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
Showing posts with label pain. Show all posts
Showing posts with label pain. Show all posts
Wednesday, January 6, 2010
Wednesday, March 25, 2009
McKinney Diabetic Specialist Discusses Foot Ulcers
Foot Ulcers: What To Do If You Have One
When using the term "ulcer", we are generally referring to a break or hole in the the skin. Ulcers are skin wounds can be slow to heal and are classified in four stages, according to which layers of skin are broken through. Stage 1 ulcers are characterized by a reddening over bony areas. The redness on the skin does not go away when pressure is relieved. The area is not an open sore, but the patient can be predisposed to having an ulcer at the site. Stage 2 ulcers are characterized by blisters, peeling or cracked skin. There is a partial thickness skin loss involving the superficial layers of the skin. Stage 3 ulcers are characterized by broken skin and sometimes bloody, watery, or creamy drainage. There is a usually complete loss of the skin along with some of the subcutaneous tissue, which includes the fat layer under the skin that holds the blood vessels and nerves.
Stage 4 ulcers are characterized by breaks in the skin involving skin, muscle, tendon and bone and are often associated with a bone infection called osteomyelitis.How an ulcer feels is dependent on the underlying cause of the ulcer. For example, one of the more common types of ulcers is seen in patients with diabetes, who have loss of sensation in their feet. In this type of ulcer, there is little if any pain, due to a condition called diabetic neuropathy. In fact, diabetics typically get this type of ulcer because they've lost their protective pain sensation. Another common ulcer is due to loss of arterial blood flow to the leg, resulting in ischemic ulcers that can be very painful. So you can see that it very important to have any break in the skin properly evaluated and the lack of pain is not always a good initiator as to the severity of the problem. There are many different diagnostic tests that can be done in the course of treating an ulcer. If the ulcer appears to be infected, and the patient has redness, drainage, swelling, and pain, then a culture of the wound should be done. The reason for the culture is to identify the type of infection, so that you can be put on the appropriate antibiotic. If there is suspicion of the bone being infected under the ulcer, the doctor will do x-rays and other imaging modalities to determine the extent of the infection. If there is suspicion that the underlying reason for the ulcer is poor blood flow, then a studies to look at you blood vessels can be done. Ulcers occur due to different reasons, so it is very important to determine the underlying medical problem that caused the ulcer. There are essentially four main reasons people get ulcers on the foot. Neuropathic Ulcers: This is when a patient has loss of sensation in the feet. It is commonly seen in people with diabetes but it can be caused by other reasons such as chronic alcohol abuse. These ulcers are generally seen under weight bearing areas and often will begin as a callus or a corn. Arterial Ulcers: This type of ulcer is due to poor blood flow to the lower extremity. This type of ulcer can be very painful and are usually found on the tips of toes, lower legs, ankle, heel and top of the foot. They can very easily become infected. Venous Stasis Ulcers: This type of ulcer is due to poor veins. Veins are the vessels that take fluid out of the legs and back up to the heart. Veins have small valves that allow blood to flow only one way, back up to the heart. The valves normally block the tendency for gravity to pull the blood back down to the legs. Sometimes the valves leak or cease to work at all. If the valves do not work, then the fluid pools down in the legs, causing swelling. This swelling leads to increase pressure in the venous system, producing discoloration of the leg and eventually this lead to ulceration. They are commonly seen around the inside of the ankle and are slow to heal. Decubitus Ulcers: This type of ulcer is caused by excessive prolonged pressure on one area of the foot. The most common place to see this type of ulcer is in a person confined to bed and they occur on the backs of the heels. The best thing you can do for an ulcer is to have it looked at by your doctor, as soon as you can. The earlier that the ulcer is treated, the better chance you have at healing it.The first thing that will be done is to inspect the wound. The doctor is looking for signs of infection, location of the wound, the color of the tissue in the wound. This is all done to determine the best treatment for that wound. Once the cause of the ulcer is determined and all the necessary referrals are made, treatment of the ulcer can begin. The treatment will be tailored to the individual ulcer and it is often difficult to predict how long it will take an ulcer to heal. Sometimes patients have to be referred to a vascular specialist if the ulcer is due to poor blood flow. Sometimes a patient has to be sent to their diabetes doctor to get their blood sugars controlled. It takes a careful thought process by the podiatrist to determine the underlying etiology of the ulcer and point the patient in the right direction.
