When my feet hurt, which appointment type do I need?

Painful feet can put a drain on your whole body, causing you to walk differently, putting additional strain on other muscles and joints.  Sometimes the cause is obvious: a corn or an ingrowing toenail is visible and, even if you need help to treat it, you understand where that pain is coming from.

It can be very frustrating when you can’t see the cause of the pain.  And unless you stay off your feet completely nothing seems to help.  Sometimes it still hurts even when you are not standing up.  Who should you ask?  The doctor?  A physiotherapist?  A podiatrist?  Someone else?  And what kind of assessment do you need?

To try to help you cut through the confusion, we are now offering three very different types of new patient assessment at Dulwich Podiatry: an initial routine podiatry consultation, an initial basic musculoskeletal (MSK) assessment and an initial advanced MSK assessment.

Most podiatric conditions can be classified into one of the following groups: neuro-vascular, musculoskeletal and dermatology.  There may be some overlap between these categories: for example, an ulcer might be linked to underlying neuro-vascular conditions, or a corn may form due to abnormal stresses on the skin due to musculoskeletal problems.

Here is a general guide to help you decide which type of initial consultation you should book:

1. Initial routine podiatry consultation:

Book this appointment for most of your dermatological foot-related conditions.  These tend to relate to skin or nails: a painful corn or hard skin, an ingrowing toenail or other toenail problem, fungal infection or verrucae.

If your dermatological foot-related condition is due to an underlying musculoskeletal problem (eg. poor foot posture or another structural problem), the podiatrist will recommend a follow up MSK consultation to address this and prevent your symptoms from recurring.

The routine podiatry consultation is also suitable for patients with diabetes who need help or advice for diabetic foot care or have concerns about ulceration or other foot problems.

2. Initial basic MSK consultation:

Foot pain can be caused by injury, poor foot posture or other structural problems.  Particular foot types may be more prone to injury.  These can include muscle sprains, tendon and ligament problems and occasionally fractures.

It is best to get the problem assessed at an early stage rather than trying to ignore it.  It is important that the cause of your foot pain is diagnosed   We can then develop the most appropriate treatment plan to get you back on your feet.

Book this appointment for your musculo-skeletal concerns: heel pain, Achilles tendon problems, flat feet or any ache or pain which is not going away after a few days’ rest.  Children should be booked in for an MSK consultation unless they have an ingrowing toenail or a verruca.

During this appointment we will take a detailed history and undertake a full clinical assessment.  Depending on your presenting symptoms, we may carry out non-weight bearing, weight bearing and functional assessments.  Treatment options will be discussed and a treatment plan devised.

3. Enhanced MSK consultation:

This is a more in-depth musculo-skeletal consultation with our Clinical Director.

In addition to a full clinical assessment, computerised plantar foot pressure analysis is used to analyse the function of your foot and ankle while you are walking.

During this appointment the Clinical Director may also, where appropriate, perform an ultrasound scan to help facilitate a clinical diagnosis.  She can also arrange a private MRI or X-ray if required.

Once a diagnosis has been reached, a full treatment plan will be designed and discussed with you.  This will be individual to your condition and your circumstances and may include the provision of orthoses, a rehabilitation exercise programme, steroid injection therapy, low level laser therapy or shockwave therapy.

If you are not sure which appointment type you need, speak to our friendly reception team on 020 8693 6000, who are always on hand to help you get the right appointment and put you on the road to recovery as swiftly as possible.

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IDEA: When your feet hurt, you want to get them fixed and getting the right diagnosis is a critical part of the process.  Our new blog helps you decide which appointment type you require to get back on your feet as soon as possibl
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IDEA: What is an enhanced MSK assessment? – images of footscan and ultrasound scan and assessing foot.  Maybe some video of exercise demonstration.
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