Important Facts You Need to Learn About Gout

January 24, 2020

Gout is an inflammatory disorder caused by high levels of uric acid in the blood. Uric acid crystallizes in the form of urate crystals in the joints of hands, feet and elbows. Gout affects roughly 3 million Canadians each year.

Causes

Gout is caused by a combination of environmental and genetic issues. Most commonly, environmental triggers include diet with foods that have high levels of purines which then break down into uric acid. Foods that can lead to high levels of urate are red meats, seafood, refined or processed carbohydrates, sugary drinks and alcohol such as beer and hard liquor.

Gout was often called the “disease of kings” as only wealthy people would be afflicted due to their rich diet and excessive drinking. The most famous king to be afflicted with chronic gout was King Henry VIII. Genetic factors such as hyperuricemia can impact the frequency of gout attacks.

Hyperuricemia occurs when your body does not filter urate properly from the bloodstream, either from the kidneys or the gut. Another common issue is if your body doesn’t break down sugars properly, this can affect how urate is stored. The risk of gout increases with age, particularly in women. The role of estrogen helps to regulate urate in the body so after menopause, urate levels in women increases drastically. Certain medications may also lead to hyperuricemia, such as diuretics and cyclosporine.

Finally, conditions linked with hyperuricemia are high blood pressure, kidney disease, thyroid disease, diabetes and sleep apnea.

Symptoms

While your body is producing high levels of uric acid this stage is called Asymptomatic gout as there are no signs or symptoms. The next stage is Acute intermittent gout and it starts off with a painful swelling in the joint often in the middle of the night. Most people wake up with the feeling their joints or foot is on fire. Gout most commonly affects the joint of the big toe because urate crystals deposit at the furthest joint in your body – gravity also plays a role. However, gout can affect any joint, the ankle and elbow are also commonly affected joints. The pain and swelling of the joints is likely to be severe for the first 4-12 hours and then a lingering pain or discomfort can last for weeks. The affected joints are also noticeably different with a red, swollen, tender and warm appearance. As gout progresses and is left untreated, the range of motion of the joint is also limited due to the swelling and deposits of hard urate crystals lumps called Tophi which damage and affect the joint structure and the surrounding skin.

Gout vs. Rheumatoid Arthritis

Rheumatoid arthritis (RA) can have similar symptoms as gout but the causes are different. RA is an autoimmune inflammatory condition where your own body attacks healthy synovial cells inside your joints. This attack causes inflammation, pain and swelling and most often attacks the hands, wrists, ankles and knees.

Tests

Gout can be diagnosed clinically with the appearance of a red, hot and swollen joint but as well as the timeframe. Your family doctor will also check for urate crystals by running tests on the fluid from your joint, blood work and possibly order an x-ray.

Treatment

Depending on the stage of gout, your family doctor will prescribe medication to either help with the pain and swelling or to prevent further attacks. Medication to help relieve pain and swelling are NSAIDS, specifically Indomethacin, colchicine and possibly corticosteroids. These drugs are often prescribed for acute gout attacks.

For chronic gout, medications to help prevent further attacks are allopurinol and probenecid. Along with medication your family doctor will advise you to make some lifestyle changes such as reducing alcohol intake, losing weight and quitting smoking.

After a gout attack, it is advised to visit a chiropodist to assess the range of motion at the affected joint and see if your gait has been altered and affected.

