Foot problems and the podiatrist

A podiatrist or chiropodist can help you with common foot problems, including ingrown toenails and bunions.

What does a podiatrist do?

Podiatrists are health care professionals who have been trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the feet and lower limbs. They also prevent and correct deformity, keep people mobile and active, relieve pain and treat infections.

They can give you and your family advice on how to look after your feet and what type of shoes to wear. They can also treat and alleviate day-to-day foot problems, including:

• toenail problems, such as thickened, fungal or ingrown toenails
• corns and calluses
• verrucas
• athlete's foot
• smelly feet
• dry and cracked heels
• flat feet
• bunions
• heel pain
• ageing feet
• blisters
• gout
• sports injuries

How can a podiatrist help?

You may want to see a podiatrist for advice and treatment if you have painful feet, thickened or discoloured toenails, cracks or cuts in the skin, growths such as warts, scaling or peeling on the soles, or any other foot-related problem.

Podiatrists can also supply orthotics, which are tailor-made insoles, padding and arch supports to relieve arch or heel pain. You put the orthotic device into your shoe to re-align your foot, take pressure off vulnerable areas of your foot, or simply to make your shoes more comfortable.

Even if your feet are generally in good condition, you might consider having a single session of podiatry to have the hard skin on your feet removed, toenails clipped, to find out if you’re wearing the right shoes (take your shoes with you for specific advice on footwear) or just to check that you’re looking after your feet properly.

Podiatrists can also help with more complex foot problems including preventing, diagnosing and treating injuries related to sports and/or exercise.

What’s the difference between a podiatrist and a chiropodist?

There’s no difference between a podiatrist and chiropodist, but podiatrist is a more modern name.

What happens at the consultation?

At your first consultation, the podiatrist will take a full medical history and do basic tests such as checking the blood circulation and feeling in your feet. They may also check the way you walk and move your lower leg joints.

They will discuss your concerns with you and then make a diagnosis and treatment plan.

Usually any minor problems that are picked up can be treated on the spot including the removal of hard skin, corns and calluses.

The session is usually completely painless (even pleasant) and takes 30 to 60 minutes.

Can I get podiatry on the NHS?

You may be able to.

Since April 1 2013, clinical commissioning groups (CCGs) were given the power to decide what footcare services to commission for their local area.

Guidance by the National Institute for Health and Care Excellence (NICE) recommends that footcare services related to long-term conditions such as diabetes, peripheral arterial disease and rheumatoid arthritis should be available on the NHS.

However, there is no NICE guidance for foot health provision that is not associated with a long-term condition. This means that each individual CCG will decide on what to make available on the NHS, depending on local need.

If your condition is not affecting your health or mobility – such as a verruca that looks ugly, but doesn’t hurt when you walk – you are unlikely to be eligible for NHS podiatry.

If you want NHS podiatry treatment, contact your GP to see if you qualify.

Find your local CCG.

Read more about getting podiatry on the NHS.

Can I see a podiatrist privately?

If free NHS treatment isn’t available, you can visit a local clinic for private treatment, but you will have to pay.

Find a local chiropodist or podiatrist.

Would a podiatrist come to my home?

If your foot problems are so bad that you find it difficult to walk, it may be possible to arrange for a chiropodist to come to your home. Tell your GP if you need to have a home visit and they should be able to find a suitable chiropodist or podiatrist.

Many private podiatrists do home visits whatever your health status.

How can I make sure the podiatrist is qualified?

Anyone who calls themselves a podiatrist or chiropodist must register with the Health and Care Professions Council (HCPC).

Go to the HCPC website to check if your podiatrist or chiropodist is registered.

It’s also worth checking that they are a member of one of the following organisations:

• The Society of Chiropodists and Podiatrists
• The Institute of Chiropodists and Podiatrists
• British Chiropody and Podiatry Association

How much does private podiatry cost?

Private fees can vary, depending on where you live and the podiatrist’s experience. Ring a few local podiatry clinics to check their prices.

Summer feet tips

Use these 10 summer footcare tips from the College of Podiatry to get your feet in shape for summer.

1. Trim your toenails for summer

Use proper nail clippers and cut straight across – not too short, and not down at the corners, as this can lead to ingrown nails. File them, if that’s easier.

