Arthritis Of The Foot

Arthritis Of The Foot
Dr. Jeffrey A. Oster, Medical Director Of Myfootshop.com.

Arthritis is a term used to describe a number of diseases that cause inflammation of joints and results in the progressive destruction of joints. Arthritis is actually a collection of many different joint diseases that affect the body and the foot in many different ways. In this article, let’s talk a bit about arthritis and how it affects the foot. We normally discuss treatment alternative for conditions, but due to the scope of this topic, we will not discuss treatment of each of the individual forms of arthritis.

Osteoarthritis

Osteoarthritis is by far and away the most common form of arthritis. Osteoarthritis is known as the wear and tear type of joint disease and will effect most of us at one point in our lives. In our discussion on osteoarthritis, please refer to the nomenclature and anatomy sections below for definitions of the terms that my be unfamiliar to you.
When I think of osteoarthritis (OA), I think of my grandmother’s hands. Those hand have done a lot of work in their time and have a bit of arthritis to show for it. The fingers, crooked and bumpy show many of the changes brought on by osteoarthritis. The bumps on the fingers are called Heberden’s Nodes. Heberden’s Nodes are a very obvious example of how osteoarthritis occurs. If you’ve ever known anyone whose experienced the symptoms of OA, they’ll tell you that a joint will flare for a period of several weeks. It may be mildly painful or even painful to the degree that the joint is unusable. And then suddenly, just as passively as it came, it leaves. Occasional, brief morning stiffness was not unusual for grandma. The pain that had been present in her hands was actually due to a series of small micro-fractures that occurred in the subchondral bone (just beneath the cartilage). It seems that in cases of osteoarthritis, the bone just below the cartilage becomes very fragile. When loads are applied to this fragile bone, it breaks down. The more the joint is used, the more the bone seems to break down.
Over time, as the bone undergoes a series of flare ups, the ability of the bone to support the cartilage becomes unstable. The subchondral bone creates an unstable supporting surface for the cartilage. When the joint tries to complete its’ normal range of motion, the cartilage is irregular and progressively erodes. This moves us into the second phase of OA pain, and that’s when we have joint range of motion that is bone on bone. Cartilage has no nerve endings to sense pain, but bone on the other hand, has plenty. As the joint moves and the bone is eroded, significant pain can be experienced.
This erosive process seen in OA seems to occur at different rates in everyone. In fact, every joint seems to undergo the changes of OA at a different rate. The rate of change does seem to be effected by the history of damage to the joint. In fact the classifications used to describe OA include Primary (idiopathic or no known cause) and Secondary (some known cause for the disease such as trauma). Past injuries seem to accelerate the rate of OA in most joints. We all know someone with that old football injury, right?
The cause of OA is unknown. Many authors have speculated that the cause may be mechanical as described above, but others have described changes such as biologic, biochemical or enzymatic; or even a combination of each of these.
Changes that occur in the foot with OA are numerous. The most common is midfoot pain that is diffuse. The midfoot is a jigsaw puzzle of pieces that are difficult to manage when effected by a systemic disease of this nature. Other finding include atrophy (loss) of the plantar fat pad of the forefoot and heel. The big toe joint is often effected by the changes of OA with bunions and hallux limitus as common complaints.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a very complex and debilitating disease that affects approximately 1% of the general population. Women are 2-3 times more prone to develop RA. RA is a process where the body’s immune system attacks the cell lining the joint capsule (synovial cells). The end result is thickening and fibrosis of the joint with destruction of the cartilage.
Symptoms of RA include an abrupt onset of inflammation. The swelling associated with RA may be isolated to one joint or effect several. Symmetrical involvement is typical with both hands or both feet being affected. In comparison to OA, morning stiffness seen in RA may last more than 30 minutes.
The finding of RA in the foot often progresses to subluxation of the joints, particularly the metatarsal phalangeal joints. Atrophy of the plantar fat pad is common.

Psoriatic Arthritis

Psoriatic arthritis (PA) is an interesting form of sero-negative arthritis. PA is associated with psoriasis in many cases, but it is not unusual to find the symptoms of PA in a patient with no previous history of psoriasis of the skin or nail.
The symptoms of PA in the foot include focal swelling of the interphalangeal joint (the toes). The toe will appear to have swollen and become painful with a limited history of injury or pain. X-rays often show slow changes that exhibit erosion called a pencil and cup appearance. This finding is common on the metatarsal phalangeal joint.

