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Dr. Spriro is a Participating Provider with the Beth Israel Lahey Physicians Organization

November 2021

Tuesday, 30 November 2021 00:00

Everything You Need to Know About Gout

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

Tuesday, 30 November 2021 00:00

Gout May Be Causing Pain in Your Big Toe

If you suffer from sudden pain, swelling, tenderness, heat, and stiffness in the joint of your big toe, you may have gout. This condition is an inflammatory form of arthritis where excess uric acid forms hardened crystals in the joints. The big toe is usually where gout occurs. People most at risk of developing gout are those with diabetes, hypertension, obesity, kidney dysfunction, or a genetic predisposition to it. Some believe that eating foods that are rich in purines can also contribute to gout’s formation in a person’s body. Uric acid is a byproduct of the body’s process of breaking down purines. People who suspect they have gout should consult with a podiatrist who can not only diagnose the condition, but help manage pain with anti-inflammatory medicine, make dietary recommendations, and even remove uric crystals in severe cases.

Gout is a painful condition that can be treated. If you are seeking treatment, contact one of our podiatrists from Boston Common Podiatry. Our doctors will treat your foot and ankle needs.

What Is Gout?

Gout is a form of arthritis that is characterized by sudden, severe attacks of pain, redness, and tenderness in the joints. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep.

Symptoms

  • Intense Joint Pain - Usually around the large joint of your big toe, and it most severe within the first four to twelve hours
  • Lingering Discomfort - Joint discomfort may last from a few days to a few weeks
  • Inflammation and Redness -Affected joints may become swollen, tender, warm and red
  • Limited Range of Motion - May experience a decrease in joint mobility

Risk Factors

  • Genetics - If family members have gout, you’re more likely to have it
  • Medications - Diuretic medications can raise uric acid levels
  • Gender/Age - Gout is more common in men until the age of 60. It is believed that estrogen protects women until that point
  • Diet - Eating red meat and shellfish increases your risk
  • Alcohol - Having more than two alcoholic drinks per day increases your risk
  • Obesity - Obese people are at a higher risk for gout

Prior to visiting your podiatrist to receive treatment for gout, there are a few things you should do beforehand. If you have gout you should write down your symptoms--including when they started and how often you experience them, important medical information you may have, and any questions you may have. Writing down these three things will help your podiatrist in assessing your specific situation so that he or she may provide the best route of treatment for you.

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

Read more about Everything You Need to Know About Gout
Tuesday, 23 November 2021 00:00

Ankle Sprains

Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over the counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain is occurring over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.

Tuesday, 23 November 2021 00:00

What Can Be Done to Treat an Ankle Sprain?

Ankle sprains can occur when one or more ligaments in the ankle are overstretched or torn, usually due to a sudden, twisting injury of the ankle. Sprains can range from mild to severe, but in all cases, a full recovery is vital to prevent future ankle injuries. For all ankle sprains, it is important to protect the sprained ankle from further injury by resting it. Applying ice, compressing, and elevating the injured ankle can help reduce swelling and inflammation. Taking over-the-counter anti-inflammatory drugs can be useful for pain management. Gentle stretching and strengthening exercises can help during the recovery process as well. Moderate to severe sprains will usually require further treatments to ensure proper healing. These may include footwear modifications, wearing orthotics, going to physical therapy, wearing an ankle brace or support, and in particularly severe cases, undergoing surgery to repair a torn ligament. If you have sprained your ankle, it is suggested that you seek the care of a podiatrist. 

Although ankle sprains are common, they aren’t always minor injuries. If you need your ankle injury looked at, contact one of our podiatrists from Boston Common Podiatry. Our doctors can provide the care you need to keep you pain-free and on your feet.

How Does an Ankle Sprain Occur?

Ankle sprains are the result of a tear in the ligaments within the ankle. These injuries may happen when you make a rapid shifting movement while your foot is planted. A less common way to sprain your ankle is when your ankle rolls inward while your foot turns outward.

What Are the Symptoms?

  • Pain at the sight of the tear
  • Bruising/Swelling
  • Ankle area is tender to touch
  • In severe cases, may hear/feel something tear
  • Skin discoloration

Preventing a Sprain

  • Wearing appropriate shoes for the occasion
  • Stretching before exercises and sports
  • Knowing your limits

Treatment of a Sprain

In many cases, the RICE method (Rest, Ice, Compression, and Elevate) is used to treat ankle sprains. However, you should see a podiatrist to see which treatment option would work best with your injury. In severe cases, surgery may be required.

