Foot pain from Gout

Gout used to be known as the disease of kings. Too much red meat and red wine caused the kings of old to suffer from gout. This is actually only one cause of gout, but an important safety tip! Gout is a disorder that results from a build up of uric acid crystals in a joint. This can be your big toe joint, ankle, or knee, most commonly; but can occur in any joint or tissue in the body. (I’ve seen it in an earlobe!) Simply said, gout hurts so bad you don’t even want a sock or sheet on your foot, let alone a shoe!
What causes gout?
Gout is a buildup of uric acid crystals in the joint or tissue. Uric acid is normally found in the blood and eliminated by the kidneys. Gout attacks are caused by either too much uric acid in your blood due to the kidneys having trouble eliminating it or simply you just make too much. Gout attacks the big toe joint most commonly, because uric acid turns to crystals as it cools down, and your big toe joint is the furthest from the heart, so the coolest joint in the body. (I always thought big toes were cool!) Seriously though, many people inherit the tendency to have gout and it is much more common in men than women. Other factors that precipitate gout can be high blood pressure, diabetes, obesity, surgery, chemotherapy, stress and certain medications. Food can cause gout attacks. Uric acid is the result of the breakdown of purines, so food with high levels of purines can cause gout. These included red meat, red wine, beer, shellfish, and organ meat. (I knew there was a reason I never liked liver and onions, it causes gout!).
Please see the following website for advice on which foods to avoid and foods to enjoy:
http://arthritis.about.com/cs/goutdiet/a/goutpurines.htm
The diagnosis of gout requires an extensive physical exam including family history, x-rays and laboratory tests for uric acid levels. It is important to distinguish gout from an infection or other inflammatory joint problem.
Treatment for gout starts with anti-inflammatory medication or injection therapy, padding and shoe gear modification. Dietary restrictions are discussed and often a long-term medication is needed to control the build up of uric acid in the blood. In a large, long-term prospective study of men aged 40 years and older, long-term caffeinated coffee consumption was associated with a lower risk for incident gout, so if you fall in this category, this may help as well. Gout can cause degenerative arthritis, so often orthotics or surgery is needed to treat the arthritic joint.
If you have the symptoms of gout, do not delay. The longer the uric acid is accumulating in your joint, the more destructive the crystals can be. Long-term outcomes hinge on immediate care. Call or contact the office today to schedule an appointment with Dr. Williams or Dr. Silvers today.

Eric M. Silvers, DPM, PA
Kory D. Williams, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

New Website

Advanced Foot and Ankle Center, the office of Dr. Eric Silvers and Dr. Kory Williams has a new website. www.advancedfoottexas.com

Dr. Silvers and Dr. Williams are foot and ankle specialists trained to treat all foot and ankle conditions. With offices in McKinney and Prosper, Texas, we assure you that we are close by.

We serve McKinney, Propser, Frisco, Allen, Anna, Melissa, Plano, Princeton and surrounding areas.

Please visit our website and call 972-542-2155 to set up an appointment.

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

New Blog Page for McKinney Podiatrists

Dr. Kory Williams, a foot and ankle surgeon with Advanced Foot and Ankle Center has just created a new Blog for our office. Please visit it at http://advancedfoottexas.blogspot.com/

Dr. Williams joins Dr. Eric Silvers in Practice. Both surgeons serve McKinney, Prosper, Allen, Anna, Frisco, Plano and surrounding communities.

Call our office at 972-542-2155 or visit our website for an appointment.


Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

Aging Feet

AGING OF THE FEETOver time, normal changes to the feet can occur. The feet are under a tremendous amount of pressure during daily activity. While walking, each step puts two to three times as much force as the person’s body weight.This pressure can alter the structure of the foot as the person ages. Feet can become slightly longer and wider. Some women experience such changes during pregnancy due to the added pressure of pregnancy-related weight gain and also due to their hormones causing increased body flexibility including the foot.There might be a slight flattening of the arch of the foot. This is normal as long as it is neither excessive nor causes pain. The foot and ankle may lose some flexibility with age as does many joints and muscles in the body. The pad of fat at the bottom of the heel may become thinner with age. Though these changes are unlikely to cause serious problems, they may be accompanied with a loss of balance.Any foot changes that cause pain or deformities should be checked by a McKinney, Texas podiatric physician. Thickening of the skin such as corns or bony growths like bunions are not part of normal aging. Changes in the shape or alignment of the toes could be signs of problems with the muscles of the foot. A McKinney, Texas podiatric physician can diagnose the condition and recommend appropriate treatment.Pain is not part of normal foot changes. Pain can indicate a problem with the nerves, such as Morton’s neuromas. It could also be due to fasciitis or other painful foot problems. Discolorations of the feet should not occur. Discoloration could be a sign of a circulation problem.Arthritis is a common problem among older adults. Arthritis can cause problems with the feet. Arthritis in the feet can cause pain, swelling, and stiffness. Though there is no cure for arthritis, medical treatment can limit its damage and debilitating effects. A McKinney, Texas Foot and Ankle Specialist should be consulted for any foot problems that are not part of normal aging.Dr. Kory Williams is a foot and ankle specialist trained to treat all foot and ankle problems including thoses associated with aging. He practices with Dr. Eric Silvers in both McKinney, Texas and Prosper, Texas. You may contact our office at 972-542-2155. Advanced Foot and Ankle Center in Prosper, Texas and McKinney Foot and Ankle Center in McKinney, Texas offer comprehensive treatment for all foot and ankle problems. You may visit our website at www.advancedfoottexas.com for more information about our practice.

