Podiatry (specialist foot care)

Cosmetic foot care professionals provide care and beauty treatment for healthy feet. They are where you go to get your nails cut and varnished or your feet pampered. Podiatrists, on the other hand, specialize in treating foot problems resulting from diseases such as diabetes or rheumatism, or things like ingrown toenails.

Specialist foot care can be helpful in the treatment of various diseases. It is particularly important for people who have diabetes because of what is known as “diabetic foot syndrome” (DFT). This is where the diabetes causes damage to nerves and blood vessels, leading to foot problems such as slow-healing wounds and ulcers, and dying tissue. If DFT is treated too late and ineffectively, it might even be necessary to amputate the affected area.

Similar foot problems can arise from other disorders, too. These include nerve damage and chronic spinal injuries. People who can't feel their feet properly anymore due to nerve damage are also prone to sores, calluses and wounds.

Podiatric treatment can help to prevent that from happening. It is also a possible option for other foot problems, including:

• thick calluses and corns,
• toenail problems such as thickening or loss of nails,
• ingrown nails, and
• toe deformities.

Specialist foot care can also be useful for people with restricted mobility who have difficulty looking after their feet themselves.

Examples of podiatric services include skin and nail treatment and fitting of medical aids. For instance:

• Removal of corns and thickened calluses
• Special pads (orthotics) to prevent rubbing and pressure on the feet
• Prevention or treatment of thickened toenails
• Fitting of nail-correction braces and systems

Podiatrists use sterilized instruments such as scalpels, nippers, burrs and sanders. With a doctor's agreement, creams and tinctures that are prescription only or only available in pharmacies can be used. In Germany, the costs of medicines only available in pharmacies are covered by public health insurance only in exceptional cases. So it’s a good idea to find out about that in advance.

They can also advise you on day-to-day foot issues such as what to bear in mind when choosing shoes or stockings, and important aspects of your personal foot-care routine.

In Germany, specialist foot care is usually provided by trained podiatrists. It is available in the following places:

• Podiatry practices
• Foot clinics, for example in diabetes practices
• Health care centers specialized in diabetes
• Hospitals

Podiatrists are the right people to help you if your foot problems do not need to be treated by a doctor. However, if you notice skin damage like open ulcers or inflammation, you will need to be treated by a doctor.

You can find specialist foot care professionals based in Germany on the websites of the following organizations:

• German Association of Podiatry (Deutscher Verband für Podologie, ZFD)
• Association of German Podiatrists (Verband deutscher Podologen, VDP)
• Federal Association of Podiatry (Bundesverband für Podologie)
• The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband)

Statutory health insurers cover the cost (minus your co-payment) of podiatric treatment for damage to the feet arising from diabetes, nerve damage, spinal injury or ingrown toenails. You need a prescription for a special therapy (Heilmittel) from a doctor to get outpatient treatment at a podiatry practice or foot clinic. People who are privately insured or who are eligible for certain benefits need a standard prescription.

A prescription for special therapy may include several treatment sessions. Sometimes only one treatment session is prescribed – and then it is possible to get additional prescriptions if needed. These sessions are then typically scheduled four to six weeks apart.

You have to pay 10 euros per prescription plus 10% of the treatment costs yourself. If, for instance, one session costs 50 euros, you will have to pay 40 euros for a total of six sessions (the basic fee of 10 euros per prescription, plus 6 x 5 euros). The part that you cover yourself is paid at the podiatry practice.

Podiatrists also offer private treatments you have to pay for yourself in full.