What does a podiatrist treat?

Podiatrists specialize in the foot, ankle, and lower leg. They diagnose and treat heel pain, bunions and hammertoes, tendon injuries, nerve conditions (Morton's neuroma, neuropathy), toenail disorders, skin conditions (warts, calluses, ulcers), fractures, sports injuries, diabetic foot complications, ankle instability, and perform foot and ankle surgery. At Balance Foot & Ankle, Dr. Tom Biernacki DPM, Dr. Carl Jay DPM, and Dr. Daria Gutkin DPM AACFAS serve Howell, Bloomfield Hills, and surrounding Michigan communities.

How often should a healthy person see a podiatrist?

Annual foot exams are beneficial if you are over 60, are an active runner or athlete, have diabetes, have a family history of foot problems, or notice any changes in foot shape, nail appearance, or skin texture. Preventive visits catch problems early — before bunions require surgery or a small nail issue becomes an infection.

Can foot problems cause knee, hip, or back pain?

Yes — the foot is the foundation of the kinetic chain. Overpronation causes the tibia to internally rotate, increasing stress on the knee and altering hip alignment. High arches transmit shock poorly, overloading the ankle and knee. Custom orthotics that correct foot mechanics frequently improve knee, hip, and back symptoms — one of the most underappreciated benefits of podiatric care.

When should I see a podiatrist versus an orthopedic surgeon?

Podiatrists specialize exclusively in the foot, ankle, and lower leg — making them the most experienced providers for most foot and ankle conditions. For foot and ankle surgery, a DPM with high case volume is appropriate. Dr. Tom Biernacki at Balance Foot & Ankle has performed over 3,000 foot and ankle procedures. Call (810) 206-1402.

Lupus Foot Pain Podiatric Care 2026

Medically reviewed by Dr. Tom Biernacki, DPM

Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026

Lupus Foot Pain Podiatric Care - Michigan podiatrist, Balance Foot & Ankle — Lupus Foot Pain Podiatric Care treatment | Balance Foot & Ankle, Michigan

Manifestation	Prevalence in Lupus	Mechanism	Podiatric Management
Arthritis / Joint Pain (MTP, PIP)	90%+ of patients	Synovial inflammation; immune complex deposition	Custom orthotics; accommodative padding; rheum coordination
Neuropathy (peripheral)	15-20%	Vasculitis affecting vasa nervorum; medications (hydroxychloroquine rare)	Monofilament testing; protective footwear; neurology co-management
Raynaud Phenomenon	30-40%	Vasospasm; reduced perfusion to digits	Warm socks; avoiding cold; avoid smoking
Skin Lesions (discoid, vasculitic)	20-30% foot involvement	Immune complex deposition in skin vessels	Wound care; compression if venous; biopsy if uncertain
Avascular Necrosis (talar, metatarsal)	5-10% (steroid-related)	Corticosteroid therapy; vasculitis	MRI for diagnosis; offloading; surgical referral if advanced
Tendon Rupture	2-5%	Steroid use + chronic inflammation	Emergency evaluation; surgical repair vs conservative

Foot Problem	Red Flags — Urgent Evaluation	Who to See
Sudden severe foot/ankle pain	Rule out avascular necrosis or tendon rupture	Podiatrist + Rheumatologist same week
Non-healing ulcer or wound	Vasculitic ulcer; infection risk high with immunosuppression	Podiatrist immediately; wound care
New foot drop or numbness	Mononeuritis multiplex; vasculitic neuropathy	Neurology + Rheumatology urgent
Blue/black discoloration of toes	Vasculitis; digital ischemia; Raynaud crisis	Vascular surgery + Rheumatology urgent
Swollen hot joint (single joint)	Septic arthritis (immunosuppressed patients at high risk)	Emergency; rule out infection
Bilateral foot edema	Lupus nephritis; heart involvement	Internist + Rheumatologist

Quick answer: Lupus Foot Pain Podiatric Care has multiple potential causes including mechanical, neurological, vascular, and inflammatory. The most common causes we identify are overuse, ill-fitting shoes, and biomechanical imbalance. Red flags requiring urgent evaluation: warmth/redness (infection), inability to bear weight (fracture), and unilateral swelling without injury (DVT). Call (810) 206-1402.

Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan

https://www.youtube.com/watch?v=8opvH3qxkW4

Dr. Biernacki discusses lupus-related foot problems and podiatric management.

lupus foot pain SLE podiatric care Michigan podiatrist

Watch: How to Cure Plantar Fasciitis in One Week? [FAST Heel Pain Relief!] — MichiganFootDoctors YouTube

Watch: Diabetic foot care & neuropathy management

MICHIGAN PODIATRIST INSIGHT

The most important clinical decision with Lupus Foot Pain Podiatric Care isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.

MICHIGAN PODIATRIST INSIGHT

How Lupus Affects the Foot and Ankle

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems — including the musculoskeletal system of the foot and ankle. Understanding the specific mechanisms by which lupus affects foot function allows for targeted podiatric management coordinated with rheumatologic care.

Inflammatory Arthritis in the Foot

Lupus causes inflammatory arthritis affecting small joints of the foot — particularly the metatarsophalangeal (MTP) joints and tarsal joints. Unlike rheumatoid arthritis, lupus arthritis is typically non-erosive (does not destroy bone) but is painful and limits function. It responds to systemic disease control with hydroxychloroquine, NSAIDs, and disease-modifying agents managed by rheumatology. Locally, custom orthotics and accommodative footwear reduce joint loading and improve functional tolerance.

Raynaud’s Phenomenon and Digital Vasospasm

Raynaud’s phenomenon — episodic digital vasospasm producing color changes (white, blue, red) in response to cold or stress — affects 30-50% of lupus patients. In the feet, this causes cold intolerance, numbness, and in severe cases, ischemic ulceration of the toes. Management includes warming strategies, calcium channel blockers (nifedipine), and protection from cold. Ischemic digital wounds require urgent wound care evaluation.

Avascular Necrosis (Osteonecrosis)

Long-term corticosteroid use — common in lupus management — is a major risk factor for avascular necrosis (AVN) of foot and ankle bones. The talus and femoral head are most commonly affected. Talar AVN produces progressively worsening ankle pain and limited range of motion, ultimately leading to ankle collapse and severe arthritis. Early detection with MRI enables core decompression in the pre-collapse stage. Advanced talar AVN may require total ankle arthroplasty or ankle fusion.

Peripheral Neuropathy

Lupus-related peripheral neuropathy contributes to foot numbness, burning pain, and proprioceptive deficits. Protective footwear, regular podiatric skin and nail care, and avoidance of injury are important for neuropathic lupus patients — particularly those also on immunosuppressive therapy that impairs infection resistance.

Skin Manifestations

Lupus produces various skin manifestations that may affect the foot: livedo reticularis (lace-like vascular pattern), purpura, perniosis (chilblain-like lesions in cold), and Raynaud’s ulcers. Wound care for lupus-related skin ulcers requires careful attention to the impaired vascular and immunological context.

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Dr. Tom Biernacki’s Recommendation

Lupus patients often don’t realize how much their disease is affecting their feet until the damage is advanced. I work closely with rheumatology teams to catch avascular necrosis early — before the ankle collapses — and to manage the foot complications of long-term steroid therapy proactively.

— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle

Frequently Asked Questions

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In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot or ankle condition, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

PubMed: Lupus and Foot/Ankle Manifestations

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.