Gout

Gout is a complex form of arthritis that can affect anyone with unexpected suddenness. It is characterized by abrupt sharp attacks of pain, redness and tenderness in the joint located at the base of the big toe. It surprises people in the middle of the night, with a terrible sensation that your big toe has caught on fire. The joint that is affected is swollen, hot, and incredibly tender to even the lightest weight. Symptoms include intense joint pain that can occur in your feet, ankles, hands, wrists, and knees. Pain is the worst within the initial four to twelve hours from the time it begins. After the worst pain begins to subside, joint discomfort may linger anywhere from a few days to weeks. Attacks that happen later will likely last even longer and affect more joints around the initial affected one. You may notice that the affected joint or joints are tender, red and swollen, and feel warm. As gout worsens, joint mobility will possibly decrease.

What does treatment look like

Medication is the best treatment for gout. The medications that you receive will be provided by your doctor after they examine your unique case of gout and better understand your current health and own preferences. Medication can be used to treat and prevent future attacks, and also prevent further complications caused by gout which can include developing tophi from urate crystal deposits.

Your doctor may also prescribe a regimen of physical therapy to keep your body moving and blood circulating. Whatever condition you have, exercise will help prolong your mobility, and your body’s ability to combat an existing condition. Keeping your body energized and exercised will help it continue to support you in the long run.

How to Prevent it

Although it is not entirely possible to prevent gout, there are several ways you can help protect yourself against future gout attacks.

  • Keep your fluid intake high: always be sure to keep your body well hydrated, which includes drinking plenty of water, and putting a limit on sweetened drinks. Watch out for drinks that have a high level of high fructose corn syrup.
  • Maintain a healthy body weight: be sure to create a lifestyle that will help you maintain a healthy body weight. This can include losing weight in a natural, healthy way. Avoid fasting or quick weight loss, which may raise uric levels that will worsen gout conditions. By simply having a diet made up of natural, unprocessed foods and having a good exercise routine you will be able to take good care of your body and its weight.
  • Limit your intake of meat: Gout can be worsened by the intake of meats such as beef, fish, and poultry. Pay attention to what types and amounts worsen your symptoms. It is important to become highly attuned to your body’s needs to know how to take care of it in your diet.
    Limit or avoid alcohol: Talk with your doctor to see if alcohol consumption is safe for you. Recent studies have shown that some types of alcohol, especially beer increase the risk of gout symptoms.

Consequences of not treating it

It is vital to speak to your doctor about any gout symptoms you may be experiencing, not doing so can result in pain that gets severely worse over time, and may end up in losing the ability to use your foot.

Bunions

What is it?

Bunions are bumps that are formed on the foot at base of the big toe. The happens when the big toe pushes against the toe beside it, forcing the big toe’s joint to grow and stick out. The skin covering the bunion may become red and sore. There are several ways that bunions can form. They can be created and worsened by the stressed placed on your feet from wearing tight, narrow shoes, or they may form because of an inherited gene. Arthritis has also been known to cause bunions. Bunions can also form on the joint of the tiniest toe. It is important to visit a doctor is you have persistent pain on your big toe, and can see a visible bump on the joint. As time goes on, you may find that you have a diminishing ability to move your foot. Bunion can also be a sign of certain types of arthritis, mainly inflammatory types like rheumatoid arthritis.

What does treatment look like?

Treatment for bunions largely depends on how severe the bunion is, as well as how much pain it causes to your feet. Nonsurgical treatments that help relieve pain and pressure caused by a bunion can include:

  • Changing shoes:

    instead of wearing tight and uncomfortable shoes, wear ones with plenty of room that provide ample space for your toes. You can also use padded shoe inserts that help distribute pressure more evenly as the feet move, which can help prevent your bunion from getting worse. You can also get over the counter arch supports over the counter, or get prescription orthotic supports.

