
The Effects of Psoriatic Arthritis on the Feet and Ankles

Psoriasis is a visible autoimmune disease characterized by red patches of skin with silvery scales. It results from an overactive immune system, attacking healthy tissue and causing excess skin cell production. However, this immune response can also trigger inflammation in joints. Approximately one-third of psoriasis patients develop psoriatic arthritis, or PsA, a chronic inflammatory joint disease. Often, psoriasis precedes PsA, but joint issues can emerge before skin symptoms, or may be so mild that patients do not connect them with psoriasis. Psoriatic arthritis can affect any joint, including the ankles and tendons around them. Symptoms include pain, tenderness, swelling, and warmth in the joints. Foot-related problems from PsA can include swelling of entire toes, heel pain from Achilles' tendon inflammation, and sole pain due to plantar fascia inflammation. Additionally, it can cause nail changes such as lifting, pitting, discoloration, or thickening. Managing PsA involves symptom control and joint protection. If you have psoriatic arthritis and it is impacting the comfort of your feet or ankles, it is suggested that you schedule an appointment with a podiatrist for a correct diagnosis and treatment options.
Arthritis can be a difficult condition to live with. If you are seeking treatment, contact Darren Day, DPM from Hawaii. Our doctor can provide the care you need to keep you pain-free and on your feet.
Arthritic Foot Care
Arthritis is a term that is commonly used to describe joint pain. The condition itself can occur to anyone of any age, race, or gender, and there are over 100 types of it. Nevertheless, arthritis is more commonly found in women compared to men, and it is also more prevalent in those who are overweight. The causes of arthritis vary depending on which type of arthritis you have. Osteoarthritis for example, is often caused by injury, while rheumatoid arthritis is caused by a misdirected immune system.
Symptoms
- Swelling
- Pain
- Stiffness
- Decreased Range of Motion
Arthritic symptoms range in severity, and they may come and go. Some symptoms stay the same for several years but could potentially get worse with time. Severe cases of arthritis can prevent its sufferers from performing daily activities and make walking difficult.
Risk Factors
- Occupation – Occupations requiring repetitive knee movements have been linked to osteoarthritis
- Obesity – Excess weight can contribute to osteoarthritis development
- Infection – Microbial agents can infect the joints and trigger arthritis
- Joint Injuries – Damage to joints may lead to osteoarthritis
- Age – Risk increases with age
- Gender –Most types are more common in women
- Genetics – Arthritis can be hereditary
If you suspect your arthritis is affecting your feet, it is crucial that you see a podiatrist immediately. Your doctor will be able to address your specific case and help you decide which treatment method is best for you.
If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
How to Care for Your Arthritic Foot
Arthritis is an inflammation of the joints and it can occur at any joint in the body, especially in the foot. It generally effects those who are older, however, it can occur at any age. Although there are many different forms of arthritis, there are three main types that occur in the foot. The three types are osteoarthritis, rheumatoid arthritis, and gout.
The primary cause of osteoarthritis is aging. As you age, cartilage degenerates around the joints which causes friction and pain. Obesity can cause osteoarthritis through mechanical stress. Injuries that damage joints can increase the probability as well. Finally, a family history of osteoarthritis can also increase chances of having it.
Rheumatoid arthritis occurs when the immune system attacks the joint linings and weakens them over a long time. While there is no known cause of rheumatoid arthritis, obesity and smoking can increase your chances of getting it. Women are also more likely to get it than men.
Gout is a form of arthritis that occurs when there is too much uric acid in your blood and painful crystals form in your joints. Men are more likely to have gout than women. People who are obese or drink alcohol often are also more likely to develop gout. Furthermore, having diabetes, heart disease, high blood pressure, high cholesterol, gastric bypass surgery or a family history of gout may increase your likelihood of developing the condition.
Symptoms of arthritis include pain, stiffness, swelling in the joints. These symptoms can make it harder and more painful to walk. Physical activity can increase pain and discomfort. Furthermore, joint pain can worsen throughout the day for osteoarthritis. Gout attacks generally last several days with the first few being the worst.
Diagnosis of gout includes either a joint fluid test or a blood test. X-ray imaging can detect osteoarthritis but not gout. On the other hand, there is no blood test for osteoarthritis. Rheumatoid arthritis is difficult to diagnosis. Doctors utilize family and personal medical history, a physical examination, and antibody blood tests to determine if you have rheumatoid arthritis.
Treatment varies for the different kinds of arthritis. Anti-inflammatory medication or steroids can help reduce pain from inflammation of the joints. Changing shoe types can help with some symptoms. Wider shoes can help with discomfort from gout and osteoarthritis. High heels should be avoided. Shoes with proper arch support and that take pressure off the ball of the foot can help with rheumatoid arthritis. Drinking lots of water can also help rid uric acid from the blood. Losing weight, improving your diet, and limiting alcohol and smoking can also help prevent or lessen the symptoms of arthritis.
If you are having trouble walking or pain in your feet, see a podiatrist to check if you have arthritis.
Anatomy of Foot Stress Fractures

