What Is the Difference Between a Podiatrist & Orthopedist? - Woman What Is the Difference Between a Podiatrist & Orthopedist? by Beth Greenwood Podiatrists and orthopedists work on the lower legs and feet. Although both podiatrists and orthopedists work with the musculoskeletal system, there are significant differences between the two. For example, orthopedists -- more commonly called orthopedic surgeons or orthopods -- and podiatrists have different medical degrees. The orthopedic surgeon is an MD -- Doctor of Medicine -- or a DO -- Doctor of Osteopathy. Podiatrists, however, earn a DPM, or Doctor of Podiatric Medicine. Both podiatrists and orthopods must be licensed to practice in all states. Education Education is one of the most obvious differences between an orthopod and a podiatrist. Orthopods follow the traditional medical education path from college through medical school and residency. As surgeons, orthopods spend five years learning general surgery as well as their specialty, for a total of 13 or more years from college entry to completion of residency.

Podiatrists are not required to have a bachelor’s degree -- although most do -- but need a minimum of three years of undergraduate education in specific subjects such as biology, chemistry and physics to attend a school of podiatry. The DPM is a four year degree and is followed by a residency which usually lasts three years, so a podiatrist might complete her educational requirements within 10 years. What They Do Both podiatrists and orthopods treat and perform surgery on the feet and lower legs, but a podiatrist’s practice is limited to that area, while an orthopod might also work on the hips, shoulders, elbows, hands or spine. An orthopod might treat conditions such as fractures, dislocations and torn ligaments in any joint. In addition, an orthopod might treat scoliosis, arthritis, osteoporosis or bone tumors. A podiatrist will focus on lower leg and foot problems such as treating calluses, removing bone spurs, providing diabetic foot care or performing bunionectomies. Either professional might prescribe braces and splints for the lower legs and feet or shoe inserts called orthotics.

Specialization Because the orthopod has a much wider scope of practice than a podiatrist, many specialize in areas, such as spine surgery. Some orthopods limit their practice to the shoulders, hands, hips or feet. Others may perform a range of surgeries but specialize in pediatric care. Some orthopods choose specialties such as reconstructive surgery or sports medicine. Podiatrists could specialize in podiatric sports medicine, where they focus on treating and preventing foot and ankle injuries for athletes. Podiatrists might also specialize in pediatrics or might choose to perform only advanced surgical procedures such as foot and ankle reconstruction. Salaries Another significant difference between podiatrists and orthopods is found in salaries. The Bureau of Labor Statistics reports that podiatrists earned an average annual salary of $133,870 in 2011, while surgeons earned $231,550. The BLS groups orthopods with all other surgeons except oral-maxillofacial surgeons and obstetrician-gynecologists, who are tracked separately, so salary data incorporates information from a broad range of surgical specialties.

However, the American Medical Group Management Association reported that orthopedic surgeons earned $501,808 annually in 2011. Consulting a podiatrist as a runner | timeoutdoors Consulting a podiatrist as a runner How and when to consult a professional and what podiatrists and chiropodists can do for runners. Consulting a podiatrist Podiatrists and chiropodists do roughly the same thing, but chiropodist is a more common term in the UK. 'Podiatry' is used internationally and in the UK can represent increased levels of training over chiropody. The terms chiropody and podiatry are not protected and therefore anyone can set up in private practice. To practice in the NHS, you need to be State Registered, and this is the qualification I'd recommend you look out for. The Society of Chiropodists & Podiatrists represents the vast majority of State Registered professionals. A state registered chiropodist/podiatrist will have the following letters of qualification after their name: 'SRCh', 'MChS', or 'FCPodS'. Podiatrists can be located under 'chiropody' in most phone directories.

It's worth phoning around to guage level of expertise and the cost of consultations and orthoses Most health authorities have a local chiropody department, perhaps termed 'podiatry' or 'foot health'. The level of gait analysis and orthoses (supportive shoe inserts) provided varies greatly between districts, depending on funding. Who is eligible for treatment, also varies and may excludes runners who by nature are relatively healthy. If you have any concerns or recurrent problems with your feet, or feel you may have a problem with your running shoes or running function, a visit to a state registered chiropodist or podiatrist is likely to be of value. A referral by a doctor is not necessary. I'd recommend phoning around several practices to gauge the level of expertise and the costs of consultations and orthoses. Insoles Sorbothane insoles provide shock absorption 'Insole' simply means a layer that sits inside the shoe under the foot. Most running shoes come with an insole, often removable. However, some people have prominent areas that are pre-disposed to irritation, or poor foot function that requires support and/or cushioning. You can buy insoles like 'Sorbothane', 'Silipos' etc.

that are designed to provide increased shock absorbency and some moderate support. Orthotics If more extensive support is required then there are more supportive in-soles, called orthotics or orthoses. There are several commercial 'over the counter' orthotics available that provide quite good support but these tend to be relatively soft to avoid causing any problems. Podiatrists can provide customised orthoses, which are moulded to the shape of the foot to provide support There are more supportive pre-formed orthoses available to professionals, which can be adapted to the individual. While these often provide excellent results they are not customised for an individual foot and therefore do not suit everybody. Podiatrists can provide customised orthoses, which are moulded to the shape of the foot to provide support. The traditional method is to take an impression of the foot, which is then filled with liquid Plaster of Paris which, when set, provides a model of the foot. Materials are then moulded to the cast to provide appropriate control. With newer technology, the impressions can be scanned into a computer which will either generate a model of the foot, or the orthoses themselves can be produced by 'Cad Cam'.