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June 5, 2023

Cold Sweats: Causes, Symptoms, and How to Manage Them

Cold sweats are episodes of excessive sweating involving feelings of coldness, clamminess, and a drop in body temperature. Our feet are particularly prone to cold sweats due to their position (away from the heart) and function. This blog post discusses the causes, symptoms, and ways to manage cold sweats. Causes of cold sweats There are several possible causes of cold sweats, including medical conditions, medication side effects, and emotional triggers. Learn more about the common cause of cold sweats in feet below: Hyperhidrosis Hyperhidrosis is the common term for excessive sweating. If you experience cold and sweaty feet without exercising or temperature changes, you may have hyperhidrosis. The underlying cause is an overreaction of your body's sweat glands. Stress and anxiety can also disrupt your body's sweat glands. There is an overall increased risk of infection in the presence of hyperhidrosis, including fungal, bacterial, and viral infections Peripheral Arterial Disease (PAD) Peripheral Arterial Disease is a condition of the body's lower extremities. The leg's blood vessels become blocked or narrowed, restricting blood flow between your lower legs and heart. Fatty plaque in the arteries is often the culprit. You may be at greater risk of PAD if you have diabetes, are over 60, or have elevated blood pressure and cholesterol. Menopause A common cold sweats culprit is menopause. Blood circulation can increase or decrease based on hormonal changes, triggering sweats. Overactive thyroid A thyroid disorder can cause plantar hyperhidrosis (excessive foot sweat) while deregulating body temperature. An overactive thyroid also messes with our blood circulation, giving the feet and skin only a quarter of the blood supply they usually need. Raynaud's disease Raynaud's disease causes cold hands and feet and numb toes. The condition decreases blood flow in certain body parts because of the blood vessels spasming in the area. Body temperature Sudden changes in core body temperature can trigger cold sweats. For instance, when sleeping, you may want to experiment with adjusting the room temperature up or down or even sleeping with your feet outside the blankets to thermoregulate your core body temperature. Other causes of cold sweats Wearing small shoes or shoes without proper ventilation: Shoes without proper breathing properties may trap in heat and cause your feet to sweat or have a cold sweat sensation. Neuropathy: Nerve damage, typical in diabetes patients, can cause excessive sweating and disrupt your average body temperature. Exercise: If you exercise and your feet continue to sweat or be moist afterwards, you may experience cold feet. Symptoms of cold sweats The top symptoms of cold sweats in the feet include Excessive sweating Feeling cold or clammy Shivering Paleness In addition to the symptoms in your feet, you may also experience these bodily feelings: Dizziness or lightheadedness Nausea or vomiting Weakness How to manage cold sweats The management of cold sweats will depend on the underlying cause. Here at Feet First Clinic, we recommend several treatment options, including: Foot deodorants, creams and sprays. Talk to your doctor about taking certain types of medications. For instance, antidepressants may lower triggers like stress and anxiety, which cause you to sweat more. Manage stress. Practice stress-reducing techniques such as deep breathing, meditation, or yoga. Ensure you're getting enough rest. A lack of sleep can trigger cold sweats, so try to get enough restful sleep. Daily foot hygiene practices. Keep feet clean and dry, regularly change socks, etc. Regularly air out your feet. Breathable footwear. Dress in layers. Removing or adding layers will stabilize your core body temperature and prevent significant shifts. Moisture-wicking socks. Schedule regular foot assessments to check for conditions that thrive in moist environments, like athlete's foot.

