12 Signs It’s Time to See a Podiatrist

Podiatrists are doctors who specialize in feet, ankles, and related structures in the leg. They help people who have issues such as dry heels, ankle pain, toe issues or other challenges related to their feet. For people with diabetes, the stakes are higher – podiatrists are a critical part of any diabetic treatment team, and knowing when to visit them can make a big difference in someone’s overall health.

No Cost Shoes is a supplier of therapeutic and diabetic shoes across the U.S., so we get questions about this a lot: “Why do I need a podiatrist?”, “How often should diabetics and non-diabetics get their feet checked?” and, of course, “What will my insurance cover?”

We think this information is important for anyone to have handy. So, we’ve developed this helpful list of 12 signs it’s time to see a podiatrist. This information can benefit everyone, though people with diabetes will find it particularly critical to follow.

1) It’s the doctor’s orders.

People often first mention foot issues to their family doctor, since this is the medical professional they see most regularly. Oftentimes, this physician will provide a referral to a podiatrist when patients bring up their feet. Like any medical referral, it’s important to follow it and see the recommended specialist.

Note: Individuals with diabetes should also speak with their physicians about filling out a Certificate of Medical Necessity (CMN) to access Medicare-covered therapeutic shoes and inserts. Click here to read the full process for getting diabetic shoes and other aids covered by Medicare.

2) Certain types of swelling.

It is not unusual for feet to swell after some activity. In fact, just about everyone’s feet are bigger later in the day due to natural swelling (this is why we recommend getting a shoe fitting in the afternoon, rather than the morning). However, some types of swelling are cause for concern. For example:

  • Swelling in just one foot;
  • Swelling that is extreme, especially if there is also pain;
  • Swelling that is persistent and doesn’t go down.

This kind of swelling can indicate an injury, blood clot, heart/circulation problems, or kidney issues. A visit to your family doctor or podiatrist is a good idea in these cases.

3) Unexplainable pain and/or numbness in one or both feet.

foot pain diabetes why to see a podiatrist

Numbness and pain in feet can be a sign of neuropathy. Many find this pain particularly flares up at night or in the morning. Those experiencing unfamiliar pains or numbness should speak to a podiatrist right away.

4) A blister, ulcer or sore that won’t go away.

A small blister is usually not cause for concern in most people. However, those with diabetes in particular may find that a small sore can turn into a large ulcer without proper care. The main signs of serious foot ulcers include black tissue or gangrene around the wound.

Keep an eye out for discoloration around a wound (especially dark colors), pain near the area, or sign of infection. Anything unusual such as this should be looked at by a professional right away, especially if diabetes is involved. Depending on the situation, your doctor or podiatrist might request an immediate appointment to look at any abnormalities, as tiny blisters can become serious problems rather quickly for someone with diabetes.

5) Thick corns or calluses.

Corns and calluses can be extremely uncomfortable, and often the right pair of therapeutic inserts or shoes can help soften the issue. A podiatrist will be able to examine the corns and recommend the best treatment options.

6) Split skin and heel dryness.

cracking skin dry heels diabetic feet

Dry skin is a common challenge for many people, but can be particularly prevalent in those with diabetes. Therapeutic inserts and shoes recommended by a podiatrist can make a big difference here.

7) Bruising or discoloration on the feet.

It can be quite a shock to see bruising on one or both feet, particularly if you don’t remember any injury taking place. Sometimes, people with peripheral neuropathy can get a foot injury without knowing it – even broken bones might fly under the radar for numb feet! Bruising and discoloration certainly warrant a trip to the podiatrist, especially if the cause of the issue is unknown.

8) Toe issues like ingrown toes or hammertoes

Ingrown toenails, hammertoes and other issues with toes are all things a podiatrist should look into, particularly if toes are causing pain or making it difficult to walk. Any diabetic with such issues should see a podiatrist right away, as the combination of hammertoes and circulation issues can lead to infections and ulcers. Luckily, therapeutic shoes and inserts can often help minimize these risks.

9) Starting a new exercise plan (in some cases).

No, we’re not saying that you need to see a podiatrist every time you plan to go to the gym. However, they should be consulted in certain cases:

  • If it will be intensive for your feet, such as training for a marathon;
  • If you have diabetes, particularly if you have had foot issues in the past;
  • If you need special shoes or inserts to support your new regimen;
  • If you have had a foot injury, surgery or challenge in the past and need to be cleared for the new venture.

10) Needing advice, fittings or a prescription for therapeutic shoes.