It is important to ask your doctor about rehab options after you receive treatment for your injury. Stretching, strength training, and balance exercises may help the ankle heal while also preventing further injury.

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

Read more about Ankle Sprains
Tuesday, 16 November 2021 00:00

Treating Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Tuesday, 16 November 2021 00:00

Posterior Tibial Nerve Neuralgia

Posterior tibial nerve neuralgia, also known as tarsal tunnel syndrome, is a nerve disorder that is caused by compression of the posterior tibial nerve. This nerve runs through the tarsal tunnel, an area along the inside of the ankle that houses nerves, blood vessels, and tendons. When the posterior tibial nerve is compressed, it causes symptoms such as foot, ankle, and toe pain, a pins and needles sensation in the foot, and numbness. Conservative treatments such as resting and icing the foot, wearing orthotics, and taking pain medications can help relieve symptoms. For more information about tarsal tunnel syndrome and to discover the best course of treatment for you, please consult with a podiatrist. 

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact one of our podiatrists of Boston Common Podiatry. Our doctors can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

  • Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
  • If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

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

Read more about Treating Tarsal Tunnel Syndrome
Monday, 15 November 2021 00:00

Do Your Child's Feet Hurt?

Have your child's feet been examined lately? Healthy feet are happy feet. If your child is complaining of foot pain, it may be a sign of underlying problems.

Tuesday, 09 November 2021 00:00

Plantar Fasciitis

The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.

Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.

Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.

For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.

No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.

 

The band of tissue on the bottom of the foot, called the plantar fascia, plays a very important role in your body. It attaches the front of the foot to the heel bone, absorbs the body’s weight and pressure during movement, and  supports the arch. There are a number of conditions or situations that overly stress the plantar fascia. Included are obesity, age, pregnancy, standing for prolonged periods of time, physical activities that strain the heel, or having high arches, flat feet and other conditions that cause you to over-pronate (roll your foot inwardly as you move). This excessive stress on the plantar fascia can irritate it or even tear it, causing it to become inflamed and painful. Podiatrists have a great deal of experience in treating plantar fasciitis as it is the leading cause of heel pain. A podiatrist may use tests such as an MRI, X-ray or ultrasound to properly diagnose plantar fasciitis and rule out other ailments that also cause heel pain. Other methods a podiatrist may use to reduce pain and treat plantar fasciitis include physical therapy, night splints that gently stretch the plantar fascia, orthotics that correct can help distribute weight more evenly, steroids to reduce inflammation and pain, and shock wave therapy that initiates the body’s healing response. In severe cases, surgery may be needed to help remove scar tissue or release tension and swelling. If you are experiencing any kind of heel pain, have it checked out by a podiatrist for proper diagnosis and treatment.

Plantar fasciitis can be very painful and inconvenient. If you are experiencing heel pain or symptoms of plantar fasciitis, contact one of our podiatrists  from Boston Common Podiatry. Our doctors can provide the care you need to keep you pain-free and on your feet.

What Is Plantar Fasciitis?

Plantar fasciitis is the inflammation of the thick band of tissue that runs along the bottom of your foot, known as the plantar fascia, and causes mild to severe heel pain.

What Causes Plantar Fasciitis?

  • Excessive running
  • Non-supportive shoes
  • Overpronation
  • Repeated stretching and tearing of the plantar fascia

How Can It Be Treated?

  • Conservative measures – anti-inflammatories, ice packs, stretching exercises, physical therapy, orthotic devices
  • Shockwave therapy – sound waves are sent to the affected area to facilitate healing and are usually used for chronic cases of plantar fasciitis
  • Surgery – usually only used as a last resort when all else fails. The plantar fascia can be surgically detached from the heel

While very treatable, plantar fasciitis is definitely not something that should be ignored. Especially in severe cases, speaking to your doctor right away is highly recommended to avoid complications and severe heel pain. Your podiatrist can work with you to provide the appropriate treatment options tailored to your condition.

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

Read more about Plantar Fasciitis
Tuesday, 02 November 2021 00:00

Sever's Disease

Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.

Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.

Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.

Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.

If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.

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