
Rheumatoid Arthritis in the Feet
Although rheumatoid arthritis attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.
Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.
Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.
In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA, such as a rheumatoid factor test. There is, however, no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.
There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.
Seniors Have a Greater Propensity of Falling

The risk of falling increases with age due to declining physical health, greater mobility issues, a more sedentary lifestyle, vision problems, hazards in the home, and side effects of medications. Falling can be serious for older people and is one of the leading causes of injury, disability, or even death in this age group. Stability and balance can be issues for seniors, which makes falling a risk. Because vision declines with age and older people have more eye-related diseases, seeing and judging distances becomes harder and it is easier to fall over obstacles in their environments. Issues with poor lighting, clutter, and improper maintenance in homes are more likely in this population, which also contribute to falling. Sadly, an elderly person is also more likely to fall for no obvious reason, but this can happen from a medical condition, such as a heart issue, circulation problems, or dehydration. To minimize falling and the consequences it might have, if you are a senior, it would be wise to assess and tend to home risks, get regular physical and eye exams, wear supportive and well-fitting shoes, use walking devices as needed, and try to stay as active as possible. Including a podiatrist among the health care professionals you see for routine foot exams and treatment of any current or brewing issues can increase your confidence that your mobility and independence will continue unharmed.
Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with Dr. Mark Spier from Maryland. Our doctor will assess your condition and provide you with quality advice and care.
Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.
How to Prevent Falls
Some effective methods that older persons can do to prevent falls include:
- Enrolling in strength and balance exercise program to increase balance and strength
- Periodically having your sight and hearing checked
- Discuss any medications you have with a doctor to see if it increases the risk of falling
- Clearing the house of falling hazards and installing devices like grab bars and railings
- Utilizing a walker or cane
- Wearing shoes that provide good support and cushioning
- Talking to family members about falling and increasing awareness
Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.
If you have any questions, please feel free to contact one of our offices located in Columbia and Reisterstown, MD . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
Causes of Flat Feet in Adults

Adults who have flat feet may experience pain. It can happen occasionally or constantly, and often requires shoes that are worn to have adequate arch support. The majority of babies are born with flat feet, and an abnormal foot structure may cause the feet to remain that way through adulthood. Flat feet may also develop in people who become overweight, as a result of the added pressure the feet endure. Additionally, existing medical conditions such as diabetes, and rheumatoid arthritis may lead to getting flat feet, and it may also happen to people as the aging process occurs. The possibility of spraining or fracturing the ankle may increase as the ankle rolls inward while walking, often causing the gait to change. Many patients find relief when specific stretches are performed that target strengthening the arch, and wearing orthotics may help to diminish any discomfort from having flat feet. If you have this foot condition, it is strongly suggested that you are under the care of a podiatrist who can offer you relief options.
Flatfoot is a condition many people suffer from. If you have flat feet, contact Dr. Mark Spier from Maryland. Our doctor will treat your foot and ankle needs.
What Are Flat Feet?
Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.
Conditions & Problems:
Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.
Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.
Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.
Symptoms
- Pain around the heel or arch area
- Trouble standing on the tip toe
- Swelling around the inside of the ankle
- Flat look to one or both feet
- Having your shoes feel uneven when worn
Treatment
If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle.
If you have any questions please feel free to contact one of our offices located in Columbia and Reisterstown, MD . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Flat Feet
Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.
Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.
It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.
There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.
Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes.
Treating Toenail Fungus
Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening. The fungal infection itself occurs beneath the surface of the nail. Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail. If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk.
The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms. Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails.
Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes. Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential. Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.
Fungal nail treatment may vary between patients and the severity of the condition. Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections. Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications. Debridement, or the removal of diseased nail matter and debris, may also be performed. In more severe cases, surgical treatment may be needed. In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed. In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.
Dealing with Stress Fractures of the Foot and Ankle
Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.
Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.
Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.
Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.
If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.
If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.
Simple Steps That Can Help Diabetic Patients

Many diabetic patients realize the importance of maintaining proper foot care. This can be an overwhelming task to accomplish, and it is beneficial that small steps are taken that can simplify the process. It is important to engage in a gentle exercise program frequently, and this can help to improve blood circulation to the feet, as well as the overall body. Eating healthy foods that can comprise a healthy diet may help to monitor glucose levels, and existing nerve damage may be controlled. Stress can raise blood pressure, and elevating the feet at the end of the day may give them a needed rest and may help to reduce existing stress. Additionally, inspecting the feet daily can reveal any cuts and scrapes that have developed. Many people who are diabetic experience neuropathy, which is the inability to feel sensation in the feet. Family members or caregivers may help patients to see the soles of their feet by helping them to use a mirror. If you have diabetes, it is strongly suggested that you are under the care of a podiatrist who can help you to manage this 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 Dr. Mark Spier from Maryland. 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 one of our offices located in Columbia and Reisterstown, MD . 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.