
Stages of Gout

Gout is a type of joint problem caused by the formation of tiny crystals. It happens when your body makes too much uric acid, or your kidneys do not get rid of it efficiently. This uric acid is a leftover from breaking down certain foods. When uric acid levels get too high, it turns into crystals that cannot dissolve and remain in your tissues, causing inflammation. Your body's defense cells try to absorb these crystals, but they may become damaged as a result of how sharp they are. Gout is more common in men and often shows up after age 30 or in women after menopause. Gout has four stages. The first stage involves high uric acid with no symptoms. The second stage includes painful joint attacks The third stage is generally pain-free periods between attacks. The fourth stage consists of severe gout with lumpy deposits that are known as tophi. During a gout attack, you will experience severe pain, redness, swelling, and warmth in the joint. The big toe is a common spot for gout, and over time, untreated gout can harm your joints. In severe cases, surgery may be needed if the joint damage is extensive. Gout can be diagnosed by examining joint fluid or having X-rays taken. If you believe you have gout, it is suggested that you schedule an appointment with a podiatrist for a proper diagnosis and treatment.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor 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 offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Gout
Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men.
Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.
People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.
Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.
Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.
To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks.
What Are the Symptoms of Athlete’s Foot?

Athlete's foot, a common fungal infection, unveils a set of unmistakable symptoms that can cause considerable discomfort. The most prevalent sign is persistent itching, often concentrated between the toes. This itching is accompanied by redness and a burning sensation, creating an overall sense of irritation. The skin may peel, crack, or exhibit a scaly appearance, particularly on the soles of the feet. Blisters may also develop, adding another layer of discomfort to this fungal predicament. Foul odor emanating from the infected feet is not uncommon, as the fungus thrives in warm, moist environments. Athlete's foot can spread to the toenails, causing them to thicken and become discolored. Recognizing these symptoms is essential for seeking timely intervention. If you have developed athlete’s foot, it is strongly suggested that you contact a podiatrist. This type of doctor can offer you correct treatment solutions, which may include prescribed medicine.
Athlete’s Foot
Athlete’s foot is often an uncomfortable condition to experience. Thankfully, podiatrists specialize in treating athlete’s foot and offer the best treatment options. If you have any questions about athlete’s foot, consult with Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor will assess your condition and provide you with quality treatment.
What Is Athlete’s Foot?
Tinea pedis, more commonly known as athlete’s foot, is a non-serious and common fungal infection of the foot. Athlete’s foot is contagious and can be contracted by touching someone who has it or infected surfaces. The most common places contaminated by it are public showers, locker rooms, and swimming pools. Once contracted, it grows on feet that are left inside moist, dark, and warm shoes and socks.
Prevention
The most effective ways to prevent athlete’s foot include:
- Thoroughly washing and drying feet
- Avoid going barefoot in locker rooms and public showers
- Using shower shoes in public showers
- Wearing socks that allow the feet to breathe
- Changing socks and shoes frequently if you sweat a lot
Symptoms
Athlete’s foot initially occurs as a rash between the toes. However, if left undiagnosed, it can spread to the sides and bottom of the feet, toenails, and if touched by hand, the hands themselves. Symptoms include:
- Redness
- Burning
- Itching
- Scaly and peeling skin
Diagnosis and Treatment
Diagnosis is quick and easy. Skin samples will be taken and either viewed under a microscope or sent to a lab for testing. Sometimes, a podiatrist can diagnose it based on simply looking at it. Once confirmed, treatment options include oral and topical antifungal medications.
If you have any questions, please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot care needs.
How to Deal with Athlete's Foot
Athlete’s foot is a type of fungal infection that affects the skin on the feet. It is caused when the tinea fungus grows on the foot. It is possible to catch the fungus through direct contact with someone who has it or by touching a surface that is contaminated with it. This type of fungus thrives in warm, moist environments such as showers, locker room floors, and swimming pools. Your risk of getting it may also increase by wearing tight-fitting, closed-toe shoes, or by having sweaty feet.
Symptoms of athlete’s foot include itching, stinging or burning sensations between the toes. You may also experience toenails that are discolored, thick, crumbly, or toenails that pull away from the nail bed.
Your podiatrist may diagnose athlete’s foot by detecting these symptoms or by doing a skin test to see if there is a fungal infection present. The most common exam used to detect Athlete’s foot is a skin lesion potassium hydroxide exam. To use this method, your doctor will scrape off a small area of the infected skin and place it into potassium hydroxide. The potassium hydroxide will destroy the normal cells and leave the fungal cells untouched so that they are visible under a microscope.
There are a variety of treatment options for athlete’s foot. Some medications are miconazole (Desenex), terbinafine (Lamisil AT), clotrimazole (Lotrimin AF), butenafine (Lotrimin Ultra), and tolnaftate (Tinactin). While these options may be able to treat your fungus, it is best that you consult with a podiatrist in order to see which treatment option may work best for you.
In some cases, Athlete’s foot may lead to complications. A severe complication would be a secondary bacterial infection which may cause your foot to become swollen, painful, and hot.
There are ways that you can prevent athlete’s foot. Washing your feet with soap and water each day and drying them thoroughly is an effective way to prevent infections. You also shouldn’t share socks, shoes, or towels with other people. It is crucial that you wear shower sandals in public showers, around swimming pools, and in other public places. Additionally, you should make sure you wear shoes that can breathe and change your socks when your feet become sweaty. If you suspect that you have Athlete’s foot, you should seek help from a podiatrist as soon as possible.
The Serious Nature of Diabetic Foot Problems