Anyone can buy therapeutic shoes without a prescription, however a podiatrist can be very helpful in clarifying what type of shoes a person needs. They can also write a prescription for shoes to help people qualify for insurance coverage, as Medicare and most insurers cover shoes for certain diabetic patients.

Along with a prescription and Certificate of Medical Necessity, Medicare and most insurers also require therapeutic shoes to be properly fitted before providing coverage. This will ensure shoes and inserts are perfectly customized to a person’s feet, making them far more comfortable and effective. Shoe fittings can often be done at a podiatrist’s office, as well as through an in-home visit from a shoe fitter. Click here to read all the options available for diabetic shoe fittings.

11) Difficulty adjusting to new shoes.

Podiatrists can offer specific instructions for “breaking in” new shoes (especially therapeutic shoes) without risking an injury, blister or other issues. This advice can be extremely valuable, so make sure to call a specialist if new shoes are giving you trouble. Trying to just “push through” can cause damage, especially in those with pre-existing conditions.

12) Insurance/Medicare covers your visit.

Why visit a podiatrist? Well, for many people the question is “why not?”!

Annual podiatrist visits are covered by Medicare for people with diabetes. Others may have the specialist paid for at least in part by a group insurance plan. Check to see if you are covered – if you are, it’s a worthwhile visit to mark on your calendar.

The Diabetes Circulation Checklist: Are You Doing These 8 Things?

If you’ve seen a podiatrist for diabetes-related concerns, chances are you’ve heard the word “circulation” mentioned a few times. But what does circulation with diabetes really mean? More importantly, how can people avoid the blood flow related risks that come with a diabetes diagnosis?

This article will help you understand and respond to common circulation concerns with diabetes. We’ll explain exactly what risk factors are involved, then provide you an easy-to-follow checklist to stay as healthy as possible on a daily basis.

What is circulation and why does it matter so much for people with diabetes?

Circulation is another word for “blood flow.” When you have poor circulation, it means that one or more body parts are not getting enough blood.  Poor circulation can have many causes, from something as simple as bad fitting shoes through to some something as serious as a heart disorder.

Circulation matters for everyone, but people with diabetes should pay particular attention to this issue. High blood glucose levels caused by diabetes can damage blood vessels, limiting their ability to transfer blood to other cells. This can affect the flow of blood throughout the body.

One of the most common consequences of poor circulation in people with diabetes is foot complications. The word for feet or legs with poor circulation is “peripheral artery disease.”

Luckily, there are ways you can prevent and/or manage poor circulation. We’ve created this Diabetes Circulation Checklist to help guide the process.

Your Diabetes Circulation Checklist

□  Quit smoking. This is a tough one for many, but smoking has the biggest impact on your circulation as a diabetic.  If you want to prevent circulation issues, putting down cigarettes should be at the top of your “To Do” list.

□  Do some exercise several times per week. Don’t worry, we aren’t asking you to run a marathon (in fact, you don’t even need to hit the gym!). Just a brisk, 30-45 minute walk several times per week should do the trick.  Movement stimulates blood flow in legs, which can prevent peripheral artery disease. For more exercise tips for people with diabetes, click here.

□  Wear therapeutic shoes. Medicare and most insurance plans cover diabetic shoes for patients with a prescription. Approved supplier nocostshoes.com will even send a shoe fitter to your home to help you access shoes with no out of pocket cost. If you don’t have a prescription, you can still order shoes at low cost from their website.

□  Visit a podiatrist regularly. The best person to write your shoe prescription is a medical specialist who deals with foot issues. Annual visits to this type of doctor, called a podiatrist, are also covered by Medicare. They’ll also be able to identify any warning signs of circulation issues and give you tips on how to manage other foot conditions you may have.

□  Take a break when in pain. Regular exercise is important for managing circulation issues, but pushing yourself too far can have serious consequences. People with circulation issues may feel pain in their calves when walking, especially if they are moving quickly, uphill, or on a hard surface. Stop to rest if you are experiencing this, and speak to your doctor as soon as you can.

□  Wear warm support socks. Socks that are too tight or thin can worsen circulation issues for people with diabetes. Diabetic support socks can aid in circulation. They also help to warm up chilly feet, which is a common symptom for those experiencing circulation issues. Do not use hot water or heating pads to warm up your feet, as nerve damage may prevent you from feeling burns.