More recently, sophisticated scanning machines have become available in an attempt to bypass the need for impression taking. Search advice Osteoarthritis Osteoarthritis Osteoarthritis Osteo-arthritis is often called the 'wear and tear' arthritis. It occurs when the cartilage of a joint becomes damaged Arthritis is a disease of the joints which causes them to become inflamed and stiffen. There are three types of arthritis – Rheumatoid arthritis, Osteo-arthritis and the less common form, Gout What is it? Osteo-arthritis (OA) is often called the ‘wear and tear’ arthritis. It occurs when the cartilage of a joint (a thin layer of gristle that covers the end of the bones and allows them to glide over each other) becomes damaged. When the cartilage deteriorates, the bone underneath can thicken, causing pain, stiffness and swelling. The joints most affected are the knees, hips, hands and big toes. In severe cases, the cartilage can deteriorate to the extent that the bones rub together making it difficult to move the affected joint at all. Symptoms vary from person to person and some people may have OA without experiencing many symptoms at all. What causes the problem?

As our joints are being used continuously through daily movement, wear and tear is inevitable but for some people the natural repair process does not function properly and causes the severe wear and tear (OA). OA can affect any of the 33 joints in the feet but mostly affects those at the base of the big toes. This joint is more prone to wear and tear from the pressures of walking, especially if you over-pronate (ie. roll your foot inwards excessively as you walk). Wear and tear at the ends of the bone cause the cartilage to erode and the bone ends may begin to join together. Eventually your big toe may become rigid (a condition known as hallux rigidus) which makes walking difficult. Or your big toe may drift towards your other toes (hallux valgus) which can lead to bunions. Is it serious? The symptoms of OA tend to be mild in most cases and tend not to get worse over time; symptoms can vary and also come and go over time. Who gets it? OA is uncommon before the age of 40 and is more common in women than men.

Though the exact cause of OA is unknown, it is probably due to the fact that as we age, we tend to put on weight and thereby put more pressure on our joints and our muscles become weaker and our body loses its ability to heal itself. When OA occurs in younger people, it is usually because the joint cartilage has been damaged through injury (such as a sprain or fracture), a bacterial or viral infection or even through overuse of a particular joint as is common in farmers (hips), plumbers (knees) and footballers (knees and ankles). Arthritis Research UK estimates that 8 million Britons are affected by OA but only 1 million seek treatment. How do I know I have it? You may initially feel a toothache-type ache in the affected joint that gets worse when you’re active, wearing high heels or when it’s cold and damp. It may progress to the stage where your feet ache at night. In severe cases, the range of movement in the joint may fail to the extent that you can’t move it at all. How do I prevent it? If you are worried that you have OA you should see your GP or a podiatrist. The earlier you are diagnosed, the more effective any treatment will be.

If you do have OA, there are many things you can do yourself to help ease the condition. Footwear Minimise the stress on joints by wearing well-cushioned shoes. Choose shoes with lace-up fastenings or an adjustable strap: they keep the heel in place and stop the toes being pushed to the front of the shoe. Your feet should keep their natural shape when in shoes. There should be a centimetre between the end of your longest toe and end of the shoe. They should also be roomy enough to accommodate any swelling so a wide, deep pair are best. Exercise Toes aren’t a part of the body we often think of exercising but by doing so and stretching regularly, you can help nourish the joint cartilage and strengthen the muscles and tendons around the joint. It is recommended that you put your feet side by side (say while you are in the bath) and try to move your big toes towards each other and do this regularly three or four times a day. You should ideally also exercise your whole body to keep your joints flexible, your muscles strong and your bone and cartilage tissues healthy. Yoga is a great exercise for all your joints, including your toes.

Swimming is also great because it doesn’t put any pressure on your joints. What are the treatments? Your GP may recommend painkillers or steroids to ease the pain. There are also creams and gels which can be absorbed into the bloodstream if rubbed on the affected joints when they are painful, such as after exercise or at the end of the day. Ideally, you should be seen by a team of rheumatologists, physiotherapists, occupational therapists and podiatrists. When should I see a podiatrist about it? Although there is no known cure for OA, there are many ways your podiatrist can help you ease the pressure on the affected joints and therefore reduce the pain and inconvenience. Orthoses are special shoe inserts that help redistribute the pressure as you walk. They’ll help you walk in such a way that alleviates the pain in your joints. Shoes Your podiatrist can advise you on the best type of footwear to wear for your exact problem. If you develop hallux valgus (where you big toe drifts towards your second toe), you may be recommended a shoe with a stiff sole as this relieves pain reducing the movement of the big toe.

In some cases, a shoe with a slight heel raise may be more comfortable. Strapping and padding Your podiatrist may strap the feet for a short time to limit joint movement. They can also provide protective shields for your toes or padding to relieve pressure and friction. Surgery If your problem doesn’t improve with the above measures, you may be referred to a podiatric surgeon who will evaluate the extent of our problem and see if you are suitable for: excisional arthroplasty (replacement of joint surfaces) interpositional arthroplasty (placing soft tissue, especially joint capsule, between the resected bone surfaces) osteotomy (decompresses and realigning the joint surfaces) joint replacement (used for irreversibly damaged joints) arthrodesis (where the bones are fused together) However, surgery is only used as a last resort. Specialist teams of rheumatologists, podiatrists/chiropodist, physiotherapists and occupational therapists, along with specialist nurses, will provide the most effective care and treatment for arthritic patients, especially those with rheumatoid arthritis.

