January 2019

Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.

Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.

To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.

There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.

In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.

Rheumatoid arthritis affects about 1.5 million people in the United States and is a very serious disease. It is an autoimmune disease that causes the body’s immune system to mistakenly attack joints. This attack creates inflammation that causes the tissue lining on the joints to thicken, which causes pain and swelling. It is important to catch this inflammation early, because over time it can damage cartilage, elastic tissue that covers bones in the joint, and the bones themselves. This damage can lead to the joint spacing between bones to shrink, which causes joints to become loose, unstable and painful. Joint deformity is also a possibility, and this cannot be reversed. Rheumatoid arthritis usually occurs symmetrically, so if one foot or ankle is affected then the other one most likely will be too. If you feel that you have any symptoms of Rheumatoid arthritis, it is highly recommended that you speak with a podiatrist to start treatment as soon as possible.

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist if you feel like the pain in your feet might be caused by RA. For more information, contact Don A. Shumway, DPM of Arizona. Our doctor will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

• Swelling and pain in the feet
• Stiffness in the feet
• Pain on the ball or sole of feet
• Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

If you have any questions please feel free to contact our office located in Snowflake, AZ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.

Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.

Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.

Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.

Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.

Fungal nail infection (onychomycosis) is one of the most common nail disorders among adults. It is a mycotic infection that occurs underneath the nail plate. The nail can become deformed, lifted, brittle, and discolored. These symptoms may lead to acute pain in the toenail area. There are various types of fungal nail infections and various types of treatments. One form of treatment is laser therapy, which also consists of varying methods. Photodynamic therapy uses light irradiation and a photosensitizing drug to find specific cells and destroy them. Other laser therapies that involve neodymium yttrium-aluminum-garnet or low-level lasers aim to selectively hinder fungal growth. Laser therapies are selective to the localized infection, which decreases the chance of systemic side effects. If you are interested in laser treatment for a fungal infection, consult with a podiatrist for further guidance.

Laser treatment can be an effective way to get rid of toenail fungus. If you have any questions about laser treatment, consult with Don A. Shumway, DPM from Arizona. Our doctor will assess your condition and provide you with quality treatment for fungal nails.

What Are Toenail Fungal Infections?

Onychomycosis, or fungal infection of the nail, is a relatively common and non-serious condition. Around 10 percent of U.S. citizens are afflicted with fungal nails. Common forms of fungus that infect the nail include dermatophytes, yeasts, and molds.

Symptoms of Toenail Fungal Infections Include:

• Nail thickening
• Brittleness of the nail
• Discoloration of the nail

Diagnosis for Fungal Nails

Fungal infections are diagnosed by fungal culture and microscopy. This will rule out any other conditions such as nail trauma, psoriasis, lichen planus, and onychogryphosis.

What Is Laser Treatment?

Laser treatment is a non-invasive, safe, quick, and painless procedure that uses the heat from a laser to kill fungus in the nail. Each infected nail is targeted with a laser for several minutes. The treatment is usually utilized several different times over a select period. During this time, a podiatrist will keep an eye on the infection.

If you have any questions, please feel free to contact our office located in Snowflake, AZ . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

Each foot, on average, has about 250,000 eccrine sweat glands that produce half a pint of sweat each day. Sweating is a natural and important bodily function. It regulates the body’s temperature by cooling the skin so that it does not overheat.  In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than what is required. People with plantar hyperhidrosis experience an excess amount of sweat on their feet. It is estimated that 2% to 3% of all Americans suffer from some form of hyperhidrosis. This condition is often caused by neurologic, endocrine, infectious, and other systemic disease. Other factors that may trigger the condition are heat and emotions.

People with hyperhidrosis may notice an overabundance of sweat on their feet, along with a strong odor. The feet may also have a wet appearance coupled with infections such as athlete’s foot or toenail fungus. The sweat may even appear in low temperatures, such as during the winter months. People with plantar hyperhidrosis often need to change their socks several times throughout the day.

The specific cause of hyperhidrosis is unknown, and many believe it may be caused by over-activity. However, others believe the condition is genetic.  Caffeine and nicotine are known to cause excitement and nervousness which are two emotions that may make the condition worse.

If you are looking to treat your hyperhidrosis the most important thing you should do is wash your feet every day.  You may even need to wash your feet twice a day, if necessary.  You should also make sure you are wearing the right socks. Wool and cotton socks are both known to be good for ventilation, meaning they allow the feet to breathe. You should avoid socks made from nylon which trap moisture and lead to sogginess. Other common treatment options are over-the-counter antiperspirants that contain a low dose of metal salt.  In some cases, prescription strength antiperspirants that contain aluminum chloride hexahydrate may be necessary. In severe cases, surgery may be required.

Untreated hyperhidrosis can easily lead to complications.  Some complications that may arise from the disorder include nail infections, warts, and bacterial infections.  Consequently, it is important that you seek treatment from your podiatrist if you suspect that you may have plantar hyperhidrosis.

The medical condition that is referred to as planter hyperhidrosis is defined as excessive sweating of the feet. Many patients may experience extreme discomfort, and this may be a result of shoes and socks that are frequently wet. There are several symptoms that may be associated with this ailment, and these may include foot infections such as toenail fungus or athlete’s foot, blisters on the feet that may come from excessive friction, or a strong and unpleasant foot odor. There may be preventive measures that can be implemented to ease the discomfort of plantar hyperhidrosis, including utilizing antiperspirants on the feet, wearing layers of cotton socks, which may be helpful in absorbing sweat, or taking oral medications. If you are afflicted with this uncomfortable foot condition, it is suggested to speak with a podiatrist who guides you to begin the correct treatment.

If you are suffering from hyperhidrosis contact Don A. Shumway, DPM of Arizona. Our doctor can provide the care you need to attend to all of your foot and ankle needs.

Hyperhidrosis of the Feet

Hyperhidrosis is a rare disorder that can cause people to have excessive sweating of their feet. This can usually occur all on its own without rigorous activity involved. People who suffer from hyperhidrosis may also experience sweaty palms.

Although it is said that sweating is a healthy process meant to cool down the body temperature and to maintain a proper internal temperature, hyperhidrosis may prove to be a huge hindrance on a person’s everyday life.

Plantar hyperhidrosis is considered to be the main form of hyperhidrosis. Secondary hyperhidrosis can refer to sweating that occurs in areas other than the feet or hands and armpits. Often this may be a sign of it being related to another medical condition such as menopause, hyperthyroidism and even Parkinson’s disease.

In order to alleviate this condition, it is important to see your doctor so that they may prescribe the necessary medications so that you can begin to live a normal life again. If this is left untreated, it is said that it will persist throughout an individual’s life.

A last resort approach would be surgery, but it is best to speak with your doctor to find out what may be the best treatment for you.

If you have any questions please feel free to contact our office located in Snowflake, AZ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.