I received a phone call from a lady who had heard I specialised in foot pain. She explained her husband had gout and could I help.
At this point I would usually explain that I specialise in biomechanical disorders, and to see his GP to discuss possible prophylactic drug treatment.
However, the lady carried on to say that her husband had suffered for years, and had pain in his ankles and ball of the foot.
I agreed to see him, half expecting to take a cursory look at a gout ridden foot and send him to his GP.
He arrived, and we discussed the pain he was feeling.
It was obvious that he had experienced an attack of gout, but what he was constantly left with was definitely not in the gout spectrum of symptoms.
His first metatarsals were swollen and very painful, and he was suffering pain to the medial and lateral ankles.
The medial knee areas were also in quite some discomfort and there was a history of sacro iliac dysfunction.
All these symptoms are indicative of severe pronation, and upon removing his socks and jeans, I was not surprised to see what I had expected.
However, the pronation was a lot worse than I had expected, to the point I wondered how the poor chap walked any more than a few yards.
I treated his immediate pain with soft tissue massage and ultrasound, which helped more than I expected, but it was obvious that he would need orthotics to correct what was a most exaggerated pronation to both mid and rear feet.
My feelings about this case are that the gout is attacking for short periods of time, for which there is effective drug treatment available. However, the general weakness in the area brought about by the faulty biomechanics are leaving it open to gout attacks?
The moral of the story is that it pays to listen to what patients tell you on the phone, and never take anything at face value.
After all, from something I wouldnt normally treat, came a patient for whom I can make a huge improvement to his life and wellbeing.
A Les Bailey orthotics article 2012
Dr Les Bailey phd,DO,acopm,apta (int part )
About Dr Les Bailey phd,DO, acopm.apta(int part)
A Les Bailey orthotics article.
Email Dr Les Bailey at.. drlesbailey@
Direct phone 07801418080
Dr Les Bailey began a career in physical therapies in 1981,qualifying at remedial massage,and later going on to qualify as an osteopath.
He gained his phd from OIUCM for his thesis on the treatment of plantar fasciitis.
He was awarded the teaching and lecturing diploma from the northern school of osteopaths in 1993.
He also holds the diploma in foot biomechanics .
Dr Les Bailey works from his clinic near Banstead in surrey.