2. Go barefoot

Go barefoot or wear open-toed sandals whenever you can in the hot weather (except when you’re in a communal shower or changing area) to help stop your feet getting sweaty and smelly.

3. Forget flip-flops

Don’t be tempted to wear flip-flops or flimsy sandals all through the summer. They don’t provide support for your feet and can give you arch and heel pain if you wear them for too long.

4. Change socks daily

If you have to wear socks in hot weather, change them once a day and choose ones that contain at least 70% cotton or wool to keep your feet dry and stop them smelling.

5. Remove hard heel skin

Hard, cracked skin around the heels is very common in summer, often caused by open-backed sandals and flip-flops rubbing around the edge of the heel. Use a foot file, emery board or pumice stone to gently rub away the hard skin, then apply a rich moisturising cream to soften the skin.

6. Banish blisters

Blisters strike more often in hot weather. They’re caused by rubbing, especially between the toes if you’re wearing flip-flops with "thongs".

Prevent summer blisters by stretching out sandals. Wear them with socks and walk around indoors to loosen them up, or use foot balm to protect your skin from chaffing.

If you do get a blister, don’t pop it. Cover it in a plaster and if it bursts, apply some antiseptic.

7. Take a break from nail polish

Nails need to breathe from time to time, so have a break from nail polish about once a month for a few days to a week. This can help prevent discoloration, particularly if you like to use dark-coloured nail polishes.

8. Watch out for foot infections

The floors of communal showers and changing rooms at open-air and hotel swimming pools are hot spots for infections such as athlete’s foot and verrucas. Don’t wander around public pools barefoot. Protect your feet by wearing flip-flops in the changing room and at the pool edge.

9. Tackle sweat

If you have sweaty feet in the summer, it’s even more important to wash your feet each morning and evening in warm, soapy water, then dry them thoroughly. You can also use an antibacterial wash, which deals with foot odour. Then wipe them with cotton wool dipped in surgical spirit and dust them with talc.

Here's more advice on how to stop smelly feet.

10. Use sun cream on your feet

Don’t stop at the ankle – put sun cream on the tops and soles of your feet as well. Not only does the skin on your feet and toes need protection, but nails are made of protein and are therefore as vulnerable to sun damage as your skin.

Foot care for older people

You're more prone to foot problems like corns, blisters and foot infections in later life as the skin becomes thinner and less elastic. But painful or uncomfortable feet aren't a natural part of ageing, and can be alleviated.

Foot problems in older people

• bunions
• corns and calluses
• heel pain or arch pain
• cracked skin
• ingrown toenails
• fungal infections (athlete’s foot)

If you’re having trouble looking after your feet, you're not alone. Age UK reports that nearly one in three older people can’t cut their own toenails.

Foot care problems tend to happen if you're less mobile than you used to be, particularly if you have difficulty bending down. Poor eyesight, can also make it harder for you to look after your feet.

How to look after your feet

Your feet will remain in better condition if you have a regular foot routine. This includes:

• cutting and filing toenails and keeping them at a comfortable length
• smoothing and moisturising dry and rough skin
• checking for cracks and breaks in the skin and inflammation such as blisters
• looking for signs of infection like nail fungus or other obvious early problems, and seeking professional advice
• wearing suitable socks and footwear
• keeping your feet clean, dry, mobile, comfortable and warm. Bedsocks are a good idea

If it's difficult for you to follow this routine yourself, see a professional chiropodist/podiatrist for help.

Foot care on the NHS

Depending on where you live, it may be possible for you to have routine chiropody/podiatry on the NHS but this is not the general rule.

NICE guidance recommends that footcare services related to long term conditions such as diabetes, peripheral arterial disease and rheumatoid arthritis should be available on the NHS.

It's less likely that you will be eligible for footcare on the NHS if you do not have a long-term condition or a specific foot problem, such as a bunion, that is hindering your mobility.

If you don't qualify for NHS treatment or you would prefer to pay privately for treatment, contact the Institute of Chiropodists and Podiatrists or the Society of Chiropodists and Podiatrists to find a registered podiatrist in your area. Make sure you ask about the cost before you agree to go ahead with treatment.

