Who needs a regular foot check-up, and what happens at one

Most people only see a foot doctor when something hurts. For some people, though, regular check-ups prevent problems that would otherwise sneak up on them. Here’s who benefits, and what a check-up actually involves.

People with diabetes

This is the most important group. Diabetes can damage the nerves and circulation in the feet, and problems can develop without pain. The American Diabetes Association recommends a comprehensive foot examination at least once a year for everyone with diabetes, including tests for loss of protective sensation and a check of the circulation.^[1]

How often after that depends on your risk. International guidelines set the schedule by risk category: once a year for low-risk feet, and every six months, every three to six months, or every one to three months as risk rises with neuropathy, poor circulation, deformity, or a past ulcer or amputation.^[2] See diabetic foot care.

Older adults

Foot problems are common with age, and they matter beyond comfort. A meta-analysis found that older people who fell were more likely to have foot pain, bunions and lesser-toe deformities, as well as reduced ankle flexibility, weaker toes and impaired sensation.^[3] The encouraging news is that care helps: in a systematic review, multifaceted podiatry interventions, including foot and ankle exercises, footwear and orthoses, reduced the rate of falls.^[4]

A check-up is worth it if you have trouble reaching your feet to trim nails, have thick or painful nails, have corns and calluses, or feel less steady on your feet.

Other people who benefit

• People with poor circulation, neuropathy from any cause, rheumatoid arthritis, or who are on dialysis.
• Runners and athletes with recurring injuries, for a look at footwear and mechanics. See what gait analysis shows.
• Children with foot pain, a limp or feet that look different from each other. See children’s foot care.
• Anyone with a foot problem that’s changing: a bunion that’s growing, a toe that’s starting to curl, or a nail that’s thickening.

What happens at a foot check-up

• Skin and nails: dryness, cracks, calluses, corns, fungal or ingrown nails.
• Sensation: a monofilament test and a vibration test.
• Circulation: pulses in the feet, skin color and temperature.
• Structure: bunions, hammertoes, arches, joint motion.
• Footwear: fit, support and wear.
• Care: trimming nails and calluses when needed, and advice on what to watch for at home.

Common questions

What should I bring to a foot check-up?

A list of your medications and medical conditions, the shoes you wear most (and any inserts or orthotics), and a note of anything you’ve noticed: a sore spot, a change in a nail, numbness, or a near-fall. If you check your feet at home, tell us what you look for.

I have diabetes but my feet feel fine. Do I still need an exam?

Yes. Nerve damage and reduced circulation can develop without any symptoms, which is exactly why an annual exam includes tests of sensation and circulation even when nothing hurts.^[1]

Can foot care really prevent falls?

It can help. In a systematic review, podiatry programs combining foot and ankle exercises, footwear advice and orthoses reduced the rate of falls in older people.^[4] Foot pain and toe deformities are among the factors linked to falling, and many of them can be treated.^[3]

When to see a podiatrist