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as your GP to refer you to your local NHS trust for free treatment but if you do not qualify for this, or need urgent attention, you should contact a private podiatrist. To talk to a podiatrist (also known as a chiropodist) about the options available regarding treatment, you can contact an NHS podiatrist or a private practice podiatrist. In both cases, always ensure that any practitioners you visit are registered with the Health Professionals Council (HPC) and describe themselves as a podiatrist (or chiropodist). To contact an NHS podiatrist, please contact your GP practice for information on an NHS referral (in some areas you can self-refer). To see a private practice podiatrist, use our search Find A Podiatrist . FOOT CARE: HOW PODIATRY AND PODIATRIST PROTECT YOUR FEET FOOT CARE: HOW PODIATRY AND PODIATRIST PROTECT YOUR FEET Abraham Lincoln had a foot doctor in the White House for his painful feet WHAT IS PODIATRY?

Authored by Dr. Burton S. Schuler, Google+ Podiatry is a branch of medicine that is dedicated to foot care by dealing with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and ankles. The aim of podiatry is to improve the health and well-being of the public. Podiatrist earn the degree of Doctors of Podiatric Medicine (DPMs) and are physicians and surgeons of the feet and ankles. Podiatrists are also called foot doctors, foot care specialist or podiatric surgeons. Podiatrists are the only health care group who specialize solely in foot care . Education of a Podiatrist The normal course of education for Doctors of Podiatric Medicine includes four years of undergraduate work, followed by four years in an accredited podiatric medical school. The new podiatrist then performes a residency of 1-3 years. DPMs are licensed in all 50 states, to diagnose and treat the foot and ankle. In order to get a state license to practice podiatric medicine the new doctor must pass written and oral examinations in the state they want to practice in. Over the past 60 years the U.S.

government has spent hundreds of millions of our dollars to train an army of foot specialist to give us good foot care. This is vital in the light of the massive outbreak of Diabetsis in the population. The treatment of Diabetsis is in this writer’s opinion is the single most important task the profession of podiatry does on a daily basis. FOOT CARE: Some of the Foot Ailments Podiatrists Treat The conditions podiatrists treat arthritis well as neurological and circulatory diseases. Podiatrists are also able to diagnose and treat any complications of the above which affect the lower limb, including skin and nail disorders, corns, calluses and ingrown toenails. Some of the other conditions treated by foot care specialist on a daily basis include. Overload Heel Pain Syndrome FOOT CARE FOR CHILDREN Treating children is also an important part of providing foot care to the public. Their unique foot problems are often missed, causing lifelong problems for them. They have structural imbalances of the feet that often cause great pains that are misdiagnosed for other problems. They can be unrecognized causing other deformities and problems within their body. The podiatrist is the best health care professional suited for treating these problems.

The other special group seen by the Doctors of Podiatric Medicine are seniors. They have their own special need of foot care. This can be ongoing palliative treatment for toenails care and for trimming of corns and calluses; and diabetic ulcerations. Circulatory problem are also common at this point in life among seniors as well as forms of arthritis’s. Again it is the foot doctor who is best qualified to treat these problems in the older patient. As stated above the treatment of diabetics especially the preventive treatment is very important. On the Job Foot Care. On a daily basis podiatrists treat foot care problems which are due directly to people jobs. Such people as waiters, hairdressers, factory workers and nurses are examples of those who are more likely to develop long-term foot problems unless preventative measures are taken. Podiatrists are best suited to treat these problems by evaluation the patient feet for biomechanics l problems that can appear with time.. Biomechanics The way that our feet work everytime we take a step is known as Biomechanics. This assessment of the motion of the foot allows for an effective diagnosis of the cause of the patients pains, and how to treat them in the future.

Podiatrists then perform clinical biomechanical evaluation of the foot to detect pathomechanical anomalies to ensure appropriate and effective treatment. The most common treatment are prescription foot orthoses , made from precise measurements of an individual’s foot and a impression of the foot/ Orthotices The fabrication of orthotics as already stated are a main stay of the modern podiatric practice. Orthoses are custom-made inserts for shoes made to control the patient’s abnormal foot pathology There are two classes of orthotics.– functional orthoses or palliative orthoses. Functional orthoses are made from a cast of the patient’s foot. They are then fabricated designed to stabilize the foot and to prevent the foot from going into a abnormal and or unbalanced position while standing . Normally they are made out of a hard material like fiberglass or a plastic material Palliative orthoses are designed specifically to treat pin point area on the bottom of the feet. Most often to treat painful area on the balls of the feet, or areas with ulcers. They are made of softer materials than functional orthotics are, normally from foam, leather or rubber They are often used for patients with severe arthritis. TREATMENTS Podiatrist use both non surgical and surgical techniques in the treatment of their patients.

In aid of making proper diagnosis they now use X-rays and Sonography and other tests . Non surgical treatments such as ultrasound, injections , taping, and paddings are used by a podiatrist on a daily basis for many podiatric problems. Surgery on an out-patient basis may involve the use of traditional orthopedic foot surgery or minimal incision surgical techniques first devolved over 40 years ago by the Academy of Ambulatory Foot Surgery . Custom orthotics are always an important part of any treatment to address the underlining biomechanical imbalances causing most foot problems. WHY YOUR FEET HURT To get a true feeling for foot care you must understand why your feet really hurt. Heredity is the major causes for having foot problems. When someone says that you look like your mom or dad, bear in mind that the resemblances can also extend to how your feet look and act. It is not unusual to see three generations of one family only to see the same problems. Most people think the reason(s) their feet are hurting are because of a bad pair of shoes, having the wrong job or just standing too much. I don’t believe so.

