Table 4.
Common Foot Problems Detected on Examination and Recommended Treatments and Referral Pathways42
| Foot Disorder | Therapeutic Interventions/Indicated Referrals | Urgency of Treatment/Referral |
|---|---|---|
| Nail disorders | ||
| Ingrown toenails | Shoes with wider toe box | Routine unless associated skin breakdown or ulceration |
| Podiatry referral for avulsion or matricectomy | ||
| Onychomycosis/fungal nail infection | Prolonged topical or oral antifungal therapy | Routine unless widespread infection |
| Podiatry referral | ||
| Skin disorders | ||
| Pigmented lesion concerning for neoplasm | Dermatology referral | Urgent |
| Ulcer | Podiatry referral | Urgent |
| Xerosis | Topical emollient | Routine |
| Urea cream (10%, 20%, or 40%) | ||
| Ammonium lactate cream (12%) | ||
| Podiatry referral | ||
| Hyperkeratosis (including callusesand corns) | Shoe inserts if related to fat pad atrophy | Routine |
| Orthoses | ||
| Podiatry referral for debridement | ||
| Bone/joint disorders | ||
| Foot pain or arthritis | Orthotics | Routine |
| Prescription shoes | ||
| Corticosteroid injections | ||
| Exercise/stretching therapies | ||
| Podiatry or orthopedic surgery referral | ||
| Physiatry referral | ||
| Physical therapy referral | ||
| Hallux valgus | Shoes with wider toe box | Routine |
| Orthoses | ||
| Referral to podiatry or orthopedic surgery if surgical correction considered | ||
| Hallux limitus/rigidus | Foot radiographs | Routine |
| Referral to podiatry or orthopedic surgery if surgical correction considered | ||
| Hammertoes | Shoes with wider, higher toe box | Routine unless associated wounds or pressure injury |
| Prescription shoes | ||
| Orthoses | ||
| Podiatry or orthopedic surgery referral if debridement or surgical correction considered | ||
| Pes cavus/planus | Orthoses | Routine |
| Podiatry referral | ||
| Plantar fasciitis/heel pain | Stretching exercises | Routine |
| Physical therapy | ||
| Orthoses | ||
| Steroid injection | ||
| Physiatry referral | ||
| Podiatry or orthopedic surgery referral | ||
| Neurovascular disorders | ||
| Clinical evidence of peripheral arterial disease | Ankle brachial indices | Urgent |
| Podiatry referral | ||
| Vascular surgery referral | ||
| Impaired light touch sensation | Neuropathy workup | Urgent |
| Podiatry referral |