The best prevention is treating the underlying cause of the ulcer. That means if you are a diabetic, check your blood sugar daily and inspect your feet every day. If the reason for your ulcer is due to swelling in the legs, then you need to wear support stockings and keep your feet elevated as much as possible. If the ulcer is due to poor blood flow, treatment may be rendered to get more blood flow and oxygen to your feet. If the ulcer is due to pressure, finding ways to relieve that pressure is required.
Dr. Eric Silvers and Dr. Kory Williams see ulcerations daily and are well trained to treat all foot and ankle conditions. They can be reached at 972-542-2155 or you may visit our website at http://www.advancedfoottexas
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
When using the term "ulcer", we are generally referring to a break or hole in the the skin. Ulcers are skin wounds can be slow to heal and are classified in four stages, according to which layers of skin are broken through. Stage 1 ulcers are characterized by a reddening over bony areas. The redness on the skin does not go away when pressure is relieved. The area is not an open sore, but the patient can be predisposed to having an ulcer at the site. Stage 2 ulcers are characterized by blisters, peeling or cracked skin. There is a partial thickness skin loss involving the superficial layers of the skin. Stage 3 ulcers are characterized by broken skin and sometimes bloody, watery, or creamy drainage. There is a usually complete loss of the skin along with some of the subcutaneous tissue, which includes the fat layer under the skin that holds the blood vessels and nerves.
Stage 4 ulcers are characterized by breaks in the skin involving skin, muscle, tendon and bone and are often associated with a bone infection called osteomyelitis.How an ulcer feels is dependent on the underlying cause of the ulcer. For example, one of the more common types of ulcers is seen in patients with diabetes, who have loss of sensation in their feet. In this type of ulcer, there is little if any pain, due to a condition called diabetic neuropathy. In fact, diabetics typically get this type of ulcer because they've lost their protective pain sensation. Another common ulcer is due to loss of arterial blood flow to the leg, resulting in ischemic ulcers that can be very painful. So you can see that it very important to have any break in the skin properly evaluated and the lack of pain is not always a good initiator as to the severity of the problem. There are many different diagnostic tests that can be done in the course of treating an ulcer. If the ulcer appears to be infected, and the patient has redness, drainage, swelling, and pain, then a culture of the wound should be done. The reason for the culture is to identify the type of infection, so that you can be put on the appropriate antibiotic. If there is suspicion of the bone being infected under the ulcer, the doctor will do x-rays and other imaging modalities to determine the extent of the infection. If there is suspicion that the underlying reason for the ulcer is poor blood flow, then a studies to look at you blood vessels can be done. Ulcers occur due to different reasons, so it is very important to determine the underlying medical problem that caused the ulcer. There are essentially four main reasons people get ulcers on the foot. Neuropathic Ulcers: This is when a patient has loss of sensation in the feet. It is commonly seen in people with diabetes but it can be caused by other reasons such as chronic alcohol abuse. These ulcers are generally seen under weight bearing areas and often will begin as a callus or a corn. Arterial Ulcers: This type of ulcer is due to poor blood flow to the lower extremity. This type of ulcer can be very painful and are usually found on the tips of toes, lower legs, ankle, heel and top of the foot. They can very easily become infected. Venous Stasis Ulcers: This type of ulcer is due to poor veins. Veins are the vessels that take fluid out of the legs and back up to the heart. Veins have small valves that allow blood to flow only one way, back up to the heart. The valves normally block the tendency for gravity to pull the blood back down to the legs. Sometimes the valves leak or cease to work at all. If the valves do not work, then the fluid pools down in the legs, causing swelling. This swelling leads to increase pressure in the venous system, producing discoloration of the leg and eventually this lead to ulceration. They are commonly seen around the inside of the ankle and are slow to heal. Decubitus Ulcers: This type of ulcer is caused by excessive prolonged pressure on one area of the foot. The most common place to see this type of ulcer is in a person confined to bed and they occur on the backs of the heels. The best thing you can do for an ulcer is to have it looked at by your doctor, as soon as you can. The earlier that the ulcer is treated, the better chance you have at healing it.The first thing that will be done is to inspect the wound. The doctor is looking for signs of infection, location of the wound, the color of the tissue in the wound. This is all done to determine the best treatment for that wound. Once the cause of the ulcer is determined and all the necessary referrals are made, treatment of the ulcer can begin. The treatment will be tailored to the individual ulcer and it is often difficult to predict how long it will take an ulcer to heal. Sometimes patients have to be referred to a vascular specialist if the ulcer is due to poor blood flow. Sometimes a patient has to be sent to their diabetes doctor to get their blood sugars controlled. It takes a careful thought process by the podiatrist to determine the underlying etiology of the ulcer and point the patient in the right direction.