  • Padding:

    there are many over the counter options for people suffering from bunions. Non-medicated bunion pads can be helpful in relieving pain. Doctors may also recommend having your foot taped into a normal position in order to reduce stress on the bunion, and help in relieving the pain.
    Pain Medication: to relieve pain, over the counter medication such as Advil and ibuprofen can be immensely helpful.

  • Ice:

    If you’ve been on your feet for too long and your bunion becomes inflamed, applying ice can help largely in relieving soreness and persistent inflammation.

  • Sometimes surgery may be required if non-surgical treatment does not provide the relief you need from your symptoms. It should be noted that surgery on a bunion isn’t recommended unless it causes constant pain that interferes with your daily activities.

    The technique used on the bunion will depend on each unique situation. Surgical procedures may involve removing swollen tissue from your big toe joint, straightening the big toe through the removal of part of the bone, or permanently joining the bones of the joint that is affected. Recovery times will depend on each unique patient. It’s possible to be able to walk on the foot immediately after surgery, although full recovery time can range from weeks to months.

    How to prevent it:

    Bunions may be hard to prevent if your are genetically predisposed to having them, however you can help in the prevention by wearing fully supportive shoes that leave plenty of room for your toes.

    Consequences of not treating it:

    Depending on the severity of the bunions, leaving them untreated can result in them worsening over time until there is a very painful deformity in the foot. It is important to have a doctor treat it in order to prevent the bunion from growing.

    Stress Fractures

    What is it/what happens to cause this issue?

    Stress fractures are tiny cracks in a bone that are caused by repetitive pressure. This is often caused by overuse like repeatedly running long distances, or jumping up and down. Stress fractures can also occur from normal use of a bone that’s been debilitated by a condition like osteoporosis. Stress fractures most commonly happen in the weight-bearing bones of the lower leg and foot. Although track and field athletes are often susceptible to stress fractures, anyone can experience a stress fracture. One common situation is people doing too much too soon when starting a new exercise program.

    The initial pain that comes from a stress fracture is subtle, yet worsening with time. The tenderness comes from a specific spot, and lessens during resting periods. The painful area may also swell. Contact your doctor if your pain becomes severe or persists even when it is at rest.

    What does a typical treatment look like?

    While doctors can sometimes diagnose a stress fracture from just looking at the medical history and physical exam, imaging tests are commonly needed to confirm the diagnosis. These include X-rays, bone scans, and MRIs depending on the severity and intricacies of your injury.

    It is vital to reduce the bone’s weight-bearing load until healing occurs. In order to do this, you may need to wear a walking boot/brace or use crutches for a period of time, usually a number of months. Although it’s not common, surgery is sometimes necessary to ensure complete healing of some types of certain stress fractures, especially those that occur in areas with a poor blood supply.

    Is there a recovery time before it’s gone or does it have lingering effects?

    Bones take quite a while to heal, and it’s important to give it the whole extent of this time to ensure it returns to its original ability. This may take several months or even longer depending on how intense the injury was. In the meantime be sure to rest, and keep any weight off the affected limb until the doctor clears you to bear normal weight. Use ice to reduce swelling and relieve pain as needed. This may be up to three or four times a day for 10 minutes at a time. Be sure to pace yourself and resume any activity slowly.

    When you are cleared by the doctor to resume activity, make a slow progression from non weight-bearing activities like swimming to your usual more strenuous activities. Any sort of high-impact activities, such as running, should be resumed on a gradual basis with careful attention being paid progression of time and distance.

    What are the consequences of not treating it?

    It is important to treat any of these symptoms and after treatment allow the foot and toes to rest. Ignoring this could lead to irreversible damage in your foot, and ultimately lead to a disability.

    Plantar Fasciitis

    What is it/what happens to cause this issue?

    Plantar fasciitis is the most common cause of heel pain. The plantar fascia is made up of a flat band of tissue that connects your heel bone to your toes to support the arch of your foot. If your plantar fascia is strained, it becomes weak, swollen, and irritated, ultimately causing your heel or the bottom of your foot to hurt whenever you try to stand or walk. Plantar fasciitis is caused by a strain on the ligament supporting your arch. Repeated strain can create tiny tears in the ligament that lead to pain and swelling.

