakness and changes in foot shape. The resulting deformities alter how weight is distributed across the foot, creating areas of high pressure that are prone to callus formation and ulceration.

Poor Circulation and Impaired Healing

Peripheral arterial disease (PAD) reduces blood flow to the feet and legs. Blood carries the oxygen, nutrients, immune cells, and antibiotics needed for wound healing and fighting infection. When circulation is compromised, even minor wounds heal slowly and may become infected. In severe cases, tissue may die due to lack of blood supply, potentially requiring amputation.

Signs of poor circulation include cold feet, pale or bluish skin color, thin shiny skin, loss of hair on legs and feet, and pain when walking (claudication). People with these symptoms need careful foot monitoring and prompt attention to any injuries.

The Importance of Regular Diabetic Foot Screening

International guidelines recommend that all people with diabetes receive at least annual foot examinations by a trained healthcare professional. These examinations assess circulation, sensation, skin condition, nail health, and foot structure. Based on the findings, patients are categorized by risk level, which determines how often they should be seen:

• Low risk: Normal sensation, good pulses, no foot deformities - annual screening
• Moderate risk: Loss of sensation OR poor circulation (not both), OR foot deformity - screening every 3-6 months
• High risk: Loss of sensation AND poor circulation, OR history of ulcer or amputation - screening every 1-3 months

When Should You See a Podiatrist?

See a podiatrist for persistent foot pain, nail problems you cannot manage safely at home, wounds that don't heal, skin changes, circulation concerns, or difficulty walking. People with diabetes, arthritis, or circulation problems should have regular podiatry appointments even without symptoms.

Many people delay seeking foot care, either because they consider foot problems minor or because they are unaware that effective treatments exist. However, early intervention is almost always more successful than treating advanced conditions, and some foot problems can indicate serious underlying health issues that require medical attention.

Signs You Should Schedule an Appointment

Consider seeing a podiatrist if you experience any of the following:

• Persistent pain: Foot or heel pain that doesn't improve with rest, or that affects your daily activities
• Nail problems: Ingrown toenails, painful nails, thick nails you cannot trim, or nail discoloration
• Skin issues: Painful corns or calluses, cracked heels, warts, rashes, or itching that doesn't respond to home treatment
• Wounds: Cuts, sores, or blisters that are slow to heal or show signs of infection
• Changes in appearance: Swelling, color changes, new lumps or bumps, or changes in foot shape
• Numbness or tingling: Persistent unusual sensations in feet or toes
• Difficulty walking: Pain with walking, limping, or feeling unsteady on your feet

Regular Care Recommendations by Risk Group

Different groups benefit from different frequencies of podiatric care:

Healthy adults with no foot problems: An annual foot health check is recommended to identify any developing issues and receive advice on foot care and footwear.

Older adults: Age-related changes including reduced circulation, thickened nails, drier skin, and reduced flexibility make foot care more challenging. Regular visits every 6-12 months help maintain foot health and prevent problems.

People with diabetes: As discussed above, frequency depends on risk category but should be at least annual, with more frequent visits for those with complications.

People with arthritis: Joint changes can alter foot mechanics and make self-care difficult. Regular podiatric care helps manage symptoms and prevent complications.

People with circulation problems: Reduced blood flow increases risk of infections and delayed healing. Regular monitoring helps detect problems early.

What Happens During a Podiatry Appointment?

During your first podiatry appointment, expect a detailed medical history, examination of both feet assessing skin, nails, circulation, sensation, and foot structure, possibly a walking assessment, and discussion of treatment options. The visit typically takes 30-60 minutes, with treatment beginning at the same appointment if appropriate.

Understanding what to expect can help reduce any anxiety about visiting a podiatrist and ensure you get the most from your appointment. Podiatry clinics aim to provide a comfortable, professional environment where foot concerns can be addressed comprehensively.

Before Your Appointment

To prepare for your visit, consider the following:

• Bring a list of medications you take, including any blood thinners, diabetes medications, or immunosuppressants
• Note any allergies to medications, dressings, or other substances
• Think about your symptoms: when they started, what makes them better or worse, and how they affect your daily life
• Bring your usual footwear if your problem might be footwear-related, as examining your shoes can provide valuable information
• Keep your feet clean but do not apply moisturizer on the day of your appointment, as this can make examination more difficult

The Initial Assessment

Your first appointment will typically begin with taking your medical history. The podiatrist will ask about your general health, any medical conditions like diabetes or arthritis, medications you take, allergies, and previous foot problems or treatments. Be honest and thorough – information about your health helps ensure safe and effective treatment.

