Posts for: April, 2013


Spring is finally here! But for most of the country we haven’t seen any signs of spring-like weather yet! (I know I’m disappointed too.) Along with this extended cold weather comes the increased likelihood of something called Raynaud’s disease. Have you ever been outside in the cold for a long period of time and when you came in your toes were purple or blue?! This is Raynaud’s Disease! The cold causes the small arteries in your toes to constrict and get smaller, which limits the blood flow to the toes and causes them to become discolored. This is not the same thing as frost bite, the symptoms are different. Cold feeling toes, color changes, numb feeling and a pricking or stinging feeling as the toes warm up are the symptoms of Raynaud’s.

Most of the time this is just annoying to deal with it, but it will go away on its own. But in recurring, severe cases or cases that are secondary to another disease, it is necessary to see a podiatrist for treatment.

Some diseases that increase the likelihood of Raynaud’s Disease and would require medical attention include Lupus, Scleroderma, Carpal Tunnel, Rheumatoid Arthritis and Sjorgens Syndrome to name a few.  If Raynauds develops and you have any of these conditions it is important to go see your local podiatrist at Affiliated Foot and Ankle Care to get the proper treatment. We have offices conveniently located in Edison and Monroe, NJ. Severe cases of Raynaud’s Disease are rare but do need to be treated!

Treatment for mild Raynaud’s is to warm up the affected areas, usually heating pads work great! In more severe cases or cases with underlying conditions medications may be prescribed. These medications include calcium channel blockers which will relax the small arteries in your feet so they stay open; alpha blockers are also used, which counteract the normal hormones in your body that constrict blood vessels, so they in turn will relax the arteries.

The most important thing after treatment that your doctor will discuss with you will be how to prevent future attacks! The common recommendations are to dress in layers and make sure skin is fully covered and kept warm and dry. So for this extended winter make sure to stay warm and covered up when going outdoors!

by Varun Gujral


I’m sure a lot of people have never heard the word talus before, but when getting to know your feet it is a very important bone. It is the one that is above your heel bone and below your two leg bones; it makes up the ankle joint. So it sounds like this is a very important bone in our feet, and it is. So what happens when you break this bone?

Let’s first see how you can actually manage to break this bone. The most common way is in car accidents, but it is also common in falls from great heights, and is very common in snowboarders. I know most of us are anxious for winter to be over, but there are a few people out there like professional snowboarder Shaun White who live for the snow, but living for the snow and snowboarding puts him at a greater risk of breaking his talus!

Some common symptoms of a talar break are tenderness and swelling, an inability to bear weight on the foot and obviously a lot of pain! In snowboarders this injury is sometimes mistaken for an ankle sprain because there is tenderness and bruising on the outside of the ankle. The only way to determine if you have a talar fracture is to go see your local podiatrists at Affiliated Foot and Ankle Care, located in Edison and Monroe NJ, immediately after an injury to get x-rays.

Your podiatrist will ask you what happened when the injury occurred and will take x-rays to look for a talar break. Before a diagnosis is made however it is important to put a padded wrap around the ankle and to elevate it above the heart and apply ice every 20 minutes until you can get to a doctor.  After the doctor has made a diagnosis there are surgical and nonsurgical treatments. Most cases will require surgery; however sometimes if the bones are still in proper alignment you can get heal the fracture with casting for 6-8 weeks. A majority of cases though require surgery and casting for 6-8 weeks with no weight bearing on the foot for at least 3 months. After the cast has been removed, physical therapy will be required to restore strength to the foot.

By: Nrupa Shah


We’ve all heard about this thing called gout, and I’m sure everyone associates it with their feet. But what exactly is this condition and how do people get it?  Gout is a build-up of uric acid within the joints of the body. Wait, what is uric acid? It is a waste product of metabolism in your body; it is made when the food you make is broken down. When this builds up in the joints it is similar to arthritis.

Certain people are more likely to have this happen than other people. There is a genetic link to it, so if someone in your family develops gout it is more likely that you will develop it compared to someone who has never had someone in their family develop it. Men between the ages of 40 and 60 are more likely to develop it, and a diet including high amount of meat, seafood and beer increase the chances of this developing.

The common symptoms of gout in the foot include pain and swelling of the joints; red, shiny skin around the joint; itchy and flaky skin of the joint. These symptoms will appear very quickly, last for around a week then disappear. The big toe is the most common place for this to occur, however it can also occur in the other toes and heel.

Your local podiatrist Dr. Gujral at Affiliated Foot and Ankle Care can diagnose this condition by using the serum uric acid test or by examining the synovial fluid of the joint. The serum uric acid test is done by drawing blood from the arm and checking for raised uric acid levels in the blood. Synovial fluid is the fluid that lines all the joints of your body to make them move, some of this fluid can be taken out of the affected joint and looked at under a microscope to look for the presence of the gout.

Gout is treated with medications and lifestyle changes to prevent future occurrences of the condition. The medications required are urate lowering therapies, these medications reduce urate levels in the body to a point below where crystals can form, and they dissolve existing crystals. Applying ice and taking Tylenol can help relieve the symptoms also. Some lifestyle changes, mostly in diet, will be required so this doesn’t happen again in the future. Cutting down on certain meats like liver, venison, kidney and turkey and other foods like seafood, spinach and asparagus will be recommended.

If you believe you have symptoms of gout, please call our office and make an appointment.  We have two offices and we are conveniently located in Edison and in Monroe, NJ.


By Varun Gujral


One of the most popular shows on TV today is “Dancing with the Stars”, and I know that we are all envious of how everyone on the show can move and ‘shake it’. And I guarantee we all wish we could look that good when we dance instead of looking silly! But the dancers and stars are putting a lot of stress on their feet, and are at risk for multiple different injuries. One major injury these dancers are at risk for is a ruptured Achilles tendon.  I’m sure everyone has heard of that, but where and what exactly is an Achilles tendon? Feel the back of your ankle, that hard thing that is going down to the back of your heel, that is your Achilles tendon. It attaches your calf muscles to your heel and is very important is helping stabilize and move your foot; so you can imagine that rupturing this tendon would be devastating.

How exactly does a rupture occur? A common way for the stars to get this by starting strenuous activity after a period of inactivity; another common way to injury this tendon is by suddenly flexing your foot upward or downward when landing on it. Dancing is a very common place to see this injury, along with other sports such as football and basketball.

The symptoms common with this injury include hearing and feeling a pop or snap at the back of the heel followed by an intense, sharp pain going up the back of the leg. There will be an inability to flex the foot downward, so there will be an inability to walk properly on the foot.

If you have any of these symptoms seek medical attention immediately! An injury like this is very serious and will require surgery and a period of rehabilitation.  Fortunately your local podiatrists at Affiliated Foot and Ankle Care located in Monroe and Edison are here to help!


By Nrupa Shah