Condition
Diabetic foot and orthopaedic pressure relief
A shoe presses, a callus becomes thicker or your foot changes shape. If you have diabetes, these observations deserve attention even if the area hardly hurts. Reduced sensation can mean that pressure or strain is only noticed late.
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Which changes need prompt help
If you have diabetes, a new open area, weeping skin, increasing redness or an unusually warm and swollen foot should be medically assessed the same day. Even a largely painless, hot, swollen foot can indicate a serious problem, such as acute damage to bones and joints known as Charcot foot. Until it has been assessed, avoid putting weight on the affected foot as far as possible; arrange help to reach care.
If you have a fever and feel very unwell, if inflammation is spreading rapidly, if your foot suddenly becomes cold or pale, or if there are other signs of a serious acute problem, seek immediate medical help. Call 112 in an emergency. Do not wait for a routine appointment for aids or a reply from the online reception.
Understanding
A closer look
At OrthoCoast, we provide orthopaedic assessment and plan pressure relief and aids. We consider how foot shape, movement and footwear interact. This complements your other diabetes and foot care; wounds, infections or circulation problems require additional medical care.
Why no pain does not necessarily mean no problem
Diabetes can affect nerves and circulation. When protective sensation is reduced, pressure, rubbing or small injuries may not be felt clearly enough. At the same time, circulation problems can make healing harder. Together, these factors make a pressure point more significant than simply an uncomfortable shoe.
Not everyone with diabetes has diabetic foot syndrome or needs the same care. Existing skin changes, previous wounds, foot shape and nerve or vascular findings help determine what is needed. An apparently normal pain response does not replace an examination.
Further information
What we assess from an orthopaedic perspective
We assess which deformities or movement restrictions affect loading and where pressure develops. This includes the skin, foot shape and existing shoes and aids. Reports from previous diabetes, vascular or wound care are important so that an orthopaedic recommendation fits your wider treatment plan.
We want to know which footwear or aids you can actually use. Are they difficult to put on? Do you feel unsteady walking in them? Are the shoes only used outdoors even though pressure relief is also needed at home? These questions help make a medically appropriate recommendation practical in daily life.
Planning pressure relief and aids together
Pressure relief aims to protect areas at risk or already affected from further mechanical loading. The insole, footwear or other form of pressure relief needed depends on the findings. With an open wound, an ordinary comfortable shoe is not necessarily enough. The provision must be coordinated with the team responsible for treatment.
The medical goals and the fitting of the aid need to be coordinated. Manufacture and supply are handled by an appropriate supplier of medical aids. Care does not end with a prescription: fit, skin condition and practical use need to be reassessed over time. Do not use a self-cut addition or altered insole as an unchecked substitute for the agreed pressure relief.
What additional care may be needed
Wound treatment, infection treatment, circulation assessment and diabetes control each have their own requirements. Orthopaedic pressure relief does not replace these measures. Particularly when there is acute deterioration, it is important to establish quickly which service will provide the necessary care.
Please therefore bring information about who has treated you so far and which instructions are already in place. We use this information to guide the orthopaedic assessment. Adjusting an aid must not delay necessary wound or vascular treatment.
What you can look out for in daily life
Look at your feet regularly and, where your risk level calls for it, every day, including the soles and between the toes. If your eyesight is poor or you cannot reach your feet, a mirror or another person’s help may be useful. Also check inside your shoes for foreign objects or troublesome seams before putting them on.
If sensation is reduced, avoid risks of injury and burns, such as walking barefoot on unsafe ground or applying strong direct heat. Do not try to ‘wear in’ a new pressure point by wearing the shoes for longer. Report changes early. The checks and pressure-relief rules that apply to you depend on your individual risk and current findings.
Frequently asked questions
Can an insole replace other foot care?
No. It can provide part of the pressure relief. Wounds, circulation, infections and diabetes management may need additional targeted care.
Should I report new pressure points even if they do not hurt?
Yes. With reduced protective sensation, pain may be absent as a warning signal. New skin changes in particular should be assessed early.
What should I bring to an orthopaedic assessment?
The shoes and aids you wear regularly, existing reports about foot, wound and vascular care, and your medication plan. Please mention a new wound or rapid change when first contacting us; do not wait for a routine visit.
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