
Gout Demystified

Gout is an inflammatory arthritis that occurs due to excess buildup of uric acid crystals that settle in joints and soft tissue. When the body breaks down the naturally occurring substance in the body and from certain foods, called purines, it produces uric acid. Usually, the kidneys excrete excess uric acid through the urine, but if not enough is expelled, it can cause gout. This affliction often begins in the big toe, but it can also affect the heel of the foot. This affliction causes inflammation, pain, and joint stiffness. Some experiencing gout might notice swelling and discoloration of the affected joint. Gout attacks happen unexpectedly, often in the nighttime, and can be intensely painful. It is said that the pain can be so severe that it can be hard to endure the weight of a blanket. A flare can last from a few days to weeks. Gout can be inherited, but males, women of postmenopausal age, those on certain medications, like diuretics, or having other medical conditions, such as diabetes or high blood pressure, are more likely to experience gout. Those who are overweight or eat diets rich in purines, like seafood, red meat, and alcohol, can be at a higher risk of gout as well. If you have extreme pain in your foot, it is strongly suggested that you see a podiatrist for an examination, proper diagnosis, and treatment to help you regain comfort.
Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact Patrick Bruton, DPM from Big Country foot and Ankle. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.
People typically get gout because of a poor diet. Genetic predisposition is also a factor. The children of parents who have had gout frequently have a chance of developing it themselves.
Gout can easily be identified by redness and inflammation of the big toe and the surrounding areas of the foot. Other symptoms include extreme fatigue, joint pain, and running high fevers. Sometimes corticosteroid drugs can be prescribed to treat gout, but the best way to combat this disease is to get more exercise and eat a better diet.
If you have any questions please feel free to contact our offices located in Abilene, and Brownwood, TX . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
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.
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.
Wounds That Don't Heal Need to Be Checked
Simple Steps for Diabetic Foot Care

Practicing good diabetic foot care is essential for maintaining proper foot health. Having elevated glucose levels in the blood can lead to developing diabetes, and the feet are often affected. Research has shown that approximately half of diabetic patients have nerve damage, which is the inability to feel existing cuts, bruises, or scrapes that are on the feet. A foot care routine can begin with washing and drying the feet, followed by inspecting the soles of the feet for any abnormalities. This can be done by using a mirror, or a family member or caregiver may be able to help. Effective foot care tips can include following a healthy eating plan, engaging in a gentle exercise program, and refraining from smoking, if applicable. It is important to wear shoes while walking inside or outdoors, in addition to trimming the toenails straight across. If you have diabetes, it is strongly suggested that you confer with a podiatrist who can help you to manage this serious condition.
Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact Patrick Bruton, DPM from Big Country foot and Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
Diabetic Foot Care
Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.
The Importance of Caring for Your Feet
- Routinely inspect your feet for bruises or sores.
- Wear socks that fit your feet comfortably.
- Wear comfortable shoes that provide adequate support.
Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.
It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.
If you have any questions please feel free to contact our offices located in Abilene, and Brownwood, TX . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Diabetic Foot Conditions
Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough. The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.
Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.
Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.
Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.
If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.
Various Types of Bunions

Research has shown that bunions are the most common medical condition that affects the front of the foot. It is easy to notice by the large bump that develops and protrudes on the side of the big toe. Severe bunions may cause the other toes to shift together, and larger shoes may need to be purchased. A bunion is considered to be a deformity and can happen from wearing shoes that do not have ample room for the toes to move freely in. High heels can fit into this category, and it is helpful to limit how frequently they are worn. There are various types of bunions, and a simple bunion is a bump on the side of the big toe joint. The same bunion may have skin irritation from rubbing against the shoes and a tailor’s bunion forms on the pinky toe. Bunions with hallux limitus can change the structure of the foot, which may cause the bunion to form on the top instead of on the side of the foot. Some people can help to wear a protective pad over the bunion for mild relief. If you have a bunion, it is strongly suggested that you visit a podiatrist who can offer you treatment options that are correct for you.
If you are suffering from bunion pain, contact Patrick Bruton, DPM of Big Country foot and Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is a Bunion?
Bunions are painful bony bumps that usually develop on the inside of the foot at the joint of the big toe. As the deformity increases over time, it may become painful to walk and wear shoes. Women are more likely to exacerbate existing bunions since they often wear tight, narrow shoes that shift their toes together. Bunion pain can be relieved by wearing wider shoes with enough room for the toes.
Causes
- Genetics – some people inherit feet that are more prone to bunion development
- Inflammatory Conditions - rheumatoid arthritis and polio may cause bunion development
Symptoms
- Redness and inflammation
- Pain and tenderness
- Callus or corns on the bump
- Restricted motion in the big toe
In order to diagnose your bunion, your podiatrist may ask about your medical history, symptoms, and general health. Your doctor might also order an x-ray to take a closer look at your feet. Nonsurgical treatment options include orthotics, padding, icing, changes in footwear, and medication. If nonsurgical treatments don’t alleviate your bunion pain, surgery may be necessary.
If you have any questions, please feel free to contact our offices located in Abilene, and Brownwood, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Bunions
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.
Foot Shuffling

Foot shuffling is when someone takes shorter strides and drags their feet when walking. Consistent shuffling can be a sign of an underlying health issue related to the nervous system, joints, or muscles. The most common neurological condition causing a shuffling gait is Parkinson’s disease. Foot shuffling can also come on from foot drop. This is when there is a difficulty or inability to lift the foot while taking a step. This condition can be caused by multiple sclerosis, peripheral neuropathy, or stroke, among other things. As one ages, the gait can change with decreased walking speed and range of motion in the ankles, knees, and hips, as well as impaired foot clearance. When the joints of the legs are tight or there is muscle weakness from injuries, health conditions like arthritis, or long periods of inactivity, a shuffling gait can also happen. Stretching and strengthening exercises, balancing activities, and orthotics can help, as well as assistive devices like a walker or cane. If you have a shuffling gait, it is strongly suggested that you see a podiatrist to help identify the underlying cause and devise an appropriate treatment plan individualized to your needs.
If you have any concerns about your feet, contact Patrick Bruton, DPM from Big Country foot and Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.
A History of Biomechanics
- Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
- In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.
Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.
Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.
If you have any questions please feel free to contact our offices located in Abilene, and Brownwood, TX . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
The Importance of Biomechanics in Podiatry
Biomechanics and its related study deal with the forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
Biomechanics and its related study deal with forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root founded Root Lab to make custom orthotics. He proposed that corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of foot orthotics to this day.
As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can take readings and also map out what treatment will do to the affected areas.
These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics are able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot. Speak with your podiatrist if you have any of these problems.