May 29, 2023

Running with Ingrown Toenails: How to Manage Discomfort and Avoid Infection

Ingrown toenails are the most common nail problem. And with toenails being put under pressure when running, combining the two can be challenging, but not totally out of the question. Although running with ingrown toenails can be uncomfortable and increase the risk of infection, it is doable. There are steps you can take to manage the discomfort and reduce the risk of complications. This article discusses tips on managing the pain associated with running with an ingrown toenail and ways to prevent infection. Don't let an ingrown toenail stop you from your running routine; read on to learn more! Can I run with an ingrown toenail? Yes. If the ingrown toenail is mild, and you take the proper precautions, you can safely run. The key is to manage discomfort and do your best to reduce the risk of complications or infection. However, there is a difference between whether you can run versus should run, and you should weigh the pros and cons outlined below. First, it's important to note that running with an ingrown toenail can worsen the condition and increase the risk of complications. If the pain is severe or you experience signs of infection, like redness, swelling, or discharge, seek medical attention immediately. If the ingrown toenails worsen, see a chiropodist or other healthcare professional. They may recommend antibiotics, specialized treatment or surgery to remove part of the affected nail. How to manage discomfort when running with an ingrown toenail To enjoy running with ingrown toenails, you must take steps to control the discomfort, reduce the risk of complications and keep the pain at bay. Here are some tips: Monitor pain and symptoms: There's no denying that physical activity can aggravate ingrown toenails. Sports with ground forces due to athletic activity, obesity or constricting footwear aid overlapping lateral nail fold penetration. Trim the toenail properly: If the ingrown toenail is mild, you can trim it yourself. Use a clean pair of nail clippers and cut the nail straight across without rounding the edges. Cutting straight across prevents the nail from growing into the adjacent skin. If your ingrown toenail is more persistent, inflamed or painful, you should see a chiropodist for treatment to prevent any risks and complications. Trim the toenail using toenail clippers: Avoid using fingernail clippers for your toenails. The strength and thickness of our toenails demand a more rigid tool to trim effectively. Wear proper shoes: Wear shoes that fit correctly and provide enough room for your toes to move freely. Tight or narrow shoes can crowd the toes and increase the risk of ingrown toenails. Take pain medication: Pain relievers can help to manage the discomfort associated with ingrown toenails. See a chiropodist for professional treatment: If your ingrown toenail is painful, inflamed, or has persisted for a long time, you should book an appointment with a chiropodist to have it properly and safely treated. This will reduce the risk of infection and allow you to resume running pain-free. How to avoid infection when running with an ingrown toenail? To prevent your ingrown toenail from worsening while running, taking the proper measures to avoid infection is vital. You can take steps to manage the discomfort and reduce the risk of complications when running with ingrown toenails. Here are some tips: Keep the affected toenail clean: Wash the affected toe with soap and water daily, and keep it dry. A clean and dry site will help to prevent the spread of bacteria and reduce the risk of infection. Apply topical treatments: You can use over-the-counter antiseptic or antibiotic ointments to the affected area to help prevent infection. Use clean toenail clippers (and maybe one from our top picks): Don't use someone else's nail clippers; clean them off before use. Bacteria are invisible to the eye, so be safe with what you put your feet in contact with. For instance, you wouldn't want to risk catching the fungus that causes athlete's foot. Apply a bandage over the ingrown toenail: Once you've cleaned the affected toenail, apply a bandage over the toenail before starting your run. This will help prevent any outside bacteria from penetrating the nail and surrounding skin.

May 8, 2023

Understanding and Treating Bunions: A Comprehensive Guide

Bunions can be a debilitating condition, but there is still plenty of hope to manage it and reduce the pain it causes. Bunions are joint deformities located at the base of the big toe. You may see bony bumps on the foot's inner side, which can be painful and uncomfortable. Bunions can also affect the alignment of the foot and cause the big toe to point inward toward the other toes. (They can also exist along the outer edge of the foot at the base of the little toe. These are known as bunionettes.) Understanding the causes, symptoms, and treatment methods can help spot bunions early and get you back to feeling better soon. Below you'll find a comprehensive guide to understanding and treating bunions. Causes of bunions Various factors, including genetics, foot shape, and footwear, cause bunions. Family history can dictate the likelihood of bunions due to inherited foot shape. People with foot shape abnormalities or imbalances like flat feet, low arches, or loose joints are also at a greater risk of developing bunions as these underlying conditions put more pressure on your big toe and surrounding areas. All of these risk factors are quite common; roughly six percent of Canadians yearly have foot injuries, bunions, and flat feet or fallen arches. Additionally, external factors like tight or narrow shoes or high heels can squeeze your toes together, which adds pressure and restricts movement across the toes. Over time, your big toe joint may shift, causing it to protrude outwards. Shoes with narrow toes can trigger and catalyze developing bunions, but footwear alone is not solely to blame. Symptoms of bunions The most prominent symptoms of bunions are pain and discomfort in your big toe. You may also experience swelling and redness and have a large bony protrusion at the base of your big toe. Due to the outgrowth and irritation, the skin over the bunion may become thickened and callused. The toe may become rigid and difficult to move in more severe cases. You may also experience difficulty wearing your regular footwear as the protrusion (resulting from your bones shifting) increases your feet's surface area. The rigidness of the big toe makes the big toe more susceptible to strain and over-exertion. Lack of flexibility further imbalances the weight across your feet and toes. This causes a vicious cycle that can further aggravate the bunion. Treatment for bunions Although bunions can be painful, not all hope is lost. You can do plenty to recognize bunions early or treat them via surgical or non-surgical methods to improve your quality of life. Depending on the severity, you can slow the progression of bunions or find ways to manage the discomfort effectively. The exact treatment typically depends on the severity of the bunions, a person's lifestyle demands, and their age. Milder cases may be managed and treated with non-surgical treatments, including specific devices, such as bunion splints or custom orthotics, or physical therapy. The more severe cases may require surgery, which in and of itself has its pros and cons. Non-surgical treatments for bunions Non-surgical treatment for bunions focuses on limiting further aggravation of the affected joint and slowing the bunion's progression. This in turn decreases pain and improves quality of life. Such treatments include: Alter your footwear: Wear shoes with a wide and deep toe box to reduce pressure on the bunion. Avoid wearing high heels or shoes with pointed toes. Use padding and taping: Apply a pad or cushion to the bunion to reduce pressure and protect the skin. Taping can also help to keep the foot in a more natural position. You can also try bunion splints and bunion aligners to properly align the joint as you go about your daily activities. Custom-made orthotic inserts or generic inserts like Superfeet may help to redistribute pressure and support the foot. Padding or cushions to protect your feet may also help. OTC pain relievers like ibuprofen can help reduce and keep swelling and inflammation at bay. Stretching and strengthening exercises can improve the flexibility and strength of the foot and ankle. Strengthening the muscles around the joint also halts the vicious cycle of bunion growth. Maintain a healthy weight to prevent sudden impact on your feet and toes. If non-surgical treatment for bunions hasn't improved the condition, you can explore surgical treatments, which we dive into below. Surgical treatments for bunions More than 100 different types of surgeries for bunions exist. An orthopedic surgeon or podiatrist may perform the surgery, depending on the nature and type of procedure. With surgery, the goal is physically to eliminate the bunion. However, surgical treatments have risks, and a bunion may still return in the future, so you should consult a medical professional. No one surgery is perfect for everyone; it's highly individual. Some of the more common surgeries for bunions are: Bunionectomy is a surgical procedure in which the bony bump is removed from the joint. The goal is to realign the joint with the rest of the foot to improve the position. Osteotomy is a procedure that involves cutting a portion of the bone to improve the toe's position. Arthrodesis (commonly known as joint fusion surgery) is a procedure that adjoins joints together. Resection arthroplasty is a procedure that removes the damaged joint. The joint is then rebuilt during the procedure. Artificial implant insertion is a procedure where an implant replaces the deformed first metatarsophalangeal (MTP) joint.