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

Proper Shoe Fitting, Discussed by McKinney Foot and Ankle Doctor

Mckinney Podiatrist Discusses Proper Shoe Fitting

Most people would be surprised that a majority of foot problems are caused from poor shoe fitting. People choose shoes for many different reasons including comfortability, style and functionality. Just because a shoe appears to look comfortable and is expensive is not the criteria to use when purchasing shoes. Shoes must fit properly, be made of sturdy materials, and have a solid construction. Due to the variability of people’s foot structure, a shoe may comfortable to one person and very uncomfortable to the next person.Shoes are designed to protect the feet during mobility and support. Unfortunately, improper shoe fit can limit joint movement, constrict circulation, decrease sensation and alter the way you walk. Poor shoe fit can also inhibit the proper functioning of custom-made foot orthotics. If improper shoe gear is worn for a long term, the muscles, joints, and connective tissues in the feet begin changing shape, adapt to the shoe and cause many foot disorders.Feet have been measured for years by a metal instrument called a Brannock Device. You have probably seen a Brannock Device in nearly every shoe store you have entered. The Brannock Device is used to measure 3 basic dimensions of the foot.A. Heel to the ball of the footB. Heel to the tip of the toesC. WidthEach measurement is used in combination to custom fit the shoe. The most important measurement is the heel to the ball of the foot, because this measurement will closely resemble how the shoe is designed to function. The shoe is designed bend at the ball of the foot, and if the shoe bends in the arch or doesn’t bend at all, this must be taken in consideration. The heel to the ball measurement defines the position of the arch and if this measurement is incorrect, the shoe and the foot will never function in harmony. Instead, they will fight each other with each and every step.When measuring the heel to toe length, allow a minimum of a 3/8 to ½ inch distance from the tip of the big toe to the front of the shoe. If the toes touch the end of the shoes, this can cause trauma to the toenails and possibly cause hammertoes and can lead to ingrown toenails. The heel should fit comfortably in the shoe with a minimum amount of slipping. In other words, the shoe should not ride up and down on the back of the heel as you walk. The heel of the shoe helps control rearfoot motion. A straight, solid heel in the shoe is very important especially in those who are flatfooted or pronate.When measuring the width of the foot, you must allow enough room in the shoe to accommodate the foot structure. If the foot is rubbing on the sides of the shoe, blisters, calluses and other problems can occur. If a patient has bunions or tailor’s bunions, this deformity can become increasingly painful with a smaller width shoe. Make sure the ball of the foot fits comfortably in the widest part of the shoe. Don’t buy shoes too tight and expect them to stretch to fit.Take in consideration the height of the toebox in the shoe. Sometimes the tops of toes can rub on the inside of the shoes. In some people, especially those with hammertoes, this can become a problem. Allow enough room in the shoe so the toes do not rub.A slight heel is important, however avoid high heeled shoes whenever possible. High heeled shoes allow for the forefoot or the “ball of the foot” to bear the entire body weight. This can cause intense forefoot pain and ultimately cause severe deformities of the foot.All foot measurements must be taken weightbearing or standing. Since the foot lengthens and widens under physiologic loading, a false measurement may be taken if the foot is measured while sitting. Most people have one foot that is larger than the other. Fit the shoe to accommodate your larger foot. Don’t select shoes solely based on the size indicated on the tag inside the shoe. Select the shoe according to how it fits your foot or shaped like your foot. The “last” of the shoe is the so-called footprint of the shoe. The last can be straight or slightly curved inward. Everyday dress shoes are normally built on a straight last, while athletic shoes are built with a slight inward curve of the forefoot. Straight last shoes are recommended for patients using orthotics in their shoes.Shoe material is also a consideration when purchasing the proper shoe. Durability, flexibility and breathability of the material has to be accounted for in the upper material of the shoe. If the material is too soft and flexible, you may not get the support and durability you are looking for. On the other hand, if the materials are too stiff and don’t “give”, they can be very uncomfortable and cause pressure. If you have feet with significant arthritic changes, it is very important to choose shoegear that will “mold” to the foot in order to take pressures off the deformity.People who have feet that sweat a lot need to find materials that breathe in an effort to get air to the feet during the day. Some shoes are designed to absorb sweat from the foot, but many do not. Naturally for those people whose feet perspire a lot, you should allow your shoes to thoroughly dry out before wearing them again. Do not store the shoes in dark closet immediately after using them. Instead, store the shoes near an open window or on the front porch to fully dry out.The sole of the shoe is a major consideration. Many people complain that the sole of the shoe is too stiff or too flexible. It is important to find a shoe with a happy medium. If you had to choose between a very flexible sole or a stiff sole, I would personally lean towards a stiff soled shoe. Shoes with excessive bend can cause a variety of foot problems. Also, try to find a shoe that will accommodate your arch height. Most people bear weight on the heel and the ball of the foot. When barefoot, the arch is usually not supported unless you have a very flat arch. Therefore, try to find a shoe that accommodates the arch height to distribute the pressure across the entire surface of the foot. Be careful though, because too much arch in the shoe will cause the patient to bear weight primarily on the arch region of the foot and can cause severe pain.If you stand on hard surfaces such as concrete or tile, a shoe with proper cushioning is necessary. Also if you participate in athletic activities, finding a shoe with good shock absorbing qualities is important. If hard soled shoes are worn in these situations, pressure calluses can develop on the bottom of the feet. Also, choose shoes that have a sole that will not slip. Soles should provide solid footing and not be slippery.Buy shoes in the afternoon or towards the end of the day. At the end of the day, the feet have expanded and swollen through activity and will be its largest size. The Brannock Device does not measure the “volume” of the shoe.Also, don’t forget to bring socks or panty hose to the store when getting fit for shoes. Many stores have socks to wear, but be prepared by bringing your own in case the store does not have them for you.It is important to realize when your foot deformity cannot be accommodated by shoes bought from a shoe store. Those patients with chronic non-healing ulcerations or severe arthritic deformities and malformations need extra protection and shoes that are custom-molded to accommodate deformities and offload pressure areas. Dr. Silvers and Dr. Williams have extensive professional experience providing custom-molded shoes. Casts of your feet are taken in the office, sent to a specialized shoe-making company in which a shoe is fabricated to you own personal specifications. If you are diabetic or have one of the previously mentioned foot deformities, you should come see Dr. Williams or Dr. Silvers to determine if custom-molded shoes are needed for you. Our office also offers extra depth diabetic shoegear and we have shoe samples in the office that you can see. If you need to have your feet properly measured and need a recommendation on proper shoe fitting, please come visit Dr. Kory Williams and Dr. Eric Silvers of McKinney Foot and Ankle Center in McKinney , Texas or our Prosper, Texas Office, Advanced Foot and Ankle Center. Our doctors have extensive training and experience in providing proper shoe fitting and offering shoe buying recommendations. We strive for complete patient satisfaction and see patients from McKinney , Frisco, Allen, Anna, Prosper, Celina, Plano , Sherman , Denison , Durant , Oklahoma and surrounding communities. Dr. Silvers is a board certified foot and ankle specialist practicing in McKinney , Texas and Proper, Texas . He sees patients from North Dallas, McKinney , Plano , Allen, Prosper, Frisco, Melissa, Anna and Princeton , Texas .To Schedule an Appointment with Dr. Silvers, please call 972-542-2155 or visit our website at http://www.mckinneyfootcenter.com Dr. Kory Williams will be joining McKinney Foot and Ankle and Advanced Foot and Ankle in July of 2009. Both Dr. Silvers and Dr. Williams strive to deliver the utmost quality foot and ankle care with a compassionate bedside manner. Our doctors have 5 years of combined foot and ankle post graduate training and over 11 years of private practice experience. Both Dr. Silvers and Dr. Williams are respected speakers in the field of Podiatric Medicine, Surgery and Practice Management. Dr. Silvers is the Past President of the Dallas County Podiatric Medical Society.

