Podiatry (Chiropody)

Foot care, or podiatry, was first used by the ancient Egyptian civilisations and later by Hippocrates who educated students in ancient Greece about removal of corns and calluses to promote health. Records also show Napoleon and the King of France using a podiatrist.   

Originally, the therapy was referred to as chiropody and dealt primarily with the treatment of corns and warts on the foot. Chiropody's first recorded use was in a published book of the late 18th century and its meaning is probably derived from the Greek "kheiropodes" (chapped feet). Chiropodist Lewis Durlacher was the first to recognise the need for a licensed profession and the first chiropody society was founded in New York in 1895.

The term 'podiatry' was first used in the early 1900s. Practitioners in the United States officially adopted podiatry as their named profession in 1958 after deciding it was the correct word to describe the study and treatment of the foot and also to avoid any confusion with chiropractic. Podiatry is now commonly used worldwide for foot care and in the UK the Society of Chiropodists added the term 'Podiatrist' to their name in 1993. 

Podiatry covers treatment of a wide range of conditions of the foot, ankle and lower limb as well as the commonly known treatment of toenail and skin disorders. Pain in the hips and back for instance can be caused by problems with the feet while people with diabetes can suffer loss of sensation or poor circulation in the feet which could then lead to damage or injury.

A podiatrist will use specialist skills to treat minor infections like ulcers and wounds and they will perform minor foot surgery to remove corns and calluses, or to cut out ingrown toenails. A podiatrist will also use corrective methods such as shoe orthotics to make walking easier for a patient or to help realign posture that may be the cause of problems in the hips or back.

Podiatry has also extended to bone, joint and soft tissue surgery that includes removal of bunions and the correction of toe deformity and ankle instability. This is usually carried out by a specialist podiatric surgeon. Outside of clinical practice, a podiatrist will also help promote foot health through advice and education in the public sector, particularly among the elderly.     

Be prepared

When you find a podiatrist is is important to know Podiatry is regulated and the title of podiatrist/ chiropodist is protected so a practitioner must be registered with the Health Professions Council (HPC) otherwise they are breaking the law. This registration replaces the former 'State Registered Chiropodist (S.R.Ch.)' title which is no longer in use, so check the phrase HPC and not S.R.Ch. is being used by your practitioner.

Podiatrists in the private sector will be members of The Society of Chiropodists and Podiatrists and this organisation represents over 8,000 members who are trained to high standards and abide by a code of ethics and practice. Members will have either M.Ch.S. or F.Ch.S. after their name. Some podiatrists/chiropodists are members of the Institute of Chiropodists and Podiatrists and will have M.Inst.Ch.P after their name.

Podiatry on the NHS is available but may be dependant on funding from your Primary Care Trust. You will need to be referred by a GP and treatment is subject to waiting times. Be aware that if your condition is seen as 'low risk' and unlikely to affect your general health or mobility then you may not be eligible to receive treatment on the NHS.

Before you find a podiatrist or find a chiropodist consider in advance of your appointment your symptoms and what you hope to achieve through podiatry and remember that a problem in the foot could be a sign of problems elsewhere in the body. You may also be asked to bring a selection of your own footwear for the podiatrist to examine. Some podiatrists offer a home visit service but check with your local practitioner before making an appointment.

It is a legal requirement of the HPC for a podiatrist to carry out a thorough medical history and physical examination during your first appointment. This will involve your podiatrist asking about any previous medical problems and then assessing the feet for circulation, skin/nail disorders, reflexes/sensation and bone/joint movement.

Once the podiatrist has made their diagnosis, they will explain your condition and discuss a treatment plan. If you have any concerns or questions let your podiatrist aware of them before they begin treatment.

Your condition will determine the type of treatment your podiatrist will employ. Problems with toenails may require minor surgery under a local anaesthetic and involve cutting away a section of the nail. Skin disorders such as corns and calluses may require removal and the podiatrist will use a special blade and then apply a pad to distribute the pressure causing them. Radiotherapy, radiosurgery, cryotherapy and laser surgery are now widely used forms of treatment for corns, verrucas and ingrowing toenails and are usually done under local anaesthetic. Your podiatrist will explain these treatments to you before carrying them out.

To correct posture and the mechanics of the foot, podiatrists will use special insoles known as orthotics. These can be placed inside your shoe to reposition your foot in such a way that it realigns the ankle and leg as a whole to alleviate pressure and pain.  

Your first appointment with a podiatrist will usually take around an hour as they assess your problem and then carry out any treatment. Certain treatments will require surgery and therefore expect to be at the clinic longer.

Cost of treatment varies and can differ from town to town. It is also dependent on the type of treatment you will need. Simple hard skin removal may cost £20 - £40 per session but minor surgery can cost much more. If you require orthotics you will be expected to pay for those and again costs vary. It is advisable to discuss the costs of different treatments, even if you don't necessarily need them, before making an appointment. If your podiatrist offers a home service, be prepared to pay a little more.

Many conditions require just an initial assessment and then minor surgery to solve the problem but other issues will need ongoing treatment. Your podiatrist will explain how many sessions you will need at your first appointment.

Podiatry is a widely used and effective treatment for a number of foot, ankle and lower limb conditions and is therefore beneficial to anyone suffering with these. Diabetics are encouraged to see a podiatrist on a regular basis as their condition can cause problems in the feet.