Table of Contents

What Is Podiatry?

Podiatry is the branch of medicine devoted to the diagnosis, treatment, and prevention of conditions affecting the foot, ankle, and related structures of the lower leg. Podiatrists are the specialists who handle everything from ingrown toenails to complex reconstructive surgery — and given that the average person walks roughly 100,000 miles in a lifetime, their work is more important than most people appreciate.

Each of your feet contains 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. That’s a quarter of all the bones in your entire body packed into two relatively small structures. When something goes wrong down there, it affects everything up the chain — your knees, hips, back, and overall mobility.

What Podiatrists Do

Diagnosis

Podiatrists evaluate foot and ankle problems using physical examination, gait analysis (watching you walk), imaging (X-rays, MRI, ultrasound), and laboratory tests. They’re trained to identify conditions that originate in the foot and also to spot foot symptoms that signal systemic diseases — diabetes, peripheral artery disease, and rheumatoid arthritis often show their earliest signs in the feet.

A diabetic patient with numbness in their toes, for instance, may be experiencing peripheral neuropathy — nerve damage caused by prolonged high blood sugar. A podiatrist might be the first clinician to notice it.

Conservative Treatment

Most podiatric care doesn’t involve surgery. Common conservative treatments include:

Custom orthotics — prescription shoe inserts molded to your foot’s specific shape and biomechanics. Unlike the generic insoles you buy at the drugstore, custom orthotics are built from a cast or 3D scan of your foot and designed to correct specific mechanical problems. They’re particularly effective for plantar fasciitis, flat feet, and conditions that result from abnormal foot mechanics.

Medications — podiatrists prescribe oral and topical medications for infections, inflammation, pain, and skin conditions affecting the feet. Antifungals for toenail infections, corticosteroid injections for plantar fasciitis, and antibiotics for infected wounds are all common.

Physical therapy referrals and exercise prescription — stretching and strengthening programs are first-line treatment for many foot and ankle conditions. Achilles tendinitis, plantar fasciitis, and ankle instability all respond well to targeted exercise programs.

Wound care — this is a huge part of podiatric practice, particularly for diabetic patients. Diabetic foot ulcers affect approximately 15-25% of people with diabetes at some point in their lives, and they’re the leading cause of non-traumatic lower limb amputation in the United States. Podiatrists manage these wounds through debridement (removing dead tissue), offloading (reducing pressure on the wound), advanced dressings, and close monitoring.

Surgical Treatment

Podiatrists perform a wide range of surgeries on the foot and ankle. During their residency, they complete three years of surgical training, and many pursue additional fellowship training in reconstruction or trauma.

Common podiatric surgeries include:

Bunionectomy — correction of bunions (bony bumps at the base of the big toe), which affect roughly 23% of adults aged 18-65 and 36% of those over 65
Hammertoe correction — straightening toes that have become bent or curled due to muscle imbalance
Plantar fascia release — cutting a portion of the plantar fascia to relieve chronic heel pain when conservative treatment has failed
Ankle fracture repair — surgical fixation of broken ankle bones
Achilles tendon repair — reattaching a ruptured Achilles tendon
Neuroma excision — removing a Morton’s neuroma, a painful thickening of nerve tissue between the toes
Reconstructive surgery — complex procedures for severe deformities, Charcot foot (a devastating complication of diabetes), and traumatic injuries

Common Conditions Podiatrists Treat

Plantar Fasciitis

The most common cause of heel pain. The plantar fascia is a thick band of tissue running along the bottom of your foot from heel to toes. When it becomes inflamed — usually from overuse, poor footwear, or biomechanical issues — the result is stabbing pain, typically worst with the first steps in the morning.

About 2 million Americans seek treatment for plantar fasciitis each year. The good news: 90% of cases resolve within 10 months with conservative treatment — stretching, orthotics, night splints, and sometimes corticosteroid injections.

Bunions

A bunion isn’t just a bump. It’s a structural deformity where the big toe angles toward the second toe, causing the joint at the base of the big toe to protrude. Genetics are the primary risk factor — if your parents had bunions, you’re significantly more likely to develop them. Tight, narrow shoes don’t cause bunions, but they can accelerate their progression and worsen symptoms.

Diabetic Foot Complications

This is where podiatry arguably saves the most lives — and limbs. Diabetes damages nerves and blood vessels in the feet, creating a dangerous combination: you can’t feel injuries, and your body can’t heal them efficiently.

The statistics are grim. About 130,000 lower limb amputations are performed on diabetic patients in the U.S. each year. But here’s the critical point: studies show that regular podiatric care reduces amputation rates by 45-85%. The American Diabetes Association recommends annual thorough foot exams for all diabetic patients.

