Best foot forward

Looking after your feet is one of the most important things you can do for yourself. Most of the time keeping them clean and dry and your toenails trimmed is enough, but if problems like bunions, heel pain or corns develop then it's time to seek professional help.

Foot specialists are known as chiropodists, though many now prefer to call themselves podiatrists, which is the internationally recognised term. Many foot problems, such as athlete's foot or corns are relatively easy to deal with, but some conditions are potentially life-threatening.

Diabetes and arthritis problems
Older people with diabetes or poor circulation who can't (or won't) wash their feet or cut their toenails may develop infections that can lead to ulceration and even amputation. Chiropodists can recognise the danger signs and alert doctors. According to the Society of Chiropodists and Podiatrists, chiropody can prevent 40 per cent of amputations in diabetics.

People with arthritis can develop bony deformities on their feet that make walking difficult. Chiropodists are trained to take casts of the feet from which to make a special foot support, or orthotic, that fits inside the shoe and can make walking virtually pain-free and even relieve associated back and hip pain.

How does it work?
State-registered chiropodists practise either within the NHS or in private practice. You may go to a clinic or health centre or, in some cases, particularly if patients are elderly and immobile, the chiropodist will come to the home.

The chiropodist will question you about your foot problem, your medical history and lifestyle and ask you to remove all your footwear in order to examine your feet. Treatment will depend on the nature of the problem and could include the prescription of orthoses (special shoe inserts), topical chemotherapy, cryotherapy (freezing), electrosurgery, ultrasonics, specialised dressings and exercises.

For example, if a verruca is getting larger or painful, the chiropodist may remove it surgically under local anaesthetic, by freezing or by forms of electro-surgery that are quick and usually completed in one visit. You will be prescribed chemical lotions or ointments to apply at weekly intervals to destroy the wart virus.

Chiropodists may specialise in various forms of treatment. Those trained in surgical techniques (podiatric surgeons) deal with problems such as bunions and in-grown toenails under local anaesthetic at NHS and private clinics. Others are particularly interested in sports medicine, diabetology (problems associated with nerve damage from diabetes that causes burning, tingling or numbness in the feet) or biomechanics (the preservation, restoration and development of foot function).