Don’t misunderstand, those things (job, shoes, standing) can definitely aggravate a foot already susceptible to having problems, but by themselves, they are rarely the real underlying causes of the foot problems. They are simply the external stresses that finally push your feet over the edge in mid-life, causing you to have pain. When I tell patients for the first time that their foot problems are NOT likely due to their job, shoes, and/or standing on their feet too much, but rather due to Ma, Pa, or Uncle Louie, they look at me dumbfounded. Think about it. Does everyone you work with, who has the same job as you, stand on the same floor for as long as you do, or wear the same exact style shoe as you, have foot problems? Of course not! Then why do you and not they? It is because in the great lottery of life, you were born with the tendency to have a Morton’s Toe or some other foot problem. Of course, if you knowingly wear shoes that are wrong for your feet, they will hurt.

In regard to shoes, don’t forget that famous age old saying, “You cannot fit a salami into a hot dog bun.” Patients ask me all the time, “ Dr. Schuler , what can I do to prevent my foot problems?” My answer is simple: “Pick different parents next time, when it comes to your feet.” Most people who inherit the tendency to have foot problems don’t have these problems until they reach middle age. That is when these inherited traits start to take their toll due to the day-in, day-out trauma that has built up over the years. Copyright © 1982 - 2013 | Dr. Burton S. Schuler | Foot Care | Podiatrist | Panama City, FL. | Website design by CYber SYtes, Inc. Ontario Podiatric Medical Association (OPMA) - About Podiatrists About Podiatrists Ballet & Foot Health Who are Podiatrists? A Doctor of Podiatric Medicine (D.P.M.) is a highly-trained specialist in care of the feet. In virtually all North American jurisdictions (including British Columbia and Alberta) podiatrists are also authorized to diagnose and treat conditions of the ankle and in a few cases the lower limb.

Ontario's chiropody scope of practice is restricted to the foot and to diseases, disorders and dysfunctions of the foot. Podiatrists are often called upon by physicians and other health care professionals for consultation and treatment of foot problems that can be experienced by everyone from children to seniors. A referral from your family physician, however, is not required to see a Podiatrist. Podiatrists are fully competent to diagnose and treat conditions of the foot among the geriatric population and over half of podiatrists' patients are seniors. Examination of children's feet is also an integral part of podiatry. Frequently, children have structural imbalances of the feet that may go unrecognized and can lead to other deformities and imbalances within the skeletal system. When detected early, these imbalances of the feet, some of which are related to the bone structure, are treated so that a sturdier foundation can be provided for the later years. Podiatric Care is required for many foot problems commonly experienced by seniors. These can include anything from routine palliative care of unmanageable toenails and calluses to diabetic ulcerations and infections. At this time in life, circulatory impairment, as well as degenerative joint and skin conditions are common findings.

With proper care and attention to their feet, seniors may enjoy many years of pain-free foot function. Some of the Foot Ailments treated by Podiatrists GENERAL Loss of Sensation (Neuropathy) Weight Bearing Imbalances Many podiatrists utilize both conventional and highly specialized methods that include both conservative and surgical techniques. X-rays and other diagnostic tests may be performed by a podiatrist. Surgery on an out-patient basis may involve the use of traditional open or minimal incision surgery including endoscopic and even laser techniques. Custom orthotics may be prescribed to correct certain biomechanical imbalances and occasionally custom shoes may be prescribed. Therapeutic modalities such as ultrasound, laser, taping, padding and parrafin wax baths may be used by a podiatrist. Foot problems are often associated with abnormal conditions in other parts of the body, both systemic and skeletal such as in back disorders. Podiatrists are trained to recognize signs of diseases that manifest themselves in the feet. These include gout, psoriasis, and various types arthritis. Early diagnosis and treatment of foot problems are worthwhile investments in overall good health. Unfortunately, major foot problems can result when people attempt to diagnose and cure their own foot ailments or neglect their feet altogether.

In the average life time, we walk approximately one hundred and eighty-four thousand kilometers, more than four times the earth's circumference! As eighty percent of people will experience a foot problem at some time in their life, it is important to seek care through a licensed podiatrist. Finally, you should remember this about podiatrists; around the world, no segment of the health profession sees and treats more foot problems day by day than a Doctor of Podiatric Medicine. If symptoms develop, see your podiatrist promptly. We only have one pair of feet to last a lifetime! Surgery | Foot Health | Learn About Feet | APMA Learn About Feet Surgery When is Foot Surgery Necessary? Many foot problems do not respond to “conservative” management. Your podiatrist can determine when surgical intervention may be helpful. Often when pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat arthritic conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions can be done with screws, plates or pins or a combination of these.

Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures but is also commonly done to lengthen or shorten the tendon, depending on the problem. In some cases, tendons may be re-routed to improve foot and ankle function. Metatarsal Surgery: Surgery on the lesser metatarsals is performed for a variety of reasons but is commonly done to redistribute the weight bearing on the ball of the foot. In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area). Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement. Your podiatrist can explain the bunion procedure that is most appropriate for your bunion. Depending on the surgery necessary, the recovery time can be very different—particularly if you need to be on crutches after the surgery or in a cast. Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of the toe bone to realign the toe or could involve fusing the toe joint (see Fusions, above). In some cases, it may involve placing an implant in the toe to maintain realignment.

Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue. Heel Surgery: Based on the condition and the chronic nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases. The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision. There have been various modifications and surgical enhancements regarding surgery of the heel. Your podiatrist will determine which method is best suited for you. Reconstructive Surgery: Reconstructive surgery of the foot and ankle consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease. Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot and/or ankle.

Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion). Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures. Preoperative Testing and Care As with anyone preparing for any surgical procedure, those undergoing foot and ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered by your podiatrist, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulatory status of the foot and legs), and a biomechanical examination. A consultation with another medical specialist may be advised by a podiatrist, depending on your test results or a specific medical condition.

Postoperative Care The type of foot surgery performed determines the length and kind of aftercare required to assure that your recovery from surgery is rapid and uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression, and elevation. Bandages, splints, surgical shoes, casts, crutches, or canes may be necessary to improve and ensure a safe recovery after foot surgery. Your podiatric surgeon will also determine if and when you can bear weight on your foot after the operation. A satisfactory recovery can be hastened by carefully following instructions from your podiatrist. Continue Common Foot and Ankle Problems - Baylor Scott & White Health > Common Foot and Ankle Problems Common Foot and Ankle Problems Click on a common podiatric problem below to find out more, including treatment options. Venous insufficiency Arthritis of the feet Arthritis is a term used in medicine meaning inflammation of a joint.

The feet are commonly affected by arthritis which can be characterized as: Pain during movement of the joints of the feet Tenderness in and around a joint Redness or swelling around a joint In severe cases, foot deformity as a result of prolonged arthritis Certain types of arthritis such as rheumatoid arthritis, osteoarthritis, septic arthritis, gouty arthritis and psoriatic arthritis can present themselves in different ways, but the pain and complaint from the patient is similar. Many of these types can be identified on a simple radiograph taken while at your doctor's appointment. Treatment: Treatments include, but are not limited to: Proper shoe gear recommendations Back to Top Ankle Sprain The ankle joint is an important joint used for walking. A joint is formed where bones come together. Joints are held together by tissue called ligaments. The ligaments allow for motion of the bones at the joint, but only within certain ranges of motion. An ankle sprain occurs when the ankle ligaments are stretched more than normal. This may be caused from the ankle "rolling" or "twisting" during an awkward fall or simply stepping down wrong. This may result in a partial tear or complete tear of the ankle ligaments.

The trauma to the ankle ligaments causes pain, bruising and problems bearing weight. The pain is usually located on the outside of the ankle but may cause pain to both sides of the ankle if severe. The ligament damage may result in the development of abnormal motion at the joint due to the loss of stability. This may increase the likelihood of future ankle sprains. Treatment: Treat ankle sprains by following RICE: Rest Compression Elevation If pain is severe and/or you cannot bear weight on the sprained ankle, you should see your doctor for an exam and X-rays to determine the extent of the injuries. Back to Top Athlete's foot Athlete's foot is a fungal infection of the skin. Symptoms include itching and redness between the toes, peeling of the bottom of the foot and dry flaky skin. Fungi can be found everywhere in the environment and athlete's foot occurs when the immune system allow fungi to infect the skin. Those at higher risk are diabetic, immunocompromised people and those frequently exposed to areas where fungi like to live – such as public showers or baths. Treatment: Athlete's foot can be treated with over-the-counter antifungal creams and lotions.

For most people this will clear the infection, however, sometimes prescription medicine is needed. If it becomes a chronic problem then the antifungal cream may need to be used once or twice a week once the main infection is cleared using prescription medicine. Back to Top Bunions / Tailor's bunions Bunions are often described as an enlarged bump on the side of the big toe. The visible bump actually reflects changes in the bony framework of the front part of the foot. When bunions form, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion's "bump." Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people never have symptoms. Tailor's bunion, also called a bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot.

The enlargement that characterizes a tailor's bunion occurs at the metatarsal "head," located at the far end of the bone where it meets the toe. Tailor's bunions are not as common as bunions, as described above, but both are similar in symptoms and causes. The symptoms of bunions and tailor's bunions include redness, swelling and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation. Treatment: Conservative treatment can consist of changes in shoe gear. Wearing shoes with a wider toe box (front half of the shoe) is sometimes helpful. Wearing open-toed shoes such as flip flops or other sandals can also be beneficial. Padding of the irritated bump with felt or other over-the-counter measures will help in some cases. When is surgery needed? Surgery is often considered when pain continues despite conservative treatment approaches. Surgery is highly successful in the treatment of bunions and tailor's bunions. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the X-ray findings, your age, your activity level and other factors.

The length of the recovery period will vary depending on the procedure or procedures performed ranging from four to eight weeks. Corns and calluses Corns and calluses occur as the body's way to protect itself from increased pressure. Corns are thickened areas on top of the foot, usually the toes. Calluses are found on the bottom or sides of the foot. They often are due to improperly fitting shoes, such as shoes that are too tight or too narrow. However, they can also be due to foot deformities such as hammertoes and bunions. Treatment: By controlling the increased pressure in the foot, calluses can be lessened. Many good over the counter padding options such adhesive pads, toe spacers and tubular slip-ons can help relieve pressure. Medicated corn removers should be avoided because they contain acids that can cause chemical burns and can be very irritating to the skin. Over-the-counter or prescription orthotic therapy Corns and calluses can also be controlled through mild abrasive therapy at home through the use of a pumice stone or nail file to the area one to two times per week. If these options do not relieve your symptoms, then medical attention should be sought for further treatment options.

