Many people experience foot problems and pain on a daily basis, and often have a choice in what physician they can see first for treatment. Some chose to see their family doctor first, others go to an emergency room or urgent care center. A smaller number of people actually directly go to a orthopaedic to have their condition treated. There are a number of conditions that need orthopaedic care from the start, as these conditions require either the expertise of the specialist or the success of their treatment courses in order to ensure a full and speedy recovery.
Heel pain on the bottom of the foot is very common, and is usually caused by a condition called plantar fasciitis. This condition is easy enough to START to treat, but in order to allow it to completely resolve and not return the treating physician must have a thorough understanding of foot biomechanics, as the foot’s structure plays a dominant role in how plantar fasciitis begins in the first place and continues despite activity restriction. We have this understanding, and are able to combine medical treatment with structural support to resolve heel pain permanently. Surgery may be necessary in some cases, which nearly all podiatrists perform, although on average this is less than 5-10% of the time.
Many family physicians and urgent care centers can provide some rudimentary care for painful ingrown toenails. This usually consists of a prescription antibiotic and soaking instructions, or a basic removal of the ingrown side of the nail. Unfortunately, these measures are only part of the treatment process, as ingrown nails must have their sides removed permanently to prevent the process from starting all over again when the nail side returns to full length. These is an extra treatment step involving a chemical that is typically used for the destruction of the nail root cells following removal of the side of the nail, called phenol, which is not often carried or offered by most family practices or urgent care centers.
Diabetic Foot Wounds
Diabetic foot wounds demand near immediate attention, as an improperly cared-for wound can place a diabetic at serious risk for an infection that could lead to an amputation. Diabetic wounds are not only diseases of the skin and its ability to heal, but are also a disease of abnormal foot pressure caused often by bone prominence. Care of diabetic wounds requires both expertise in wound care principles as well as understanding in how the bone and general foot structure contributes to the wound process. Wounds not only must have proper dressings and periodic in-office surgical care to remove nonviable tissue, but also pressure reduction measures to allow the skin to heal. In most cases providing more comprehensive care than wound care centers, and can provide full wound care as well as pressure reduction through an intimate knowledge in foot structure and biomechanics. Diabetics should call their family physicians first for all medical situations regarding their abnormal blood sugar or other complications. Unfortunately, it is not uncommon for an ignored or under treated diabetic foot wound to quickly worsen and lead to leg infection and gangrene.
Bunion and Toe Pain
We do treat bunions, hammertoes, and all sources of toe and forefoot pain more than any other condition, save for heal pain and nail disease. There can be many complex mechanical causes for these conditions, as genetics has only an initial role in most cases of bunions and other toe and foot deformities. Treatment may involve multiple measures designed to control inflammation as well as reduce mechanical irritation to the bone or joint in question, and surgery may be needed to correct the condition permanently. These conditions are successfully treated all day long by podiatrists, and should be the obvious first choice in care when foot pain develops.
Foot and Ankle Sprains That Are Not Healing
Sprains are a common injury, and often occur in the evenings or weekends after most medical practices are closed. It is very appropriate to present to an urgent care center or emergency room for serious foot and ankle sprains to ensure there is no fracture. However, most of the time these injuries have subtle damage that can lead to instability and pain later on, even when no fracture is present. If a sprain has not significantly improved in a couple weeks following the injury, to the point there is little to no pain remaining, then you need to seek a doctor consultation to ensure there is not a more significant injury present. Urgent care center and emergency room staff can initiate treatment of fractures and major injuries, but are by no means foot and ankle specialists and can either miss or under treat a more significant soft tissue injury as there are sicker patients who require their attention.