Telemedicine and Podiatry: What Can Be Treated Virtually and When You Need to Come In

Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · Balance Foot & Ankle · (810) 206-1402

Last reviewed: May 2026

Quick answer: Telemedicine Podiatry Virtual Visits affects roughly 1 in 4 adults in our practice that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

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✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Telemedicine and Podiatry: What Can Be Treated Virtually and When You Need to Come In

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 11, 2026 · (810) 206-1402

Telemedicine in Podiatry: What Can and Cannot Be Done Remotely

Telehealth expanded dramatically across all medical specialties in recent years, and podiatry is no exception. Virtual visits offer genuine value for certain situations — but foot and ankle care involves physical examination, gait observation, and hands-on assessment that cannot be fully replicated through a screen. Understanding what telemedicine can and cannot accomplish in podiatry helps patients decide when a virtual visit is appropriate and when an in-person examination is necessary.

What Telemedicine Podiatry Visits Can Accomplish

Follow-up visits for established conditions are ideal for telehealth. If you have plantar fasciitis and want to review how your stretching program is progressing, discuss whether your orthotics are helping, or ask about a medication side effect, a virtual visit is efficient and appropriate. Post-operative check-ins for wound appearance can be conducted via video with good lighting — the patient shows the wound and the surgeon assesses healing status. Prescription renewals, lab result review, referral coordination, and second-opinion consultations based on submitted imaging are all well-suited to telemedicine.

Triage is another valuable application. Patients unsure whether a foot problem warrants an emergency room visit or can wait for a scheduled appointment can get guidance through a virtual encounter, potentially avoiding unnecessary and expensive emergency care.

What Requires an In-Person Visit

New or undiagnosed conditions almost always require physical examination. Palpating for point tenderness, assessing joint range of motion, evaluating pulses and sensation, performing the windlass test for plantar fasciitis, or conducting the single heel-rise test for posterior tibial tendon dysfunction cannot be done remotely. Wound debridement, nail procedures, corticosteroid injections, orthotics casting or scanning, and any surgical consultation require the patient to be present.

Diabetic foot checks — which require sensory testing with a monofilament, vascular assessment, and careful skin inspection between the toes — are not adequately performed via telemedicine despite their importance. Diabetic patients should maintain in-person foot care intervals regardless of telehealth availability.

How to Get the Most from a Virtual Podiatry Visit

Preparation makes virtual visits significantly more productive. Before the appointment, take clear photos of the affected foot in good lighting from multiple angles — top, sole, and sides. If there is a wound, photograph it in natural light next to a ruler for scale. Prepare a description of when the pain started, what makes it better or worse, what treatments have been tried, and what medications you take. Have your shoe collection accessible so you can show your podiatrist what you typically wear. If you have prior X-rays or MRI reports, scan or photograph them to share during the visit.

Telehealth Platforms and Privacy

HIPAA-compliant telehealth platforms protect the privacy of your medical information during virtual visits. Consumer video apps such as FaceTime or Zoom are acceptable for telehealth in some regulatory frameworks but may not offer full HIPAA protection. Dedicated healthcare telehealth platforms provide encrypted connections with appropriate security standards. Ask your provider which platform they use and confirm it meets privacy requirements before your appointment.

Insurance Coverage for Telehealth Podiatry

Coverage for telehealth podiatry visits expanded significantly after 2020 and has been maintained by many insurers. Medicare, Medicaid, and most major commercial insurers now cover telehealth visits for established patients with certain conditions. Coverage policies vary — contact your insurer before the visit to confirm that your specific plan covers virtual podiatry consultations and whether any geographic or platform restrictions apply.

What Telemedicine Can and Cannot Do for Foot and Ankle Care

Telemedicine visits are effective for a defined category of podiatric encounters: follow-up visits for established diagnoses where physical examination findings are already documented and treatment monitoring is the primary purpose; medication review and prescription management for ongoing conditions; triage assessment to determine urgency and whether in-person evaluation is needed; results review for imaging or laboratory tests; and educational consultations explaining a new diagnosis, surgical procedure, or treatment plan. These encounters comprise a significant portion of podiatric practice and can be conducted effectively via video with clear clinical documentation.

However, telemedicine cannot replace the physical examination for initial diagnosis of most foot and ankle conditions. Palpation — feeling for tenderness over specific anatomical structures — is fundamental to foot and ankle diagnosis and cannot be performed remotely. Stress testing of ligaments, assessment of joint range of motion, evaluation of tendon function, and examination of skin breakdown or wound status all require in-person evaluation. Patients presenting with a new, undiagnosed foot or ankle problem, acute injuries, active wounds, or conditions requiring imaging should be seen in person. The appropriate use of telemedicine enhances access and efficiency without compromising diagnostic quality.