Find out how a podiatrist can help.

Medical foot problems

If you have a specific problem with your feet, see your GP. You don't have to put up with pain and discomfort in your feet simply because you're getting older.

Most foot problems can be treated, which means you will be in less pain and able to move around better.

Find out more about how to look after your feet.

10 tips on foot care

Read our top 10 tips on how to look after your feet, with special advice for the over-60s.

Watch a video about ingrown toenail

Your feet take the weight of your whole body, so foot problems can quickly lead to discomfort and affect the way you walk. This can in turn cause knee, hip and back pain.

Research from The College of Podiatry shows that nine in 10 of us experience some sort of foot problem, with one in five admitting to suffering with foot pain often or constantly.

Podiatrist Lorraine Jones says: "What this research shows is that a huge amount of people are willing to put up with sore, aching and painful feet.

She adds: "Your feet shouldn't hurt on a daily basis. If you are experiencing discomfort it is usually because you aren't wearing the right footwear. You don't need to put up with it so do seek professional advice."

Here are 10 tips from the College of Podiatry to keep your feet in good condition and prevent problems:

Foot facts

Wash your feet often

Keep your feet clean by washing them every day in warm soapy water, but don't soak them, as this might destroy your skin's natural oils.

Dry your feet well

Dry your feet thoroughly after washing them, especially between the toes which is where fungal infections such as athlete's foot can develop.

Moisturise and file

If your skin is dry, apply moisturising cream all over the foot, except for between the toes. Gently remove hard skin and calluses with a pumice stone or foot file – don't overdo it though or skin will grow back harder than ever.

Cut toenails carefully

Trim your toenails regularly using proper nail clippers. Cut straight across, never at an angle or down the edges. This can cause ingrown toenails.

Shoe shop in the afternoon

Shop for shoes in the afternoon. Your feet swell as the day goes on and if shoes fit in the afternoon when your feet are at their largest, you can be assured they will always be comfortable.

Footwear tips for work

If you have to wear heels at work, wear comfortable shoes to and from the office and only wear your smart shoes once you're in the office. Also, try to vary the heel height, between low, medium and high. Read how to choose the right footwear for work.

Limit time wearing high heels

Be shoe savvy. Wear high heels and pointed shoes for special occasions only, and always wear the right shoes for the job (so no sandals for mountain climbing). Read this guide to choosing the correct shoes.

Change your socks often to avoid foot odour

Change your socks daily to keep your feet fresh. Read advice from the Institute of Chiropodists and Podiatrists on buying socks.

Read how dirty socks can cause smelly feet.

Watch out for foot bugs in communal changing areas

Wear flip-flops to avoid catching athlete's foot and verrucas when you use public areas such as gym showers, swimming pools or hotel bathrooms.

Take care with flip flops

You can't wear flip-flops all the time. They don't provide support for your feet and can give you arch and heel pain if you wear them too much.

Foot pain advice for over-60s

If you're over 60, foot care becomes even more important. Age takes its toll: your skin thins, your joints begin to stiffen and your feet become more vulnerable to the cold.

Not only that, but as podiatrist Emma Supple says: "Physically, it gets more difficult for us to get to our feet, and failing eyesight doesn't help."

Emma says: "Go to see a professional for a foot MOT every six months and never put up with foot pain as if it is normal. Your feet shouldn't hurt."

Read footcare tips for older people.

Find a chiropodist or podiatrist.

How to stop smelly feet

Smelly feet aren't fun for anyone, but there is an effective, simple and cheap treatment that you can use at home which will banish foot odour within a week.

Who gets smelly feet?

Anyone can get smelly feet but they're more likely if you:

• are a teenager
• are pregnant
• are under mental or emotional stress
• stand up all day at work
• have a medical condition called hyperhidrosis (excessive sweating)
• are taking certain prescribed medications

Medically known as bromodosis, stinky feet are a common year-round problem.

The main cause is sweaty feet combined with wearing the same shoes every day.

Why feet sweat

Anyone can get sweaty feet, regardless of the temperature or time of year. But teenagers and pregnant women are especially prone because hormonal changes make them sweat more.