    What does a typical treatment look like?

    Your doctor will check your feet and watch you stand and walk. A description of your symptoms, including where the pain is, and even what time of the day the foot hurts the most will aid in the evaluation of the injury. To further understand your health history, he or she will also ask questions concerning your past health, including any illnesses or injuries you have previously had, as well as your daily level of activity.

    After this your doctor may take an X-ray of your foot if there appears to be a problem with the bones of your foot, such as a stress fracture. While there is no treatment that works best for everyone with plantar fasciitis, there are many things you can try to help your foot get better depending on the severity of the problem:

  • -Make sure to give your feet enough rest by cutting back on activities that make your feet hurt.
  • -Put ice on your heel to reduce pain and swelling. Or take an over-the-counter pain reliever.
  • -Make it a routine to do toe stretches, calf stretches and towel stretches several times a day, especially when you first get up.
  • -Make sure you have shoes with good arch support and a cushioned sole. A specialist can help you find exactly what your foot needs.
  • If these treatments do not help to alleviate the pain, your doctor may recommend splints that are worn at night, shots of medicine in your heel, or other treatments. It is likely that you won’t need surgery, as it is only suggested by doctors for patients who still experience pain after trying other treatments for 6 to 12 months.

    Is there a recovery time before it’s gone or does it have lingering effects?

    After beginning treatment, you will have less pain within a few weeks. However, it may take time for the pain to go away completely. This may range from a few months to a year.

    Be sure to correctly follow and stay on the path of your treatment, not doing so will result
    in continuing pain when you stand or walk. While you are in treatment you will need to reduce your level of activity, or switch to another type of activity that decreases the stress on your feet. This, with stretching, anti-inflammatory drugs, and making sure that you have good-quality shoes, will usually allow your condition to improve in response. It may take several months for your pain to go away completely.

    What are the consequences of not treating it?

    It is important to treat any of these symptoms and after treatment allow the foot to rest. Ignoring this could lead to irreversible damage in your foot, and ultimately lead to a disability.

    Hammer Toes

    What is it/what happens to cause this issue?

    Hammertoes happen when there is a muscle and ligament imbalance around the toe joint that causes the joint in the middle of the toe to bend and become stuck in this position. The most common symptom is rubbing and irritation on the top of the bent toe.

    There are two types of hammertoes:

    Flexible hammertoes- in which the toe still can be moved at the joint. This is an earlier, milder form of the problem and comes with several treatment options.

    Rigid hammertoes- in which the tendons in the toe become rigid, and press the joint out of alignment. At this stage, the toe is unable to move, and surgery is needed.
    Symptoms to look out for include: pain when putting on a shoe, corns forming on top of the toe joint, swelling in joint and red coloring, difficulty in moving the toe joint, pain in the ball of the foot under the bent toe.
    Getting a thorough medical exam will confirm whether or not you have a hammertoe. Usually, an X-ray is part of this exam to correctly assess the extent of the deformity.

    What does a typical treatment look like?

    You should see a doctor if you are experiencing symptoms commonly associated with a hammertoe. You can take these steps to temporarily relieve the pain and discomfort:

    • -Wear only shoes that are broad and high across the toes, known as a wide toe-box shoe. Be sure there is at least one-half inch of space between the longest of your toes and the tip of the shoe.
    • -Be sure to give your feet a rest and don’t wear heels higher than 2 inches.
    • -Buy non-medicated hammertoe pads. They fit around the pointy top of the toe joint and are very helpful in relieving painful pressure.
    • -Gently massaging the toe may help relieve pain.
    • -If you are experiencing any swelling, ice packs help provide relief.

