Podiatric medicine is the branch of healthcare focused on diagnosing and treating conditions of the foot and ankle. Practitioners earn a Doctor of Podiatric Medicine (DPM) degree and are licensed to use medical, surgical, and mechanical treatments to address everything from heel pain and ingrown toenails to complex fractures and diabetic wounds. Their scope covers the vascular, neurological, dermatological, and musculoskeletal systems of the foot and ankle, and they are also trained to recognize systemic diseases, like diabetes or peripheral artery disease, that first show signs in the lower extremities.
What Podiatrists Actually Treat
The range of conditions a podiatrist handles is broader than most people expect. On the non-surgical side, common visits involve plantar fasciitis and heel pain, neuromas (pinched nerves in the ball of the foot), tendinitis, flat feet, and arthritic joints. Skin and nail conditions like fungal infections, warts, and corns also fall squarely in a podiatrist’s lane. Many offices prescribe custom foot orthotics, which are molded insoles used to manage heel pain, flat feet, metatarsalgia (pain in the ball of the foot), and diabetic foot complications.
On the surgical side, podiatrists perform procedures on bones, joints, and soft tissues of the foot and ankle. Bunion correction is one of the most common surgeries. The surgeon typically cuts and realigns the bones of the big toe joint, securing them with screws or pins. Minimally invasive versions of this procedure are becoming more popular because they use smaller incisions, leave less scarring, and allow faster recovery. Other frequent surgeries include hammertoe correction, neuroma removal, joint fusion for severe arthritis, and fracture repair.
In some states, a podiatrist’s surgical authority extends above the ankle. Massachusetts law, for example, permits podiatrists to perform Achilles tendon lengthening and tendon transfers that require incisions into the lower leg. The exact boundaries vary by state, with each state’s practice act defining the surgical limits.
Diabetic Foot Care
Diabetes is one of the biggest reasons people end up in a podiatrist’s office. Poor circulation and nerve damage in the feet make diabetic patients vulnerable to wounds that heal slowly and infections that can escalate to amputation. Podiatrists manage these risks through regular foot exams, wound care, custom orthotics, and offloading techniques that reduce pressure on vulnerable areas.
The impact of this care is measurable. A study published in JAMA Network Open found that diabetic patients with kidney failure who received foot and ankle care from a podiatrist had a 9% lower likelihood of major amputation (above or below the knee) compared to those who did not receive that care, along with an 11% lower likelihood of death or amputation combined. For a population at extremely high risk, routine podiatric visits can be a meaningful layer of protection.
How Podiatrists Are Trained
Becoming a podiatrist requires four years of podiatric medical school, where students study anatomy, physiology, pharmacology, and lower-extremity biomechanics. After earning their DPM degree, graduates enter a three-year residency in podiatric medicine and surgery conducted at hospitals and healthcare institutions. These residencies include both inpatient and outpatient rotations covering surgical technique, wound management, sports injuries, and general medical care of the foot and ankle. Some programs extend to four years for residents pursuing advanced training in reconstructive rearfoot and ankle surgery.
After residency, podiatrists can pursue board certification through the American Board of Foot and Ankle Surgery (ABFAS) or the American Board of Podiatric Medicine (ABPM). Those who completed the extended reconstructive training can sit for a specialized ankle surgery certification through ABFAS.
Podiatrist vs. Orthopedic Surgeon
Both podiatrists and orthopedic surgeons can treat foot and ankle problems, but they arrive there through different training paths and with different scope. An orthopedic surgeon earns an MD, completes five years of residency covering the entire musculoskeletal system (spine, hip, shoulder, hand, and more), and may then subspecialize in foot and ankle work through an additional fellowship. A podiatrist’s entire education, from day one of medical school through every year of residency, is concentrated on the foot and ankle.
In practical terms, if your problem is isolated to the foot or ankle, a podiatrist has deep, focused expertise in that area. If your foot pain is connected to issues further up the chain, such as hip misalignment, back problems, or a systemic joint condition like rheumatoid arthritis affecting multiple parts of the body, an orthopedic surgeon may offer a broader perspective. Many patients see both types of specialists at different points in their care.
Subspecialties Within Podiatric Medicine
Podiatrists don’t all practice the same way. The field has several recognized areas of concentration:
- Podiatric sports medicine: focuses on athletic injuries like stress fractures, Achilles tendon problems, and biomechanical issues that affect performance. The American Board of Multiple Specialties in Podiatry offers a formal certification in this area.
- Diabetic wound care and limb preservation: centers on preventing and treating foot ulcers to avoid amputation.
- Lower extremity geriatric medicine: addresses the foot and ankle problems that accumulate with age, from arthritis to balance-related issues.
- Minimally invasive foot and ankle surgery: uses smaller incisions and specialized instruments to reduce recovery time.
- Pediatric podiatry: covers conditions like clubfoot, flat feet, and gait abnormalities in children.
Diagnostic Tools in a Podiatry Office
A podiatric visit typically starts with a physical exam and a visual assessment of how you stand and walk. X-rays are standard for evaluating bone alignment, fractures, and joint degeneration. Many offices also use gait analysis, either through direct observation or with computerized equipment that records your walking pattern on video or pressure-sensing platforms. These tools help identify abnormalities in how your foot strikes the ground, which informs decisions about orthotics, physical therapy, or surgical correction.
More advanced imaging like MRI or weight-bearing CT scans may be ordered for complex cases involving soft tissue damage, ligament tears, or surgical planning. Vascular testing, such as checking blood flow with a Doppler ultrasound, is common for diabetic patients or anyone with circulation concerns.
Professional Oversight and Regulation
Podiatrists are licensed at the state level, and each state’s practice act defines what procedures they can perform. The American Podiatric Medical Association, founded in 1912, serves as the profession’s national advocate, working with legislators, regulatory bodies, and insurance payors to support podiatrists’ ability to practice to the full extent of their training. State boards of podiatry handle individual licensing, continuing education requirements, and disciplinary actions.
The field currently employs a relatively small number of practitioners compared to other medical specialties. The U.S. Bureau of Labor Statistics projects 2% employment growth for podiatrists from 2024 to 2034, which is slower than average. The median annual salary was $152,800 as of May 2024.