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

Ingrown Toenail Surgery

McKinney Foot and Ankle Specialist Discussed Ingrown Toenail Surgery

Surgery to treat ingrown toenails is typically done in the office. Dr. Eric Silvers and Dr. Kory Williams of Advanced Foot and Ankle in McKinney and Prosper, Texas have extensive training and experience in treating ingrown toenails. If the toe is infected, then the nail plate border must be removed in order for the infection to resolve. The procedure involves putting the toe to sleep at the base of the toe away from the ingrown portion of the nail. Dr. Williams and Dr. Silvers will spray a medication that will numb the skin prior to injecting the medication that numbs the toe for the procedure. If the toe is not infected, then our doctors will give you the option of permanently correcting the nail so that you will not suffer from ingrown toenails again. This process can be achieved by applying a chemical to the nail border or by surgically removing a portion of the nail root. 99% of the time these procedures are done in the office, but they can also be performed in the surgery center. At Advanced Foot and Ankle, we strive to offer skilled, gentle foot and ankle care. We see many patients of all ages who suffer from ingrown toenails. Our procedure room is equipped with both a television and also music that is play overhead. For more information on ingrown toenails please read the following posts or visit our website at

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

Dry Feet as discussed by McKinney, Texas Foot and Ankle Specialist

MY PAINFUL DRY FEET!!

