Everything You Need to Know About Gout

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 metatarsal phalangeal joint on the big toe; though it has 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 and the children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, again noted as being particularly painful, is the leftover uric acid crystallizing in the blood stream and travel to the space between joints where they rub causing agonizing friction when the patient moves. Symptoms include; pain, redness, swelling, and inflammation. Tertiary side effects may include fatigue and fever though reports of these effects are very rare. Some patients have reported that, as temperature drops (when you sleep for instance) the pain may intensify.

Most cases of gout are easily diagnosed by a clinician’s assessment of the various symptoms; however, there are defined tests that can be performed. If the doctor does not suggest them first, you may want to have a blood test to detect elevated levels of uric acid, perhaps withdraw synovial fluid in the joints (where the crystals would lay), as well as the use of an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms; non-steroid anti-inflammatory drugs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation, however, diet, lifestyle changes, and preventative drugs are necessary to fully combat the most severe cases.

 Those that lead a sedentary lifestyle are at a higher risk for gout. Any amount of exercise decreases probability of repeat encounters with the condition. Also, staying away from, or reducing drastically, consumption of red meat, sea food, and fructose-sweetened drinks reduces the likelihood of chronic gout as well.

As for diet, beyond what has already been mentioned, ingesting Vitamin C, coffee, and particular dairy products help on the preventative maintenance side of healthy living. While new drugs are out on the market that inhibit the body’s production of uric acid-producing enzymes, reducing or eliminating as much as possible your overall levels of uric acid will ensure you lead a gout-free life.

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics 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 remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. 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 may rearrange 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 do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Ingrown Toenail Care

An ingrown toenail is caused when a toenail grows sideways into the bed of the nail, causing pain and swelling. Sometimes this can become infected causing drainage and may become serious.

There are many risk factors that can predispose a person to this common condition. Cutting your nails too short, participating in sports, diabetes, being overweight, or having a fungal infection of the toe can all cause ingrown toe nails. Many people are genetically prone to ingrown nails and it can often be related to genetics. Often the problem can come from wearing ill-fitting shoes, or even from shoes that keep the feet slightly damp.

There are some things that you can do to prevent and treat these painful problems. Letting your toe nails grow a little longer will help prevent this condition. If you do develop an ingrown nail, soaking the toe in hot water will help prevent infection and lessen pain. You may want to add antibiotic soap or Epsom salts to the water. This will help to prevent infection.

Some experts also recommend placing small pieces of cotton under the affected part. This will help the toenail to grow up instead into in your nail bed. Resting with your feet up can reduce swelling and redness.

If your pain is so severe that it keeps you from everyday activities, it is time to see your podiatrist. Also, if you see a red streak running up your leg, or if your infection is spreading, see a podiatrist immediately. There are many quick treatments that can lessen your pain and have you walking with comfort.

One method of treating an ingrown toenail involves using a Band-Aid. Wrapping the affected toe with a Band-Aid will prevent infection and also keep the nail from growing out at painful angles.

If your podiatrist feels it is necessary, he or she may make a small incision and remove part of your toe nail. Medication will be placed in the nail bed to prevent re-growth of the problem nail parts. This will be done under local anesthesia and should lessen your discomfort in no time. You will be advised to stay off your foot for a day or so, but can then carry on normal activities.

Take care of your feet; you have many steps to take in your life. Walking in comfort should be a priority for a lifetime of healthy living.

Sesamoiditis

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

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