All You Need to Know About Gout

Gout is a general term for a variety of arthritic conditions caused by a buildup of uric acid. This buildup usually affects your feet. If you have gout, you will probably feel swelling and pain in the joints of your foot, particularly your big toe. Sudden and intense pain, or gout attacks, can make it feel like your foot’s on fire.

The condition was first identified as early as 2,640 BC by the ancient Egyptians; But, despite its long history, gout remains a major public health concern, with an increasing number of people suffering from what can be an extremely painful condition.

Fortunately, gout is treatable and there are preventative measures that can be taken to reduce the risk of developing the painful condition.

Symptoms of gout

There are four stages of gout: asymptomatic hyperuricemia, acute gout, interval gout, and chronic tophaceous gout. These stages vary in symptoms and treatment.

Hyperuricemia happens when you have too much uric acid in your blood. If you have no other symptoms, it’s called asymptomatic hyperuricemia.

Acute gout happens when hyperuricemia causes uric acid crystals to develop in one of your joints. It causes intense pain and swelling, and your joint may also feel warm. You may experience multiple acute gout attacks over a period of months or years.

Interval gout is the period between acute gout attacks. It’s also called intercritical gout. You won’t have any symptoms during this stage.

Chronic tophaceous gout can happen if you leave your gout untreated. It can take 10 years or longer to develop. In this stage, hard nodules (tophi) develop in your joints and the skin and soft tissue surrounding them. Tophi can also develop in other parts of your body, such as your ears. They can cause permanent damage to your joints.

Causes of gout

Gout is a complex disease. There are a variety of factors that can play a role in causing it. Certain conditions, such as blood and metabolism disorders, can cause your body to produce too much uric acid. Drinking too much alcohol can also lead to excess uric acid.

Certain foods can also cause gout when you eat too much of them. These include:

  • shellfish
  • red meat
  • organ meat
  • sweet juices
  • salt

You can also develop gout if your body isn’t eliminating uric acid properly. If you’re dehydrated or starved, it can make it difficult for your body to excrete uric acid. This causes it to build up as deposits in your joints.

Diagnosing gout
Your doctor can make a diagnosis of gout based on a review of your medical history, a physical exam, and your symptoms. Your doctor will likely base your diagnosis on your description of your joint pain, how often you’ve experienced intense pain in your joint, and how red or swollen the area is.

Treating gout
In most cases, your regular doctor can treat your gout. If you have severe complications or develop chronic tophaceous gout, your doctor may refer you to a rheumatologist. This type of doctor specializes in arthritis.

Your doctor may prescribe medications, such as:

  • colchicine to reduce pain in your joint
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce inflammation and pain in your joint
  • corticosteroids, such as prednisone, to reduce inflammation and pain in your joint
  • medications to reduce your body’s production of uric acid, such as allopurinol
  • medications to help your body eliminate uric acid, such as probenecid

Complications of gout

If left untreated, gout can eventually cause tophi to develop near your inflamed joints. This can lead to arthritis.

Preventing gout

You can take many steps to help prevent gout. For example:

  • Limit how much alcohol you drink.
  • Limit how much purine-rich food, such as shellfish, lamb, beef, pork, and organ meat, you eat.
  • Eat a low-fat, nondairy diet that’s rich in vegetables.
  • Lose weight.
  • Stop smoking.
  • Exercise.
  • Stay hydrated.

Have Ankle Pain? Could Be a Sprain

We all know how easy it is to twist and ankle or foot especially this time of year with extreme weather, activities and all around hustle and bustle. Take this advice on how to keep safe and learn the proper treatment just in case.

What Are the Symptoms of an Ankle Sprain?

You may have a sprained ankle if you notice the following symptoms in the ankle:

  • swelling
  • tenderness
  • bruising
  • pain
  • inability to put weight on the affected ankle
  • skin discoloration
  • stiffness

The ankle can sustain many different types of injuries. It’s important to see your doctor when you’re experiencing problems with your ankle. Your doctor can determine whether the injury is a sprain or something more severe.

What is ankle sprain exactly

So what actually happens when you sprain your ankle? You stretch or tear the ligaments—the bands of tissue that hold your bones together—usually on the outside of the ankle.

The good news is that most sprains are minor and will heal, given time and proper treatment. The bad news is that once you have sprained your ankle, you are prone to more sprains.

Ankle sprains are classified by severity:

  • Grade 1 – A mild sprain with no tearing of the ligaments, minor swelling, and some pain while walking.
  • Grade 2 – A moderate sprain with partial tearing of the ligaments, noticeable swelling, bruising, and difficulty walking.
  • Grade 3 – A severe sprain with complete tearing of the ligaments, sharp pain, severe swelling, internal bleeding, and the inability to walk.

Most ankle sprains are minor and clear up through home treatment. But Grade 2 and 3 sprains should be seen and treated by a podiatrist or doctor. Severe swelling or pain can be a sign of internal bleeding, full ligament rupture, or broken or fractured bones.