□  Examine your feet on a daily basis. Many telltale signs of poor circulation are evidence in the feet. Keep an eye out for sores that won’t heal, discoloration, shiny skin and slow toenail growth. If you see anything unusual, discuss it with your podiatrist.

□  Elevate your feet when you are sitting. Paying attention to your feet is important even when you’re not moving. Elevation and wiggling toes from time to time are great ways to encourage blood flow.

Where to Get Fitted for Diabetic Shoes

The online marketplace is buzzing with websites where you can buy diabetic shoes at the click of a button. This may seem like a convenient option, but if you’re not careful you could miss a critical step: Getting your diabetic shoe fitting from a certified and Medicare-approved shoe fitter.

Many people are surprised to learn that feet can change size from one year to the next. While all diabetic shoe brands available on nocostshoes.com are Medicare approved, picking the right one for you may require some professional help.

Why do you need to get professionally fitted for your diabetic shoes?

There are a few reasons to involve a foot care professional in selecting your diabetic shoes.

  • Medicare and insurance often require a professional fit. After all, no insurer wants to pay for shoes that hurt more than they help!
  • Improperly fitting shoes can exaserbate foot problems. When you have diabetes, even the smallest blister can turn into a life-altering ulcer. The impact of this should not be underestimated.
  • Shoe fittings are covered anyways, so why not? If you are eligible for coverage, Medicare will cover the furnishing and fitting of one pair of therepeutic shoes and three sets of inserts per year.

What is a licensed shoe fitter, exactly?

One common misconception is that a “shoe fitter” is anyone with a measuring tape who works in a shoe store. In reality, fitting people for therepeutic shoes requires a bit more expertise.

The American Board for Certification in Orthotics and Prosthetics, Inc (ABC) is the body that trains and certifies shoe fitters in the United States. Your insurance may require that someone with the certification “ABC Certified Fitter-Therapeutic Shoes (ABC CFts)” or an equivilant background confirm your shoe size before you order shoes.

Now we come to the most pressing question – where in the world can you find these very specific professionals?

Option #1 – Get a Medicare approved in-home shoe fitting.

For most people, the most convenient option is to arrange for an in-home shoe fitting. Medicare-approved shoe supplier Quantum Medical Supply offers fittings from certified professionals who come right to you. In-home shoe fitters can also help you to select and order shoes from approved suppliers, directly billing Medicare or insurance for cost.

To arrange for your fitting, check your eligibility at nocostshoes.com or call 1-866-923-2423.

Option #2 – Visit your Podiatrist’s office.

Podiatrists and their assistants are able to provide shoe fitting services as needed. If you are regularly seeing one of the below professionals, consider asking them about shoe fitting at your next appointment:dr with xray feet back joints why to wear orthotics

  • A podiatrist
  • An orthotist
  • A prosthetist
  • A pedorthist

If your doctor does not supply shoes directly, they may offer you a recommendation for where to purchase shoes. Having your feet measured by someone connected with the supplier is a good idea, even if your podiatrist has already taken a look. This will help you account for any differences between brands and give you an opportunity to select shoes that are comfortable for you.

Option #3 – Check with your pharmacy.

As of 2012, 25 percent of ABC Certified Fitter-Therapeutic Shoes (ABC CFts) worked in a pharmacy setting. Your pharmacy may have someone on staff with the right designation, or they may be able to refer you to a professional nearby. Pharmacies are also a good source for some types of therapeutic inserts.

Making Sure Your Shoe Fitting is Covered by Medicare

You should always confirm the credentials of your shoe fitter to ensure their services will be covered under your health care plan. The best option is to use someone who can directly bill your insurance or Medicare. This lowers your risk and confirms that they are approved to provide this service.

Finding the right pair of shoes is important, so don’t be afraid to ask for help throughout this process! You can reach out to the a diabetic shoe supplier such as nocostshoes.com, speak with your podiatrist, or contact Medicare directly to confirm the details you may need.

11 Critical Reasons to Wear Your Doctor-Prescribed Orthotics and Custom Insoles

One of the most common misconceptions about orthotics is that they are prescribed for one specific reason. In reality, specialty shoe inserts support your physical health in many, many different ways. While your podiatrist might recommend this solution in response to something like foot pain, a broken arch, or diabetes complications, custom shoe inserts or orthotics offer multiple benefits.

When your podiatrist tells you to wear custom insoles, there are plenty of reasons to listen. Here are the top 11 reasons to wear the custom orthotics or insoles prescribed to you by a medical professional.