    There are several treatment options that vary according to how severe the hammertoe:

    • -Drugs that reduce inflammation can ease the pain and swelling. Cortisone injections may be prescribed to relieve acute pain.
    • -Over-the-counter metatarsal pads
    • -The doctor may also recommend doing a variation of foot exercises to help restore muscle balance.

    If the above methods do not resolve the hammertoes, surgery may be needed. This is minimal surgery that can be done in a surgery center without the need for hospitalization. There are several surgical techniques that are used to treat hammertoes effectively. In less severe cases, the doctor will remove a small piece of bone at the joint that is involved and realign the toe joint. More severe hammertoes may require more complicated surgery.

    Is there a recovery time before it’s gone or does it have lingering effects?

    Recovery time largely depends on the severity of the hammer toe, and type of surgery performed. Symptoms can last for weeks to months, and will slowly get better with time.
    You will need to wear a special type of shoe after surgery to protect your toe and to keep it in the right position for 3 to 6 weeks. About 2 weeks after the surgery, your doctor will remove your stitches or sutures. If a pin was put in place to keep your toe straight while it heals, it will be removed 3 to 6 weeks after surgery.

    What are the consequences of not treating it?
    It is important to treat any of these symptoms and after treatment allow the foot and toes to rest. Ignoring this could lead to irreversible damage in your foot, and ultimately lead to a disability.

    Achilles Tendinitis

    Achilles Tendinitis is commonly caused by an overuse of the Achilles tendon, a vital band of tissue that connects the calf muscles at the back of the lower leg to your heel bone. It commonly happens in runners who suddenly increase the intensity or length of their runs, as well as people who play a certain sport only on the weekends. Achilles tendinitis can usually be treated with simple but strategic home care under your doctor’s supervision. These self-care strategies are necessary to prevent recurring episodes. However, the more serious cases of Achilles tendinitis can lead to sudden tendon ruptures that may require surgical repair. Symptoms to look for include:

    • -continuing mild ache above the heel or in the back of the leg after running or other sports activities that mainly use the legs.
    • -tenderness or stiffness in lower legs, especially in the morning.

    What does a typical treatment look like?
    Tendinitis generally responds well to self-care measures. This incudes taking over-the-counter pain medications like ibuprofen, or naxopren to treat any pain. Physical therapy uses specific exercises that stretch and strengthen the Achilles tendon and help build stronger structure support for it. Orthotic devices, such as shoe inserts also help strengthen the tendon. When having a doctor examine it, they will gently press on the affected area to determine the exact location of pain, tenderness or swelling. He or she will evaluate the current flexibility, alignment, range of motion and reflexes of your foot and ankle to thoroughly evaluate its condition.
    Your doctor may order one or more of the following tests to better assess the severity your condition:

    X-ray- to help rule out other conditions that can cause similar symptoms.
    Ultrasound-to produce real-time images of the Achilles tendon in motion, and evaluate blood flow around the tendon.
    MRI- to produce very detailed images of the Achilles tendon in more severe cases. Although tendinitis usually responds well to less invasive measures, after several months, more severe cases may require surgery to correctly repair the tendon.

    Prevention:
    While it may not be possible to prevent Achilles tendinitis, you can certainly take measures to reduce your risk:

    • -Always increase any activity level gradually. If you’re just beginning an exercise regimen, be sure to begin slowly and gradually increase the duration and intensity of the training.
    • -Be sure to choose your shoes carefully. Shoes worn while exercising should provide a great cushioning for your heel and a firm arch support to help reduce the tension in the Achilles tendon.
    • -Make it a habit to stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before and after exercise to continuously maintain flexibility. This is especially important to avoid reoccurring Achilles tendinitis.
    • -Strengthen your calf muscles. Strong calf muscles help the calf and Achilles tendon to better handle the stresses they encounter with activity and exercise.
    • -Cross-train instead of sticking to one main activity. Be sure to alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and swimming. This way, your body will be balanced as it grows in strength and ability.

    What are the consequences of not treating it?

    If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.