January Articles 2014

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 The synovial fluid in the joint can also be withdrawn through a needle to be checked for uric acid crystals.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.



How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. Several common injuries can occur due to running. When the back of the kneecap starts wearing away and starts causing pain in the knee, this is commonly referred to as runner’s knee. Runner’s knee can occur because of decreased strength in the quadricep muscles or shoes that do not offer proper support to the inside of the forefoot. Runner’s knee usually is treated with strengthening exercises focusing on the quad muscle and sports orthotic. To prevent runner’s knee, efforts should be focused on hip strengthening. Physical therapy is also beneficial in helping to learn the best exercises to heal runner’s knee. To prevent runner’s knee, strengthen the quad muscles to keep the kneecap aligned.

Overtraining is one cause of a common running injury called iliotibial band syndrome, which occurs when the iliotibial band gets irritated, causing pain and discomfort to the outside knee area. Another common running injury is known as plantar fasciitis, which occurs when the bone in the foot becomes inflamed and irritated. This injury primarily causes pain in the foot. Causes can include a high arch, incorrect footwear, tight muscles and flat feet. The best way to avoid plantar fasciitis is stretching and proper footwear.

Stress fractures are a common injury for runners. These fractures can occur because of overtraining, lack of calcium or running style. In runners, it is common for stress fractures to occur in several locations including the inner bone of the leg, the thighbone, the bone at the base of the spine and the toe bones in the foot. The best approach to preventing stress fractures are proper footwear maintenance and running on a surface with enough “give” to absorb some of the shock produced during running.

Besides overtraining, other causes of these common running injuries are poorly fitting footwear, irregular biomechanics, and lack of flexibility and strength. The best way to avoid running injuries is to prevent them. Fortunately, each of these common running injuries can be prevented. To avoid running injuries it is highly recommended to wear only footwear that fits properly and that suits your needs. Running shoes are the only protective gear that runners have to safeguard them from injury; therefore, choosing the correct footwear for running is important. It is important, too, to think about other aspects of your running routine like training schedules, flexibility and strengthening, and tailor them to your needs in order to minimize the possibility of injury. Regular stretching before and after running should be considered also when trying to avoid running injuries. Stretching keeps muscles limber resulting in greater flexibility.



Plantar Fasciitis Treatment

A study conducted by Luca M. Sconfienza, M.D., of the University of Genoa in Italy focused on a relatively new treatment option combines steroid injections and ultrasound waves. This form of treatment was found to be 95% effective in plantar fasciitis patients in the study.

The plantar fascia is a connective tissue that stretches the bottom length of your foot from the heel. The condition of plantar fasciitis is an inflammation of this connective band, known for causing discomfort and pain while standing or walking. Although the condition can be treated, conservative methods may take up to a year before they become effective.

Conventional treatments include certain exercises, night splints, arch support, staying off your feet and overall rest. Previously the cure for plantar fasciitis was shockwave therapy, which directs sound waves to the area where pain is being experienced. Despite the treatment’s success it is considered painful and requires several sessions before any notable results occur. It is also fairly expensive and does not cure the pain for every plantar fasciitis patient.

Dr. Sconfienza examined the effects of a new technique that combined ultrasound-based methods similar to shockwave therapy, applying a steroid injection directly to the plantar fascia. This form of treatment is a one-time outpatient procedure that involves a small dose of local anesthesia. A needle punctures the affected area and causes a nominal amount of bleeding that assists the fascia in healing. This technique is known as dry-needling.

Dr. Sconfienza found that 42 of the 44 patients that were involved in the new procedure had their symptoms disappear completely within a three week timespan, including pain. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza said. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”



What to Know About Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body, connecting the heel to the lower leg and calf muscles. This tendon helps to aid the process that involves movement in the legs, such as walking and running. Since this tendon is very important to providing mobility to an individual, if there are any injuries to the Achilles tendon they need to be addressed by a physician immediately.

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendon is the less severe of the two injuries. Often diagnosed through MRI, Achilles tendinitis involves inflammation, an increased blood flow to the tendon, tendon thickening, pain that ranges from dull to severe and slowed movement. Despite tendinitis being the milder of the two conditions, it should still be looked at and treated by a physician right away, or else one risks the chance of incurring a greater injury.

Achilles tendon ruptures are much more difficult to treat. They are caused by the tendon snapping or ripping, with more immediate, and painful, symptoms. The results are immediate and absolutely devastating, and will render the patient immobile. Depending on the injury’s severity, treatment and recovery time for Achilles tendon ruptures often vary, which may take up to a year. Fortunately there are both operative and non-operative methods available in terms of treatment. A podiatrist can help you determine which option is best for your condition.

Although no injury is completely preventable, there are ways to minimize the chances of incurring an injury. Be sure to stretch out the tendon before and after physical activity as it can stimulate the tissue. Exercises that include squats, calf raises, lunges, leg presses, leg curls and leg extensions are all good ways to help strengthen the tendon.

Individuals who may overexert themselves during physical activity incur a higher risk for these injuries. This is especially true for athletes. Try to be on a cushioned surface when exercising, such as a mat, as heel pressure can be relieved this way. Occasion appropriate footwear can also serve to minimize the risk of tendon-related injuries. And of course, a healthy diet increases tendon, and bodily, health while decreasing obesity associated risks.

Visit a podiatrist if you think you have an injury in the Achilles region. Failure to address these injuries can cause further damage and complications that could even render you immobile.

2014
January

2013
May - June - July - August - September - October - November - December