Back to Top Diabetes-related foot problems Diabetes can be dangerous to your feet, even a small cut could have serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. An example of this would be not noticing a pebble in your shoe, so you develop a blister, then a sore, then a stubborn infection that might eventually lead to the amputation of your foot or leg. To avoid serious foot problems that could result in losing a toe, foot, or leg: Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. (If your eyesight is poor, have someone else do it for you.) Call your doctor if you notice anything. Moisturize your feet, but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But do not moisturize between the toes, as this could encourage a fungal infection. Cut nails carefully and straight across; file the edges. Don't cut them too short, this could lead to ingrown toe nails.

Wear clean, dry white socks and change them daily. Wearing white socks allows you to see at a glance if your feet might be bleeding. Shake out your shoes and inspect the inside before wearing. Remember, you may not feel a pebble, so always shake out your shoes before putting them on. Never walk barefoot – not even at home! You could step on something and get a scratch or cut. Take care of your diabetes. Keep your blood sugar levels under control. Keeping your blood sugar below 140 could decrease your chances of numbness and tingling in your feet. Never trim corns or calluses. No "bathroom surgery" - let your doctor do the job. Get periodic foot exams. See your podiatrist on a regular basis for an examination to help prevent the foot complications of diabetes. Diabetic shoes and inserts Footwear and orthotics play a vital role in diabetic foot care. Diabetic shoes should have extra depth to accommodate for any deformities in the forefoot. They may also have what is called a rocker bottom which is incorporated into the sole to decrease the motion that your foot will have to make.

This allows for a reduction in friction and shear forces that can often cause blisters or wounds on your feet. Orthotics are designed to bring the ground up to the bottom of the foot to accommodate for any bony prominences. Soft materials that conform to your foot are used to construct these inserts. These materials are designed to accommodate pressure and hot spots by conforming to heat and pressure. By customizing inserts to your foot, the comfort and protection needed in diabetic foot care is accomplished. Diabetics should get a new pair of shoes every year with three sets of inserts. Back to Top Flatfeet Flatfooted is a term used to describe a foot where the arch appears to be non-existent when a person stands. Flatfooted patients tend to have pain at various areas of their feet, but mostly complain of pain at the instep or heel pain. These patients will also sometimes have impinging type pain at their outside ankle area. Patients will notice that most shoes are uncomfortable and do not provide the support needed. Treatment: Treatments include: Various conservative types of padding or bracing Possible surgical intervention Back to Top Foot perspiration (excessive) and odor The foot is densely covered with sweat glands, which causes excessive perspiration of the foot.

This perspiration paired with wearing shoes and/or socks with inadequate air ventilation provides ideal conditions for bacteria and fungi to grow and thrive. Odor is the result of the growth of the bacteria and fungi. The excessive moisture contributes to athlete's foot and plantar's wart infections. What can I do to prevent foot perspiration and odor? Thoroughly wash feet Choose properly fitting, cotton socks with proper ventilation. Many socks are made of nylon, which does not provide proper ventilation and increases perspiration, increasing foot odor. Change socks regularly Back to Top Foot ulcer An ulcer is a sore on the skin or a mucous membrane caused by tissue breakdown. The ulcers that develop on feet are due to skin and tissue breakdown resulting in an open area. Anyone can get ulcers on their feet, but it is more likely in someone who has decreased sensation in their feet. Decreased sensation, or neuropathy, can be caused by several things, but the most common cause is diabetes. Ulcers usually develop over boney prominences and in areas of increased pressure. Once an area "breaks down" or becomes ulcerated you must decrease the pressure to that area for it to heal.

Effectively healing ulcers requires adequate offloading, circulation, good nutrition and the prevention or management of infection. Treatment: If you develop an ulcer you should have it evaluated by a doctor. The doctor may make recommendations on appropriate wound care and shoe gear. Your doctor can also evaluate you for healing potential, such as the amount of circulation (blood flow) to the area. If the ulcer has drainage, redness, pain, and/or an odor you should seek medical attention immediately. Back to Top Hammertoes A hammertoe is a toe that stays curled instead of being straight. This often makes the knuckle prominent and will become painful and rub on shoes. Sometimes due to the curling, all the weight is put on the tip of the toe and this area can become painful and callused as well. Treatment: Conservative treatment includes multiple padding options. If the pain is on top of the toe, tubular slip on type padding may work well. Calluses on the tip of the toe can be offloaded with a crest pad, which is a slip-on pad that sits under the toe to help straighten and lift it. This does not correct the toe but helps to lessen the symptoms.

If padding does not work, surgery can be done to straighten the toe. Back to Top Heel Pain Heel pain is a very common complaint. You may have noticed a severe pain in the bottom of your heel, especially when you first step out of bed in the morning. You may also experience the pain after long periods of sitting. This pain is usually due to inflammation or irritation of a ligament that stretches from your heel bone to the ball of the foot, known as plantar fascia, and is called plantar fasciitis. Heel pain may also be due to other causes such as a stress fracture, tendonitis, arthritis, nerve irritation or – less common – a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. What are the common causes of plantar fasciitis? The most common cause of plantar fasciitis is usually due to a fault in the foot structure. If you are flatfooted or have high arches, you are more likely to develop plantar fasciitis. Also, wearing improper footwear on hard, flat surfaces can put a strain on the plantar fascia and lead to plantar fasciitis.

