Podiatry: Medical Foot Care

The term podiatry is derived from the Greek words “podos” and “logos”, which translated means “teaching of the foot”. Medical podiatry combines cosmetic and medical aspects both in the care and prophylaxis of the healthy foot and in the secondary prophylaxis of foot diseases. The profession of podiatrist belongs to the medical professions and requires a 2-year training followed by a state examination. The occupational title of medical chiropodist or podiatrist has been protected by a podiatry law since January 2, 2002. The range of tasks is varied and enables the podiatrist to work independently, in their own practices and in an organized network of doctors and other medical professions such as physiotherapy or occupational therapy. The activities in medical podiatry are closely related to the following medical specialties and require sound knowledge in this regard:

  • Internal medicine – especially in diabetology, the treatment of diabetic foot finds its place.
  • Dermatology – skin diseases are detected by the podiatrist and referred to the specialist for further treatment; in some cases, skin diseases are treated in medical cooperation with
  • Orthopedics – foot malpositions and false load syndromes can also be treated by the podiatrist in medical cooperation

Today, so far only the medical foot care of the diabetic foot is reimbursed by health insurance. The clinical picture of the diabetic foot can have two fundamentally different forms due to the developments. One distinguishes the neuropathic-infected foot from the ischemic-gangrenous foot. In 50-70 percent of cases, the neuropathic-infected foot is present, in which the peripheral nerves are damaged due to years of deficiency (diabetic neuropathy). The ischemic gangrenous foot is the result of peripheral arterial circulatory disorders, which can lead to the death of entire tissue districts. The incidence is 20 to 30 percent of all cases of diabetic foot.

Indications (areas of application)

  • Patients at risk for diabetes mellitus (diabetes) or rheumatic disease who are more prone to foot disorders
  • Hyperkeratosis and pressure sores
  • Blisters
  • Clavi (corns)
  • Ingrown, thickened or unaesthetic nails
  • Mycosis (fungal infection)
  • Calluses
  • Verrucae (warts)

The procedure

The scope of duties of the medical chiropodist is large and includes:

  • Professional cutting of nails or removal of thickened nails.
  • Treatment of hyperkeratosis (cornification) and clavi (corns) without disease value.
  • Probing of the nail bed – hyperkeratoses and clavi can also be removed here.
  • Foot gymnastics – the patient is instructed preventively to train the mobility of his feet.
  • Foot massages – the podiatrist performs soothing massages.
  • Advice and guidance – home care and appropriate care products are addressed
  • Cosmetic foot care

In addition to simple cutting of nails, the podiatrist masters special treatment methods for ingrown nails and detects nail mycoses (nail fungus) that require medical therapy. In addition to the removal of severe hyperkeratosis, calluses and clavi, verrucae (warts) can also be removed. Other measures may include:

  • Protection of painful areas in the form of pressure and friction protection.
  • Orthonyxia – treatment method for ingrown nails: Making special nail clasps
  • Nail prosthetics – artificial nail replacement

Procedure of podological treatment:

  • Anamnesis and findings – if the patient is treated for the first time is a detailed inspection and palpation necessary.
  • Foot bath – the foot bath is used to cleanse and soften the skin of the foot, has a relaxing effect on the patient and lasts about 5-10 minutes
  • Removal of hyperkeratosis – special tools are used to remove cornification and calluses, if necessary, keratolytic agents are used to soften the callus
  • Shortening the nails – shortening is done carefully in accordance with the individual nail shape.
  • Work in the nail fold – removing cornification, etc.
  • Grinding the edges of the nail and care
  • Conclusion – z.B. a foot massage

Benefit

Medical foot care is becoming increasingly important. A professional treatment lasts about 40 minutes and is characterized by an impeccably neat and hygienic workplace, a careful examination and a detailed consultation with the patient. Serious diseases especially in the context of diabetic foot syndrome (DFS) can be prevented.