April 17, 2023

How to Choose the Right Footwear for Your Job

The proper footwear for your job can make a world of difference. Footwear that ticks all the boxes - safety, comfort, support, and durability - not only makes your day-to-day more enjoyable, but your feet will also thank you. Here are some simple yet effective tips to follow when choosing the most suitable footwear for your job: 1. Recognize the potential hazards and risks of your job First and foremost, footwear should be specific to your job. Various jobs have differing demands, and therefore you should choose accordingly. For example, if you work in construction, you may opt for footwear with toe protection, a higher collar, and slip-resistant soles, as the Canadian Centre for Occupational Health and Safety recommends. A mix of protection and grip is critical for outdoor jobs with heavy objects and lifting. 2. Understand the demands of your job on your feet Knowing the demands of your job on your feet is equally crucial for choosing the most appropriate footwear. If you work indoors and are on your feet, we recommend looking for well-supported, more lightweight, breathable footwear. For instance, a nurse or teacher may stand or walk for multiple hours daily, adding stress to their feet and legs. Walking or running shoes may be more appropriate for these professions as cushioning, breathability, lighter weight, and support can be beneficial. Cooks, chefs, barbers, hairdressers, cashiers, and manufacturing employees may also prefer lighter-weight shoes as they are constantly on their feet. Want to know more about how different jobs affect our feet? See our complete guide on how our jobs affect our feet differently. 3. Know your shoe size Ill-fitting shoes are the leading cause of foot pain and problems: 8 out of 10 shoes fit incorrectly. We recommend verifying your shoe size, as our feet can shrink and swell throughout the day and the year based on the season. Therefore, do a shoe fitting later in the day to accommodate the slightly enlarged size. (And under the same conditions as you would work, for instance, with your work socks.) In addition, your feet may change size due to aging, so we recommend regular sizing checks for accuracy. Visit a local foot clinic or specialty shoe store for a proper fitting. Here at Feet First Clinic, our chiropodists perform footwear assessments. The chiropodist will examine your feet and gait and make footwear recommendations to match your foot shape, structure, alignment and accommodative needs. 4. Identify your foot type Knowing your foot type can help you choose the correct footwear for your job. Foot types vary significantly from person to person but generally classify as: Flat feet: Feet with little to no arch, which causes the arch of the foot to make complete contact with the ground. You may overpronate and require more structured shoes or custom orthotics to correct the biomechanical issue. Neutral feet: Feet with a moderate arch. Generally, people with a neutral arch don't require footwear with added stability features. High arches: Feet with a high arch that makes zero to minimal ground contact. You are more likely to under pronate and require structured shoes or orthotics to correct the pattern. A chiropodist can help determine your foot type and recommend appropriate footwear. 5. Check the profession's safety standards If you work in a profession with specific safety standards, prioritize the information on the shoe's label or the manufacturer's website. Specific footwear may need to meet standards to adequately protect you and your feet from the risks and hazards of the job. Certain symbols are also displayed on footwear boxes to let you know which is appropriate for your job.