Stress fractures are tiny cracks in bones, often seen in the feet due to repetitive stress. Two main types of these fractures exist, consisting of fatigue fractures from overuse and insufficiency fractures in weakened bones. Common in weight-bearing bones like the metatarsals, these fractures result from activities like running and jumping. Symptoms can include localized foot pain and swelling. Diagnosis through imaging is essential. Relief involves rest, reducing impact on the feet, and sometimes using supportive devices, such as crutches or braces. If you have endured a foot stress fracture, it is suggested that you visit a podiatrist who can accurately diagnose and treat this condition.
Stress fractures occur when there is a tiny crack within a bone. To learn more, contact Darren Day, DPM from Hawaii. Our doctor can provide the care you need to keep you pain free and on your feet.
How Are They Caused?
Stress fractures are the result of repetitive force being placed on the bone. Since the lower leg and feet often carry most of the body’s weight, stress fractures are likely to occur in these areas. If you rush into a new exercise, you are more likely to develop a stress fracture since you are starting too much, too soon. Pain resulting from stress fractures may go unnoticed at first, however it may start to worsen over time.
Risk Factors
- Gender – They are more commonly found in women compared to men.
- Foot Problems – People with unusual arches in their feet are more likely to develop stress fractures.
- Certain Sports – Dancers, gymnasts, tennis players, runners, and basketball players are more likely to develop stress fractures.
- Lack of Nutrients – A lack of vitamin D and calcium may weaken the bones and make you more prone to stress fractures
- Weak Bones – Osteoporosis can weaken the bones therefore resulting in stress fractures
Stress fractures do not always heal properly, so it is important that you seek help from a podiatrist if you suspect you may have one. Ignoring your stress fracture may cause it to worsen, and you may develop chronic pain as well as additional fractures.
If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Stress Fractures of the Foot and Ankle
Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.
The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.
Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.
Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.
It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture. Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.
The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.
Arthritis Can Cause Pain in the Feet and Ankles
Causes and Definition of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, a condition affecting the inner ankle and foot, arises from compression of the tibial nerve within the tarsal tunnel. This tunnel, enclosed by bone and soft tissues, houses nerves, arteries, and tendons. When pressure on the tibial nerve increases, it can result in tarsal tunnel syndrome. Causes vary, with one primary factor being overuse, leading to inflammation and swelling within the tunnel. Flat feet or conditions altering foot biomechanics may contribute by narrowing the tunnel and compressing the nerve. Ankle injuries, cysts, or tumors within the tunnel can exacerbate the compression, as can systemic conditions like diabetes or arthritis. Symptoms encompass tingling, burning sensations, and pain radiating to the arch, heel, or toes. Recognizing these indicators and understanding the diverse causes of tarsal tunnel syndrome is vital for timely intervention. If you have foot pain, it is strongly suggested that you schedule an appointment with a podiatrist who can diagnose and treat tarsal tunnel syndrome.
Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Darren Day, DPM of Hawaii. Our doctor 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 offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. 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 compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
Complications of Gout

Gout, a form of inflammatory arthritis, can lead to several complications if not properly managed. Chronic gout can cause persistent pain and swelling in the joints, significantly affecting mobility and quality of life. Over time, the buildup of uric acid crystals in the joints can lead to tophi, which are lumpy deposits that can be felt under the skin. These tophi can become inflamed or infected, causing further discomfort and complications. Repeated gout attacks can also lead to joint damage and deformity, particularly in the big toe, feet, ankles, and knees. This damage can be debilitating, leading to reduced joint function and chronic pain. Moreover, gout is often associated with other serious health conditions, including kidney stones as a result of excess uric acid. It can also increase the risk of cardiovascular diseases and chronic kidney disease. These complications underscore the importance of making an appointment with a podiatrist. If you have developed gout, it is strongly suggested that you are under the care of this type of doctor who can offer you relief and preventive options.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Darren Day, DPM from Hawaii. 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 Honolulu and Kahuku, HI . 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.
Laser Treatment for Fungal Toenails

Fungal nail infections, medically known as onychomycosis, can be stubborn and challenging to treat. Traditional methods consisting of topical antifungal creams or oral medications may not always provide the desired results. In such cases, laser treatment for fungal nails has emerged as an alternative solution. Laser treatment, often referred to as laser therapy or laser fungal nail treatment, is a non-invasive procedure designed to target and eradicate the fungal infection in toenails or fingernails. During the procedure, a specialized laser emits a focused beam of light, which generates heat that penetrates the infected nail and the underlying fungal structures. This controlled heat effectively kills the fungus without causing damage to surrounding tissues. Laser treatment for fungal nails is considered a safe and efficient option, particularly for individuals who are reluctant to use or cannot tolerate traditional medications. If you have developed toenail fungus, it is suggested that you schedule an appointment with a podiatrist who can determine if laser treatment is right for you.
Laser treatment can be an effective way to get rid of toenail fungus. If you have any questions about laser treatment, consult with Darren Day, DPM from Hawaii. Our doctor will assess your condition and provide you with quality treatment for fungal nails.
What Are Toenail Fungal Infections?
Onychomycosis, or fungal infection of the nail, is a relatively common and non-serious condition. Around 10 percent of U.S. citizens are afflicted with fungal nails. Common forms of fungus that infect the nail include dermatophytes, yeasts, and molds.
Symptoms of Toenail Fungal Infections Include:
- Nail thickening
- Brittleness of the nail
- Discoloration of the nail
Diagnosis for Fungal Nails
Fungal infections are diagnosed by fungal culture and microscopy. This will rule out any other conditions such as nail trauma, psoriasis, lichen planus, and onychogryphosis.
What Is Laser Treatment?
Laser treatment is a non-invasive, safe, quick, and painless procedure that uses the heat from a laser to kill fungus in the nail. Each infected nail is targeted with a laser for several minutes. The treatment is usually utilized several different times over a select period. During this time, a podiatrist will keep an eye on the infection.
If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.