Rheumatoid Arthritis in the Feet

Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.

Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.

To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.

There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.

In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.

How to Prevent Running Injuries

Overtraining and overusing the feet are the main causes of common running injuries. A number of these common injuries are caused by overrunning. Runner’s knee is a condition that is characterized by the back of the kneecap beginning to wear away and cause pain in the knee. This frequently occurs due to either a decrease in strength in the quadriceps muscles or ill-fitting shoes that are lacking in proper support for the inside of the forefoot. Strengthening exercises focusing on the quad muscle and sports orthotics are the usual treatments for those suffering from runner’s knee. Prevention of the condition lies in a focus on hip strengthening and quad-strengthening to keep the kneecap aligned. To help learn the best exercise to heal runner’s knee, one can also undergo physical therapy.

One common injury, called iliotibial band syndrome, is often caused by overtraining. This condition occurs when the iliotibial band gets irritated, creating pain and discomfort in the outside knee area. Plantar fasciitis, another common running injury, also occurs as a result of inflammation and irritation. Plantar fasciitis is an inflammation and irritation of the bone in the foot. A large amount of pain is often experienced due to plantar fasciitis. The condition can be caused by a high arch, improper footwear, tight muscles, or flat feet. It can best be avoided by stretching and wearing appropriate footwear that supports the foot.

Another common injury for runners is stress fractures. These injuries occur due to running style, overtraining, or a lack of calcium. Stress fractures most often occur in several locations in runners, including the inner bone of the leg, the thighbone, the bone at the base of the spine and the bones of the toes. Stress fractures are best prevented by wearing proper footwear and by running on flat and hard surfaces; this will absorb some of the shock created during running.

Aside from overtraining, other causes of common running injuries include ill-fitting footwear, a lack of flexibility and strength, and irregular biomechanics. The best way to avoid running injuries is to prevent them from even occurring. Both iliotibial band syndrome and stress fractures are preventable. The first step that should be taken to prevent running injuries is to only wear footwear that fits properly and that is appropriate for whatever activity you are doing. Running shoes are the only protective gear available to runners that can safeguard them from sustaining injuries. Choosing the right pair of shoes is therefore extremely important. While running shoes are an important factor, it is also important to consider other facets of your running routine such as training schedules, flexibility, and strengthening. These elements should be considered and altered according to your running needs to best maximize your run and minimize the possibility of injury. Careful stretching before and after a run should also be considered to help prevent running injuries. Stretching muscles enables greater flexibility and a lesser chance of sustaining injury.

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Heel Pain

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.

Ankle Foot Orthotics for Athletes

Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.

Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.

The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.

Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Diabetic Foot Conditions

Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough.  The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.

Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.

Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.

Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.

If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.

Rare Foot Conditions

A podiatrist will be able to address a variety of rare foot conditions, particularly the ones that affect children. The most common are Kohler’s disease, Maffucci syndrome, and Freiberg’s disease. They can be properly diagnosed by having an X-ray taken, but in more serious cases an MRI may be needed. Kohler’s disease generally affects younger boys and bone deterioration may result from an interruption of blood supply. Children who have Kohler’s disease may find relief when the affected foot is rested, and a special boot is worn. Benign growths in the long bones of a child’s foot may lead to the development of bone lesions, and this is known as Maffucci syndrome. People who have this condition find mild relief when custom-made orthotics are worn. Freiberg’s disease targets the ball of the foot and can typically affect pre-teen and teenage girls. The metatarsal bone becomes deteriorated and flattened, and common symptoms include swelling and stiffness. A cast is often necessary to wear with this disease as it can help to reduce existing pain. Erythromelalgia is a rare foot condition, and its cause is unknown. Symptoms of this disease can include intense burning pain and the feet may appear red or feel warm. Relief may be found when the affected foot is immersed in ice water. It can also be beneficial to elevate the foot frequently. If your child complains of foot pain, it is strongly suggested that you consult with a podiatrist who can diagnose and treat rare foot conditions. 

How to Care for Your Arthritic Foot

Arthritis is an inflammation of the joints and it can occur at any joint in the body, especially in the foot. It generally effects those who are older, however, it can occur at any age. Although there are many different forms of arthritis, there are three main types that occur in the foot. The three types are osteoarthritis, rheumatoid arthritis, and gout.

The primary cause of osteoarthritis is aging. As you age, cartilage degenerates around the joints which causes friction and pain. Obesity can cause osteoarthritis through mechanical stress. Injuries that damage joints can increase the probability as well. Finally, a family history of osteoarthritis can also increase chances of having it.

Rheumatoid arthritis occurs when the immune system attacks the joint linings and weakens them over a long time. While there is no known cause of rheumatoid arthritis, obesity and smoking can increase your chances of getting it. Women are also more likely to get it than men.

Gout is a form of arthritis that occurs when there is too much uric acid in your blood and painful crystals form in your joints. Men are more likely to have gout than women. People who are obese or drink alcohol often are also more likely to develop gout. Furthermore, having diabetes, heart disease, high blood pressure, high cholesterol, gastric bypass surgery or a family history of gout may increase your likelihood of developing the condition.

Symptoms of arthritis include pain, stiffness, swelling in the joints. These symptoms can make it harder and more painful to walk. Physical activity can increase pain and discomfort. Furthermore, joint pain can worsen throughout the day for osteoarthritis. Gout attacks generally last several days with the first few being the worst.

Diagnosis of gout includes either a joint fluid test or a blood test. X-ray imaging can detect osteoarthritis but not gout. On the other hand, there is no blood test for osteoarthritis. Rheumatoid arthritis is difficult to diagnosis. Doctors utilize family and personal medical history, a physical examination, and antibody blood tests to determine if you have rheumatoid arthritis.

Treatment varies for the different kinds of arthritis. Anti-inflammatory medication or steroids can help reduce pain from inflammation of the joints. Changing shoe types can help with some symptoms. Wider shoes can help with discomfort from gout and osteoarthritis. High heels should be avoided. Shoes with proper arch support and that take pressure off the ball of the foot can help with rheumatoid arthritis. Drinking lots of water can also help rid uric acid from the blood. Losing weight, improving your diet, and limiting alcohol and smoking can also help prevent or lessen the symptoms of arthritis.

If you are having trouble walking or pain in your feet, see a podiatrist to check if you have arthritis.

Ingrown Toenail Care

An ingrown toenail is a toenail that grows sideways into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.

Several factors affect whether a person is at risk from an ingrown toenail. The many causes include being overweight, diabetes, participating in sports, having a fungal infection of the toe, and cutting your nails too short. Ingrown toenails also have a genetic predisposition, causing some people to be more prone to receive the condition than others. Other causes include improperly fitting shoes and shoes that keep the feet damp.

Ingrown toenails can be preventable with certain measures. For starters, allowing your toe nails to grow slightly longer in length will help prevent them from becoming ingrown. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help prevent an infection from forming. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is also suggested, as this may help the toenail grow upwards and not into the nail bed. Swelling and redness can be reduced by resting with your feet elevated.

A podiatrist should be seen if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact a podiatrist immediately. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.

An ingrown toenail can be easily treated with a Band-Aid. Simply wrap the affected toe with a Band-Aid to prevent infection and keep the nail from growing out at a painful angle.

In more serious cases, your podiatrist may decide to make a small incision to remove a portion of your toenail. To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day. Afterwards, normal activities can be resumed.  

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