You're also more likely to have foot perspiration if you're on your feet all day, if you're under a lot of stress or if you have a medical condition called hyperhidrosis, which makes you sweat more than usual. Fungal infections, such as athlete's foot, can also lead to bad foot odour.

According to podiatrist, Lorraine Jones, feet become smelly if sweat soaks into shoes and they don't dry before you wear them again.

Bacteria on the skin break down sweat as it comes from the pores. A cheesy odour is released as the sweat decomposes.

"Your feet sweat into your shoes all day so they get damp and bacteria start to grow. The bacteria continue to breed once you've taken your shoes off, especially if you put them in a dark cupboard. Then, when you put your shoes back on the next day, even if you've just had a shower, putting your feet into still damp shoes creates the perfect conditions for the bacteria to thrive – warm, dark and moist."

How to treat smelly feet

The good news is that there's a simple, quick, sure-fire solution to smelly feet.

• Wash your feet with an anti-bacterial soap called Hibiscrub. There are lots of over-the-counter foot hygiene products at your local chemist, but Hibiscrub is the best one.
• Leave on the Hibiscrub for a couple of minutes, then wash it off.

According to Lorraine, "if you do this twice a day, you'll definitely banish smelly feet within a week."

She adds that you shouldn't use Hibiscrub on your feet if you have broken skin, such as eczema.

Preventing smelly feet

Keeping feet fresh and sweet smelling is all down to good personal hygiene and changing your shoes regularly. To keep feet fresh:

• Never wear the same pair of shoes two days in a row. Instead, wear different shoes on successive days so they have at least 24 hours to dry out.
• Make sure teenage boys have two pairs of trainers so that they don't have to wear the same pair for two or more consecutive days.
• Wash and dry your feet every day and change your socks (ideally wool or cotton, not nylon) at least once a day.
• Keep your toenails short and clean and remove any hard skin with a foot file. Hard skin can become soggy when damp, which provides an ideal home for bacteria

If you're particularly susceptible to sweaty feet, it's a good idea to:

• dab between your toes with cotton wool dipped in surgical spirit after a shower or bath – surgical spirit helps dry out the skin between the toes really well – in addition to drying them with a towel
• use a spray deodorant or antiperspirant on your feet – a normal underarm deodorant or antiperspirant works just as well as a specialist foot product and will cost you less
• put medicated insoles, which have a deodorising effect, in your shoes
• try feet-fresh socks – some sports socks have ventilation panels to keep feet dry, and antibacterial socks are impregnated with chemicals to discourage the odour-producing bacteria that feed on sweat
• wear leather or canvas shoes, as they let your feet breathe, unlike plastic ones
• wear open-toed sandals in summer and go barefoot at home in the evenings

When to see a doctor

Smelly feet are a harmless problem that generally clears up. Sometimes, however, it can be a sign of a medical condition.

See your GP if simple measures to reduce your foot odour don't help, or if you're worried that your level of sweating is abnormally high.

Your doctor can offer you a strong prescription antiperspirant or refer you for a treatment called iontophoresis, which delivers a mild electric current through water to your feet to combat excessive sweating.

Here are more tips on how to look after your feet.

Top tip for prevention

'Never wear the same pair of shoes two days in a row. Instead, wear different shoes on successive days so they have a minimum of 24 hours to dry out'

Lorraine Jones, chiropodist

Choosing sports shoes and trainers

Sports shoes are probably the most important piece of fitness equipment you'll buy, so it's vital to pick the right pair.

There are big differences in the way various sports shoes support your feet. This means it's not good for your feet if you play football or tennis in the same trainers you use for jogging, for example.

Mike O'Neill, from The College of Podiatry, says serious back, knee and hip pain, Achilles tendonitis, shin splints (leg pain), traumatised toes and painful blisters are some of the conditions people wearing ill-fitting trainers may face.

"Unfortunately, 65% of the UK's recreational sportsmen and women wear the wrong shoes for their chosen sport," he says. "Trainers are the most important piece of fitness equipment you'll ever buy, and changing what you wear on your feet can prevent injuries."

Football boots

Football can put a lot of stress on the feet, especially when you're playing on hard surfaces such as artificial turf. The boots can also put pressure on your feet, and it's not unusual for a footballer to develop corns and calluses or damaged, thickened and ingrown toenails.

