Podiatrist Blog

Posts for: April, 2017

By Joseph Stuto, DPM
April 27, 2017
Category: toe conditions
Tags: arthritis   Gout   uric acid  

Well, Easter weekend has come and gone.  Some of you have visited family, over indulging on the goodies the bunny delivered, while others may have stayed home.  Hopefully nobody’s diet change was enough to set off the painful big toe sensation referred to as Gout.   

Gout is actually very common, and is characterized by sudden, severe attacks of pain, redness and tenderness in joints, typically the joint at the base of the big toe. It can really put you out of commission!  Gout is a complex form of arthritis, which can affect anyone, but men are more likely to get it.  However, women do become more susceptible to it after they go through menopause.

An attack of gout can really come out of the blue.  It can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire!!  OUCH!  The affected joint is hot, swollen and so tender that even the weight of a sheet may seem intolerable.  Not a fun way to be pulled out of happy dream land…

Luckily, gout is treatable, though.  There are also some ways to reduce the risk of gout recurring.  According to the Mayo Clinic, gout occurs when urate crystals accumulate in your joint, which happens when you have high levels of uric acid in your blood.  Your body produces uric acid when it breaks down purines- substances that are found naturally in your body, as well as in certain foods, such as steak, organ meats and seafood.  Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).

Some ways to avoid gout in the future is to reduce your consumption of these things afore-mentioned.  You should also try to maintain a healthy weight.  If you are overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating it- which greatly increases your risk of gout.  Certain diseases and conditions also make it more likely that you’ll develop gout. 

They are: 

  • high blood pressure untreated
  • diabetes
  • metabolic syndrome
  • heart disease
  • kidney disease

If you experience sudden, intense pain in a joint, call your doctor!  Gout that goes untreated can lead to worsening pain and joint damage.  You should get to the doctor immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.  Call Dr. Joseph Stuto if you’re experiencing this, or any other foot or ankle issue that needs attention.  Dr. Stuto has two convenient Brooklyn locations available for you to visit.

People with diabetes have to be extra vigilant when it comes to their feet.  Wondering why, if you are not diabetic, or familiar with the problems a diabetic faces?  Or all too familiar with diabetic foot problems (if you are suffering from them yourself!)? Unfortunately, people with diabetes have to constantly monitor their sugar intake, and blood sugar.  If they have too much glucose (aka sugar) in their blood for a long time, it can cause serious bodily complications- including foot and skin problems.  Besides skin and feet problems, high sugar levels can also make them prone to heart disease, eye damage, and many other problems! 

So, how does diabetes affect the feet?  Typically, uncontrolled diabetes can damage the nerves in the legs and feet.  If this happens, the sufferer might not feel heat, cold or pain.  This lack of feeling is a condition known as diabetic neuropathy.  This can be dangerous, as a person with this might have a cut or sore on their foot that they are not aware of.  Due to the lack of feeling, this wound could get worse, get infected, and then get dangerously infected before the person even realizes it is there.  A person with this condition is also more susceptible to cold- making them more prone to frostbite, in extreme circumstances.  Same goes for heat- a person with diabetic neuropathy can burn their feet more easily-walking on a hot blacktop, hot sand, etc.- as their sense of pain is muted due to the nerve damage.

Diabetes can also affect the blood flow in a person's body.  Poor blood flow in the arms and legs is called peripheral vascular disease.  This disease is a circulation disorder that affects blood vessels that are far from the heart.  If you have an infection in your foot, or anywhere else in your body, it makes you more susceptible to infection because of the poor blood flow.  This can put you at risk for developing gangrene, which can lead to amputation, in severe cases!  No one wants to have that happen!

These two afflictions- poor blood flow, and damaged nerves are only a couple of the problems a diabetic faces with their feet.  Sad to say- the list is long, and there isn't time to get into it all in this article.  But the important thing to take from this is that if you are diabetic, you have to take extra special care of your feet.  And if you do discover anything other than the norm, you should see your podiatrist immediately.  Dr. Joseph Stuto has two convenient Brooklyn locations to visit.  Call Dr. Stuto if you have any foot or ankle problem- he can help!

Are you suffering from heel spurs and/or plantar fasciitis?  If you are, you are probably more than familiar with the intermittent or chronic pain associated with these conditions.  These conditions are especially exacerbated by jogging, running, or walking long distances.  Especially, if inflammation develops at the point of the spur formation.  The cause of the pain is not necessarily the heel spur itself, but the soft-tissue injury associated with it.  


Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning!  OUCH!!  They say the pain then turns into a dull ache as the day goes on.  They also say that the sharp pain tends to return after they stand up after having been sitting for a prolonged period of time.  One would think that rest would be helpful for heel spurs or plantar fasciitis, however, many people say that the pain is the worst AFTER A NIGHT’S SLEEP!  So, what can you do to get rid of this cumbersome pain?  Here are some non-surgical treatments your podiatrist can recommend:


  • Wearing different types of shoes… we can give shoe recommendations for minimizing heel pressure
  • Various stretching exercises
  • Shoe inserts or orthotic devices
  • Physical therapy
  • Taping or strapping to rest stressed muscles and tendons
  • Injecting a cortisteroid in the area of inflammation


More than 90 percent of people get better with non-surgical treatments, so rest assured, this is usually the case!  For future reference, you can try to prevent heel spurs by wearing well-fitting shoes with shock-absorbent soles, supportive heel counters, and rigid shanks.  Also, be sure to choose appropriate shoes for each physical activity, and do appropriate warm-up and stretching exercises before each activity.  Call Dr. Joseph Stuto if you are experiencing recurrent heel pain, or are having any other foot or ankle issue.  He has 2 convenient Brooklyn locations available to see patients.  


By Joseph Stuto, DPM
April 06, 2017
Category: toe conditions
Tags: toenail fungus  

Do your toenails appear thicker than normal, yellowish or cracked?  Well, if so, you may be suffering from toenail fungus.  Toenail fungus is an infection that gets in through the cracks in your nail or cuts in your skin that can make your toenail change color or get thicker.  It can also be painful sometimes.  Since our toes are often warm and damp, they are the perfect breeding ground for fungus.  Different kinds of fungi and yeast can affect different parts of the nail.  When these conditions are left untreated, the infection can spread to other toenails, skin, or even fingernails!  ICK, right?!

 If you are noticing that your toenails are looking like this, there is a good chance that they are infected with fungus.  Infected nails are not only usually thicker than normal, but they can be warped or oddly shaped.  Typically, they are yellowish in appearance and can break easily.  When fungus builds up under your nail, it can loosen and even separate the nail from the bed. 

So, why do people get toenail fungus, and who gets it?    People who have diabetes, athlete’s foot, or a weak immune system, who smoke, or whose family members have it are also at a higher risk.  Men are more likely to get it than women, and older people are more likely to develop toenail fungus, as well.  If you are a swimmer, or someone who spends a lot of time in the water… or someone with an injured toenail, your odds for getting toenail fungus go up.

Toenail fungus can be tricky to identify, as it can look like other conditions.  It is important to get a diagnosis if you suspect you have it.  Dr. Joseph Stuto has two convenient Brooklyn locations for people to visit.  You should see a podiatrist if you think you have toenail fungus, as it is often confused with psoriasis.

The good news is that you can treat toenail fungus topically in many cases.  However, sometimes an antifungal prescription pill is recommended, and in worst case scenarios- removing the damaged area of the nail or skin.  Hopefully, you’ll be one of the people who can get rid of the icky fungus with a topical cream or nail lacquer.  Call Dr. Stuto so he can help you get on the road to having fungus-free feet!