By Dr.Brian C. Rell, DPM, FACFAS
Disease states or trauma can damage the joint, bones and soft tissue in our feet and ankles; however, the most common foot and ankle disorder is caused by inflammation and is widely known as arthritis.
Arthritis is an inflammation of the joints. Some of the common arthritic symptoms are joint pain, stiffness, warmth, immobilization, and loss of range of motion, fatigue and inadequate blood flow. While there are many forms of arthritis, two of the main types of arthritis are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). With Osteoarthritis, wear and tear damages the cartilage in the joints and causes friction between the bones rubbing together. Injury or infection usually causes Rheumatoid Arthritis. RA is an autoimmune disease that causes the body to attack its own lining of the joints and membranes; this results in painful swelling and inflammation.
Common symptoms of arthritis:
• Swollen Joints
• Joint Pain
• Sensations of warmth or burning
• Decreased range-of-motion
• Limited flexibility
• Loss of strength
Gout is a form of arthritis and is caused by a build-up of uric acid. Years ago many professionals believed that rich foods triggered gout, but we now know that gout is an internal illness that builds up uric acid crystals in the joints and causes swelling, redness, and a great deal of pain.
Common symptoms of Gout:
• Extreme pain
• Skin discoloration
More women than men experience the painful boney growth on their big toe, known as a bunion, or Hallux Valgus. One of the leading causes of a bunion is from wearing shoes that are too tight, too narrow or too high. All of this causes pressure on your toe joint, which in turn starts to ache, become fluid filled and can have boney growths.
Uniquely, bunions can also be hereditary and run in families, especially in females, generation after generation. A form of arthritis can also cause these painful, red, boney, growths.
Depending on the type of arthritis that is affecting the foot and ankle, many treatment options are available. The standard therapies are NSAID’s, corticosteroid injections and the RICE method (rest, compression, ice, and elevation). Staying off of your inflamed ankle and foot is imperative for healing. In some cases, your podiatrist can give you a brace or compression stocking to help immobilize your foot, but it’s key to not try and get back in the game too soon. There are also surgical options for advanced arthritis; this is especially true with rheumatoid arthritis, where the synovium needs to be surgically removed to relieve pain and swelling.
Gout medications are offered in a daily maintenance form that lowers the level of uric acid in the blood, and in an acute form, which can be taken to reduce a flare-up of gout. Many people suffering from gout will benefit from both types of medications.
A newer therapy called, Biologic Response Modification can be used for rheumatoid and other inflammatory arthritis. This treatment works by blocking inflammation without inhibiting the immune system.
Along with taking the appropriate medications on a daily basis, for Gout and ankle arthritis, the best treatment is to avoid walking or standing for long periods of time and elevating the feet as much as possible.
For bunions, many individuals will start out trying to alleviate their pain by wearing more comfortable shoes, or by wearing gel toe inserts that help keep the toes in the proper alignment. Icing the foot can help to tamp down inflammations, as well as taking NSAID’s (ibuprofen) as needed to lessen the discomfort.
When the conservative approach begins to stop working, which is not unusual, as most bunions fail to heal on their own, surgery is the definitive answer. Surgery can be performed using minimally invasive techniques or more aggressive surgery depending on the severity of the bone, joint, and tendon dysfunction.
Surgery can include removing boney spurs, removing part of the toe bone, relieving tension on ligaments and tendons, realigning and reconnecting the joint and bones.
A podiatrist will evaluate your symptoms and pain level, and from there create an individualized plan for your best treatment options. They will provide you with the best solution for your needs.
Dr. Brian C. Rell, DPM, FACFAS
Dr. Rell is double board certified by the Board of Foot and Ankle Surgery and specializes in the treatment of all podiatric and orthopedic foot, ankle, and lower leg conditions. He has been in private practice in the Sarasota and Bradenton area for over 15 years.
If you are experiencing any foot and ankle pain, please call (941) 256-3873.
941.256.3873 | www.swfafl.com