Items filtered by date: October 2017
Red, Hot, Swollen Painful Big Toe?
Gout most commonly occurs in the big toe joint and is a type of metabolic and arthritic disorder in which there are elevated uric acid crystals within the joint. Uric acid is a byproduct of purines that are a part of many foods we eat, which explains why diet plays an important role in gout attacks. The clinical presentation of gout is often an appearance of a “sausage toe” with a red, hot, swollen painful joint. Gout attacks are usually sudden occurring without warning or any signs of trauma. These gouty attacks can be recurrent over the years.
The following are treatments that may be considered by your doctor or podiatrist for gout:
- Diet – stay hydrated and avoid purine-rich foods such as alcohol, seafood, and red meats
- NSAID – indomethacin or naproxen for acute gout attacks
- Colchicine – anti-inflammatory for acute gout attacks
- Allopurinol – for overproducer of uric acid and the treatment of the chronic gout
- Probenecid – for undersecreter of uric acid and the treatment of chronic gout
Gout can be a very painful intense condition that can stiffen the joints but with treatments prescribed by your doctor such as in the above list will work well to resolve the gouty attack. Those who have chronic gout may have hardened deposits of uric acid crystals in the soft tissue causing a palpable lump called tophi. When this occurs, your doctor may suggest a fluid needle aspiration to remove the tophaceous substance. Often times, your doctor will also culture the tophaceous material and view it under a polarized light microscopy to confirm the diagnosis of gout by visualizing the urate crystals.
Most people can manage and prevent future gouty flare-ups once the diagnosis of gout is made in simply modifying diet and drinking lots of water. When you experience a sudden attack of gout, call your podiatrist as soon as possible to best treat this painful condition.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office
Pain in the Back of the Heel or Ankle
Insertional Achilles tendinosis is when micro trauma or tears occur on the Achilles tendon from repetitive overload stress. Over time this can also lead to Achilles tendon inflammation especially where it inserts into the heel bone called the calcaneus. This is an acute or chronic condition that is associated with pain and swelling at the back of the heel or ankle region.
The following is a list of other possible signs and symptoms of insertional Achilles tendon injury:
- Achy pain on first step with redness or swelling at the back of the heel
- Sharp pain or palpation at the back of the ankle where the Achilles inserts
- An associated lump located on the heel bone with an overuse or chronic injury
- Irritation with shoe gear rubbing against the heel
This painful condition is common among athletic or work-related overuse injuries as well as repetitive friction from improper shoe gear. Your podiatrist or doctor may order radiographic imaging to determine if you have a prominent heel bone or calcaneal tuberosity called a Haglund’s deformity that is contributing to the friction and irritation to the area.
Your podiatrist may suggest to modify some activities such as avoid walking uphill or on uneven surfaces, and walking in open back shoe gear. Other alternative treatments a podiatrist may prescribe are to immobilize you in a walking boot as well as taking NSAIDS to decrease the tendon inflammation. Your doctor or podiatrist may also recommend physical therapy that focuses on stretching the calf muscles to relieve the strain on the Achilles tendon. If conservative treatments fail, then surgery may be indicated especially in chronic cases. So call your podiatrist today to diagnosis and best treat insertional Achilles tendinosis!
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office