Should I go to podiatrist?

May 19, 2009 10:43 AM

My feet are in pain. What kind of doctor should I go to? I've heard that podiatry is sort of a dubious branch of medicine.

So my feet are in bad shape. I've been walking in big, sturdy boots (Timberlands) for nearly a year without proper arch support. The arches of my feet have been hurting for a while, especially my left. The left foot has been getting worse lately, and is starting to feel a bit numb behind the knuckle of the big toe (not the joint on the toe, but where the toe meets the foot). Also, my left knee has problems and has been acting up lately.

I bought a nice arch support yesterday, so hopefully that'll help. But I really feel like I should go to a doctor and get this checked out. I know that "numb toes" is an indication of diabetes, but for various reasons I think this is probably more of a skeletal/muscular issue.

I've heard that podiatry is like chiropractry, where some people will swear by it but others feel it's kind of dubious. What kind of doctor should I go to?

posted by Sloop John B to health & fitness (17 answers total)

Why not just buy some new shoes and walk around in them for a week or two first? I'm a big fan of Nike Frees (Vibrams are better, but I wouldn't recommend them right away.) Switching to Frees cleared up my knee problems pretty much immediately.
posted by restless_nomad at 10:47 AM on May 19, 2009 [1 favorite]

I saw a podiatrist, and he just recommended Birkenstock insoles, which pretty much solved my problem. He also told me what to look for in footwear. I wear good runners with the Brikenstock insoles (about $60 CAD, and they last a year or so), and no more pain.
posted by Penelope at 10:51 AM on May 19, 2009

Go to a primary care physician, and decide with him/her what the next best option might be. She might refer you to an orthopedist or a podiatrist, or something else.
I wouldn't characterize podiatry like chiropractics. Podiatrists go to school for four years, and take mostly the same classes as medical students - this is true at least where I study. They are very talented, and very passionate about their studies.
posted by honeybee413 at 10:52 AM on May 19, 2009

You're in the US? Go to a podiatrist. They're real doctors.
posted by zippy at 10:56 AM on May 19, 2009 [5 favorites]

Podiatry does not fall into the same category as chiropractics. They are legit.
posted by amro at 10:59 AM on May 19, 2009 [1 favorite]

A podiatrist diagnosed and treated a fracture and ligament tear that two orthopedists couldn't find ("You sprained it. Use crutches.") Podiatrists know feet & ankles the way you know the back of your hands.

In terms of legitimacy, a podiatrist isn't an MD but is entitled to be called "Doctor" and is treated under law the same way dentists and osteopaths are. The Medical Practice Act covers explicitly who is a real doctor and who isn't. I didn't find any references in the MPA to chiropractors.
posted by workerant at 11:06 AM on May 19, 2009

If it was me I would try to find an Orthopaedist with specialized training in Foot and Ankle. Or if the Podiatrist wanted to do surgery, I would definitely get a second opinion from a Foot and Ankle Ortho.
posted by texas_blissful at 11:13 AM on May 19, 2009

If your shoes are killing you, try changing your shoes. Some people swear by minimalist shoes like the Nike Free or Vibram Five Finger. Others live Birkenstocks. I happen to like both. My weight fluctuates, and I find that when I'm on the heavier side, my feet thank me when I wear well cushioned running shoes with good arch support. Asics and Saucony are good brands but there are plenty of others. If you're in NYC, you can go to Paragon and try on a wide variety of shoes to see what feels good. At the end of the day your feet will be swolen and will certainly let you know what feels good and what doesn't. For me, trying on new running shoes after wearing ill-fitting shoes feels like magic.
posted by ladypants at 11:19 AM on May 19, 2009

And if your feet still hurt with new shoes then it's time to check in with your primary care doctor or a podiatrist.
posted by ladypants at 11:20 AM on May 19, 2009

fwiw, I thought I had screwy arches and it turned out to be something totally different.

Custom orthotics changed my life, no joke. I stopped running into things (I hit the corners of tables so often I couldn't even tell you where I'd gotten the big bruises I always had), and started enjoying exercise. I lost 30 pounds because of it, which in turn, made my knees and hips much happier. They were a miracle, I tell you! Over the counter inserts and self-diagnosing wasted a lot of time and money for me. Go get it checked out, if you can afford it in any way.
posted by small_ruminant at 11:24 AM on May 19, 2009 [1 favorite]

Also, bring these Timberlands with you when you go shoe shopping. A good salesperson will be able to look at the wear pattern and recommend shoes accordingly. I suggested Paragon because their sales people are mostly runners who care a great deal about stride, and the fit of shoes and they do a good job advising customers in a no-nonsense way. Runners shops also offer similar service. Shoes are pretty much the only equipment runners need (and even that is debatable) so they put a lot of thought into the investment.
posted by ladypants at 11:25 AM on May 19, 2009

I've had good luck with podiatrists for my various foot issues. I haven't let them cut me, though (despite a few recommendations for surgery).

If I were you, I'd find a podiatrist and see what they can do; but yes, I'd get a second opinion from an ortho if surgery is recommended. Unfortunately orthotics are often not covered by insurance (something about durable medical equipment...), but they can be a lifesaver.

I do think it's useful to find a podiatrist who comes well-recommended, especially for your specific issue; are there other people in your timberland-wearing-community who have seen one and have good reports?
posted by nat at 12:10 PM on May 19, 2009

I have an excellent podiatrist--now. I first saw a terrible one. I sought a second opinion about my problem. I usually do.

So, as practitioners go, it's the same as any other doctor. There are bad and good ones out there.

But podiatry is a legitimate discipline. All they do is feet (and ankles). I would definitely see a podiatrist to treat any foot or ankle musculoskeletal or skeletal problem instead of an orthopedist. I think orthopedists have too much on their mind to just think about feet, but that's a personal bias.
posted by FergieBelle at 1:10 PM on May 19, 2009

Are you sure that you're not getting podiatry mixed up with reflexology? Reflexology is a foot-based pseudoscience that some people swear by and that has even less factual basis than chiropractics.
posted by darksasami at 1:42 PM on May 19, 2009

Podiatrists are licensed as physicians and surgeons in most states. They can and do perform surgeries at the hospital I work at. From what you describe, a podiatrist would be much better equipped than an orthopedist to handle your problems.
posted by Slarty Bartfast at 1:59 PM on May 19, 2009

I have had a very positive experience with a podiatrist in the US, for a problem that two different general practitioners bungled massively. So yeah, go see a podiatrist.
posted by browse at 2:45 PM on May 19, 2009

Podiatrists are legit and they know feet better than GPs.

I had a painful lump develop on the back of my heel. I first went to my primary care doctor, who basically said "That's just where your heel joins your ankle, and you've just rubbed it a bit. It'll go away". It didn't go away. I then went to a podiatrist who accurately diagnosed the problem - which was a real problem - and found a solution. I wished I'd gone to the podiatrist in the first place.
posted by andraste at 11:43 PM on May 19, 2009