Podiatry Medicine in India – Decoding Challenges and Potential
Not many of you would be aware of Podiatry as a stream of healthcare and medicine. This medical specialty is aimed exclusively at the diagnosis, treatment, and prevention of foot and ankle disorders, ranging from trauma, and sports injuries, to even aches and pains, among others. However, in the recent times, it has become synonymous with Diabetic Foot Care in India. Although the growth of podiatry has been slower compared to other medical disciplines, the Diabetic Foot Care and Sports Medicine have been growing significantly in India, over the last couple of years.
Despite the critical importance of foot health, the field of podiatry remains relatively underexplored and underutilized. We delve into its current status and understand its immense potential and while taking cognisance of the challenges and complexities that exist in the current shape of this highly exclusive medical specialty.
The Rising Tide of Diabetic Foot Amputations
Diabetes looms as a swiftly escalating health crisis in India, with an estimated 101 million individuals afflicted by the condition and 136 million teetering on the brink of pre-diabetes. This places it among the top three public health concerns nationwide. However, there exists a glaring disparity in diabetic foot awareness and management across the Indian populace. Despite growing awareness, a noticeable lack of empathy and adherence to daily foot care regimens persists among individuals afflicted by diabetic foot ulcers, frequently occurring within the initial year of a diabetes diagnosis. Shockingly, approximately 140,000 major amputations (below or above the knee) and over 1.4 million minor and major amputations (extrapolated data) occur annually, according to published statistics. Alarmingly, up to 80% of these amputations could be averted with timely intervention and specialized foot care. Podiatric surgeons emerge as pivotal figures in diabetic foot care, offering holistic management strategies encompassing wound care, biomechanical assessments, patient education, and the provision of custom and offloading footwear, among other ortho-mechanical devices.
Sports Injuries: The Growing Concern
While the surge in India’s competitive sports scene is a testament to growing enthusiasm, it is also cause for the rising number of complex foot and ankle-related injuries. Additionally, as more individuals are embracing sports and fitness as a way of life, the incidence of sports-related foot and ankle injuries is on the rise among non-athletes as well. From ligament tears to stress fractures, these injuries pose a formidable challenge to both mobility and athletic performance. While traditional avenues like orthopedic clinics and general physicians remain go-to options, the specialized expertise of podiatric surgeons and foot and ankle specialists is becoming increasingly invaluable. Their targeted interventions not only aid in injury prevention but also serve to optimize an athlete’s performance, underscoring their indispensable role in the realm of sports medicine.
Arthritis of the Leg and Feet: Navigating the Painful Path
Arthritis, a degenerative joint disorder, ranks as the second most prevalent health issue in India. Osteoarthritis, rheumatoid arthritis, and gout stand out as the leading types, affecting approximately 22% to 39% of the population. While arthritis affects the overall joints of the body, it’s the leg and the feet that “carry the weight of the problems”. Podiatric surgeons and Foot and Ankle experts can deploy a multi-faceted approach to manage arthritic conditions, combining pharmacological interventions, orthotic devices, and physical therapy to remove pain, improve joint functions, and increase mobility. The specialised knowledge of podiatry medicine and biomechanics ensures tailor-made treatments that confront the unique challenges posed by arthritis of the lower extremities.
Wound Care: Healing from the Ground Up
Wounds in the lower limb, resulting from any kind of trauma/injury, vascular issues, or underlying medical conditions like diabetes, require utmost care to prevent complications and promote healing. Podiatric surgeons and wound care specialists can help in proper wound assessment and management, debridement, offloading, employing advanced techniques like ultrasonic debridement, 3D bioprinting, etc., and topical therapies to expedite healing and reduce infection risk.
Beyond Diabetic Foot: The Expansive Realm of Podiatry
It’s important to recognise here that Podiatry is not just about Diabetic Foot (though it remains the cornerstone of the treatment); it caters to an expansive spectrum of foot and ankle conditions. It could be from fungal infections between the toes, ingrown toenails, sports injuries, trauma, geriatric foot conditions, paediatric foot conditions, congenital deformities and neuromuscular disorders, podiatric surgeons possess the expertise to diagnose, treat, and manage a universe of foot-related ailments.
The Road Ahead: Unlocking Podiatry’s Potential in India
With challenges galore posed by limited awareness, inadequate infrastructure, and a scarcity of specialized training programs, podiatry medicine in India holds immense promise. With the rising prevalence of chronic diseases, increasing sports participation, and growing emphasis on holistic healthcare, the demand for specialized foot care is definitely going to escalate. What would be key to it, is a much aware Indian population.
To unleash the full potential of podiatry in India, concerted efforts are required to:
Raise awareness
Educate the public and healthcare professionals about the importance of foot health and the role of podiatrists in specialised foot care
Conduct Training Programs
Establish dedicated podiatry training programs and encourage interdisciplinary collaboration to enhance foot care expertise across the healthcare spectrum.
Promote Research
Increase research initiatives focused on podiatry-related issues to drive innovation, improve treatment results, and inform evidence-based practice.
In conclusion, podiatry medicine in India stands at a crossroads. It is poised for growth and transformation. By addressing the current challenges and capitalizing on emerging opportunities, we can elevate foot health standards and ensure that every individual receives the specialized care they deserve. After all, when it comes to foot health, expertise matters.
