Whats Aching Your Big Toe
It is easy to forget how important your big toe is most of the time it stays out of sight and out of mind, hidden beneath our socks and shoes. But if you have ever had toe pain, you know it can keep you off your feet and up at night.
When arthritis affects the foot it usually hits at the base of the big toe in what is known as the MTP, or metatarsophalangeal joint. This can cause big problems for the tiny joint that has to bend and bear about 50% of your body weight every time you take a step.
Here are six common culprits of big toe joint painmany of which are relatedand ways you can find relief.
Determining The Cause Of Your Swollen Toe
Six Problems That Can Be Caused By Tight Shoes
Tight shoes might help you look stylish at the expense of being comfortable on your feet. But the human foot has a complex anatomy, and wearing shoes that are too tight can do a lot more damage than making you uncomfortable at a social gathering. When you pick a new pair of shoes, you should prioritize comfort and fit to avoid unintended side effects.
Here are six problems that can be caused by tight shoes:
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When Is Surgery Considered For Gout
The question of surgery for gout most commonly comes up when a patient has a large clump of urate crystals , which is causing problems. This may be if the tophus is on the bottom of the foot, and the person has difficulty walking on it, or on the side of the foot making it hard to wear shoes. An especially difficult problem is when the urate crystals inside the tophus break out to the skin surface. This then can allow bacteria a point of entry, which can lead to infection, which could even track back to the bone. Whenever possible, however, we try to avoid surgery to remove tophi. The problem is that the crystals are often extensive, and track back to the bone, so there is not a good healing surface once the tophus is removed. In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered.
Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase , since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus.
The Key Differences Between Gout And Bunion
Scientifically or medically, the name for gout is gouty arthritis, while that for bunions is Hallux Valgus. Gout is mainly an inflammatory kind of arthritis, while a bunion is a bony disfigurement of the big toe which mainly appears as a bone misalignment of the toe. Developing a bunion is more of a mechanical problem, and the big toe can push against the second toe to cause a bulge in your foot.
Gout will develop due to excessive quantities of uric acid in the bloodstream brought about by an excretion failure by the kidneys. The exact cause of a bunion is not known. However, it is linked strongly to genetics, injury, anatomical and congenital deformity. Flat feet and ill-fitting footwear worsen a bunion. Gout is systematic, while bunions are primarily localized toe deformities.
Gout is more prevalent and affects more men, while bunions are more prevalent among women.
Last but not least, gout may occur in any one or multiple joints of the body. A bunion is evident, and it only occurs on one or both of the big toes.Gout starts with depositions in the big toe which other joints and tissues can follow. If gout affects the big toe only, it is referred to as podagra.
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Should I Walk With Gout
Due to the pain and discomfort of a gout attack, it is always best to stay seated, elevating your feet if at all possible, until the flare-up passes.This may take a minimum of 4 hours, If you must walk during an attack, it is best to use a cane to help keep full pressure off the foot, and to provide extra stability.
Pain On The Top Of The Foot: Causes
Wearing too-tight shoes or doing excessive exercise can cause a sharp pain on the top of your foot when you walk. You can get a clearer idea of the cause of your pain by looking closely at your symptoms.
- A stress fracture or sprained metatarsal can cause swelling, bruising, or pain that starts after repetitive or intense exercise.
- Osteoarthritis or tendinitis can cause stiffness, swelling, and pain that lasts for a long time. There might be a lump next to a tendon, or you may feel crackling or grating while moving your foot.
- Gout can cause red, swollen, hot skin severe or sudden pain when you touch your foot and pain starting from the base of your big toe.
You could experience a sharp pain on the top of your foot as a result of overuse, injury, or inflammation of the tendons, ligaments, or bones in your foot. Peripheral neuropathy is a condition that causes severe burning pain, tingling, and numbness in the foot. Some other causes of sharp foot pain include:
- Diabetic neuropathy
Talk to your doctor if any of the following scenarios apply to you:
- The pain is severe or stops you from performing normal activities.
- The pain is recurrent or getting worse.
- The pain doesnt get better after treating it with home remedies for two weeks.
- Youre experiencing numbness, loss of sensation, or tingling in your foot.
- You have diabetes, as foot problems can become more severe with diabetes.
You should visit an urgent care center if any of the following scenarios apply to you:
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What To Do During An Attack
- take any medication youve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure youre well hydrated
Apply the ice pack to your joint for around 20 minutes. Dont apply ice directly to your skin and dont apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
Current Fitness Level And Future Plans
One of the things you have to decide on when buying a new pair of running shoes is the distances you will be running. Knowing what youre training for helps you narrow down your options. Your past running activities also determine what kind of shoes you need.
If youre new to running and you intend to do your first marathon, a more supportive pair of shoes is essential. Runners are classified based on the mileages they cover. Below 20 miles, they are termed as low-mileage runners, 20-40 miles are medium-mileage runners, and those who do 40 miles a week are considered high-mileage runners. The amount of stability of the shoe and the cushioning relies on the mileages you cover.
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How To Avoid Five Common Foot Problems
Bunions, athletes foot, toenail fungus and gout. Most of us can admit that weve run into a foot problem, or two. While feet may not be the most glamourous thing to talk about, it is important that we address and take care of this important, yet often neglected, part of our body. Here are some of the most common foot problems and how to avoid them.
Cheaper Shoes For Gout Patients Might Help
Further research needs to be done that will allow doctors and patients to better recognize the best shoes available for comfort that also are economically priced, the researchers write. Gout patients need shoes that are wide enough, have ample cushioning, and allow motion control.
