Did you know that the foot contains almost one quarter of all the bones in the body? That’s 26 to be exact, with 14 of them found in the toes alone. Your feet also contain 33 joints, 107 ligaments, and 19 muscles. They contain 250,000 sweat glands and there are more nerve endings per square centimetre in the foot than any other part of the body.
Your ankle is also an engineering marvel. Comprised of two main joints, three ligaments and six tendons, the ankle is a key component of the mechanics of the foot.
With so much complexity and pressure on these delicate extremities, it’s no wonder that about 75 per cent of Canadians will experience foot or ankle problems at some point in their lives and when they do, they turn to a podiatrist of chiropodist for help.
Difference Between a Podiatrist and a Chiropodist
In Canada, depending on which province you live in, the terms chiropodist and podiatrist may be used interchangeably. Podiatrist is simply a modern word that evolved from what was historically known as chiropody.
Globally, most countries now use the term podiatrist to refer to a foot specialist. In Canada, the province of Ontario has both podiatrists and chiropodists, and there are slight differences between the two.
Chiropodists must complete a four-year undergraduate program in the sciences followed by three years at a post-secondary program paired with clinical training. Board exams, as well as provincial licensing exams, must then be passed to receive a license to practice. Chiropodists are not permitted to use the designation of doctor.
A podiatrist is certified as a Doctor of Podiatric Medicine (DPM) and has more education than a chiropodist. According to the Canadian Podiatric Medical Association, podiatrists must be educated at one of the twelve schools of Podiatric Medicine across North America (11 of which are in the United States) after earning a bachelor’s degree. They must also finish a 1- to 3-year surgical hospital-based residency and pass their board and provincial licensing exams before they are able to practice in Canada.
In Ontario, the only province where they co-exist with chiropodists, podiatrists may “communicate a diagnosis” to their patients and perform surgical procedures on the bones of the forefoot. They can also order diagnostic X-rays. Chiropodists are not allowed to offer these services in Ontario so most patients will see orthopedic surgeons or podiatric surgeons for these procedures.
It’s important to note that since 1993, Ontario law prohibits the registration of new podiatrists. Practitioners identified as DPM have graduated from a Doctor of Podiatric Medicine/DPM program but are limited to practicing as chiropodists in Ontario. In the rest of Canada, you will consult with a podiatrist. You do not need a referral to see a podiatrist or chiropodist in Canada.
What do Chiropodists and Podiatrists do?
Chiropodists and podiatrists help diagnose and treat problems of the ankle and feet. If you have any the foot issues below, it’s likely time to see a foot specialist:
- Numbness, pain or swelling in the foot.
- Nail fungus.
- Continuous heel pain.
- You think you’ve sprained or broken your ankle or foot.
- A reoccurring case of the fungal infection athlete’s foot.
- You have diabetes – you should see the podiatrist once a year.
- Ingrown toenails.
- Bunions.
- Painful corns or calluses.
- Joint pain in the foot or ankle.
Treatment methods offered include, but are not limited to:
- Foot-health evaluation and education.
- Management of painful nail and skin conditions.
- Prescribing drugs.
- Recommending or prescribing modified or custom footwear.
- Providing custom orthotics or braces.
- Applying specialized modalities (e.g. ultrasound, acupuncture, Transcutaneous Electrical Nerve Stimulation (TENS), Laser therapy etc.).
- Injections into the foot.
- Soft-Tissue surgery (if licensed to do so).
- Bone surgery (if licensed to do so).
The range of diagnostic and treatment options offered by a podiatrist or chiropodist may vary based upon their class of registration as well as on the competencies and training of the individual.
For this reason, you are advised to enquire about the range of treatments provided in advance of setting up an appointment to ensure that treatment options meet your expectations and needs. Also, read other patients reviews to get a good sense of what this practitioner can treat, and how effective their treatment protocols are.
Cost
Podiatric medicine is not included in the Canada Health Act; however, some provinces provide partial coverage in select instances. Therefore, most podiatrists charge an out-of-pocket fee to cover part or all of their services and treatment.
Ontario chiropodists do not bill OHIP for the services they provide. The majority are in private practices, but they may provide some services at publicly funded clinics. Check your local clinics for more details.
The good news is that podiatric/chiropody services are covered by most third-party insurance providers, extended health care plans, Veterans’ Affairs, and/or can be used for income tax health deduction purposes.
Whether you consult a chiropodist or a podiatrist, knowing what to expect from these foot specialists can help you make informed decisions for the health of your feet.