This is general orientation only. It describes what commonly happens; it does not describe what will happen in your case, and it is not a substitute for the instructions you are given by whoever is actually seeing you.
Before you go
Write down the story. When did it start? Was there an event — a change of shoes, a new job, an increase in running, a holiday, an injury — or did it appear from nothing? What makes it worse and what makes it better? Is it worse first thing, at the end of the day, or at night? Is it changing? Human memory in a consulting room is unreliable, and a written timeline is one of the most useful things you can bring.
Bring your shoes. Not your best ones — the ones you actually live in, and the ones you were wearing when the problem began. The wear pattern on a sole, the shape a shoe has been pushed into, and the space inside it are genuinely diagnostic. Bring any insoles or orthoses you use, and the shoes you use them in.
List your medications and conditions. Including diabetes, any circulatory or heart condition, inflammatory arthritis, thyroid disease, previous foot surgery, previous ulceration, and any medicine that affects the immune system or blood clotting. These change both the diagnosis and the safe treatment options.
Do not remove hard skin or trim nails right before the appointment. It is a natural instinct and it removes the evidence. The clinician needs to see the foot as it normally is, including the callus that has formed where the pressure is.
Practical details. Clean feet, socks that come off easily, and clothing that lets the lower leg be examined — trousers that roll to the knee, or bring shorts. Pulses and swelling are assessed above the ankle, not only at the foot.
What usually happens
History. The conversation described above, plus questions about general health, occupation, activity, and what you need your feet to be able to do.
Inspection. The foot looked at from all sides, standing and sitting, including between the toes and the sole. Skin condition, nail condition, callus distribution, foot shape, toe alignment, swelling, colour and hair growth all carry information.
Palpation. Pressing to locate the precise source of pain, which is frequently not where the person points. Feeling for pulses at the ankle and the top of the foot.
Movement and strength. Joint range at the ankle, the midfoot and the toes; muscle and tendon strength tested against resistance.
Sensory testing. Where relevant — and always where diabetes is present — testing protective sensation, often with a calibrated nylon monofilament and sometimes a tuning fork. It is painless and takes a minute, and it is the check that determines how urgently everything else needs to be treated; the National Institute of Diabetes and Digestive and Kidney Diseases explains why it is central to a diabetes foot review.
Gait. Watching you walk, usually barefoot and sometimes in your shoes. Standing posture and single-leg balance may also be assessed.
Imaging, when it will change something. X-rays for bone and joint questions; ultrasound for soft tissue; MRI for the harder questions. Imaging is not routine and a good clinician orders it when the answer will alter the plan, not to be thorough for its own sake.
Questions worth asking
- What do you think is causing this, and how confident are you?
- What else could it be, and what would make you change your mind?
- What happens if I do nothing?
- What are the non-surgical options, and how long should I give them before we conclude they have not worked?
- What should I stop doing, and what can I keep doing?
- What specifically should I look out for that would mean coming back sooner?
- If footwear needs to change, what exactly am I looking for when I go shopping?
That last question is worth asking explicitly. "Wear sensible shoes" is advice nobody can act on; "you need a wide toe box, a firm heel counter and a removable insole" is.
Afterwards
Most foot problems are managed over weeks and months rather than resolved in a single visit, and the parts that happen at home — the exercises, the load management, the footwear change, the wearing schedule for a new device — are usually the parts that determine the outcome. Write down the plan before you leave, because it will be less clear by the time you get home.
If something is not improving on the timescale you were given, or if it worsens, that is a reason to go back rather than to conclude that nothing can be done. And if you are not confident in the explanation you were given, asking for a second opinion is an ordinary and reasonable thing to do.
For the symptoms that should not wait for a routine appointment at all, see when a foot problem needs professional care. For what the profession is and how it is trained, see what is a podiatrist.