Well, the Winter months area here, and in Texas, that means low humidity which means DRY SKIN. It is often known as "winter itch," since the low humidity essentially draws the moisture out of the skin. Also, the dry heat from the furnace in the winter time can reduce the moisture in the air.Every year we see many patients that complain of dry, cracked skin, especially along the bottom of their feet, especially the heels. This can be a serious problem especially for our diabetic patients in which cracked skin can be a source of infections. Lets face it, our feet spend hour after hour in shoes every day. Bacteria love dark, warm and moist environments as do fungi and molds. Poorly controlled diabetics with cracked skin on their feet are highly susceptible to foot infections as a result their skin condition and poor immune system. Dry feet can not only be unsightly, but also uncomfortable. They can itch, look red and can give the sensation of small critters crawling on your feet, especially at night. So, what are the causes for dry feet? Harsh soaps, certain clothing, long hot showers, low humidity in the environment, certain medications and even many medical problems including diabetes, poor nutrition, thyroid disorders, psoriasis and eczema.The skin has a coating of fatty substances called lipids that keep moisture in the skin which equates to soft, moist skin. So whatever the cause of the dry skin, the lipid content in the skin essentially is reduced which leaves the skin susceptible to becoming dry. The medical condition for dry skin is "Xerosis of the skin."If dry skin is left untreated, it can lead to dermatitis, which is dryness of the skin. This can in tern lead to infections and swelling of the skin. Despite the fact the external moisturizers are often the treatment for dry skin, they are often misused. Topical moisturizers must be applied to the dry skin when it is moist. Thus the best time to apply the topical moisturizers is after you dry off from a bath or a towel. Apply the moisturizer to your feet and let it soak in for a few minutes and then wipe off the excess. There are thousands of moisturizers available. However, some work better than others. Typically, the thicker the product the better. If the moisturizer runs off your hand after applying it, then it is not thick enough. Turning down the heat in your home can also help with dry skin since the indoor air will not be as dry. This in addition to using a humidifier and wearing extra clothing when you are outside during the winter months will help. Prolonged exposure to hot water can wash away the oils in your skin that help to keep moisture in. It is best to limit showering to only a few minutes and to turn the water temperature down. The water does not have to be ice cold, but luke warm water is advised over hot water. The use of body soap can also be a cause of dry skin since soaps can wash away body oils that help to keep your skin moist. Surprisingly, only certain parts of your body need to be washed with soap since on an average day, most people do not get that dirty. Soap does not need to be applied to your entire body daily. The only body parts that need to be washed with soap on a daily basis are the face, hands, feet, groin and underarms and the rest of the body can simply be rinsed with water. For dry skin care, it is helpful to purchase mild, fragrance free soaps. It is also not advised to wash your skin with harsh, abrasive implements. They are not needed and can be damaging to your skin. There are also medications that can cause dry skin. Some of the medications are used to treat other systemic conditions such as high blood pressure such as diuretics, allergy medications such as antihistamines and many medication to treat Acne. If you do notice that your skin is drying out after starting a new medication, ask your doctor that prescribed the medication. He or she may be able to recommend another drug to treat your condition.As one ages and the amount of hormones in the body changes, this can cause the skin to become dry. Also some people are genetically prone to developing dry skin. Despite the cause, dry skin can not only be unsightly, but also painful and can jeopardize the heal of not only the foot but also the person with the dry skin. But don't worry, it can be treated. At McKinney Foot and Ankle in McKinney, Texas and Advanced Foot and Ankle in Prosper, Texas, Dr. Eric Silvers and Dr. Kory Williams treat hundred of people every year for dry skin. We offer products such as Idonia, Lantiseptic Skin Protectant and Amerigel Lotion and have wonderful results. If you need to have your feet examined and treated for dry feet, visit Dr. Kory Williams and Dr. Eric Silvers of McKinney Foot and Ankle Center in McKinney , Texas or our Prosper, Texas Office, Advanced Foot and Ankle Center. Our doctors have extensive training and experience all types of foot and ankle problems. We strive for complete patient satisfaction and see patients from McKinney , Frisco, Allen, Anna, Prosper, Celina, Plano , Sherman , Denison , Durant , Oklahoma and surrounding communities. Dr. Silvers is a board certified foot and ankle specialist practicing in McKinney , Texas and Proper, Texas . He sees patients from North Dallas, McKinney , Plano , Allen, Prosper, Frisco, Melissa, Anna and Princeton , Texas .To Schedule an Appointment with Dr. Silvers, please call 972-542-2155 or visit our website at http://www.mckinneyfootcenter.com Dr. Kory Williams will be joining McKinney Foot and Ankle and Advanced Foot and Ankle in July of 2009. Both Dr. Silvers and Dr. Williams strive to deliver the utmost quality foot and ankle care with a compassionate bedside manner. Our doctors have 5 years of combined foot and ankle post graduate training and over 11 years of private practice experience. Both Dr. Silvers and Dr. Williams are respected speakers in the field of Podiatric Medicine, Surgery and Practice Management. Dr. Silvers is the Past President of the Dallas County Podiatric Medical Society.

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

McKinney Foot and Ankle Center ads New Podiatrist

Dr. Eric Silvers and the staff of McKinney Foot and Ankle Center in McKinney, Texas and Advanced Foot and Ankle in Prosper Texas are proud to introduce Dr. Kory Williams. Dr. Williams will be joining McKinney Foot and Ankle Center and Advanced Foot and Ankle in July of 2009. Dr. Williams has advanced training in foot and ankle surgery. He along with Dr. Silvers have extensive training in foot and ankle care including sharp stabbing heel pain often referred to as planter fasciitis or heel spurs, bunion deformities, repair of failed bunion surgery, hammer toe corrections, treatment of toe and foot injuries and foot lumps and tumors (tumours, tumers), ankle surgery including ankle stabilization surgery, repair of tendon ruptures or tears including Achilles Tendon tears and injuries. Both Dr. Silvers and Dr. Williams also offer conservative treatment of many foot and ankle conditions including plantar (planter warts) toenail fungus, athletes foot, toe and foot sores, gangrene to the toe or the foot, vascular problems, diabetic neuropathy. Both office offer radiofrequency treatment of foot and ankle conditions including heel spurs and plantar fasciitis that causes sharp shooting pain to the foot or the heel.

McKinney Foot and Ankle and Advanced Foot and Ankle in Prosper, Texas offer convenient office hours including daytime, same day, early morning, evening and lunchtime appointments. Please call 972-542-2155 to schedule an appointment or visit out website at www.mckinneyfootcenter.com to make a online appointment request. We look forward to seeing you.