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Stephan J. LaPointe, DPM, PhD, FACFAS

Featured

Featured

Monday, 27 January 2020 00:00

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.

Monday, 20 January 2020 00:00

Foot care is important regardless of your profession, but those who work on their feet must pay special attention. Bunions, calluses, blisters, and plantar warts are just a few of the many conditions that can arise after standing all day. While painful at their worst, these conditions can easily be avoided with the right foot care. This includes both appropriate footwear and proper posture—important elements that affect the health of your feet.

Choosing appropriate footwear means choosing a shoe that has a negative heel. This means that the heel is slightly lower than the ball of your foot, which places less of a strain. If you have a profession that requires you to be on your feet all day, investing in a pair of high-quality shoes is pertinent. High-quality shoes can be purchased from a respected manufacturer that emphasizes foot care and foot health.

Despite the regularity of wearing shoes, the feet are naturally not designed to be enclosed. Regular “barefoot” time for your feet can be beneficial for foot health. Among other methods, allowing your feet to breathe can help alleviate the pain and pressure your feet may be experiencing from being on your feet all day.

Simple foot exercises and yoga positions can help improve both the health and function of your feet. Active foot exercises that create movement will stimulate your foot’s blood flow and circulation, and yoga positions that place your feet flat onto the floor will stretch out their muscles. Yoga is particularly beneficial for your Achilles tendon and calf muscles, which are areas that can become especially problematic if not taken care of. Foot exercises and yoga positions can be easily performed every day at virtually any location and any time; whether it is at the office, at the gym, or at home right before you go to bed. Simple stretching can increase your foot health by miles.

The foot pain you experience after lengthy hours working on your feet may seem inevitable and unavoidable; in reality, however, that is not the case. Wearing proper footwear and performing simple foot exercises and stretches can help ease foot pain and allow you to truly avoid frustrating foot problems.

Your feet can easily be kept healthy with some education and a little effort. Pain that begins at the feet can eventually affect the whole body. Begin taking care of your feet now!

Monday, 13 January 2020 00:00

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.

Monday, 06 January 2020 00:00

Being a parent involves caring for your child in every way you can. You make sure they are eating the right food, being nice to others, and staying out of any trouble. However, it is also important that you are watchful of their health, more specifically their foot health. Maintaining good foot health in childhood is important in preventing later conditions in life from happening. As children continue to develop, their feet require different techniques of care. Here are some various ways in which you can help your child’s feet stay healthy.

A baby needs a lot of care and attention overall, but the importance of their feet should never be forgotten. Before a baby turns one, their feet change and develop greatly. It is important that during this time, a mother avoids putting tight socks on their child. She should also encourage movement of their feet so the baby can begin to feel more comfortable using them.

As a baby enters the toddler years of his or her life, they are begin to walk around. When your baby begins to take those first steps, it is crucial that they are wearing protective shoes on their feet. As a mother that is observant of your child’s feet, you may notice changes in them. This is completely normal as the feet are becoming susceptible to the activity of walking. It is normal for a toddler to be a bit unsteady or to “walk funny” at first.

When your child grows out of their toddler years, it is important that you begin to show him or her how to care for their feet on their own. Practice with your child proper hygiene in order to prevent foot fungus or infection. Since children are constantly on the move, it is crucial to be cautious of any accidents or injuries that might occur. If an injury occurs, it is advised that you take your child to be examined by a doctor immediately. Since your child is still growing, particular injuries can shift the way in which a bone or other important part of the foot is developing.

Babies and kids are always changing and growing. Your job as a parent is to make sure they stay healthy and making sure they are properly maintained. This involves proper foot care and making sure the feet stay healthy. Following this guide, your child can live a long and happy life.

Monday, 30 December 2019 00:00

An ingrown toenail is a nail that has curved downward and grows into the skin.  This typically occurs at the nail borders, or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail.  In most cases, however, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Monday, 23 December 2019 00:00

Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.

There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.

People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.

Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.

If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.

Monday, 16 December 2019 00:00

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Monday, 09 December 2019 00:00

A neuroma is a thickening of nerve tissue and can develop throughout the body.  In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes.  The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.

Neuromas can be caused by anything that causes compression or irritation of the nerve.  A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes.  Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas.  Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.

Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up.  Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot.  An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.

Treatment for Morton’s neuroma can vary between patients and the severity of the condition.  For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed.  Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition.  The severity of your condition will determine the procedure performed and the length of recovery afterwards.

Monday, 02 December 2019 00:00

Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.

One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.

There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing.  Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.

A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.

If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.

If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.

Monday, 25 November 2019 00:00

Diabetes can cause two problems that can potentially affect the feet: Diabetic neuropathy and Peripheral Vascular Disease. Diabetic neuropathy occurs when nerves in your legs and feet become damaged, which prevents you from feeling heat, cold, or pain. The problem with diabetic neuropathy is that a cut or sore on the foot may go unnoticed and the cut may eventually become infected. This condition is also a main cause of foot ulcers. Additionally, Peripheral vascular disease also affects blood flow in the body. Poor blood flow will cause sores and cuts to take longer to heal. Infections that don’t heal do to poor blood flow can potentially cause ulcers or gangrene.

There are certain foot problems that are more commonly found in people with diabetes such as Athlete’s foot, calluses, corns, blisters, bunions, foot ulcers, ingrown toenails, and plantar warts. These conditions can lead to infection and serious complications such as amputation. Fortunately, proper foot care can help prevent these foot problems before they progress into more serious complications.       

Each day you should wash your feet in warm water with a mild soap. When you finish washing your feet, dry them carefully especially between your toes. You should also perform daily foot inspections to ensure you don’t have any redness, blisters, or calluses. Furthermore, if you are diabetic, you should always wear closed-toed shoes or slippers to protect your feet. Practicing these tips will help ensure that your feet are kept healthy and away from infection.

If you have diabetes, contact your podiatrist if you have any of the following symptoms on your feet: changes in skin color, corns or calluses, open sores that are slow to heal, unusual and persistent odor, or changes in skin temperature. Your podiatrist will do a thorough examination of your feet to help treat these problematic conditions.

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