April 10, 2023

The Importance of Footwear for Foot Health

Footwear is an integral part of our overall health as well - not just our foot health. Proper footwear can serve several purposes, including protection, support, stability, comfort, and cushioning, all of which can help keep foot problems and conditions such as ingrown toenails, tendonitis, blisters, and foot pain at bay. In this article, you'll learn about five key reasons footwear is critical for short- and long-term foot health. Protection Shoes protect the feet from cuts, scrapes, and other injuries. They also shield the feet from outside elements like rocks, hot pavement, and cold weather. Proper footwear with protection can help prevent foot conditions, including frostbite, broken bones, stress fractures, stubbed toes, and black toenails. Protection is especially important if you have diabetes; people with diabetes should wear covered footwear both indoors and outdoors. Protection is also about wearing the right shoes for the correct purpose. For instance, wear tough winter footwear in cold conditions to help prevent cold-related skin injuries. Relatedly, wear proper athletic footwear for various sports, including tennis, basketball, football, hockey, and running, as footwear can have specific features for the various movements you make while participating. Support Proper footwear supports the feet by helping distribute your body weight evenly across your legs and feet. Proper weight distribution can help prevent foot and leg pain and reduce the risk of sprains and fractures. Mainly, proper support can help prevent foot conditions, including pain from flat feet, plantar fasciitis, Morton's neuroma, Achilles tendonitis, blisters, heel spurs, and osteoarthritis. Cushioning Shoes with good cushioning can absorb shock and reduce pressure on the feet. Whether running, on the job or just walking around casually, cushioning can help reduce impact-related injuries such as tendonitis, osteoarthritis, plantar fasciitis, hallux rigidus, and metatarsalgia. Stability Shoes with a stable sole and a firm heel counter provide stability. Stability is especially important for people who overpronate or have flat feet. You can get stability from shoes with stability features in the midsole that control the movement or the foot and ankle, or from custom orthotics. Proper footwear with stability can help reduce pain associated with overpronation, like Achilles tendonitis, plantar fasciitis, and osteoarthritis. Comfort A critical component of footwear for foot health is comfort. Shoes should fit snugly but not tight to prevent common foot conditions like ingrown toenails, blisters, calluses, and corns. Ill-fitting shoes can add pressure points throughout your feet and toes. By choosing shoes that provide protection, support, cushioning, stability, and comfort, you can help to prevent foot problems and keep your feet healthy and pain-free.