Ingrown Toenails

Deceptively simple, occasionally serious. An ingrown toenail occurs when the edge of the nail grows into the surrounding skin, causing pain, swelling, and sometimes infection. Mild cases can be managed at home, but recurrent or infected ingrown nails require podiatric care. The definitive treatment — partial nail avulsion with chemical matrixectomy — has a recurrence rate of less than 5%.

Fungal Toenail Infections

Onychomycosis (fungal nail infection) affects about 10% of the general population and up to 50% of people over 70. The nails become thick, yellowed, brittle, and sometimes painful. Treatment is challenging because oral antifungal medications require months of use and carry liver toxicity risks, while topical treatments have lower cure rates. Laser treatment has shown promise but evidence is still mixed.

Education and Training

The path to becoming a podiatrist is long and rigorous.

Undergraduate Education

Four years of college, typically with a heavy science emphasis — biology, chemistry, physics, and organic chemistry. Most podiatric medical schools require the MCAT for admission, the same standardized test required by MD and DO programs.

Podiatric Medical School

Four years at one of nine accredited colleges of podiatric medicine in the United States. The first two years mirror the medical school curriculum: anatomy, physiology, biochemistry, pharmacology, and pathology. The final two years focus on clinical rotations with an emphasis on lower extremity medicine and surgery.

Residency

Three years of hospital-based residency training in podiatric medicine and surgery. Residents gain experience in surgical techniques, trauma management, wound care, biomechanics, and the management of systemic conditions that affect the feet.

Board Certification

After residency, podiatrists can pursue board certification through the American Board of Foot and Ankle Surgery (ABFAS) or the American Board of Podiatric Medicine (ABPM). Board certification requires passing written and oral exams and demonstrating a minimum number of surgical cases.

The Biomechanics Connection

One thing that makes podiatry unique is its deep focus on biomechanics — the study of how your body moves. Your feet are the foundation of your kinetic chain. When they don’t function properly, the effects ripple upward.

Overpronation (excessive inward rolling of the foot during walking) can cause not just foot pain but also shin splints, knee pain, and hip problems. A high-arched, rigid foot that doesn’t absorb shock well can contribute to stress fractures and back pain.

Podiatrists perform detailed gait analyses — sometimes using pressure-mapping technology and motion capture — to identify biomechanical abnormalities. Corrections might involve orthotics, shoe recommendations, strengthening exercises, or in severe cases, surgical realignment.

Podiatry vs. Other Foot Care Providers

The terminology can be confusing. A podiatrist (DPM) is a doctor who diagnoses and treats foot conditions, including performing surgery. An orthopedic surgeon (MD/DO) who subspecializes in foot and ankle can do similar work but comes through a different educational pathway. A physical therapist may treat foot and ankle conditions through exercise and manual therapy but doesn’t prescribe medications or perform surgery. A pedorthist fits and modifies footwear and orthotic devices but doesn’t diagnose or treat medical conditions.

For most foot problems, a podiatrist is the right first call. They can handle the vast majority of conditions in-house, and they’ll refer you to other specialists when the situation calls for it.

Taking Care of Your Feet

Most foot problems are preventable, or at least manageable, with basic attention. Wear shoes that fit properly — your feet change shape over your lifetime, so get measured periodically. Inspect your feet regularly, especially if you have diabetes. Don’t ignore persistent pain; feet that hurt are telling you something. And trim your toenails straight across, not rounded at the corners.

Your feet carry you through roughly 8,000 to 10,000 steps per day. Giving them some attention isn’t excessive — it’s overdue.

Frequently Asked Questions

When should you see a podiatrist?

See a podiatrist if you have persistent foot or ankle pain, numbness or tingling in your feet, thick or discolored toenails, a wound on your foot that won't heal, bunions or hammertoes causing discomfort, recurring athlete's foot, heel pain that doesn't resolve with rest, or if you have diabetes and need regular foot exams.

Is a podiatrist a real doctor?

Yes. Podiatrists earn a Doctor of Podiatric Medicine (DPM) degree, which requires four years of podiatric medical school after completing undergraduate education. They also complete three years of hospital-based surgical residency. They are licensed to diagnose, treat, and perform surgery on the foot and ankle.

What is the difference between a podiatrist and an orthopedist?

Podiatrists (DPM) specialize exclusively in the foot and ankle. Orthopedic surgeons (MD or DO) treat the entire musculoskeletal system — bones, joints, muscles, and tendons throughout the body — and some subspecialize in foot and ankle. Both can perform foot and ankle surgery. The educational pathways differ: podiatrists attend podiatric medical school, while orthopedists attend medical school followed by orthopedic surgery residency.

Does insurance cover podiatry visits?

Most health insurance plans cover podiatry visits for medical conditions. Medicare covers medically necessary podiatric care, including diabetic foot care, bunion surgery, and treatment of injuries. Routine foot care like nail trimming is typically not covered unless you have a qualifying condition such as diabetes or peripheral vascular disease.