When to Consult a Podiatrist vs. a Pedorthist

When is it time to see a podiatrist about your foot problems? If you are typical, you probably first tried to get relief from your foot pain with over-the-counter insoles. Some people then visit a store that has a pedorthist to get a custom shoe fitting and insole recommendation. Three podiatrists comment on the limitations of these methods and when it is best to see a podiatrist instead.

Podiatrists vs. Pedorthists

Both are professionals trained to care for feet, but there are significant differences between podiatrists and pedorthists. Podiatrists are medically and surgically qualified to treat foot and ankle problems, while pedorthists are allied health professionals.

The three experts who provided guidance about the differences between the two professional include:

• Dr. Brian Harley, Chief of Podiatry, Wellstar Windy Hill Hospital, Marietta, Georgia
• Dr. Lisa Klemeyer of the Aesthetic Family & Podiatry in Sarasota, Florida
• Dr. Andrew J. Schneider, Tanglewood Foot Specialists, Houston, Texas

Podiatrist

The podiatrists noted that you can only get a true diagnosis of the cause of your foot problems by seeing a podiatrist or physician. While insoles and changes to your shoes may help, this is best done after being assessed by a medical professional. Some symptoms that warrant seeing a podiatrist include:

• Numbness, tingling, or burning sensations in your feet or toes
• Acute injury with swelling, bruising, or sudden pain
• Pain for more than a week
• Loss of function

For example, numbness and tingling may be due to diabetic peripheral neuropathy, which might even be the first sign of undiagnosed diabetes. A podiatrist can refer such problems to other physicians or he may specialize in treating diabetic foot problems.

For many orthopedic problems, a podiatrist can prescribe medication, administer injections, prescribe custom orthotic devices, and, when necessary, perform surgery.

Pedorthist

Pedorthists are not licensed to diagnose acute issues, but they are skilled at recommending shoes and insoles. A pedorthist can be consulted when there is a persistent ache or pain when walking or running, according to Dr. Schneider. "The pedorthist then will be in a good position to recommend a particular shoe, insert, or combination to improve the gait, foot efficiency, and reduce the level of pain."

Visiting a shoe fitting or insole store can be of value. Here are some of the situations noted by the podiatrists:

• To get a foot analysis and recommendation for an over-the-counter arch support or insole
• To get a recommendation for a shoe the will maximize the effectiveness of a custom orthotic prescribed by a podiatrist
• To have a custom insole produced to support your foot properly, which may include casting and molding
• To have a podiatric prescription filled for diabetic therapeutic shoes and accommodative inserts, custom shoes, and custom modifications to shoes
• When looking for shoes for specific issues such as flat feet, painful arches, painful heels, bunions, hammertoes, diabetes, and arthritis

Dr. Harley notes that people should not be fooled by over-the-counter or online "custom" orthotics which are not truly custom, just to save some money. "With orthotics and braces, you get what you pay for. You get not only a quality product, but the training behind it which allows the pedorthist to diagnose the problem, determine which materials are needed, and fabricate the inserts properly."