The best prevention is treating the underlying cause of the ulcer. That means if you are a diabetic, check your blood sugar daily and inspect your feet every day. If the reason for your ulcer is due to swelling in the legs, then you need to wear support stockings and keep your feet elevated as much as possible. If the ulcer is due to poor blood flow, treatment may be rendered to get more blood flow and oxygen to your feet. If the ulcer is due to pressure, finding ways to relieve that pressure is required.
Dr. Eric Silvers and Dr. Kory Williams see ulcerations daily and are well trained to treat all foot and ankle conditions. They can be reached at 972-542-2155 or you may visit our website at http://www.advancedfoottexas
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
Wednesday, February 4, 2009
McKinney Foot Doctor Discusses Toe Injuries
Injuries to the Toes
Injuries to the great toe or lesser digits (2nd, 3rd, 4th and 5th toes) are quite common. These injuries range from a simple stub of a toe on a piece of furnature to traumatic injuries including machinery injuries and gun shot wounds. Most injuries include fractures most often involving the lesser toes. Fractures to toes can be treated and the injured individual is advised to seek medical attention. If the fracture to lesser digit is in good alignment, then simple buddy splinting along with a rigid soled shoe is often the standard treatment protocol. If the lesser digital fracture is displaced, closed reduction many times can be carried out after the toe is put to sleep using a local anesthetic. Using distraction (pulling on the toe) the fracture many times can be reduced. Sometimes surgical reduction of lesser toe fractures is required utilising reduction and pinning of the toe. Fractures to the large toes (first toe, big toe) are much more serious. The big toe serves many functions including balance and with walking. There are two larger muscles that attach to the the big to via tendons. Because of these tendons, it is important for those people who have a big toe fracture to many times be placed in a below the knee walking cast or boot. Displaced (shifted) fractures of the big toe often have to be realigned using closed reduction (manipulation) or surgical reduction with pinning, screws and/or plates. It is very important to have a big toe injury treated by a qualified podiatric physician and surgeon.Sporting injuries to the big toe and lesser toes are also very common. This can include toe fractures, joint dislocations and and tendon ruptures. Prompt diagnosis and treatment is important for the quickest recovery and return to function. Traumatic toe injuries from machinery (warehouse, power equipment or farm injuries to the foot) are often very serious. Immediate medical attention is required to reduce the risk of toe and/or foot loss from damage to foot blood vessels and/or infection. One should seek immediate medical attention at a local emergency room or urgent care center. Blunt trauma to the big toe or lesser toes should also be evaluated in a timely fashion. Often times blood will collect under the toenail plate (subungual hematoma). This can cause prolonged pain and increase the risk to infection to toe. The skin under the toenail (nail bed) can be damaged from blunt trauma (injury) to the toe. If the nail bed is injured (lacerated) prompt repair is advised to reduce the risk of infection. Injury to the toenail plate and the nail bed often results in long term damage to the toenail not to mention toenail loss (toenail falling off) shortly after the injury. As the nail grows back, it is not uncommon for the toenial to be mishaped, thick and/or yellow. Toenail fungal infections are often acquired by trauma to the toenail and toes. Prompt diagnosis and treatment is of utmost importance for the best recovery.Dr. Eric Silvers is a board certified foot and ankle specialist practicing in McKinney, Texas and Prosper, Texas. His office phone number is 972-542-2155 and the office Website is www.advancedfoottexas.com. Same day appointments are often available. Dr. Silvers e-mail is drericsilvers@gmail.com
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
