Podiatry Medicine in India's Decoding Challenges and Potential

Dr. Sanjay Sharma, Co-founder of FootSecure

In an exclusive interview with India Pharma Outlook, Dr. Sanjay Sharma, co-founder of Foot Secure, sheds light on podiatric medicine and how it has been gaining traction in recent times while speaking of the challenges that accompany this relatively unexplored medical stream. He is an alumnus of RGUHS, IIMB, UC Berkeley, and AIIMS(New Delhi). He has 18+ years of clinical experience, 10 years exclusively in Podiatry. He is the thought leader in Telemedicine & Podiatry, with over 90 presentations and publications. He has been awarded the Rising Star by the Government of Karnataka and Times healthcare awards in 2020.

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 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, 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 unexplored and under-utilized. We delve into its current status and understand its immense potential while taking cognizance of the challenges and complexities that exist in the current shape of this highly exclusive medical specialty.

The epidemic of Diabetic Foot Amputations

Diabetes continues to be a serious health crisis in India, with an estimated 101 million individuals suffering from the same currently and 136 million on the brink of pre-diabetes.  However, there exists a sharp 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. With timely intervention by podiatric experts specialising in diabetic foot care, patients can finally access holistic management strategies including wound care, biomechanical assessments, and knowledge sharing, and gain insights into the use of custom and offloading footwear, among other ortho-mechanical devices that can help prevent further deterioration of their condition.

Sports-related Injuries:

In the past decade, there has been a rising interest in both competitive and non-competitive sports in India across age groups. From professional athletes to professionals and people across all age groups are now consciously indulging in games or work-outs, making them prone to higher chances of foot and ankle-related injuries. These could range from ligament tears to stress fractures and wounds and even cause temporary or permanent mobility challenges, not to mention a dip in performance.  While traditional avenues like orthopedic clinics and general physicians continue to be the primary 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 faster recovery but also injury prevention and optimization of an athlete's performance, underscoring their indispensable role in the realm of sports medicine.

Arthritis of the Leg and Feet:

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 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:

Foot and ankle wounds, which typically arise from trauma or injury to the vascular system or from underlying medical problems such as diabetes, need to be treated with extreme caution to avoid complications and amputations.  Podiatric surgeons and wound care specialists can assist with appropriate wound assessment and management, debridement, offloading, and topical therapies to lower the risk of infection and speed up healing. They can even use sophisticated techniques like 3D bioprinting and ultrasonic debridement.

Beyond Diabetic Foot:

It’s important to recognize 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, pediatric 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

With challenges like limited awareness, inadequate infrastructure, and lack of specialized training programs, podiatry medicine in India has a lot of potential to grow.  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 more 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 specialized 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: Encouraging research in podiatry will help in not only creating awareness about the need for this specailised healthcare stream but also drive innovation, improve treatment results, and encourage evidence-based practice. It will also allow an increasing number of young healthcare professionals to explore podiatry as a rewarding career option.

In line with the above, it is safe to conclude that podiatry medicine in India has immense growth potential, and by addressing the current challenges and capitalizing on emerging opportunities, India can elevate its foot health ecosystem and ensure that every patient receives the specialized care they deserve.

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