Chiropody | Podiatry

What is podiatry? 

Also known as chiropody, podiatry is a branch of medical science practised by specialist 'foot doctors'. They are commonly referred to as podiatrists. Podiatrists are specifically trained to treat problems of the feet and, therefore, are not medical doctors. However, advanced training means podiatrists can go on to perform surgery (podiatric surgeons). 

A podiatrist uses a range of techniques to treat chronic conditions that affect lower limb function. This may be the result of hindered mobility, pain or infection. Therapeutic, surgical, orthotic or palliative treatments are among the most effective methods. These can help to alleviate a range of common foot problems, such as corns, Athlete's foot and bunions. 

Is there a difference between podiatry and chiropody? 

A frequently asked question is “What’s the difference between podiatry and chiropody?” The truth is that podiatry and chiropody are the same things. However, ‘podiatry’ is the most commonly used name today.

In the 1990s, the UK moved away from ‘chiropody’ to reflect the internationally recognised term for a foot specialist. There was also some confusion with ‘chiropractors’ as chiropractic medicine began to grow in popularity. Fundamentally, chiropody and podiatry deal with the same degree of assessment, diagnosis and treatment of the lower limb. Both are regulated by the Health and Care Professions Council (HCPC). This means the title is legally protected. Anyone calling themselves a podiatrist/chiropodist must be on the HCPC register to practice.

Maintaining foot health 

Feet take the weight of the entire body. As a result, they can be subjected to a lot of stress and strain. Maintaining foot health with proper care is key to preventing common foot problems, which can only add to the stress your feet are under. 

What can cause foot problems? 

There are many reasons why foot problems occur, and they can cause extreme discomfort and pain. Walking may also become difficult as foot problems can affect mobility. This can escalate and lead to knee, back and hip pain - affecting overall well-being. 

There are many reasons why someone may experience problems with their feet. Some common causes include:

• improper or ill-fitting footwear 
• diabetes (affecting nerves and blood flow in the feet) 
• ageing 
• walking barefoot in damp places (such as by a swimming pool)
• poor foot hygiene 
• arthritis 
• inflammation 

Podiatry treatment ensures any abnormalities, infections or injuries of the foot do not cause further problems. It can also educate people about the importance of maintaining foot health for better mobility, independence and quality of life. If you are experiencing symptoms such as persistent pain, redness or soreness of the feet, you should seek advice as soon as possible. A GP can refer you to a podiatrist for treatment or you can seek treatment privately.

What does a podiatrist do? 

The role of a podiatrist is to treat and reduce common foot problems that can hinder mobility and cause pain. People of all ages and health can seek treatment. A foot doctor will provide general foot care knowledge to help them maintain healthy feet in the future. With the right care and advice, patients can learn to take better care of their feet and avoid further problems. 

Many podiatrists choose to specialise in specific areas of foot care. This means they can supply a range of treatment options and foot health advice. For example, some are trained in biomechanical analysis. This involves the study of feet alignment and structure and how these elements affect posture and motion. 

Podiatrists with this expertise will assess patients for common foot problems such as flat feet, heel pain, knee pain and bunions. They will then implement treatment - most commonly, orthotics. This involves the provision of tailor-made insoles or padding. These orthotic devices can be inserted into shoes to re-align feet and relieve arch or heel pain. They will help to improve mobility, provide comfort and reduce the development of further foot problems. A podiatrist may also recommend special podiatry shoes to provide extra support. 

In addition to orthotics, foot doctors may also specialise in: 

• Diabetic care - Due to restricted blood supply to the feet, diabetics can be prone to foot problems. Podiatrists can help diabetics maintain foot health and prevent serious problems.
• Sports injuries – Overexertion can put feet at risk of injuries such as muscle pull, ankle sprain, and blisters. Podiatrists can identify these and provide appropriate treatment to facilitate a speedy recovery.
• Paediatrics – Treating common foot problems in children.
• Geriatrics – Treating common foot problems in the elderly.
• Podiatric soft tissue surgery – A podiatrist can remove minor skin problems of the foot such as verrucas and corns. Using sterile instruments, they will cut them out while the patient is under local anaesthetic.
• Wound healing – A foot doctor will tackle wounds that can damage the skin. These include abrasions, lacerations and punctures. Treatment is designed to prevent complications and preserve function.
• Rheumatology – Caring for patients with conditions affecting the musculoskeletal system. These include joint diseases such as arthritis, bone and muscle diseases, and conditions affecting soft tissues.

What problems do podiatrists treat? 

If you are due to see a podiatrist, your first consultation will involve an assessment of your feet. Your foot doctor will inspect your lower limbs and the nature and severity of your ailments. They will take into account the architecture, alignment, look and texture of your feet to make a diagnosis. They will also detail any concerns and issues you may have noticed, as well as your lifestyle and health in general.

