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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.
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.
The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.
While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.
Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If bone is removed it is then replaced with prostheses, or synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.
Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.
Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.
Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.
It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.
For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.
Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.
Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works the muscles.
Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet off of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.
In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis. It’s also important to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage. This encourages circulation in the feet as well as muscle relaxation.
Plantar warts are growths that typically appear on the heels or other weight-bearing areas of the feet. These warts are caused by the human papillomavirus (HPV). The virus enters the body through breaks in the skin, such as cuts, that are on the bottom of the feet. Plantar warts are more likely to affect children and teenagers, people with weakened immune systems, people who have a history with plantar warts, and people who walk barefoot in environments exposed to a wart-causing virus.
If you suspect you have plantar warts, you may have the following symptoms: pain or tenderness while walking, a lesion that interrupts the ridges in the skin of your foot, small fleshy lesions on the bottom of the foot, or a callus where a wart has grown inward over a well-defined spot on the skin.
HPV causes plantar warts to form and is very common. There are more than 100 kinds of the virus in existence. However, only a few of them cause warts on the feet. The other types of HPV are likely to cause warts on other parts of the body.
If you have plantar warts, your podiatrist may try different treatment methods depending on your specific case. Some treatments for plantar warts are peeling medicines (salicylic acid), freezing medicines (cryotherapy), or surgical procedures. Laser treatments and vaccines are also used to treat plantar warts.
Overtraining and overusing the feet are the main causes of common running injuries. A number of these common injuries are caused by overrunning. Runner’s knee is a condition that is characterized by the back of the kneecap beginning to wear away and cause pain in the knee. This frequently occurs due to either a decrease in strength in the quadriceps muscles or ill-fitting shoes that are lacking in proper support for the inside of the forefoot. Strengthening exercises focusing on the quad muscle and sports orthotics are the usual treatments for those suffering from runner’s knee. Prevention of the condition lies in a focus on hip strengthening and quad-strengthening to keep the kneecap aligned. To help learn the best exercise to heal runner’s knee, one can also undergo physical therapy.
One common injury, called iliotibial band syndrome, is often caused by overtraining. This condition occurs when the iliotibial band gets irritated, creating pain and discomfort in the outside knee area. Plantar fasciitis, another common running injury, also occurs as a result of inflammation and irritation. Plantar fasciitis is an inflammation and irritation of the bone in the foot. A large amount of pain is often experienced due to plantar fasciitis. The condition can be caused by a high arch, improper footwear, tight muscles, or flat feet. It can best be avoided by stretching and wearing appropriate footwear that supports the foot.
Another common injury for runners is stress fractures. These injuries occur due to running style, overtraining, or a lack of calcium. Stress fractures most often occur in several locations in runners, including the inner bone of the leg, the thighbone, the bone at the base of the spine and the bones of the toes. Stress fractures are best prevented by wearing proper footwear and by running on flat and hard surfaces; this will absorb some of the shock created during running.
Aside from overtraining, other causes of common running injuries include ill-fitting footwear, a lack of flexibility and strength, and irregular biomechanics. The best way to avoid running injuries is to prevent them from even occurring. Both iliotibial band syndrome and stress fractures are preventable. The first step that should be taken to prevent running injuries is to only wear footwear that fits properly and that is appropriate for whatever activity you are doing. Running shoes are the only protective gear available to runners that can safeguard them from sustaining injuries. Choosing the right pair of shoes is therefore extremely important. While running shoes are an important factor, it is also important to consider other facets of your running routine such as training schedules, flexibility, and strengthening. These elements should be considered and altered according to your running needs to best maximize your run and minimize the possibility of injury. Careful stretching before and after a run should also be considered to help prevent running injuries. Stretching muscles enables greater flexibility and a lesser chance of sustaining injury.
Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.
The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.
The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.
If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.
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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.
Heel spurs are the result of calcium deposits that cause bony protrusions on the underside of the heel. Heel spurs are usually painless, but they have the potential to cause heel pain. Heel spurs tend to be associated with plantar fasciitis, which is a condition that causes inflammation of the band of connective tissue that runs along the bottom of the foot. They most often occur to athletes whose sports involve a lot of running and jumping.
Some risk factors for developing heel spurs include running and jogging on hard surfaces, being obese, wearing poorly fitting shoes, or having walking gait abnormalities.
It is possible to have a heel spur without showing signs of any symptoms. However, if inflammation develops at the point of the spur’s formation, you may have pain while walking or running. In terms of diagnosis, sometimes all a doctor needs to know is that the patient is experiencing a sharp pain localized to the heel to diagnose a heel spur. Other times, an x-ray may be needed to confirm the presence of a heel spur.
Heel spurs can be prevented by wearing well-fitting shoes that have shock-absorbent soles. You should also be sure that you are choosing the right shoe for the activity you want to partake in; for example, do not wear walking shoes when you want to go on a run. Additionally, maintaining a healthy weight can be beneficial toward preventing heel spurs, as it will prevent an excess amount of pressure being placed on the ligaments.
There are a variety of treatment options for people with heel spurs. Some of these include stretching exercises, physical therapy, shoe inserts, or taping and strapping to rest stressed muscles and tendons. If you have heel pain that lasts longer than a month, don’t hesitate to seek help from a podiatrist. Your doctor can help you determine which treatment option is best for you.
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.
According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans. Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases. Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.
Complications of the disease may lead to several foot and ankle-related conditions. The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat. Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.
To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure. Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation. The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.
Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding. These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form. Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet. The resulting deformity is a foot that is flattened and wider in appearance.
To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes. Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces. In more serious cases, surgery may be considered to treat more developed deformities. Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.
