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Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.
The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well.
This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.
Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.
Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.
Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.
Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.
Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.
Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.
Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.
The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.
Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.
Diabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients, neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.
Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers and can cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear well-fitting socks.
Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that may be prescribed to help with any neuropathy experienced by the diabetic patient. It is also advisable to visit a podiatrist if one is experiencing any conditions involving the feet, such as ingrown toenails, which in more severe cases can cause infection.
Diabetic feet must be inspected daily. Diabetic foot care at home is possible if a patient is provided with instructions from their podiatrist. Patients can relieve dry heels with creams or ointments. Suspected wounds should warrant an immediate call to the podiatrist. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.
Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.
The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.
Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.
Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.
If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.
Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
Sesamoiditis is a condition in which the sesamoid bones in the forefoot become inflamed from physical activity. Sesamoid bones are bones that are not connected to other bones but are located in tendons or muscle. Two of these sesamoid bones are very small and located on the underside of the foot near the big toe. Athletes such as runners, baseball and football players, and dancers are likely to experience sesamoiditis. Those with high arched feet, flat feet, or runners who run on the ball of their foot are also prone to suffer from sesamoiditis.
Symptoms include pain or throbbing on the ball of the foot near the big toe. The pain generally starts with a mild throbbing but gradually builds up to shooting pain. Bruising, swelling, and redness are possible, but in most cases, these symptoms are not present. However, moving the big toe can result in pain and difficulty.
To conduct a diagnosis, the podiatrist will examine the ball of the foot and big toe. They will look for any outliers and check the movement of the toe. X-rays will be taken to rule out any other conditions and ensure that it is sesamoiditis.
Treatment for sesamoiditis is generally mild and includes rest, anti-inflammatory and pain medication, and ice treatments to deal with the swelling and pain. Orthotics may be needed with people who have flat or high arched feet to relieve pressure off the bones. In some cases the toe will be taped and immobilized to allow healing. The podiatrist may also decide to use a steroid injection to help with swelling as well. If you have sesamoiditis, you shouldn’t engage in any intensive activity, as it may inflame the area and worsen your pain. If the sesamoid bone has fractured, surgery may be required to remove the sesamoid bone.
If you are suffering from sesamoiditis or are experiencing symptoms similar to sesamoiditis, you should stop all physical activity that puts strain on the area. Furthermore you should see a podiatrist for a diagnosis to see if you have sesamoiditis.
A neuroma is a thickening of nerve tissue and can develop throughout the body. In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes. The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.
Neuromas can be caused by anything that causes compression or irritation of the nerve. A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes. Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas. Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.
Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up. Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot. An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.
Treatment for Morton’s neuroma can vary between patients and the severity of the condition. For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed. Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition. The severity of your condition will determine the procedure performed and the length of recovery afterwards.
Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.
An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.
Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.
People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.
Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.
Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.
Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.
Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.
If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.
The foot and ankle area works with 26 bones, 33 joints, and more than 100 different muscles, tendons, and ligaments. Problems with any parts of this network can result in some kind trauma within the foot and ankle area. Most foot and ankle trauma is a result of aging or intense activities such as sports. However, trauma in this area can also be the result of simple things such as wearing heels too much or even walking on an uneven pavement. There are several kinds of symptoms related to specific injuries, and there are also several different treatments that could be used as well.
Foot Injuries and Symptoms
Some common injuries in the feet include stress fractures and bunions. Stress fractures are small cracks in a bone or severely bruised parts of the bone. This type of injury is caused by intense and repetitive activity, which is found in actions involved with sports and exercise. Symptoms of this injury include pain, swelling, tenderness, and possible bruising. Another common injury with bones is also bunions, which are bony bumps typically formed on the big and little toes. This injury is typically a result from wearing high heels and unfit shoes. Some common symptoms are swelling around the big and little toe areas, as well as pain and restricted movement.
Ankle Injuries and Symptoms
The common injuries associated with ankle trauma consist of sprains, strains, and fractures. These injuries are defined by the type of tissue that has been damaged. Fractures are breaks within the bones caused by sudden impacts to the area. Sprains relate to any damage of the ligaments, commonly caused by being stretched beyond their normal range of motion. Strains are attributed to damage of the muscles and tendons from being pulled too far. Symptoms of these injuries include severe pain, limited range of motion, and swelling.
Diagnosis and Treatment
Since there are several types of injuries with a variety of symptoms, it is important to see a podiatrist about your condition. Podiatrists can run a variety of tests to diagnose an injury accurately. This includes physical examinations, X-rays, or MRIs. A podiatrist may even run a stress test, which is an X-ray taken while pressure is applied to the damaged area. Once your injury has been diagnosed, the doctor may have you wear a cast or a splint, or gradually develop your range of motion. Severe injuries may require physical therapy or even surgery if necessary. If you have any concerns from past foot and ankle trauma experiences, consult with Dr. Steven Sheridan from Ankle & Foot Specialty Clinics. Our doctor can assess your condition and provide you with quality foot and ankle treatment.
If you have any questions, please feel free to contact our office located in Sandusky, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
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Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection. The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives. Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth.
Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering. Sometimes, blisters can evolve into the cracks or breaks in the skin. The exposed tissue can then create pain, swelling, and discharge. The spread of infection can cause itching and burning as well.
While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet. Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched. Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.
Proper foot hygiene is essential in preventing athlete’s foot. You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected. Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.
While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks. Any treatment used can be supplemented by frequently bathing the feet and drying the toes. If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist. He will determine if the underlying cause of your condition is truly a fungus. If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.
A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.
Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.
A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.
Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.
For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.
The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.
The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.
A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.
If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.