A good, well-fitting pair of boots is essential. There shouldn't be any signs of pressure on the foot after a game or training session.

Tennis and squash shoes

When playing racquet sports, such as tennis or squash, it's important to choose shoes specifically designed for the purpose. These sports involve a lot of side-to-side movement, and running shoes won't offer the right stability.

Racquet-sport shoes are heavier and stiffer than running shoes, as their toes are built for stop-and-go action. Comfort should be your number one priority, and it's important to replace your sports shoes frequently.

Aerobics trainers

Fitness shoes are ideal for aerobics because they combine flexibility, support and cushioning to absorb impact and lessen shock to the feet.

Running shoes

Running shoes are great for running – and only running. They're very flexible, allowing the foot to bend and flex through each step, but they're not suitable for sports such as tennis that involve sideways stepping.

It's a good idea to get your running shoes properly fitted to suit your foot type. If they're too small, they can cause blisters and black toenails.

There are many types of trainers on the market, so try to find a specialist retailer who will assess your foot and find the right shoe for you. Good specialist running shoe retailers will offer gait analysis to get you in the right type of running shoe.

Walking and hiking boots

Walking is a great way to increase your activity levels, while the more adventurous might go hiking. They're both good for your heart and lungs, but are low-impact activities, so carry less risk of injury.

Ramblers offers the following advice on the best footwear for walking and hiking:

• For short walks in urban areas or easy countryside, all you need is a good, comfortable pair of shoes that won't cause blisters. Use tough shoes that are a good fit, with an arch support, a slightly elevated heel and "breathable" uppers, such as leather. Casual shoes or quality trainers with heavy soles will do.
• If you go walking regularly, you could invest in a pair of proper walking shoes or some lightweight walking boots. These will give your feet and ankles support, and may be waterproof. For highland walks over difficult terrain, good walking boots are essential.

Basketball and netball shoes

Sports shoes for court games such as basketball and netball give a combination of flexibility and sideways support. Cross-trainers are stiffer, provide more support for side-to-side movements, and can be used across a range of activities.

Read advice from The College of Podiatry on how to look after sporty feet.

How to look after your feet if you have diabetes

It's especially important to look after your feet if you have diabetes. Here's how to take care of your feet and advice on when to get professional help.

Diabetes can reduce the blood supply to your feet and cause a loss of feeling known as peripheral neuropathy. This can mean foot injuries do not heal well, and you may not notice if your foot is sore or injured.

"The risk of complications can be greatly reduced if you're able to bring your blood sugar levels under control," says foot specialist Mike O'Neill.

"Ensure that your blood pressure and cholesterol levels are also monitored and controlled with medication if needed."

Foot care tips if you have diabetes

• See a private or NHS podiatrist at least once a year. You should be eligible for an NHS podiatrist if you have a long term condition such as diabetes. Ask your GP for a referral or find a local podiatrist.
• Keep your feet clean and free from infection.
• Wear shoes that fit well and don't squeeze or rub. Ill-fitting shoes can cause corns and calluses, ulcers and nail problems.
• Never walk barefoot, especially in the garden or on the beach on holidays to avoid cuts and try to avoid sitting with your legs crossed so you don't constrict your blood circulation.
• Cut or file your toenails regularly.
• Get corns or hard skin treated by a podiatrist.

Stop smoking to protect your feet

If you have diabetes, it's important to try to stop smoking. Smoking impairs the blood circulation, particularly in people with diabetes. It can seriously worsen foot and leg problems.

Read more about how the NHS can help you to stop smoking.

When to see a doctor

Seek treatment from your GP or podiatrist if blisters or injuries do not heal quickly.

You should see your doctor urgently if:

• you notice breaks in the skin of your foot, or discharge seeping from the wound
• the skin over part or all of the foot changes colour and becomes more red, blue, pale or dark
• you notice extra swelling in your feet where there was a blister or injury
• there is redness or swelling around an ulcer or in an area where you've previously been warned to seek immediate attention

The Society of Chiropodists and Podiatrists has more information on diabetes and footcare (PDF, 1.3Mb).