Injuries to the great toe or lesser digits (2nd, 3rd, 4th and 5th toes) are quite common. These injuries range from a simple stub of a toe on a piece of furnature to traumatic injuries including machinery injuries and gun shot wounds. Most injuries include fractures most often involving the lesser toes. Fractures to toes can be treated and the injured individual is advised to seek medical attention. If the fracture to lesser digit is in good alignment, then simple buddy splinting along with a rigid soled shoe is often the standard treatment protocol. If the lesser digital fracture is displaced, closed reduction many times can be carried out after the toe is put to sleep using a local anesthetic. Using distraction (pulling on the toe) the fracture many times can be reduced. Sometimes surgical reduction of lesser toe fractures is required utilising reduction and pinning of the toe. Fractures to the large toes (first toe, big toe) are much more serious. The big toe serves many functions including balance and with walking. There are two larger muscles that attach to the the big to via tendons. Because of these tendons, it is important for those people who have a big toe fracture to many times be placed in a below the knee walking cast or boot. Displaced (shifted) fractures of the big toe often have to be realigned using closed reduction (manipulation) or surgical reduction with pinning, screws and/or plates. It is very important to have a big toe injury treated by a qualified podiatric physician and surgeon.Sporting injuries to the big toe and lesser toes are also very common. This can include toe fractures, joint dislocations and and tendon ruptures. Prompt diagnosis and treatment is important for the quickest recovery and return to function. Traumatic toe injuries from machinery (warehouse, power equipment or farm injuries to the foot) are often very serious. Immediate medical attention is required to reduce the risk of toe and/or foot loss from damage to foot blood vessels and/or infection. One should seek immediate medical attention at a local emergency room or urgent care center. Blunt trauma to the big toe or lesser toes should also be evaluated in a timely fashion. Often times blood will collect under the toenail plate (subungual hematoma). This can cause prolonged pain and increase the risk to infection to toe. The skin under the toenail (nail bed) can be damaged from blunt trauma (injury) to the toe. If the nail bed is injured (lacerated) prompt repair is advised to reduce the risk of infection. Injury to the toenail plate and the nail bed often results in long term damage to the toenail not to mention toenail loss (toenail falling off) shortly after the injury. As the nail grows back, it is not uncommon for the toenial to be mishaped, thick and/or yellow. Toenail fungal infections are often acquired by trauma to the toenail and toes. Prompt diagnosis and treatment is of utmost importance for the best recovery.Dr. Eric Silvers is a board certified foot and ankle specialist practicing in McKinney, Texas and Prosper, Texas. His office phone number is 972-542-2155 and the office Website is www.advancedfoottexas.com. Same day appointments are often available. Dr. Silvers e-mail is drericsilvers@gmail.com
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
Thursday, November 13, 2008
Dr. Silvers to open a Prosper, Texas Location
Dr. Eric Silvers of McKinney Foot and Ankle Center will be opening a second office in Prosper, Texas the early part of 2009. Dr. Silvers is a board certified foot and ankle specialist and has been in practice for over 11 years. He serves communities in Collin County including Prosper, McKinney, Plano, Allen, Anna, Melissa, Frisco and Princeton Texas. Dr. Silvers treats all ages from infants to geriatrics with foot and ankle conditions. Some conditions include heel and arch pain as a result of plantar fasciitis, injuries to the foot and ankle including running injuries, fractures and wound care to the foot and ankle, bunions, plantar warts, shin splints, Achilles tendinitis and tendon ruptures, ingrown and fungal toenails, just to name a few. Dr. Silvers will still maintain his main location in McKinney, Texas.To schedule an appointment with Dr. Silvers please call McKinney Foot and Ankle Center at 972-542-2155 or visit our website at www.mckinneyfootcenter.com.
Wednesday, November 12, 2008
McKinney Texas Foot and Ankle Specialist
What Can a Podiatrist Do About Foot Pain?
Let’s start at the beginning and answer the question, “What is a Podiatrist?”
A podiatrist is a specialist who focuses on your feet and ankles. We are quite simply “The Experts” on your feet and ankles and should be the very first doctor you call when you experience pain or other problems with them. I’ve listed many of the foot problems podiatrists treat in this book.