Reiter’s Syndrome

Reiter’s Syndrome (RS) is an unusual form of arthritis that is usually found in men.. RS is often described as a sexually transmitted disease due to the history of the disease occurring following sexual intercourse which resulted in a chlamydial infection. It is suggested to treat those with RS, and their sexual partners, for C. trachomatis infections.
The symptoms of RS include burning upon urination (urethritis), dry eyes and joint pain. Joint pain in the back and feet are common. These symptoms occur 7-14 days following sexual intercourse and subside over a period of several months to years. Recurrence of pain is not unusual. About the Author
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of
Myfootshop.com and is in active practice in Granville, Ohio.

Activities for people with Alzheimer

Alzheimers is one disease that people dread to be diagnosed with. Who can blame them?

It is one of the most debilitating disease known to man and it affects not only one area or one system but all. Of course, since it is a progressive disease, effects on the various systems of the body does not happen at one time.

As the disease progress, the effects become wide-range.

Alzheimers disease is perhaps the best-known disease under Dementia, a disorder that affects the mental processes. It is characterized by the progressive loss of memory that may lead to inattentions and inability to focus at a task, language problems and behavioral changes.

Patients with Alzheimers disease for instance may initially find themselves at a loss for words or unable to remember some bits of facts that happened the day before. But as the days progress, they will find themselves starting to forget important things like their addresses, their age and sometimes even their names.

Patients who are in the later stages of Alzheimers will start to forget how to do routinary things like brushing their teeth, taking a bath or using their utensils. Some may not speak altogether because they will often forget the words that they should be using or saying. Some will also behave differently, brought on by the frustration of not being able to do the things that they used to do. Often times, patients at the later stages will become dependents, acting like children who do not know what to do with themselves.

Although there are medicines that can slow down the progress of the disease especially if discovered early on, there is no solution to the problem. Once it settles into the system, it would be there for life and there is no chance of it ever disappearing.
Like medicines, there are activities that according to scientists can slow down the progression. Below are just some of them:

Read

Something as simple as reading the newspaper everyday and keeping your mind informed with the latest news is already something that can prevent the disease from settling in. Just make it a point to use your brain. Be an analytical reader and raise questions and do not just absorb the texts and then forget about it. Being an active reader and allowing your imagination free reign will go a long way for exercising the brain. In fact, studies have shown that people who love to read are less likely to be diagnosed with Alzheimers.

Answer puzzles

Another mental exercise that people with Alzheimers do to help slow down the process is to answer puzzles such as word hunts, cross words and even Sudoku. The more that you use your brain, the better will be your prognosis. Answering word games will also make sure that you practice words and increase your vocabulary, making it less likely for you to forget words and language.

Attend classes

Being old does not mean that you cannot learn. Patients with Alzheimers should make it a point to learn something new. This will exercise their brains. Creative tasks such as arts and crafts is another way to tap into the brains resources without tiring them out. Learning a new thing also gives people with Alzheimers the sense of purpose that they have lost since they were diagnosed with the disease.

Acid Reflux Medication: Keeping Heartburn at Bay

In a normal digestive process, the partially digested food is being forwarded by muscular movements from the stomach to the intestines. However, for some people, the stomach contents travel back to the esophagus from the stomach. This condition is known as acid reflux.

Common symptoms of this disease include heartburn, difficulty in swallowing, regurgitation, chest pains, dental erosion, hoarseness, asthma, dyspepsia, vomiting, and many others.

If not properly treated, acid reflux can last for several months. But drug treatment can play an essential part in the treatment process of a patient.

The most common medications used include the following:

Antacids. These drugs are used to neutralize the acids in the digestive tract and are primarily taken in for relief of mild symptoms, such as occasional episodes of indigestion and heartburn. They also act to incite the defensive mechanisms of our stomach by building up the secretion of mucous and bicarbonate. Most antacids can be bought over the counter even without a medical prescription. Moreover, these drugs are one of the first to be recommended by professionals to lessen the pain brought about by heartburn or mild symptoms. The three basic ingredients of antacids are magnesium, calcium, and aluminum.

Acid suppressants such as histamine blockers are also commonly used. Histamine blockers obstruct the production of stomach acids by alienating the actions of histamine. Histamine is a chemical in the body that promotes the production and secretion of acids in the stomach. Anti-histamines are available even without prescription and offers relief of symptoms in most of the patients with frequent acid reflux. Patients have to wait for 30 to 90 minutes for these drugs to take effect. But their effect also lasts six to 24 hours. In cases of severe symptoms, a patient may have to take two dosages a day. In some researches, histamine blockers have shown to improve asthmatic symptoms in those who endure from both acid reflux and asthma.