Virtual and In-Person Podiatry at Balance Foot & Ankle

Balance Foot & Ankle in Howell and Bloomfield Hills offers telehealth visits for appropriate established-patient follow-up and consultations. For new patients, acute injuries, or conditions requiring physical examination and imaging, our in-person offices provide hands-on exam plus imaging when needed with digital X-ray on-site. Contact our offices to determine whether your specific situation is appropriate for a virtual visit or requires in-person evaluation.

Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment
• Bunion Treatment

Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

What is Foot pain?

Foot pain is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.

Symptoms and warning signs

Common signs of foot pain include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.

Conservative treatment options

Most cases of foot pain respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.

When is surgery considered?

Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.

Recovery timeline and prevention

Recovery from foot pain varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Hills. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist if: foot or ankle pain has lasted more than 2–4 weeks without improvement, you’re changing your gait to avoid pain, you have an open wound or sore that isn’t healing, you notice nail discoloration or thickening, you have diabetes and any foot concern, or pain is severe enough to wake you at night. Most foot conditions are easier and cheaper to treat early — what starts as a minor issue can become a surgical problem with months of delay.

What is the difference between a podiatrist and an orthopedic surgeon?

Podiatrists (DPM — Doctor of Podiatric Medicine) specialize exclusively in the foot, ankle, and lower leg. Orthopedic surgeons (MD/DO) have broader musculoskeletal training but variable foot/ankle subspecialization. For foot and ankle-specific problems, a podiatrist often has more focused training and experience. For injuries involving the leg above the ankle, complex pediatric cases, or multi-level reconstruction, orthopedic consultation may be appropriate. We frequently co-manage patients with orthopedic colleagues.

How do I know if my foot pain is serious?

Signs that warrant same-day or next-day evaluation: severe pain that appeared suddenly without clear cause, swelling, redness, and warmth that appeared suddenly (possible gout, infection, or Charcot fracture), an open wound that looks infected (redness spreading, pus, warmth), inability to bear weight, or any foot problem in a diabetic patient. Pain that’s been present for weeks and is stable is important but not an emergency — schedule within 1–2 weeks.

Can foot problems cause back and knee pain?

Yes — this is a kinetic chain effect. Abnormal foot mechanics (overpronation, supination, leg length discrepancy) cause compensatory changes in knee, hip, and lumbar alignment. Roughly 30% of patients presenting to our clinic with knee pain have a treatable foot-level biomechanical cause. Correcting foot mechanics with orthotics or appropriate footwear often provides significant knee and back relief. If you have chronic knee or back pain and haven’t had your foot mechanics evaluated, it’s worth a consult.

Are orthotics worth it?

For the right conditions, yes — custom orthotics are among the most cost-effective interventions in podiatry. They’re most effective for: plantar fasciitis, flat feet with secondary knee/back pain, leg length discrepancy, metatarsalgia, posterior tibial tendon dysfunction, and diabetic foot pressure management. Quality OTC orthotics ($35–60) resolve symptoms for 60% of patients with mild-to-moderate conditions. Custom orthotics are appropriate when OTC options have failed or when the biomechanical problem is complex. We cast custom orthotics in-office.

How do I choose the right running shoes?

Start with your foot type (flat, neutral, high arch) and running pattern (overpronator, neutral, supinator). Flat feet and overpronators do best in stability or motion-control shoes. Neutral feet do well in neutral-cushioned shoes. High arches need maximum cushioning with flexible soles. Always buy running shoes at the end of the day (foot swelling peaks then), get properly fitted by a specialist, and replace every 300–500 miles. If you’ve been injured repeatedly, a gait analysis can identify the mechanical flaw driving your injury pattern.

What is the difference between a sprain and a fracture?

A sprain is a ligament injury (the tissue connecting bones); a fracture is a break in the bone itself. Both can occur with the same trauma (ankle roll, fall). The old test — ‘if you can walk, it’s not broken’ — is wrong; many fractures are initially weight-bearable. Key differences: a fracture typically produces localized bone tenderness along the bone itself, while a sprain is tender over the ligament. X-ray is the standard to differentiate. High-grade sprains without proper treatment can be as disabling as fractures.

How do I prevent foot and ankle injuries?

The four most impactful prevention strategies: (1) Supportive, appropriately fitted footwear for your foot type and activity. (2) Gradual activity progression — the 10% rule (never increase weekly mileage or intensity by more than 10%). (3) Regular calf and ankle mobility work. (4) Strengthening the posterior tibial tendon, peroneals, and intrinsic foot muscles. Most overuse injuries are preventable; most acute injuries are not — but ankle sprain recurrence (60–70% without rehab) is prevented by balance and proprioception training.

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 reached over one million views and almost 1 million subscribers on youtube.