Jeffrey Conforti, D.P.M.
2 Sears Dr., Suite 201
Paramus, NJ 07652

201-986-1900

 

What is Gout?

Gout is a form of arthritis that is unusually painful. A slight touch can send shooting pain. The most common area for gout to occur is in the metatarsal phalangeal joint of the big toe. Other areas of the body frequently affected by gout are the knees, elbows, fingers, ankles and wrists. 

Gout occurs when there are elevated levels of uric acid in the blood. This condition is called hyperuricemia. Hyperuricemia is a genetically pre-disposed condition about 90% of the time and occurs because the kidneys do not produce the correct amount of uric acid. Children of parents who have had gout will have a 20% chance of developing it themselves. The excess uric acid in the blood forms crystals that deposit in between joints causing friction with movement. 

Symptoms of gout caused by this friction include pain, redness, swelling, and inflammation. Fever and fatigue may occur as well, although these symptoms are rare. The pain can be worse during the night when the body’s temperature lowers.

Gout can be diagnosed clinically by a doctor’s observation of the redness, swelling, and pain. More definitive tests can be performed by the doctor as well. Blood tests check for elevated uric acid levels in the blood. The synovial fluid in the joint can also be withdrawn through a needle to be checked for uric acid crystals. Chronic gout can be diagnosed by X-ray.

Treatment given for acute gout diminishes the symptoms. Non-steroid anti-inflammatory drugs such as Colchicine and other corticosteroid drugs will stop the swelling, redness, and inflammation in cases of acute gout. If gout becomes chronic, there are multiple ways to combat it. Lifestyle changes and changes in diet may be necessary, as well as preventative drugs. 

Gout can be aggravated by a sedentary lifestyle. Exercise will reduce probability of future cases of gout. Certain foods cause or increase the risk of gout and their consumption should be avoided or kept at a minimum. These foods include red meat, alcohol, sea foods, and drinks sweetened with fructose. 

Lifestyle changes and diet that help prevent gout include exercise and certain foods that help decrease the chance of gout recurring. Gout preventative foods include Vitamin C, coffee and some dairy products. New drugs have been discovered that inhibit the body’s production of certain enzymes. These are the enzymes that produce uric acid. Lowering your levels of uric acid will greatly reduce the chances of developing further cases of gout.

 

Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain conditions and should therefore be well informed about problems that may arise and what they can do to properly avoid or treat them.

Some of the most common problems are foot ulcers, ingrown toenails, fallen arches, and fungal infection. A foot ulcer is an open sore on the foot and  can be a result of decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal infection is a condition that results in deformed and discolored toenails.

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a doctor for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier and between your bones and the ground as well as giving the skin on the foot a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. They also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.

 

Pregnancy and Foot Health

Many pregnant women complain about foot pain while they are expecting, primarily caused by weight gain and hormonal changes taking place in the body. By understanding how pregnancy impacts the health of a woman's feet, a pregnant woman can take action to keep her feet as healthy and comfortable as possible.

Because a woman's weight changes during pregnancy, more pressure is brought to bear on both the legs and the feet. This weight shift can cause two major foot problems: over-pronation, also known as flat feet, as well as edema, which is swelling of the feet. Over-pronation occurs when the arch of the foot flattens, causing the foot to roll inwards when the individual is walking, and can aggravate the plantar fascia tissues located along the bottom of the feet. If these tissues become inflamed, a pregnant woman can experience pain in the heel of the foot as well as severe foot pain while walking or standing. Swelling of the feet, or edema, often occurs in the later stages of pregnancy, caused by slow circulation and water retention, and may turn the feet a light purple color.

To keep feet in good health and prevent over-pronation, pregnant women should avoid walking barefoot and be sure they are wearing shoes that offer good arch support. Often a device known as an orthotic can be added to regular footwear in order to provide additional support for the feet during pregnancy. Any expectant mother whose feet hurt should first check to see if the shoes she is wearing are old, worn out and not offering the arch of the foot the proper support necessary to support and distribute the weight of her body during pregnancy.

To treat edema of the feet, a good start is to wear quality footwear which offers support and good circulation. Keep feet elevated whenever possible by using a foot stool while seated. Stay well hydrated by drinking plenty of water to prevent water retention in the feet. Any swelling that occurs in only one foot should be examined as soon as possible by a doctor.

Good foot health during pregnancy can help expectant mothers avoid foot pain that leads to other health problems. Massaging the feet and doing regular gentle exercise like walking aids in foot health by contributing to good circulation. Supportive shoes are also a good investment that will support foot health during pregnancy.

 

Biomechanics in Podiatry

Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body causing an interference with the biological structure and focuses on the movement of the ankle, the foot and the forces that interact with them.

At some time in our lives we will all experience foot problems, regardless of our lifestyle or age, and we all take our mobility for granted until we are in pain. Twists or turns can cause problems and apply stress to the feet, and that pain will spread from the foot structure to the surrounding tissues. The pain will concentrate in the foot and ankle, but may eventually spread up into the knees, hips and back.

The history of biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded. Afterwards, during the first century AD, corns on feet were recorded as specifically growing on feet and toes. In 1974 biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections of conditions could be implemented to gain strength and coordination to the area. His basic principles of thermoplastic foot orthotics are still in use throughout the industry today.

Modern technology improvements are based on past theories and therapeutic processes providing a better understanding of podiatry concepts for biomechanics. Computers provide accurate determinations about the forces, movements and patterns of the foot and lower legs with the most important information captured. Today’s knowledge of detailed measurement of external and internal forces in the foot is critical to the individual’s treatment. Like most health industries, precise determinations assist the practitioner in diagnosing and prescribing the best treatment for health improving results.

Advances in materials and more awareness of biomechanics have developed enhanced corrective methods, offering further options for foot-related injuries. Shoe orthotics options have expanded to treat walking inability, helping to realign the posture deviations caused by hip or back health occurrences. Attention to posture and foot mechanics uses individual insoles to position the foot, aligning the ankle and leg. The corrected positioning comforts the pressure and helps to ease the pain. Understanding foot biomechanics can help improve and eliminate pain, stopping further stress to the foot. However, these results can only happen if one seeks a podiatrist who specializes in biomechanics.

Foot & Ankle Medical & Surgical Care
                                                 
Paramus, NJ Location
2 Sears Drive
Paramus, NJ 07652
201-986-1900
 
 
Affiliated With
Hackensack University Medical Center
The Valley Hospital
Board Certified, American Board of Foot & Ankle Surgery
Board Certified, American Board of Podiatric Orthopedics
 

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