Podiatrist or Orthopedic Doctor for Foot Problem?

Updated on January 08, 2016
J.B. asks from Boston, MA
15 answers

For those of you who have had foot issues, would you recommend a podiatrist or orthopedist? I have what I believe is a bone spur or some sort of inflammation on the top of my foot at the base of the big toe, on both feet. I suppose they could also be bunions but from what I've seen, those are more on the side of the toe and push the tip of the toe towards the other toes, while my big toes still curve inward. I'm not in pain but would like to know what these are and how to reduce them or keep them from getting worse. The only complexity is that since I was a young child, my ankles have rolled in but I don't have "flat feet" - normal arches, but just a weird misalignment of the ankles. I compensate by walking on the outer edge of my feet to keep the ankle where it should be when I'm barefoot or in dress shoes, and I wear running shoes with strong inner support. My primary care once commented on the misalignment and said that eventually it would cause problems so I wonder if the bone spur/inflammation/whatever it is is the start of "problems" (well along with periodic knee, hip and back pain that may or may not be related).

So...in your experience is it better to work with someone who does nothing but feet all the time? Or someone who deals with the whole muscolo-skeletal system? if it helps. I have no intention of having surgery or any invasive treatment (afterall I'm not in paln from these bumps) but if it's inflammation of the bone or soft tissue, would be interested in managing it conservatively and mitigating any future damage

Thanks for any advice or experience you can share!

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answers from Philadelphia on

I have a great podiatrist. I also have a great ortho doc for my knees but I could not find an orthopedist that specializes in feet. Therefore I see a podiatrist for foot issues.

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answers from Washington DC on

years ago i went to a podiatrist and he was great. for my recent foot injury i went right to a physical therapist who has been even better. i'm able to run again!
i think if you see a good one, any of 'em may work. but consider a kickass PT too.

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answers from Boston on

I would say either, if it were just foot problems. But you are saying that you also have knee, hip and back pain which may or may not be related. You are already changing the way you walk, and you've bought shoes with arch support without knowing whether it's the right sort of support.

You could certainly start with a podiatrist who could help you a lot with the foot/shoe issue. Whether you need orthotics or not is to be determined. If you don't, you should buy sneakers/running shoes from an excellent running store that fits athletes. They can watch you walk/run and help with corrective footwear. It's already odd though, because you don't walk naturally. So it may take some work and some consultation.

If that resolves your back/knee/hip issues, great. Otherwise you may need an orthopedist or an osteopath. Different forms of training, and different from a podiatrist, but all legitimate. I'd consider seeing at least 2 people in 2 different disciplines just to get perspective. If they agree, great. If they don't, you can get a 3rd opinion. But I wouldn't fool around with this because you're going to be dealing with the repercussions for the rest of your life, and this sort of thing just never gets easier as we get older.

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answers from Milwaukee on

If you do a google search on who to see for foot problems, a podiatrist or an orthopedist, you can get a number of sites with information. I am including a link below which breaks down the training, limitations & approaches of each specialty well. Keep in mind, a podiatrist goes to a different school than an orthopedist, but BOTH are doctors. Podiatrists are more specialized to the foot than an orthopedist, and many also perform surgery.

The most important thing to consider when making your decision is whether or not the doctor you see is appropriately addressing your concerns, and following a plan of care you are comfortable with. It sounds like the pain you have in your hip, knees, back is more a result of secondary inflammation due to compensation for improper alignment or instability in your feet. I think choosing either specialty would be appropriate to address your issue - just make sure if you choose an orthopedist that they specialize in foot/ankle care, as many of them take a general practice, or specialize in other joints.

Good luck! T.

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answers from Los Angeles on

I would START with a podiatrist.

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answers from Seattle on

I've had foot problems before, and I've been to both a podiatrist and an orthopedist. Frankly, I've had better results with the orthopedist. Here's why.

The podiatrist dealt only with the foot and ankle, nothing else. The orthopedist dealt with not just the foot issues but how it affected my whole body, from my posture, my spine, to how I walked, to my other bone structures, and actually found out I had other structural problems that the podiatrist missed.

I am not a doctor, so I can't diagnose your issues, but I would recommend going to an orthopedist. That kind of doctor will look at the whole body.

As a side note, about the education of a podiatrist, they go to 4 years of medical school at a special podiatry school, then do 4 years of a residency. They are an MD, but not an MD like an orthopedist who goes to a traditional medical school.

Good luck!

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answers from Dallas on

I have done both and each one has their positive aspects.

I started with the Ortho Dr. because we have a fantastic top notch group here. He did all the testing of my walk, x rays, etc and I ended up with $600 custom orthotics that I do not use today. I used them about a year. I also get flareups of gout and the ortho was not the best for that issue.