However, in a study dated 2001, it was suggested that histamine blockers occasionally impart complete relief of symptoms for dyspepsia and heartburn.

Proton pump inhibitors are also employed as a medication. They act to trim down the production of stomach acids by reacting with the cells found in the stomach wall which produce and release acids into the stomach. However, researches have revealed that the use of proton pump inhibitors poses some concerns. Side effects, although uncommon, include diarrhea, headache, itching, and nausea. Moreover, these drugs should also be stayed away from by pregnant and breast-feeding mothers.

Another medication that is generally handled is the use of agents which protect the mucus lining in the gastrointestinal region. This kind of drug acts by attaching to an ulcer crater so that it will be guarded from damage caused by digestive acids. It is advisable for people undergoing maintenance therapy with mild or moderate acid reflux conditions. Likewise, it has minor side effects, including constipation.

Anti-spasm drugs are also utilized to prevent acid and even non-acid reflux. A gamma-amino acid butyric acid agonist, an anti-spasm drug is generally used to abate the spasms in the muscles. Unlike most medicines used for acid reflux, it can also lessen non-acid refluxes and amplify the pressure in the lower esophageal sphincter, a muscle that separates the esophagus from the stomach and prevents backing up of stomach contents.

Acid Reflux Disease Symptoms: Knowing your Body

Acid reflux disease is a condition in which the stomach acids abnormally reflux into the esophagus. This phenomenon is irregularly experienced by most people, most especially after eating.

Our body uses gastric and stomach acids to break down the food that we eat. Normally, after the digestion in the stomach, the food is delivered by the digestive muscles to the intestines for extra digestion. But in patients who have acid reflux disease, the acidic stomach contents are moved back to the esophagus, which then causes inflammation. Cigarettes, alcohol, caffeine, pregnancy, and fatty foods are some factors which worsens acid reflux conditions.

Our present knowledge about acid reflux based on medical researches tells us that this disease is common in men as it is in women. There is no sexual preference. Moreover, the prevalence of acid reflux is more frequent in people of 40 years of age or more.

Symptoms of acid reflux may be typical or atypical. But based on the diagnosis of acid reflux patients, only 70% of those who have this disease manifest typical symptoms.

Typical or esophageal symptoms concern indicators which are related with the esophagus. Such symptoms include the following:

Heartburn. This is a condition in which the patient feels a painful burning feeling in the esophagus. The pain often develops in the chest and may swell to the neck or throat. This is most probable to occur in relation with these activities: after a heavy meal, lifting, bending over, and lying down. Based on one study, about 75% of acid reflux patients experience this symptom at night. These nigh-time patients also tend to experience more harsh pain than those whose symptom occurs at other times.

Dyspepsia. Researches show that about half of acid reflux patients have dyspepsia. This is a syndrome which consists of pain and distress in the upper abdomen, nausea after a meal, and stomach fullness. It is not a rule however, that those who have dyspepsia have acid reflux.

Regurgitation. This is when the gastric contents back up into the pharynx and sometimes as far as the mouth. In cases where the acids have spilled into the tracheobronchial tree, respiratory complications can be stimulated.

There are many instances, though, that acid reflux patients do not manifest symptoms such as regurgitation and heartburn. Instead, they experience atypical or extraesophageal symptoms which include the following:

Throat Symptoms. Although it does not commonly happen, acid reflux patients suffer from symptoms that occur in the throat. Hoarseness, the feeling of having a lump in the throat, dry cough are undergone by those who have acid laryngitis, a throat symptom. Patients can also have difficulty in swallowing, a condition known as dysphagia. In critical cases, the food may get trapped in the throat or even choke, which can result to a severe chest pain. Other throat symptoms are chronic sore throat and persistent hiccups.

Vomiting and Nausea. When a patient suffers from nausea which persists for weeks, he may have acid reflux. There are few instances where vomiting can occur as often as once a day.

Respiratory Symptoms. Coughing and wheezing are counted as respiratory symptoms. These result from the overrunning of the stomach acids into the tracheobronchial tree creating bronchoconstriction.

Acid reflux disease can last for several months if not given proper medical attention. Drug treatment may only be required for a short time. But when the symptoms tend to repetitively occur, the drug treatment may have to be reapplied.