If you have a Grade 2 or 3 sprain, a doctor or podiatrist should help treat you. If you have a Grade 1 sprain, start off by following the classic RICE principle:

  • Rest: Put your physical activity on hold and keep your weight off the ankle as much as possible. Use crutches to get around if necessary.
  • Ice: Ice your ankle for about 20 minutes every few hours for the first few days, tapering down until your symptoms are gone.
  • Compression: Wrap your ankle in an elastic bandage to keep down swelling and provide support.
  • Elevation: Prop your ankle up on a pillow when you are sitting or lying down.

You can also take over-the-counter anti-inflammatory medication to help with pain and swelling.

Note that if you don’t treat your ankle sprain properly, not only will you be prone to frequent future sprains but you may also develop a condition called chronic ankle instability. Make sure you get proper medical attention and treatment for your sprain.

First, concentrate on healing the damage so you can get back on your feet. This may take as long as 4 to 8 weeks, depending on the severity of the sprain. Be patient and don’t rush your recovery—returning to activity too soon risks chronic ankle pain, instability, and other problems.

When your ankle no longer hurts and feels as strong as the other ankle, you are ready to resume your normal activities. But even after one sprain, your ankle is now weaker and prone to further sprains, so you’ll want to take some extra preventative measures:

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Your Nails and Health: Read the Signs

Did you know your nails can reveal clues to your overall health? A touch of white here, a rosy tinge there, or some rippling or bumps may be a sign of disease in the body. Problems in the liver, lungs, and heart can show up in your nails. Keep reading to learn what secrets your nails might reveal.

Yellow Nails
One of the most common causes of yellow nails is a fungal infection. As the infection worsens, the nail bed may retract, and nails may thicken and crumble. In rare cases, yellow nails can indicate a more serious condition such as severe thyroid disease, lung disease, diabetes or psoriasis.

Cracked or Split Nails
Dry, brittle nails that frequently crack or split have been linked to thyroid disease. Cracking or splitting combined with a yellowish hue is more likely due to a fungal infection.

Puffy Nail Fold
If the skin around the nail appears red and puffy, this is known as inflammation of the nail fold. It may be the result of lupus or another connective tissue disorder. Infection can also cause redness and inflammation of the nail fold

Pale Nails
Very pale nails can sometimes be a sign of serious illness, such as
anemia, congestive heart failure, liver disease or malnutrition.

White Nails
If the nails are mostly white with darker rims, this can indicate liver problems, such as hepatitis. In this image, you can see the fingers are also jaundiced, another sign of liver trouble.

Bluish Nails
Nails with a bluish tint can mean the body isn’t getting enough oxygen. This could indicate a lung problem, such as emphysema. Some heart problems can be associated with bluish nails.

Rippled Nails
If the nail surface is rippled or pitted, this may be an early sign of psoriasis or inflammatory arthritis. Discoloration of the nail is common; the skin under the nail can seem reddish-brown.

Spooned nails
It could be anemia or lupus. Do you have a depression in the toenail deep enough to hold a water droplet? Also known as koilonychias, spoon-shaped toenails or fingernails can indicate iron deficiency, as well as hemochromatosis (overproduction of iron), Raynaud’s disease (which affects blood supply to the fingers and toes), and sometimes lupus (an autoimmune disease in which the body’s immune system attacks cells, tissues, and organs).

Dark Lines Beneath the Nail
Dark lines beneath the nail should be investigated as soon as possible. They are sometimes caused by melanoma, the most dangerous type of skin cancer.

Nails Are Only Part of the Puzzle
Though nail changes accompany many conditions, these changes are rarely the first sign. And many nail abnormalities are harmless — not everyone with white nails has hepatitis. If you’re concerned about the appearance of your nails, see a dermatologist.

Trimming Toenails: Technique Is Important
Trimming your toenails may seem simple enough, but it isn’t something to be done carelessly. While most people don’t need to visit a professional to take care of their toes — people with diabetes are an exception — they need to be sure they’re clipping their nails properly to reduce the risk of future foot problems.

Cut toenails straight across, don’t cut them too short, and make sure your tool of choice is a large toenail clipper. Ingrown toenails, nails that become lodged in the skin instead of growing normally, are a primary reason for foot pain, and they can lead to serious infection.

You depend on your feet, so make sure you give them the care they deserve!


Footstrike 101: How Should Your Foot Hit The Ground?

When moving quickly as in running, jogging, and even powerwalking, there are three different ways your foot can strike the ground: with the heel, midfoot or forefoot. Scientists have debated a great deal over which type of footstrike is the best for the body, and a wide range of evidence shows benefits for all types. So, which one is best? The answer is complicated.

What happens to your feet is merely part of a holistic, whole body, integrated movement pattern. Running is essentially a unique way of moving. While it is still a common belief that a forefoot or midfoot strike (that is, landing on the ball of your foot when you run) is better and creates less force through the body, a new study bolsters a body of research that there is no “ideal” running style.