The physical examination involves looking at both feet, even if your problem only affects one foot. The podiatrist will assess:

• Skin condition: Looking for dryness, calluses, corns, wounds, color changes, and signs of infection
• Nail health: Checking for ingrown nails, fungal infection, thickness, and deformity
• Circulation: Feeling pulses in the feet and checking temperature, skin color, and hair growth
• Sensation: Testing ability to feel touch and vibration, particularly important for people with diabetes
• Foot structure: Assessing arches, joint mobility, and any deformities
• Walking pattern: Observing how you walk to identify biomechanical issues

Treatment

Depending on your needs, treatment may begin at your first appointment or may be scheduled for a follow-up visit. Common treatments include:

Nail care: Trimming and thinning nails using specialized instruments that can safely manage even very thick or curved nails. For ingrown toenails, the podiatrist may remove the offending nail edge under local anesthesia if needed.

Callus and corn removal: Using scalpels and specialized debridement tools to painlessly remove thickened skin. This is not painful as callused skin has no nerve supply. The podiatrist will also identify and address the underlying cause.

Wound care: Cleaning and dressing wounds, removing dead tissue (debridement), and providing advice on ongoing wound management.

Footwear advice: Recommendations for appropriate shoe types, fitting, and modifications based on your foot shape and any conditions you have.

Custom orthotics: If biomechanical issues are identified, the podiatrist may take measurements or casts for custom-made insoles to improve foot function and reduce pain.

How Can You Care for Your Feet at Home?

Good home foot care includes daily inspection (especially for diabetics), washing and thorough drying, moisturizing dry skin (avoiding between toes), careful nail trimming straight across, wearing well-fitting shoes, and never walking barefoot. Avoid self-treating corns, calluses, or nail problems with sharp instruments or chemical treatments.

While professional foot care is important, daily self-care forms the foundation of good foot health. Establishing good habits helps prevent many common foot problems and allows early detection of issues that need professional attention.

Daily Foot Hygiene

Wash your feet daily with lukewarm water and mild soap. Hot water can burn if you have reduced sensation, so always test the temperature with your elbow or use a thermometer. Dry your feet thoroughly, especially between the toes, as moisture promotes fungal growth. If your skin is dry, apply a good quality moisturizer to the tops and soles of your feet, but avoid putting moisturizer between the toes where excess moisture can cause problems.

Nail Care

Trim toenails regularly, cutting straight across rather than in a curved shape to help prevent ingrown toenails. Use proper nail clippers designed for toenails, and file any sharp edges with an emery board. If you have difficulty seeing your feet clearly, have trouble reaching your feet, have thick or difficult nails, or have diabetes or circulation problems, consider having a podiatrist manage your nail care instead.

Daily Inspection

Check your feet daily for cuts, blisters, redness, swelling, or any changes. If you cannot see the bottoms of your feet easily, use a mirror or ask someone to help. This is particularly important for people with diabetes or reduced sensation who may not feel injuries when they occur.

Footwear Guidelines

Wearing appropriate footwear is one of the most important things you can do for your foot health:

• Choose shoes that fit properly: Have your feet measured regularly as foot size can change with age. Shop for shoes in the afternoon when feet are slightly larger
• Ensure adequate toe room: Your toes should not be squeezed or rubbing against the end of the shoe
• Break in new shoes gradually: Wear new shoes for short periods at first to avoid blisters
• Inspect shoes before wearing: Check for foreign objects, worn areas, or seams that might cause rubbing
• Avoid going barefoot: Even at home, wear slippers to protect your feet from injury
• Change socks daily: Choose socks made of moisture-wicking materials, and avoid socks with tight elastic that restricts circulation

How Do You Choose a Podiatrist?

Look for a registered, licensed podiatrist with appropriate qualifications for your country. Consider their experience with your specific condition, clinic location and accessibility, availability of appointments, and whether they participate in any health insurance programs you have. Personal recommendations and online reviews can also be helpful.

Choosing the right podiatrist involves several considerations. Podiatry regulations and qualifications vary by country, so it's important to verify that any practitioner you see meets the professional standards required in your location.

Verify Qualifications and Registration

Podiatrists should be registered with the relevant regulatory body in your country or region. This registration ensures they have completed appropriate training and maintain professional standards. Don't hesitate to ask about qualifications – reputable practitioners are happy to share their credentials.

Consider Your Specific Needs

While all podiatrists provide general foot care, some have additional training or experience in specific areas such as diabetic foot care, sports injuries, pediatric podiatry, or surgical procedures. If you have a particular condition, consider seeking a podiatrist with relevant expertise.

Practical Considerations

Think about practical factors such as clinic location, appointment availability, accessibility for people with mobility issues, and whether the practice accepts your health insurance if applicable. Many podiatrists work in both public healthcare settings and private practice, and the options available to you may depend on your country's healthcare system.

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