The DPM after our name stands for Doctor of Podiatric Medicine. Most people know that podiatrists deal with foot and ankle problems and work with seniors, or diabetics, or people with poor circulation; but what most people don’t know is that podiatrists treat patients of all ages. A podiatrist is also well-qualified to help children and young adults with the problems that they can experience with their feet and ankles.
Podiatrists are required, just like any other doctor, to be licensed by the state in which they practice. When medically necessary, podiatrists can perform surgery to correct or remedy problems. Before we recommend surgery, we will explore the many conservative therapies and remedies that are available for our patients and then recommend the very best course of treatment. As medical science advances and new therapies become available to the public, podiatrists are increasingly able to offer their patients some of the most state-of-the-art care available. I’m constantly amazed at the new therapies I can offer my patients and will discuss several of them now.
Conservative Foot Care
Also known as non-surgical treatment, conservative foot care is being used to treat many foot problems with dramatic results. Any initial visit to a podiatrist’s office will start with a patient history and physical examination. Diagnostic x-rays and laboratory tests can also be used to help determine the best course of treatment.
Non-surgical treatments may be called for in many cases including medical conditions which preclude the option of elective surgery, time commitment constraints, and elderly patients with many medical conditions. Patients with arthritis, diabetes, and circulatory foot problems may all be helped by non-surgical treatments. In spite of not being able to opt for foot surgery many patients find great relief from pain and discomfort through the use of conservative foot care treatments.
There are a wide variety of non-surgical treatments being used by podiatrists today. Injections, oral and topical medications, and foot, ankle, or toe strappings are all examples of conservative foot care. Other options are exercise, custom-made walking shoes, and orthotics. Additional treatments prescribed by podiatrists include physical therapy, foot massage, trimming of corns and calluses, and proper nail trimming and foot care. Visit our website at http://www.mckinneyfootcenter.com/.
Dr. Silvers is a board certified foot and ankle physician practicing in McKinney, Texas.
Let’s start at the beginning and answer the question, “What is a Podiatrist?”
A podiatrist is a specialist who focuses on your feet and ankles. We are quite simply “The Experts” on your feet and ankles and should be the very first doctor you call when you experience pain or other problems with them. I’ve listed many of the foot problems podiatrists treat in this book.
The DPM after our name stands for Doctor of Podiatric Medicine. Most people know that podiatrists deal with foot and ankle problems and work with seniors, or diabetics, or people with poor circulation; but what most people don’t know is that podiatrists treat patients of all ages. A podiatrist is also well-qualified to help children and young adults with the problems that they can experience with their feet and ankles.
Podiatrists are required, just like any other doctor, to be licensed by the state in which they practice. When medically necessary, podiatrists can perform surgery to correct or remedy problems. Before we recommend surgery, we will explore the many conservative therapies and remedies that are available for our patients and then recommend the very best course of treatment. As medical science advances and new therapies become available to the public, podiatrists are increasingly able to offer their patients some of the most state-of-the-art care available. I’m constantly amazed at the new therapies I can offer my patients and will discuss several of them now.
Conservative Foot Care
Also known as non-surgical treatment, conservative foot care is being used to treat many foot problems with dramatic results. Any initial visit to a podiatrist’s office will start with a patient history and physical examination. Diagnostic x-rays and laboratory tests can also be used to help determine the best course of treatment.
Non-surgical treatments may be called for in many cases including medical conditions which preclude the option of elective surgery, time commitment constraints, and elderly patients with many medical conditions. Patients with arthritis, diabetes, and circulatory foot problems may all be helped by non-surgical treatments. In spite of not being able to opt for foot surgery many patients find great relief from pain and discomfort through the use of conservative foot care treatments.
There are a wide variety of non-surgical treatments being used by podiatrists today. Injections, oral and topical medications, and foot, ankle, or toe strappings are all examples of conservative foot care. Other options are exercise, custom-made walking shoes, and orthotics. Additional treatments prescribed by podiatrists include physical therapy, foot massage, trimming of corns and calluses, and proper nail trimming and foot care. Visit our website at http://www.mckinneyfootcenter.com/.
Dr. Silvers is a board certified foot and ankle physician practicing in McKinney, Texas.
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