when to see a podiatrist

When To See A Podiatrist

Feet play a vital role in our daily activities, but they’re often overlooked.  The shoes you wear, the activities you do, and how you walk can take a real toll on your feet. In this blog post we will discuss the reason why and when you should see a Podiatrist (or foot doctor as they are commonly called).

Many people believe that having sore, achy feet and legs after a long day at work is normal.  This is not the case!

The problem people make is that they usually wait longer than they need to, or when their condition becomes unbearable before coming in to see their foot doctor or Podiatrist – and this ends up causing their conditions to worsen.  Visiting a Podiatrist is the first step in keeping your feet happy and pain free. Podiatrists will give you a timely diagnosis and proper treatment plan, and recommendations if any further referral is necessary.

As Podiatrists, we can help patients with a variety of foot, ankle, and lower limb conditions.  Foot and ankle problems can be due to chronic medical conditions like arthritis or diabetes, but even everyday situations, such as overuse, poorly fitting shoes, and the types of surfaces you stand on, can impact your feet.

You should go see a Podiatrist if:

  • You are having difficulty walking or running
  • You have consistent pain in your feet and ankles (ex. heel pain, arch pain)
  • You are experiencing pain and discomfort in your toes and toe nails (ex. ingrown nail, fungal nails, hammertoes)
  • You have bothersome skin conditions such as callus, corns, warts, cracking, blisters, scaling, and peeling of the feet/heels.
  • You have a painful bunion
  • You suspect a strain, sprain, or broken bone
  • You have any signs of infection on your feet or legs(redness, swelling, pus, and inflammation)
  • You think you have Athlete’s feet or other fungal infections
  • You are Diabetic
    • Diabetes makes you significantly more prone to foot problems. If you have diabetes, you should have a foot exam performed by a foot doctor or podiatrist at least once a year.
  • You are getting numbness in your legs, feet, or toes
  • You have any open wounds or ulcerations on the feet – this can lead to serious infection if left untreated
  • You are having difficulties reaching your feet and taking care of them
  • You are starting to run regularly
    • Runners are especially prone to aches and pains like shin splints
  • You are having shoe fitting and footwear problems
  • You have outgrown your orthotics

If you said yes to any of the above points, it would definitely benefit you to book an appointment with a Podiatrist or foot doctor to get an assessment as soon as possible.

During an initial visit, the Podiatrist will take a medical history, perform a vascular, neurological, biomechanical, dermatological, musculoskeletal, orthotic, and footwear assessment.  Based on the practitioner’s findings, an individualized treatment plan is formulated for the patient.  Treatment plans might consist of daily exercises, proper footwear, custom orthotics, foot care, sports strapping, foot manipulations, injections, topical medication, surgery, etc.

There are too many foot and ankle conditions to list everything; but the most common conditions treated in the foot clinic are:

  1. Flat Feet
    • Pes Planus or Flat Feet is a condition where the medial longitudinal arch is lower than normal, or if has fallen or collapsed.  Some individuals are born with flat feet (congential/genetic)  while others can develop this in later stages of life (ex. Adult acquired flat foot). Patients with flat feet are prone to foot and leg injuries such as plantar fasciitis, knee pain, low back pain, bunions, and developing arthritis.
  2. Plantar Fasciitis
    1. Plantar fasciitis is the most common foot condition seen in the clinic. Classic signs and symptoms include pain with the first few steps when getting out of bed or after sitting for an extended period of time, and then the pain decreases after a few minutes of walking around. Towards the end of the work day or with increased activity, people will start to experience the pain again. There is usually pain present when palpating the medial heel tubercle area and along the medial longitudinal arch. Treatment options include: daily exercises, proper footwear, custom orthotics/arch supports, sports taping, foot mobilization and manipulation therapy, cortisone injections, and extracorporeal shockwave therapy.
  3. Heel Spurs
    • Heel spurs are bony prominences and calcifications that can form on the plantar and posterior aspects of the calcaneus causing heel pain. Some patients have naturally occurring heel spurs that  are asymptomatic while other heel spurs can form due to mechanical factors such as chronic plantar fasciitis and fallen arches. Some medical conditions such as Ankylosing Spondylitis can cause the formation of heel spurs.  X-rays will confirm the presence of heel spurs in the foot and ankle. Treatment options include: daily exercises, custom orthotics, heel cushions, cortisone injections and extracorporeal shockwave therapy.
  4. Bunions
    • Hallux Abducto Valgus or Bunions is a bony deformity where the Hallux (Bog Toe) deviates laterally toward the second toe, and they develop a bony prominence on the medial aspect of the 1st metatarsal phalangeal joint. Signs and symptoms include swelling, redness, and pain around the big toe joint, and loss of range of motion.  Causes of bunion formation include: narrow fitting footwear such as high heels, genetics, improper biomechanics, trauma, and can be associated with different types of arthritis such as rheumatoid and psoriatic arthritis.  If left untreated, the deformity will get worse and more painful as the bunion becomes more prominent, and arthritic. Hammertoes will develop as well as the bunion deformity gets worse. Females are 2-3 times more likely to develop this than males. Conservative treatment options include: foot manipulation and mobilization therapy, sports strapping /splinting, custom made orthotics, orthopedic footwear, and daily stretching and strengthening exercises. Some cases will require surgical correction but it is highly recommended that conservative options are exhausted before considering surgery.
  5. Fungal nails
    • Onychomycosis or Fungal Nails occur in about 10% of the population and are usually caused by the dermatophytes T. rubrum, T. mentaprophytes , E. Floccosum, and Candida albicans.
    • It is more common to occur in the toenails than fingernails due to slower growth, dark humid environments, excessive heat and moisture due to occlusive footwear. Fungal infections can also be caused from using infected equipment, using public bathing facilities, and being diabetic increases your chances of developing a fungal nail infection.  Treatments will consist of proper nail care by your Podiatrist, oral or topical anti-fungal medication, laser treatment, and possible surgical removal of the nail in some cases.
  6. Ingrown toe nails
    • Onychocryptosis or Ingrown Toe Nail is painful nail condition where a portion of the nail starts to imbed into the skin around the toenail. If left untreated, this can lead to infection of the toenail and surrounding skin area (paronychia) and can become very painful. This can occur due to improperly cut nails, poorly fitting footwear, abnormal nail shape, fungal nail infection,  bunions, and trauma to the area. Podiatrists can determine the cause of the ingrown toe nail pain and treat it accordingly, through conservative or surgical treatment.
  7. Diabetes
    • Patients living with Diabetes can experience many foot complications, with the worst case being possible amputation of the toes, feet, or legs due to infection. It is advised that Diabetics get their feet routinely checked by a Podiatrist to identify any risk factors, such as poor circulation, neuropathy, footwear, skin conditions (corns, callus, heel fissures, dry skin) and nails, that could lead to possible infection of the foot. Sterilized equipment is used  when performing any Diabetic foot care.
  8. Wounds/ulcers
    • Podiatrists are specialized in wound care management and healing. Diabetic foot ulcers, arterial ulcers, venous ulcers, pressure ulcers,  and wounds created by trauma can all be treated by a Podiatrist.   Depending on the type of wound, a Podiatrist would debride away any unwanted tissue in the area, and apply the appropriate wound care dressing for that specific ulcer. Offloading using boot walkers, felt padding, strapping, and specialized shoes is often necessary to promote better healing.
  9. Painful corns & callus
    • Hyperkeratosis or Callus develop in areas of the feet where there is increased repetitive pressure. This is the body’s way of protecting the area from breaking down due to the pressure. As callus grows and gets thicker, they can start to become painful, and if they are neglected, they can develop corns in the area which are even more painful. Podiatrists will debride any corn or callus tissue, identify any factors contributing to the callus formation (ex. Improper fitting shoes, bunions, hammertoes, etc.), recommend foot creams and emollients, and determine if custom made orthotics will help prevent callus formation.

A Podiatrist can help you and your family with all their foot care needs, and help promote and maintain pain free feet.  Whether it is a painful toe nail, heel pain, plantar wart, or bunion, we can properly assess and treat it all.  It all depends on you to make the phone call and come in!

To book an appointment with Arthritis & Injury Care Centre’s Podiatrist please contact visit our contact page.

Arthritis & Injury Care Centre offers a Podiatrist in Halifax ; a Podiatrist is Dartmouth ; a Podiatrist in Clayton Park ; a Podiatrist in Saint John; and a Podiatrist in Fredericton.

 


 

Authors:
Dr. Jason Ju, BHSc, D.Ch
Arthritis & Injury Care Centre

Olivia Northrup, Business Administration Manager
Arthritis & Injury Care Centre

 

 

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