Bunions
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.
Risk Factors of Gout and Affected Areas
Gout is an arthritis that can cause sudden, severe pain and inflammation in the foot often affecting the instep and ankle areas. This condition occurs due to a buildup of uric acid crystals in the joints that may lead to intense pain, swelling, and redness. The instep, or the top of the foot, is particularly susceptible to gout attacks, while the ankle may also be affected causing discomfort and restricted movement. Risk factors for developing gout include a diet high in purines, which are found in red meat and certain seafood, excessive alcohol consumption, obesity, and genetic predisposition. If you have gout, it is strongly suggested that you are under the care of a podiatrist who can help you to manage this condition.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Neeta Hasmukh, DPM from Total Podiatry. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a form of arthritis that is characterized by sudden, severe attacks of pain, redness, and tenderness in the joints. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep.
Symptoms
- Intense Joint Pain - Usually around the large joint of your big toe, and it most severe within the first four to twelve hours
- Lingering Discomfort - Joint discomfort may last from a few days to a few weeks
- Inflammation and Redness -Affected joints may become swollen, tender, warm and red
- Limited Range of Motion - May experience a decrease in joint mobility
Risk Factors
- Genetics - If family members have gout, you’re more likely to have it
- Medications - Diuretic medications can raise uric acid levels
- Gender/Age - Gout is more common in men until the age of 60. It is believed that estrogen protects women until that point
- Diet - Eating red meat and shellfish increases your risk
- Alcohol - Having more than two alcoholic drinks per day increases your risk
- Obesity - Obese people are at a higher risk for gout
Prior to visiting your podiatrist to receive treatment for gout, there are a few things you should do beforehand. If you have gout you should write down your symptoms--including when they started and how often you experience them, important medical information you may have, and any questions you may have. Writing down these three things will help your podiatrist in assessing your specific situation so that he or she may provide the best route of treatment for you.
If you have any questions, please feel free to contact our offices located in San Antonio, Uvalde, and Jourdanton, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.
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 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.
Types of Ankle Sprains
Ankle sprains are common injuries that occur when the ligaments supporting the ankle are stretched or torn. There are three main types, each varying in severity. The most common is the inversion ankle sprain, where the foot rolls inward, causing damage to the lateral ligaments on the outside of the ankle. This often happens during sudden twists or turns in activities like running or jumping. Less common is the eversion ankle sprain, where the foot rolls outward, affecting the medial ligaments on the inside of the ankle. Eversion sprains tend to be more severe and can sometimes be associated with fractures due to the strong ligaments involved. Lastly, high ankle sprains involve injury to the ligaments above the ankle joint, known as syndesmotic ligaments. Each of these are graded by severity. These sprains, common in sports like football and soccer, usually take longer to heal. If you have endured an ankle sprain, it is suggested that you schedule an appointment with a podiatrist for a diagnosis, type and grade of sprain and to obtain proper treatment.
Ankle sprains are common but need immediate attention. If you need your feet checked, contact Neeta Hasmukh, DPM from Total Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.
How Does an Ankle Sprain Occur?
Ankle sprains take place when the ligaments in your ankle are torn or stretched beyond their limits. There are multiple ways that the ankle can become injured, including twisting or rolling over onto your ankle, putting undue stress on it, or causing trauma to the ankle itself.
What Are the Symptoms?
- Mild to moderate bruising
- Limited mobility
- Swelling
- Discoloration of the skin (depending on severity)
Preventing a Sprain
- Wearing appropriate shoes for the occasion
- Stretching before exercises and sports
- Knowing your limits
Treatment of a Sprain
Treatment of a sprain depends on the severity. Many times, people are told to rest and remain off their feet completely, while others are given an air cast. If the sprain is very severe, surgery may be required.
If you have suffered an ankle sprain previously, you may want to consider additional support such as a brace and regular exercises to strengthen the ankle.
If you have any questions please feel free to contact our offices located in San Antonio, Uvalde, and Jourdanton, TX . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Three Grades of Ankle Sprains
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.