Treatment: Some initial treatment options that can be started at home are: Avoid going barefoot, even in your home Stretching exercises Good, supportive footwear such as a running shoe Pain medication, such as ibuprofen Rest If these treatment options do not help or if the pain continues for several weeks with little to no improvement, you should contact your podiatrist. A podiatrist will examine your foot and do tests to determine the source of your heel pain. If a spur of bone is seen on X-ray, it may be called heel spur syndrome. The treatments for plantar fasciitis and heel spur syndrome are the same. Back to Top Ingrown toenail An ingrown toenail is the result of the nail curving downward and growing into the skin, usually at the nail borders (the sides of the nail). This "digging in" of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe. If an ingrown nail causes a break in the skin bacteria may enter and cause an infection in the area – often marked by drainage and a foul odor.

However, even if your toe isn't painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection. Treatment: Treatment consists of removal of the portion of the nail that has grown into the skin. A short course of antibiotics may also be needed. Removing the ingrown portion of the nail is usually all that is needed. You should see your doctor if this condition develops and does not resolve on its own, especially if it's a recurrent problem. Your doctor will advise you on treatment options. Back to Top Metatarsalgia Metatarsalgia is a term used to describe pain in the bottom of the ball of the foot while standing or walking. Sometimes patients will describe a burning or dull pain that continues to burn at the balls of the feet after resting. Patients will frequently say that it feels like they are walking on the bone and don't have any padding in that area. Since it is such a general term used to describe pain in the area, your physician will likely need plain radiographs to rule out other problems or reasons why the pain is localized to that area. Treatment: Treatments include shoe gear recommendations, padding or supportive devices and possible surgery.

Morton's neuroma A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton's neuroma, which occurs at the base of the third and fourth toes between the metatarsals. "Intermetatarsal" describes its location - in the ball of the foot between the metatarsal bones (the long bones extending from the toes to the midfoot). Neuromas may also occur in other locations in the foot. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage. Treatment: Treatments include: Padding techniques provide support for the metatarsal arch, thereby transferring the pressure from the base of the toes to the back of the foot. Decreasing the pressure on the nerve and decreasing the compression when walking. Placing an icepack on the affected area helps reduce swelling. Custom orthotic devices provided by your podiatrist provide the support needed to reduce pressure and compression on the nerve. Changes in shoe wear.

It's important to wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels. Non-steroid anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Injection therapy – if there is no significant improvement after initial treatment, injection therapy may be necessary. Surgery may be considered in patients who have not received adequate relief from other treatments. Generally, there are two surgical approaches to treating a neuroma. Neuromas can either be removed or released. The length of the recovery period will vary, depending on the procedure or procedures performed. Back to Top Peripheral edema Peripheral edema is the swelling of tissues (most commonly in the lower limbs) as the result of the accumulation of excess fluids under the skin and the spaces within the tissues that are outside of the blood vessels. It is a very common problem and because of gravity, swelling is very noticeable in the lower extremities. What causes peripheral edema? Medications (estrogen and testosterone, calcium channel blockers, and antidepressants) Peripheral edema can also have serious systemic causes which include kidney, heart or liver disease.

Treatment: Treatment of edema is usually aimed at the underlying cause, which may include removing the excess fluid with diuretics, elevating the legs, or using compression stockings or compression pumps. Back to Top Plantar warts Plantar warts are skin growths on the soles or bottom of your feet. Their name comes from where they are located – plantar is the term used to indicate the sole of the foot. These lesions or skin growths are caused by the human papillomavirus (HPV). This virus likely enters your body through tiny cuts and breaks in your skin. Plantar warts often develop beneath pressure points in your feet, such as the heels or balls of your feet. A callus may build up over the wart as well. If the wart(s) develop under a pressure point, they may become painful and cause difficulty walking. Treatment: Treatments include an examination by your doctor to get the correct diagnosis as there are other types of lesions that may develop on the foot which also look like warts. A correct diagnosis will lead to an appropriate treatment. There are several treatment options including topicals and surgical excision. See your doctor for the best treatment plan for you.

Back to Top Prescription orthoses Foot pain can often be alleviated with the use of prescription orthoses. These orthotics are designed from either a custom impression of your feet or a scanned image of the bottom of your feet. Using computerized technology, a personalized set of orthotics are made. They can be fabricated from several different materials making them more rigid or cushioned. Custom prescription orthotics can be used to correct deformities or offload an area that is causing you pain. They can also be customized to allow your foot to function in the most efficient way possible decreasing unwanted movement. Everyone from runners to the leisure walker can benefit from a pair of prescription orthoses. Back to Top Sports-related injuries Sports injuries are unfortunately a common occurrence within the foot. Different sports such as soccer and track put added stress on the legs and feet and can lead to painful drawn-out injuries. Frequently, injuries such as ankle sprains, muscle strains/tears, turf toe, fractures and dislocations are seen by podiatrists. Early diagnosis and clinical evaluation is a must for many of these injuries in order to avoid further injury. Treatment: Various treatment recommendations from immobilization with casts, walker boots, physical therapy or surgery are all employed when dealing with these injuries.

