Thursday, December 15, 2011

When Should I Call My Podiatrist?

Over the years, I have noticed that many of my patients hesitate to call my office for an appointment, wondering if the problem they have will just get better by itself.  Sometimes, that is the correct thing to do – wait a few days to see if it gets better.  If it does get better, then you’ve saved yourself from having to come in to see the doctor.  However, there are some instances when waiting a few days (or weeks) can be dangerous, and you can end up with a very serious problem that could have been treated without too much difficulty had it been addressed sooner.  I would like to discuss a few instances where waiting to see the doctor is a poor choice.

If you have diabetes, and notice any redness, blistering, warmth or open sores on your feet, I personally want to see you ASAP.  We will make room for you on the schedule.  We will stay late.  If for some reason, we can’t see you, we may even recommend you go to the emergency room at the hospital.  It is shocking how fast a little blister on the foot can progress to a large, infected ulcer (sore), leading to possibly loss of the leg itself.  If you have had a past history of a foot ulcer, or have poor circulation, you are at even greater risk.  Please don’t wait to call!

Any injury that causes significant pain, you really should have it looked at.  Often, patients will say that they didn’t think they needed to be seen after an injury because they could still walk.  The ability to walk or move the injured part of the foot, they reason, means it is not broken.  While this may sound reasonable, it is in many cases not so.  I have seen many fractures over the years that were dismissed as a simple sprain just because they could still walk.  Your suspicion for a fracture should be higher if you see significant swelling, pain that persists beyond a few days, or see bruising around the injured site.  And, when you come to my office, I may believe there is a fracture based on my exam of you, but even I won’t know for sure in most cases until an x-ray is taken.  Fractures that are not addressed can lead to poor healing, or in some cases, lack of healing at all.

Ingrown toenails are something that patients will put up with for weeks, and in some cases, months before coming in to see me.  And it is true that mildly ingrown toenails will sometimes work themselves out.  However, I have found that a lot of patients delay coming in to have the ingrown toenail treated because of fear of the minor surgery to remove the ingrown nail.  Let me put that fear to rest.  The vast majority of patients who have ingrown toenails removed say to me afterwards that the procedure was not anywhere near as painful as they had feared, and they express relief at how much better the toe feels afterwards.  Contrast that to the patient I am currently treating.  He has a severely ingrown, infected toenail that has been literally festering for years.  In his case, the infection has gone into the bone, and he now is scheduled to have his toe amputated to remove the infected bone.  This is not something that happens frequently, but had I been able to address his ingrown toenail when it first became an issue, he would have been relieved of years of pain, and he would not be losing his toe.

Finally, heel pain is a problem that patients tend to procrastinate treating.  If a patient were to begin to feel the symptoms of heel pain (also known as plantar fasciitis), I would recommend first using over the counter arch supports.  If the symptoms are not improving in a week or so, I would recommend having the patient into the office to see me to verify the diagnosis, and begin more aggressive treatment of the condition.  Plantar fasciitis is a condition that can almost always be treated successfully using conservative measures.  I have found that those patients who do go on to require surgery, their symptoms have been present for longer periods of time, often without any treatment being received at all.

The list I have provided in this blog is certainly not conclusive.  In short, if a patient feels any concern at all about their feet, I recommend having them come in for an evaluation.  It may be that nothing is wrong.  If that’s the case, you’ll have peace of mind.  However, if something more serious is amiss, we can get you on the road to a full recovery.


  1. I had a bunion ectomy on my left foot and I still have a bunion on my right foot. I had the surgery 2 yrs ago this June. After the surgery I now have a lump feeling in my left foot between first and second toes, it doesn't hurt much anymore but it always feels swollen. In my right foot that I didn't have surgery on I wore orthotics and developed a neuroma between 2nd and 3rd toes I have had a cortisone shot and it didn't help. What do u suggest I do? As soon as I get out of bed in the morning my right foot hurts. Thx

    1. It sounds like you have a number of issues that should be taken care of. Unfortunately, it's hard for me to know exactly what's wrong with you without being able to see you. It does sound like it's time to make an appointment to be seen.

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    3. Thx. I am close to Indy. Do u recommend a Dr in this area.

    4. I'm afraid I do not know any podiatrists well enough in the Indianapolis area to recommend. You may want to call your regular doctor and ask for his/her recommendation.

  2. I had two injections for neuroma in my right foot 8 weeks ago. I have two neuromas in same foot. Pain free instantly and for 8 weeks until I woke up 3 days ago and pain is back as bad as it was before injections. Instant pain! Is that normal if the injection fails?

  3. I had two injections for neuroma in my right foot 8 weeks ago. I have two neuromas in same foot. Pain free instantly and for 8 weeks until I woke up 3 days ago and pain is back as bad as it was before injections. Instant pain! Is that normal if the injection fails?