Benefits and Drawbacks of Ankle Fusion Surgery
Ankle fusion surgery, also known as arthrodesis, involves joining the bones of the ankle joint to alleviate pain and improve function. This procedure is often recommended for people with severe arthritis or significant joint damage when other treatments have failed. One major advantage of ankle fusion is the reduction of pain, as the procedure eliminates the damaged joint surfaces. It can also restore stability and improve walking ability. However, there are potential drawbacks to consider. The primary downside is the loss of ankle mobility, which can impact overall movement and flexibility. Additionally, there may be a risk of complications, such as infection or nonunion of the bones. If you are suffering from the above ankle conditions, it is suggested that you consult a podiatrist who can determine if ankle fusion surgery is right for you.
Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Neeta Hasmukh, DPM of Total Podiatry. Our doctor will assist you with all of your foot and ankle needs.
When Is Surgery Necessary?
Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:
- Removing foot deformities like bunions and bone spurs
- Severe arthritis that has caused bone issues
- Cosmetic reconstruction
What Types of Surgery Are There?
The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:
- Bunionectomy for painful bunions
- Surgical fusion for realignment of bones
- Neuropathy decompression surgery to treat nerve damage
Benefits of Surgery
Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.
Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.
If you have any questions please feel free to contact our offices located in San Antonio, Uvalde, and Jourdanton, TX . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Foot Surgery
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.
Preventing Diabetic Limb Loss
Preventing limb loss in diabetic patients is a significant health concern, as the majority of nontraumatic lower-limb amputations are linked to diabetic foot ulcers, or DFUs. The rise in diabetes-related amputations, especially among younger adults, underscores the importance of proactive care. Key factors that contribute to amputation can include poor glucose control, unmanaged peripheral neuropathy, and ineffective wound care. Early intervention by a podiatrist is essential to both identify and manage these risk factors. Regular foot assessments, proper wound care, and controlling blood sugar levels can significantly reduce the risk of amputation. Podiatrists play a vital role in these preventative strategies, by performing debridement, managing infections, and recommending appropriate dressings. These combined efforts can halt the progress of an ulcer and decrease the likelihood of an amputation. If you have diabetic foot problems that may lead to a loss of limbs, it is suggested that you schedule regular appointments with a podiatrist for treatment and management options.
Diabetic Limb Salvage
Diabetic limb salvage can be an effective way in preventing the need for limb amputation. If you have a foot ulcer and diabetes, consult with Neeta Hasmukh, DPM from Total Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Diabetic Limb Salvage?
Diabetic limb salvage is the attempt of saving a limb, such as the foot, that has an infected ulcer, from amputation. Podiatrists also try to make sure that there is enough function in the foot after the salvage that it is still usable. Those with diabetes experience poor blood circulation, which prevents proper healing of an ulcer. If the ulcer is left uncheck, it could become infected, which could result in the need for amputation.
Diabetes is the number one cause of non-traumatic amputations in the United States. Amputation has been found to lead to higher mortality rates. This translates into higher healthcare costs, and a reduced quality of life and mobility for amputees. Podiatrists have attempted to increase the prevalence of limb salvage in an attempt to solve these issues.
Diagnosis and Treatment
Limb salvage teams have grown in recent years that utilize a number of different treatments to save the infected limb. This includes podiatrists that specialize in wound care, rehabilitation, orthotics, and surgery. Through a combination of these methods, limb salvage has been found to be an effective treatment for infected limbs, and as an alternative to amputation. Podiatrists will first evaluate the potential for limb salvage and determine if the limb can be saved or must be amputated.
If you have any questions, please feel free to contact our offices located in San Antonio, Uvalde, and Jourdanton, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Diabetic Limb Salvage
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.
Arthritis Can Cause Pain in the Feet and Ankles
If you are suffering from tenderness, pain, or stiffness in the joints of your feet or ankles, call us to schedule an appointment.