Back to Top Toenail fungus The medical term for toenail fungus is onychomycosis, which means fungal infection of the nails. This condition may affect toe or finger nails, however toenail infections are particularly common. You may also experience pain in the toes and an odor from the nail fungus. How do I know if I have toenail fungus? Some common signs of toenail fungus are: Thickened and discolored nails, usually yellow Rough and crumbly nails that separate from the nail bed Nails that are distorted in shape A build-up of debris under the nail How did I get toenail fungus? Nail fungal infections are typically caused by a fungus that belongs to a group of fungi called dermatophytes. However, yeasts and molds can also be responsible. All of these microscopic organisms can be found anywhere, but prefer to live in warm, moist environments. Toenail fungus is more common than fingernail fungus because your feet are often confined to a shoe, which provides the dark, warm and moist environment that fungi thrive in. Another reason is that the blood circulation at your toes is diminished when compared to your fingers, which may make it harder for your body's immune system to fight off this infection.

When should I seek medical treatment for toenail fungus? Nail fungus can be difficult to treat and once an infection begins it can persist indefinitely without medical intervention. See your doctor at the first sign of nail fungus – often a tiny white or yellow spot under the tip of your nail. What are the treatment options for toenail fungus? Nail fungus is extremely difficult to treat and repeat infections are very common. Treatment options are oral medications, antifungal lacquer and/or topical medications. If your nail infection is severe or extremely painful, your doctor may suggest removing the nail. Chronic Venous Insufficiency (CVI) Chronic venous insufficiency is a condition where blood pools in the veins of the lower legs. The first signs of chronic venous insufficiency are usually ankle and leg swelling. Your legs may feel heavy, tired, itchy, or achy, especially at the end of the day or after prolonged standing. As the swelling and pressure increases, your skin may actually start to leak a yellowish fluid from your pores. This fluid is plasma which is a normal component of blood.

Eventually, if the swelling is not stopped, the small blood capillaries will burst releasing red blood cells and giving the skin a reddish brown discoloration called hemosiderine. At this point the skin is very fragile which increases the chances of the patient to develop leg ulcers. These ulcerations are called venous stasis ulcers and as with any opening in the skin, there is a high incidence of a secondary infection to the leg. This infection can spread very fast to the surrounding tissues and even become life threatening. What causes chronic venous insufficiency? Arteries bring oxygenated blood from the heart to the organs in the body and veins return the deoxygenated blood back to your heart and lungs. To accomplish this, blood needs to flow upward from the veins in the legs. For this to happen, the muscles in the lower extremities need to contract.This contraction will squeeze the veins, pushing the blood upward. To keep the blood flowing in an upward direction and not back down, the veins contain one-way valves. This valve system is known as the venous pump and works very effectively when you walk, however when you sit or stand for long periods of time the blood in your legs can pool and increase the venous blood pressure.

Chronic venous insufficiency occurs when the valves in the vein become damaged and are not able to close all the way. This allows blood and fluid to leak backward causing blood to pool in the lower legs which is known as venous stasis. Several things can cause the valves to be damaged including: Varicose veins Missing valves in veins, or the valves in the veins do not work properly Blockage in the vein by a clot Muscles inadequately squeezing the veins Treatment: Compression stockings help maintain swelling by squeezing the veins, which helps prevent blood pools from forming in the lower extremities. Elevating your feet above the level of your heart whenever you are lying or sitting and avoiding any long periods of sitting or standing will also help decrease edema. Compression bandaging if there are ulcerations or breakdown of the skin to help control the swelling and heal the skin. Once healing has occurred, the use of compression stockings will usually prevent any reoccurring skin breakdown. Bunions | Foot Health | Learn About Feet | APMA Learn About Feet Bunions What Is a Bunion?

A bunion is a “bump” on the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place. The toe is forced to bend toward the others, causing an often painful lump of bone on the foot. Because this joint carries a lot of the body's weight while walking, bunions can cause extreme pain if left untreated. The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. A bunion—from the Latin "bunio," meaning enlargement—can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor's bunion". Causes Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This disruption can lead to instability in the joint and cause the deformity. Bunions are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk and our inherited foot type or our shoes.

Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes. Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition. Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women.

Symptoms The symptoms of a bunion include the following: Development of a firm bump on the outside edge of the foot, at the base of the big toe Redness, swelling, or pain at or near the MTP joint Corns or other irritations caused by the overlap of the first and second toes Restricted or painful motion of the big toe Home Treatment What can you do for relief? Apply a commercial, non-medicated bunion pad around the bony prominence Wear shoes with a wide and deep toe box If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling Avoid high-heeled shoes over two inches tall When to Visit a Podiatrist If pain persists, podiatric medical attention should be sought. Bunions tend to get larger and more painful if left untreated, making non-surgical treatment less of an option. Diagnosis and Treatment Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity.

A podiatrist may recommend these treatments: Padding and Taping: Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain. Medication: Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation caused by joint deformities. Physical Therapy: Often used to provide relief of the inflammation and bunion pain. Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement. Orthotics: Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity. Surgical Options: When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatrist. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain. A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity.

Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatrist. Prevention There are some steps that may help prevent, or at least slow, the progression of bunions: Avoid shoes with a narrow toe box If your foot flattens excessively, make sure you wear supportive shoes, and if necessary, get custom orthotics from your podiatrist See your podiatrist at the first signs or symptoms of a bunion deformity, as early treatment may stop or slow its progression Continue

Question: A Podiatrist is traditionally more commonly called a?
Answer: Chiropodist