Following a diagnosis, your podiatrist will review treatment options. Usually minor foot problems such as verrucas, calluses and corns can be treated straight away. More complicated conditions will require further sessions and possibly additional forms of treatment. A typical session should last between 30 and 60 minutes. 

Below we explore podiatry treatment used to tackle some of the most common foot problems and complaints: 

Corns and calluses 

These are thickened areas of hard or soft skin that are caused by excessive pressure or rubbing. People who wear poorly fitting shoes and/or do a lot of running and walking are more likely to develop corns and calluses. These will usually form on the balls of the foot and the top of the toes. 

Although gentle rubbing with a pumice stone or foot file can remove superficial areas of hard skin, a podiatrist will tackle the root cause of corns and calluses through orthotic care. Special padding, insoles and strapping will be provided to prevent rubbing and alleviate any pressure on the feet. If the corns and calluses do not respond to this treatment, they may need to be removed with soft tissue surgery. 

Ingrowing toenail 

An ingrowing toenail refers to the way a nail cuts into the skin next to it rather than growing straight. This can cause a lot of pain and inflammation and can increase the risk of infection. Ingrowing toenails can also make it difficult to walk comfortably. Podiatry treatment involves regular nail trimming and advice on self-care. Appropriate footwear will also be recommended. In some cases, soft tissue surgery will be needed to remove the nail altogether. 

Athlete's foot 

This is a common fungal infection that thrives in moist warm areas of the skin - particularly between the toes. Symptoms include itchy, damp and soggy skin, and in some cases cracking, flaking and bleeding. Athlete’s foot can be treated at home, but a podiatrist can help identify the best treatment for specific types. They will likely prescribe special creams, ointments and powders. They will also put in place treatment to tackle any fungus that has spread to the toenails. 

Fungal nail infections 

Fungal nail infections are caused by the same fungus that triggers Athlete's foot. Symptoms include nail deformity, discolouration and crumbliness. Treatment typically involves oral medication to kill the fungus, and nail cutting to expose the nail bed to a lighter, cooler environment. A podiatrist will also advise on appropriate footwear and self-care tips.

Sometimes fungal nail infections are caused by injury. This allows the fungus to creep in and multiply under the nail. A foot doctor will provide extra care and treatment for this. 

Dry and cracked heels 

The skin around the heel tends to be thicker than other parts of the foot. When it becomes too dry and lacking in moisture it can lead to splits and cracking. In some cases, the deep fissures will completely break apart and bleed. This can be very painful and uncomfortable. A podiatrist will recommend balms or special creams that contain moisturisers to help. They will also check for infections in open wounds and treat them accordingly. Again advice will be given on footwear to prevent the condition from worsening or returning. 

Flat feet 

Flat feet are where some people’s feet have low arches or no arches at all. It tends to be a hereditary condition, and for some, it does not cause any major problems. Others will endure constant pain and discomfort. This is because flat feet can put a strain on muscles and ligaments, causing pain in the legs, the inside of the ankle, and in the knee, hip or back. A podiatrist can teach exercises and provide foot orthotics to ease symptoms. In the minority of cases, surgical intervention may be needed to correct the position of the foot. 

Bunions 

This is a bone deformity of the joint at the base of the big toes. It is where the big toe points towards the other toes and the foot bone attached to it bulges outwards. While genetics can play a part, wearing poorly fitting shoes over a long period of time can cause bunions. The condition can change the shape of your foot, cause swelling and make walking painful. 

A podiatrist will generally treat bunions and toe deformities in the form of foot orthotics. They will suggest wide comfortable footwear made of softer material and will provide insoles to slow down joint changes and improve foot function. A foot doctor may also consider felt or gel padding to prevent rubbing and will remove any areas of hard skin to aid comfort. In more severe cases, a podiatrist may suggest patients seek surgery to have their bones realigned. 

How can you benefit from podiatry? 

People often seek podiatry treatment to ease pain and lingering health problems associated with the foot. However, you can choose to have regular sessions with a foot doctor as part of a healthy foot care regime. Even if your feet are generally in good condition, a podiatrist can help to prevent the onset of ailments. They will also keep an eye out for any changes in mobility, foot alignment and architecture. 

Podiatry treatment is ideal for those who cannot implement effective self-care for their feet, such as elderly patients and children. Diabetics and patients suffering from rheumatoid arthritis will also benefit from regular treatment. These types of conditions can place the foot at a greater risk of complications that can take longer to heal. Treatments are designed to relieve symptoms, improve the foot's function and prevent future disease. By doing this, podiatry helps individuals maintain their independence and overall well-being. 

How to find a podiatrist

On Therapy Directory, we have a list of podiatrists who are fully qualified to carry out treatment effectively. As podiatrists are regulated by the HCPC, we only list those who have shown proof of membership. This means you can have peace of mind that the person you are contacting is adequately trained to offer professional foot care. Once you have browsed their profiles, simply reach out to arrange an appointment. 

Useful resources:

• Royal College of Podiatry