Serious foot infections in diabetic individuals pose significant health risks and often lead to amputations and even death. These infections are a concerning complication of diabetes and require careful attention. They can be caused by various factors, including poor blood sugar control, reduced blood flow, and nerve damage in the feet. In diabetic foot infections, bacteria can enter through minor cuts or sores, leading to cellulitis, abscesses, or even gangrene. Early detection and prompt treatment are crucial to prevent severe complications. Common symptoms include redness, warmth, swelling, and pain in the affected foot. Treatment typically involves antibiotics, wound care, and in some cases, surgical intervention to remove infected tissue and improve blood flow. Diabetic patients must take special precautions to prevent foot infections, such as daily foot inspections, proper hygiene, wearing well-fitting shoes, and maintaining good blood sugar control. If you have diabetes, it is suggested that you schedule regular appointments with a podiatrist to monitor your foot health, and receive timely intervention to prevent serious infections.
Diabetic Limb Salvage
Diabetic limb salvage can be an effective way in preventing the need for limb amputation. If you have a foot ulcer and diabetes, consult with Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Diabetic Limb Salvage?
Diabetic limb salvage is the attempt of saving a limb, such as the foot, that has an infected ulcer, from amputation. Podiatrists also try to make sure that there is enough function in the foot after the salvage that it is still usable. Those with diabetes experience poor blood circulation, which prevents proper healing of an ulcer. If the ulcer is left uncheck, it could become infected, which could result in the need for amputation.
Diabetes is the number one cause of non-traumatic amputations in the United States. Amputation has been found to lead to higher mortality rates. This translates into higher healthcare costs, and a reduced quality of life and mobility for amputees. Podiatrists have attempted to increase the prevalence of limb salvage in an attempt to solve these issues.
Diagnosis and Treatment
Limb salvage teams have grown in recent years that utilize a number of different treatments to save the infected limb. This includes podiatrists that specialize in wound care, rehabilitation, orthotics, and surgery. Through a combination of these methods, limb salvage has been found to be an effective treatment for infected limbs, and as an alternative to amputation. Podiatrists will first evaluate the potential for limb salvage and determine if the limb can be saved or must be amputated.
If you have any questions, please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Diabetic Limb Salvage
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If bone is removed it is then replaced with prostheses, or synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
Morton's Neuroma
Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.
This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.
Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.
There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.
Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.
Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.
Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.
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.
How to Care for Diabetic Foot
Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.
It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain. You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.
A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.
A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.
On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.