Move forward to the podiatrist, he also watched my walk, xrayed and had me get MRI's of my ankle. This Dr. is also a well known great Dr. in my area. My ankle was locking up on me. We ended up doing a procedure called PRP (Platelet Rich Plasma) where they took my blood and a hormone from a pig and it was injected into the site. I stayed in bed a week with a hard brace, NO weight at all on it and then a boot for 3 weeks. I am back to walking 4-8 miles at a time with no pain. This was an experimental treatment not covered by insurance and not approved by the FDA yet. A lot of professional athletes do this when they have an injury. What happens is that your own stem cells react to the injection and they in turn heal you. I did this 2.5 years ago and I am still going strong!!

I also have some plantar issues and I will wear a hard brace at night sometimes that helps a lot. We also did some PT.

I have issues with both feet. He did get an antiflammatory RX for me that I only take if gout flares up. My gout flares up with stress so put me in a stressful situation and it gets going. I am told the gout is inherited due to my Native American heritage. I am not overweight and my blood tests are all good so it does not make complete sense. Thankfully it does not happen often because the pain is excruciating.

At this point, I tend to go to the podiatrist over the ortho for my foot issues.

I hope you find relief, it really sucks when it hurts to walk.

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answers from Phoenix on

If you know for sure it's a foot problem then I'd start with the foot doc. They may then refer you to an ortho after that. That's what we did for my SD. Good luck.

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answers from Las Vegas on

I've had several foot issues as follows: Sesamoiditis, neuromas, bone spurs and of most recent, plantar's faciitis. that said, visited THREE Podiatrists, two of which TWICE and none were of any good use. Desperate to find a cure, particularly for what turned out to be a severe case of Plantar's Faciitis, I turned to the internet and on a whim, came across some guy's blog who was also having many foot problems but getting no where with traditional treatments (like cortisone shots, specially made orthotics) he wrote about a doctor in Portland, Oregon named Ray McClanahan. Now, I don't live in Portland but out of desperation for pain relief, went to the doc's website. On there, he has SEVERAL articles and youtube videos, all for free, which discuss proper shoewear and why we have many of the foot issues that we do.. I read every article on there, not only the pertaining to my own foot issues, but on other ailments. After watching all of his videos and reading all the articles, I began to follow his suggestions, one.. I needed to find a show that would allow my toes to splay and not turn inward (which many shoes cause the toes to do) and hence, cause misalignment.. two, I started to ice my foot and more importantly, I did LEG stretches, in particular for my calf muscles, which because they were so tight, they inevitably pulled on my heels, which in turn caused me to have bone spurs, which in turn, my and calf and feet being so tight, caused the plantar's... none of this was explained to me by the podiatrist I saw in person, instead, I read and read about foot injuries on the doctor's website.. my best advice, go to the NWfootandankle website (look up that doctor's name) and see for yourself how valuable the info he has to share.. IF it wasn't for that doctor, I would still have foot issues.. This was about two years ago when I found his website.. since then, my feet are 90% well.. Not 100% because had I caught the neuromas earlier and instead of getting cortisone shots, I believe IF I had just switched footwear, I wouldn't have such scarring on the inside. anyway, the neuromas are still much much better. the plantar's is finally gone as are the bone spurs... again, had I never found that website, I truly don't think I'd be writing this today and instead, probably have been talked into some type of surgery.. check out his website, you ll be glad you did..

good luck

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answers from Los Angeles on

A successful orthopedic surgeon advised me to be sure you see a Foot and Ankle Specialist, who has more education, experience and a broader scope than a podiatrist. Good luck!

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answers from Oklahoma City on

I have always thought a podiatrist was good for shoe lifts to help straighten feet, arches, help with exercises to strengthen hips which effects a person being pigeon toed.

An ortho doc is one who deals with bones. If I thought I was going to have surgery I'd go to the ortho doc first. If I thought it was how I stand, walk, function on my feet then I'd try the podiatrist first.

To me an ortho doc is for surgical issues that are serious.

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answers from Portland on

I've been to both.

I have a gait problem (how I walk) and also have developed bunions because of it.

The orthopedic specialist knew more. He looked at how I walked - my spine, my hips, my legs, feet, ankles. He could order x-rays, etc. I suppose a podiatrist could too - I'm not sure. Both fitted me for orthotics at different times.

The podiatrist was not familiar with my gait problems. I thought that was a bit surprising at first, but he basically said he dealt with feet and feet abnormalities. He even offered to buff my dry skin on my feet for me and he removed a corn.

So - if you're looking to find out what the problem is, if it's related to bones at all, I'd probably see the orthopedist. For flat feet, arches, and that kind of thing - I'm guessing the podiatrist would be good. Good luck :)

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answers from St. Louis on

I would look at the education of both doctors and take the one who is a medical doctor. Podiatrist can tend to have less education.

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answers from Springfield on

i would start with the foot doc. they know the foot the best. they also kow when its not a foot issue and will tell you to see an ortho.

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answers from Boston on

See who PCP refers you to.

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