April 3, 2023

Foot Pain: Causes and Treatment

Are your feet giving you a hard time? Foot pain can have many causes, including injury, overuse, medical conditions, and poor footwear. The underlying cause will dictate how to treat your foot pain, which can include anything from supportive footwear, to stretching exercises, to rest, to medication. In this article, we'll go through six common causes of foot pain and how to treat them: Plantar Fasciitis Achilles Tendonitis Bunions Ingrown Toenails Osteoarthritis Plantar fasciitis Causes Plantar fasciitis occurs when the plantar fascia (the band of tissue that connects the heel bone to the toes) becomes inflamed. It is caused by inadequate arch support or overexerting the plantar fascia. For instance, poorly constructed shoes, obesity and pregnancy, high-impact activity, and long periods of standing (like if you have a standing desk or work in a standing-first occupation) cause strain on the plantar fascia. Treatment Plantar fasciitis treatment involves rest and recovery, which should be the first course of action. Then physical therapy, like massaging your arch and stretching and strengthening exercises, are effective. Additional treatment methods include shockwave therapy, taping, wearing a splint or boot cast, and custom orthotics designed to provide additional arch support. Read more: See our complete guide on plantar fasciitis. Achilles tendonitis Causes Achilles tendonitis is an injury to the Achilles tendon, the part of the leg that connects the calf to the heel bone. It is usually caused by overuse. Overworking the Achilles heel is done through various avenues. The most common causes include overexercising, weight gain, joint disorders like rheumatoid or psoriatic arthritis, bursitis, a sudden fall or past trauma, and biomechanical abnormalities. Treatment Within 72 hours of injury, the first form of treatment you should pursue is rest and recovery. Good R&R prevents aggravation and stops the condition from worsening at its most vulnerable. Once you remove the cause, effective treatment methods include shockwave therapy, strengthening and stretching exercises (see our how-to), custom orthotics, and anti-inflammatories. Read more: See our complete guide on Achilles tendonitis. Bunions Causes Bunions are a type of joint deformity where the base of the big toe shifts outwards. There is a combination of factors that can either cause, directly or indirectly, bunions. Genetics (namely foot shape or joint-related), tight footwear or high heels, flat arches, and activities that stress the toe base (like running or ballet) can lead to bunions. Treatment Treatment options include footwear modification, anti-inflammatories, bunion splints, bunion aligners, taping, shoe stretching, orthotics, shockwave therapy, and surgery. Note that bunions are progressive, meaning non-invasive treatment focuses on preservation rather than reversing damage already done. Surgery is an option if you'd like to remove the bunion. Read more: See our complete guide on bunions. Ingrown toenails Causes Ingrown toenails occur when the edges of the toenail grow into the skin, causing pain and swelling. Ingrown toenails can be caused by: Cutting the nail too short or too far down along the edges Poorly fitted shoes. Injury to the nail bed. A genetic disposition to ingrown toenails. Treatment In some cases, you can treat ingrown toenails at home; otherwise a foot specialist can treat the condition. To treat your ingrown toenail at home, soak your foot daily in warm water with Epson salts, massage the skin at the edges of the nail, wear shoes with a wide toe box, and let the toenail grow out. When it does, cut the nail straight across. Never try to cut out your own ingrown toenail as this can lead to infection. If the toenail doesn't improve within 3–5 days, it's time to call the foot specialist. A foot specialist can safely treat ingrown toenails at any stage. In-office ingrown toenail treatment includes antibiotics, softening the skin around the nail, removing or cutting open the area to drain pus, Onyfix nail correction system, partial or complete nail avulsion, phenol, or surgery. Read more: See our complete guide on ingrown toenails. Osteoarthritis Causes Osteoarthritis is the most common form of arthritis and is caused by wear-and-tear of the cartilage between the joints. Getting old is the most common cause of osteoarthritis. Our joints get more mileage as we age and eventually wear down. Low bone density (for instance, in post-menopausal women) can also lead to osteoporosis, contributing to osteoarthritis (it would be like having defective brake pads). Additionally, unhealed trauma or injury, weakened deconditioned muscles, sudden weight gain, and biomechanical abnormalities like hammer toes or bunions can all lead to osteoarthritis. Treatment Treatment of osteoarthritis focuses on management, as it's a progressive condition. Physiotherapy, stretching, and light exercise to strengthen the muscles in the lower body is vital for managing osteoarthritis symptoms and preventing the condition from worsening. This can be done in conjunction with proper footwear and medication like anti-inflammatories. Custom orthotics can also help by effectively rebalance the weight distribution across your feet while adding support. Read more: See our complete guide on osteoarthritis.

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Important Facts You Need to Learn About Gout

Causes

Symptoms

Gout vs. Rheumatoid Arthritis

Tests

Treatment

Here’s to Many More Years of Foot Care!

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Related Posts

Cold Sweats: Causes, Symptoms, and How to Manage Them

Running with Ingrown Toenails: How to Manage Discomfort and Avoid Infection

Understanding and Treating Bunions: A Comprehensive Guide

How to Choose the Right Footwear for Your Job

The Importance of Footwear for Foot Health

Foot Pain: Causes and Treatment

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