1. Orthotics take pressure off your joints.

When you walk or run, multiple body parts are working together to get you from point A to point B. Orthotics help your feet to properly carry your weight, which has a positive influence on every other body part involved in your movement. In particular, it takes pressure off of important joints including your ankles, knees, and hips.  That means less pain and healthier movement all around!

2. Orthotics reduce back pain.

back pain xray why to wear orthoticsWhen your feet are not properly carrying weight while you walk, the pressure shifts to other body parts.

The chain reaction usually goes like this: Feet aren’t doing their job, so knees have to make up for it. The knees then turn inward (this is often referred to as “knock-knees”), shifting the angle where the thigh bone meets the pelvis and damaging a person’s posture. That unsteady posture is bad news, especially for the lower back.

Custom orthotics get to the source of these back issues, improving gait and posture by supporting the feet.

3. Orthotics help you move faster.

You might not be a professional athlete, but moving at a decent speed can make a big difference on a day to day basis. Orthotics absorb shock when walking or running. This better, easier foot movement makes a big difference in speed as well as stamina when moving.

4. Orthotics prevent injury.

dr with xray feet back joints why to wear orthoticsFoot injuries are a big concern for people with diabetes. Nerve damage can make it difficult to identify or respond to foot pain, which can lead to exacerbated injuries and even loss of limbs. Orthotics add support for feet, reducing the risk of rolling an ankle or sustaining another foot injury. Orthotics can also help those who already have injuries to walk in a way that doesn’t add to the issue.

5. They prevent calluses and corns.

When calluses and corns grow bigger, they can cause serious discomfort and walking problems. Abnormal weight distribution on the feet is often the cause of these issues, making orthotics a great choice for someone looking to reduce or prevent this issue.

6. They prevent the wearing down of skin from diabetic blisters.

For diabetics, there is no such thing as a minor foot wound. Every foot issue must be taken seriously – even the smallest blister can turn into an ulcer, which may require amputation in serious cases.

Orthotics are one way diabetics can prevent or properly care for blisters. Custom fitted inserts can reduce the friction between the foot and the shoe, preventing blisters from developing or worsening.

It’s important that those who are using orthotics for friction management use custom fitted inserts that aligns with their feet. These are often covered by Medicare or insurance for prescription-holding diabetics.

7. Orthotics can realign your feet and ankles, preventing future foot problems.

Orthotics aren’t just for people currently struggling with their feet – they can also be a great preventative measure. Many people push through issues like fallen arches and misaligned ankles, causing them to worsen over time. As soon as your podiatrist notices over-pronation and suggests orthotics, you should start using them (yes, even if you don’t have that much pain yet). This will improve your foot function for years to come.

8. Orthotics allow you to walk for longer periods.

Not only do orthotics help you walk faster, but they can give you more endurance to boot! By improving alignment and posture, the right inserts can make walking and running feel like a lot less work, so you can stay standing or moving for longer periods without fatiguing your body.

9. Orthotics reduce or eliminate foot pain.

foot pain preventionIt’s no surprise that orthotics can make walking more comfortable. After all, they are well-cushioned, shock absorbing, often custom-fitted inserts – what’s not to like?

Still, many people only use their inserts from time to time and forgo consistent use. When you do this, you’re not allowing the orthotics to properly repair your over-pronation and may still feel pain in your feet. Consistent use will allow the orthotics to really make an impact in how you walk, reducing foot pain and preventing injuries.

10. Orthotics can preserve your hips and knees.

As you age, your hips and knees can weaken. It is not uncommon for people to need surgery on these body parts. Whether you are caring for your joints after a surgery or are trying to prevent deterioration to begin with, orthotics are a great option.

11. Orthotics can stabilize any destruction or deformities in the foot.

Orthotics are great for preventing foot issues, but they can also be an important part of healing existing problems. People who have a foot challenge or deformity may struggle to walk in a way that protects their posture, joints, and other parts of their feet.  A podiatrist is an important person to work with to address these issues, and following their advice for care is critical to avoid future challenges.

How do I get custom insoles or orthotics?

There are several different types of shoe inserts, from generic over-the-counter brands to custom fitted insoles with a friction management design. Patients should medical professional to get personalized advice on what types of orthotics are best for their needs. Medicare covers three pairs of custom insoles each year for Americans with diabetes and a prescription, so it’s particularly important (and often free!) for diabetics to look into this option.

If you’re a medical professional or diabetic patient looking for insoles and shoes with direct insurance billing, visit nocostshoes.com.