By Michael Nirenberg, DPM
Not everyone goes to the doctor when they have a medical problem, and when many people do go, they don’t always seek out the best trained doctor for their problem. Today, medicine is very specialized. There are entire medical journals and textbooks for every part of the body: head, stomach, veins, and yes, feet. That is where podiatrists come in.
Podiatrists or Doctors of Podiatric Medicine (DPM) are physicians who specialize in the treatment of foot and ankle problems. Most podiatrists have spent at least three or four years studying the basic sciences in a university or college after graduating high school, then studied four more years at a school of podiatric medicine, and then most go on to do foot and ankle residencies for two to three additional years or in some cases, even more.
Podiatrists treat all problems related to the foot or ankle, and the length is endless. However, the more common problems I see are heel pain, arch pain, ingrown toe nails, bunions (bumps on the inside of the big toe), hammertoes (bent toes), flat feet, foot or ankle arthritis, fungal toe nails, sores (ulcers), infections, sprains and fractures, ankle pain or weakness, nerve problems and neuropathy (numbness, burning, or tingling), shin splints, gout, athlete’s foot, sports medicine and diabetics foot problems, children’s foot problems, swelling or discoloration, plantar warts, dry skin, and moles, cysts or tumors.
Some aches and pains in our feet or ankles may go away in a day in a two; others do not, and that is when you need to go to a podiatrist. Many people who see me for a painful foot or ankle have had pain for several days or weeks, but some have been limping around for several months or even over a year! Pain is the body’s way of telling us something is wrong. Don’t ignore it.
Some people with foot or ankle problems never have pain. For example, diabetics who have neuropathy (a deterioration of the nerves of their feet) may fracture a bone or develop an infection or sore on their foot and not have any pain. Recently, I had a patient with diabetes come to see me complaining of a small sore on the bottom of their foot; an x-ray revealed a needle inside the foot. Because the patient had very little feeling in their feet they didn’t know they had stepped on anything sharp.
In all patients foot problems can quickly become serious, but diabetics are especially at risk. It is not unusual for diabetics who don’t seek podiatric care promptly to develop gangrene and need a toe or the whole foot amputated. Prompt treatment is essential. All diabetics or anyone else with decreased feeling in their feet needs to have any foot or ankle problem checked by a podiatrist immediately.
Some people may notice one foot swelling or flattening. Diabetics and others with neuropathy may not have pain, however these are the people most at risk for a particularly serious problem called charcot arthropathy. In charcot arthropathy the bones of the foot weaken and slide out of position and may actually break through the bottom of the foot, leading to infection and even amputation. For other patients, a rapid flattening of one foot may mean the main tendon holding up their foot has torn.
It is a good guideline for anyone who notices swelling, redness, increased warmth or a change in the shape of his or her foot or ankle to see a podiatrist promptly.
Lastly, a podiatrist should check any lumps, bumps, cysts, tumors or moles on your foot or ankles. These problems are usually harmless, but occasionally they can be cancer and life threatening.
The most common complaint I hear from my patients is, “I should’ve come to see you sooner.” If you have a foot or ankle problem, the best advice I can give you is, don’t wait for it to hopefully go away-it may not.
To schedule an appointment with Dr. Nirenberg or another podiatrist at Friendly Foot Care, please call (219)663-2273. To learn about our amazing feet and ankles, visit Dr. Nirenberg’s blog America’s Podiatrist.