February 2025

Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men. 

Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.

People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.

Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.

Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.

To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks. 

According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

A podiatrist is a Doctor of Podiatric Medicine who treats the foot, ankle, and related structures of the leg. If you are having any pain, injuries, or abnormalities in these areas, it is best that you seek help from a podiatrist.

Podiatrists complete four years of training in a podiatric medical school. Their training is like that of other physicians, and they may go on to complete a fellowship training after a residency training. Some podiatrists are board certified meaning they have advanced training, clinical experience, and have taken an exam to prove their skills. Certifying boards for podiatry are the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine. Podiatrists may work in private practices, hospitals, clinics, or they may even become professors at colleges of podiatric medicine.

While in college, those who want to be podiatrists often take biology, chemistry, and physics classes in preparation for podiatry school. In podiatry school, students study how the bones, nerves, and muscles work together to help you move around. Additionally, they study injuries and how to properly diagnose and treat them. Admittance into podiatric medical school requires the completion of 90 semester hours of undergraduate study with a good grade point average, and acceptable scores on the MCAT (Medical College Admission Test)

Podiatrists treat many different conditions such as: aching feet, ankle pain, bunions, corns, hammertoes, fungus, ingrown toenails, plantar fasciitis, sprains and more. Common forms of treatment for these conditions are physical therapy, drugs, or surgery. Podiatrists may also recommend corrective shoe inserts, custom-made shoes, plaster casts, and strappings to correct deformities.

Even if you are someone whose feet are in generally good condition, you should still visit a podiatrist to have your feet properly exfoliated and maintained, or to make sure you are looking after your feet properly.

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.