More than half of those in the study mentioned cost as a factor in shoe selection, suggesting that cost may influence gout patients to purchase improper footwear.
Obesity may also be a factor in pain related to the footwear of gout patients, the researchers write.
Rome and his colleagues suggest that proper footwear selection be discussed with gout patients to reduce foot pain and impairment.
Previous research has shown that gout is on the increase around the world and is the most common form of inflammatory arthritis affecting men.
The study is published in Arthritis Care & Research, a journal of the American College of Rheumatology.
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Tips On Compression Socks
Compression stockings for gout are readily available online. Here are some tips on purchasing and wearing compression socks for gout:
Ten Common Foot Problems
The feet take a lot of daily abuse from walking, running, jumping, and climbing, so naturally, they are subject to many different types of problems.
From injuries to inflammation, several different types of damage and malfunctions can lead to foot problems.
The feet are made of up 26 bones each, making them one of the most intricate areas of the body. Nevertheless, according to the College of Podiatry, a person will walk an estimated 150,000 miles in their lifetime, roughly the equivalent of walking around the world six times.
Improper footwear, diabetes, and aging are some of the chief contributors to foot problems. This article will highlight some of the most common foot concerns, their causes, and when to seek treatment.
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What Can Trigger A Gout Attack
Several things can cause the crystals to shake loose into your joint cavity, triggering an attack. These include:
- a knock or injury to the joint
- an illness that may make you feverish
- having an operation
- having an unusually large meal, especially a fatty meal
- drinking too much alcohol
- starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.
What To Do If You Have A Ganglion Cyst
A ganglion cyst is a noncancerous lump of tissue, often found on the foot and ankle. Sometimes, they can cause discomfort, especially while wearing tight shoes. If you notice a lump on your foot or ankle, schedule a visit to a podiatrist and explore your treatment options. If the ganglion cyst is small and doesnt cause discomfort, the podiatrist may recommend monitoring it to see whether it will resolve itself over time.
If treatment is needed, it may involve aspiration. The podiatrist can drain the cyst of fluid via a needle. However, sometimes a ganglion cyst will return after aspiration. In these cases, the cyst may need to be removed surgically. In the meantime, it can be helpful to modify your footwear. Your podiatrist can offer specific recommendations for shoes that fit your needs, and he or she may recommend placing a pad inside the shoe.
The podiatrists of Advanced Foot & Ankle Specialists look forward to meeting you and discussing your podiatric condition. You can reach our podiatry offices in Houston or Sugar Land by calling 242-3338.
11100 South West Freeway, Houston, TX 77031 Working Hours: Monday – Friday: 9 AM – 5 PM
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The Role Of Medication In Prevention Of Gout
Table 3: Medications to pevent attacks of gout
Standard medications in preventing gout attacks
i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8
ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.
Table 4: Reasons to use medication to lower uric acid
Preventing Flares With Medication
If you have gout, you may take a uric-acid lowering therapy such as allopurinol, Uloric , Zurampic® , Krystexxa® or Duzallo® .37 You might also take Mitigare® 0.6 mg capsules to help prevent gout flares.8 The safety and effectiveness of Mitigare for acute treatment of gout flares during prophylaxis has not been studied. Mitigare is not an analgesic medication and should not be used to treat pain from other causes. The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain. Talk to your doctor about the gout flare prevention strategy that may be right for you.
While ULTs have been shown to reduce uric acid and Mitigare® 0.6 mg capsules have been proven to help prevent gout flares in adults38, recent studies show that wearing the right kind of footwear may make a difference for people with gout as well911.
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Home Remedies From The Refrigerator
Apple preserves. This may neutralize the acid that causes gout. Take as many apples as you wish, then peel, core, and slice. Simmer in a little water for three hours or more, until they turn thick, brown, and sweet. Refrigerate. Use as you would any preserve.
Cherries. Cherries may remove toxins from the body, clean the kidneys, and yes, even help give you a rosy complexion. Because of their cleansing power, they’re at the top of the gout-relief list. If you can bake a cherry pie, you may be making a gout treatment. Cherry compote, cherry juice, cherry jam, cherry tea, cherry anything works.
Comfort As A Priority
All participants stated the importance of comfort, supporting the idea that having comfortable footwear was a priority. The concept of striving for comfort was evident, with feelings of satisfaction upon finding comfortable footwear:
âI didnât realise that you can have comfortable shoes, cause Iâve never had comfortable shoes beforeâ Participant 10, Male, 48 years old
For some, feeling comfortable was more important than âlooking goodâ:
âIâve been wearing shoes in the past that donât look good, but they are comfortable. Thatâs, and then, I mean I always get eyes and looks and weirds, but I didnât really care I was just like âoh, Iâm comfortable manââ Participant 6, Male, 40 years old
Footwear characteristics such as having good fit, cushioning, being lightweight and having enough room to accommodate the foot, were identified as important influencers of footwear comfort:
âThe fit of the shoe is important if itâs too, if itâs too tight then itâs not comfortableâ Participant 8, male, 72 years old
Having uncomfortable footwear led to foot pain, which in turn could influence oneâs mood and ability to participate. This consequence was viewed with frustration:
âI’m the person who has to sit with a problem when I get home tonight because my feet are sore, and then I can’t sleep, and then you don’t sleep, and then you’re miserable as H the next morning, and then you’ve got to work, and you’re grumpyâ Participant 1, Female, 61 years old
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