Most of the tenets of good running form are universally agreed upon by coaches, athletes, physiologists, foot gurus and shoe designers: an upright postural alignment with a slight forward tilt, a compact arm swing and short strides that result in a cadence of 180 steps per minute or higher.

But the one thing that still seems to be a stickling point is footstrike—how and where your foot hits the ground. Certainly there is a distinct difference between heel-striking, a midfoot-striking gait and running on your forefoot. Various studies support the pros and cons of each style, but the impacts also vary considerably among individual runners. Where your foot contacts the ground is much more important than how it contacts the ground, says Bend, Ore., physical therapist Jay Dicharry, one of the country’s leading running gait analysts and running injury experts.

“I look at footstrike as more of an effect than a cause in running form,” Dicharry says. “There’s more to it than just the foot- strike. Just because you heel-strike doesn’t mean you have bad form.”

Studies show between 50 and 80 percent of runners are injured every year. Many of those overuse injuries result from a runner applying too much force on a repetitive basis.

“The way to reduce the chance for injuries is to run with the least possible musculoskeletal stress on your system possible with the least metabolic cost”

“The most important thing is that you want your feet to land as close to your body for a given pace as possible,” says Dicharry, the author of “Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention.”

“If you force your body into a specific forefoot strike, you might be able to instantly decrease the amount of impact force and biomechanical strain,. But you also might be forcing yourself to overstride, making yourself work harder and ultimately lessening your running economy,” Dicharry says.

Quick Tips to Fixing Your Form

Get out of the back seat. “A lot of runners run with an arched lower back, which puts the body weight too far back,” Dicharry says. “Running in lighter shoes with a flatter heel-toe ramp will help facilitate getting out of the back seat, but so will consciously running with upright, slightly forward-leaning posture.”

Land close to your body. The reason many runners run with a dramatic heel-striking gait is because they’re overstriding. Try to have your feet hit the ground as close to your body as possible by shortening your strides and increasing your stride cadence.

Vary the surfaces you run on. Your body figures out how to land better when you have more practice landing on surfaces that aren’t flat and smooth. Vary your runs by running through a grass park or running over the rough concrete of an alley.

Run softly. Try to run with as little impact force as possible with light footstrikes. “Smooth and soft is best,” Dicharry says. “Being a heel-striker isn’t bad, but if you hear a ‘ker-plop’ every time your foot hits the ground it means that muscles in the lower leg are working overtime to control the lowering down of your forefoot—one of the major causes of shin splints.

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Do You Have Shin Splints?

Shin splints are a common lower extremity complaint, especially among runners and other athletes. They are characterized by pain in the front or inside aspect of the lower leg due to overexertion of the muscles. The pain usually develops gradually without a history of trauma, and might begin as a dull ache along the front or inside of the shin (Tibia) after running or even walking. Small bumps and tender areas may become evident adjacent to the shin bone. The pain can become more intense if not addressed, and shin splints should not be left untreated because of an increased risk of developing stress fractures. Shin splints usually involve small tears in the leg muscles where they are attached to the shin bone. The two types of shin splints are: anterior shin splints, in the front portion of the tibia; and posterior shin splints, occurring on the inside of the leg along the tibia.

Shin splints can be caused when the anterior leg muscles are stressed by running, especially on hard surfaces or extensively on the toes, or by sports that involve jumping. Wearing athletic shoes that are worn out or don’t have enough shock absorption can also cause this condition. Over-pronated (flat feet) are another factor that can lead to increased stress on the lower leg muscles during exercise. People with high arched feet can also experience shin splint discomfort because this foot type is a poor shock absorber.

The best way to prevent shin splints is to stretch and strengthen the leg muscles, wear footwear with good shock absorption, and avoid running on hard surfaces or excessive running or jumping on the ball-of-the-foot. Insoles or orthotics that offer arch support for over-pronation are also important. Treatment for shin splints should include taking a break from the exercise that is causing the problem until pain subsides. Icing the area immediately after running or other exercise can also be effective, along with gentle stretching before and after training. Another option is taking aspirin or ibuprofen to relieve pain and reduce inflammation. It is important not to try to train through the pain of shin splints. Runners should decrease mileage for about a week and avoid hills or hard surfaces. If a muscle imbalance, poor running form or flat feet are causing the problem, a long-term solution might involve a stretching and strengthening program and orthotics that support the foot and correct over-pronation. In more severe cases, ice massage, electrostimuli, heat treatments and ultra-sound might be used.

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DISCLAIMER:  The information contained on this site is not provided by medical professionals and is provided for informational purposes only.  The information on this site is not meant to substitute consulting with your podiatrist, doctor or other health care professional. The information available on or through this site is in no way intended to diagnose, influence treatment or cure any foot or other health problems nor is it a substitute for the services or advice of a podiatrist, physician, or health professional.  You should always consult a physician licensed in your state in all matters relating to your health.