732-744-0003 (Metuchen Office)

241 Forsgate Dr., Suite 206
Jamesburg, New Jersey 08831



By Monroe Foot & Ankle Care
February 03, 2016
Tags: gout  

You wake up in the middle of the night because your big toe is in extreme pain. The joint feels hot and it is red and swollen. These are the classic symptoms of an attack of gout. Gout (also known as gouty arthritis) occurs when uric acid (which, under normal circumstances the body eliminates) builds up and forms crystals in a joint. It usually only affects one joint during an attack and the big toe joint is the one most commonly afflicted. Why the big toe joint? There are two possible reasons. First, uric acid crystallizes in cooler temperatures. Your big toe is the part of the body farthest from the heart and therefore it is the coolest part. Also, the big toe gets quite a bit of use and pressure because of its role in walking, standing and nearly every ambulatory motion our body performs.

Who Gets Gout?

For some patients at Monroe Foot & Ankle Care, the tendency for gout is inherited. Men are more likely to get it than women. Diet is also thought to play a part. Foods high in purines are known to bring on attacks of gout. These include: red meat, shellfish, rich sauces, red wine, beer and brandy. Certain other protein compounds, such as the ones found in lentils and beans may also contribute to the illness. Other factors that make a patient more susceptible to gout include:

  • High blood pressure
  • Diabetes
  • Obesity
  • Chemotherapy
  • Surgery
  • Stress
  • Certain medications and vitamins

Treating Gout

Our board certified podiatrist, Dr. Elliot M. Perel, will ask questions about your health history and lifestyle to try to determine what is behind your gout. He may suggest changes to your diet and also that you increase your fluid intake. The foot doctor may also prescribe medications to relieve pain and swelling. In some cases, resting and elevating the affected may be recommended.

Gout can reoccur and even become a chronic problem that leads to joint damage. If you have suffered an attack of gout, make an appointment at our Jamesburg or Metuchen office and get relief from the painful condition of gout. 

By Monroe Foot & Ankle Care
January 28, 2016
Category: proper foot care

Don’t neglect your feet this winter. Cold weather poses special challenges to feet and ankles and a few simple steps can help you avoid foot problems. At Monroe Foot & Ankle Care we want our patients to take a proactive approach to caring for their feet and preventing disabling foot conditions. Here are 5 steps to happier winter feet:

  1. Moisturize. Heated homes, offices, cars and stores can dry out your skin. On your feet, this can lead to cracks and fissures. Not only are these painful and difficult to heal, they can provide an entry point for bacteria, resulting in an infection. Use a thick moisturizer at night and put cotton socks on after applying if your feet are very dry.
  2. Watch for ice. Black ice, slippery driveways and snow covered curbs all present a perfect opportunity for twisting your ankle. Wear sensible shoes when you are walking in winter weather (carry your pretty heels to the party and change when you get there!). If you do twist your ankle, make an appointment at either our Metuchen or Jamesburg office to have it checked out by our podiatrist, Dr. Elliot M. Perel. Even if you are not in extreme pain and are able to bear weight on your ankle, an ankle sprain still may have occurred. Successful rehabilitation depends on prompt evaluation and treatment.
  3. Minimize risk for bacteria and fungi exposure. Gym locker rooms and showers, indoor pools, nail salons and any other public, damp places where people commonly go barefoot are breeding grounds for bacteria and fungi. The risk for athlete’s foot, fungal toenails and warts can be greatly reduced by wearing flip flops or shower shoes in these settings.
  4. Invest in warm socks. Unless you are talking about serious ski or snow boots, most winter footwear may cover more of your foot but isn’t necessarily designed to insulate. If you have a long walk from the train or bus to your office or will be outside in cold temperatures for any period of time, wool or other warmth inducing socks will help prevent frost nip and frost bite. For people with diabetes, neuropathy or other circulatory issues, keeping feet warm is not just a matter of comfort, it’s a serious health concern.
  5. Choose supportive boots. Have you noticed that your feet are hurting more in winter? Many boots are not made with good arch support, which can lead to heel pain and soreness in other parts of your foot. If boots are a big part of your winter wardrobe, choose ones that have strong support for your arch.

If cold weather has brought winter foot woes your way, call our office at 732-521-2155 to make an appointment.

By Monroe Foot & Ankle Care
January 22, 2016

Keeping Children’s Feet Healthy as They Grow

From the time they are born, the health of your children’s feet is as important as the health of the rest of their bodies. At Monroe Foot & Ankle Care, we believe that knowing a few basics about the development of your child’s feet and what to be on the lookout for can help ensure that your child will have strong feet that function properly. It can also minimize the chances of developing podiatric disorders as they grow and when they are adults.


When babies are born, their feet are very flexible and will undergo changes in size and shape during the first year. What’s most important is allowing an infant to stretch and kick their feet freely. If you are going to put socks or shoes on them, make sure they are not tight fitting and do not squeeze the toes or feet.


When your child reaches the toddler stage, they will begin to walk—when he or she is ready! Don’t force your toddler to stand or walk. Your child’s first steps may not appear normal to you. It’s common for young children to be slightly “pigeon-toed” or to walk on their tip toes. Usually, children naturally outgrow these tendencies but keeping an eye on their gait is necessary to catch structural problems early. If your child appears to be flat footed or the shape of the foot or toes seems abnormal, you should discuss this with your foot doctor.

Being Vigilant

As your child grows, one of the most important steps you can take to protect your child’s feet is to make sure they have properly fitting shoes. There should always be some space between the toes and the end of the shoe. Shoes conform to an individual’s feet so avoid passing shoes down from one child to another.

Inspecting your child’s feet regularly and having a good hygiene regimen will also help prevent many common podiatric foot problems such as fungal toenails, warts, athlete’s foot and ingrown nails.

If your child suddenly does not want to participate in the physical activities that they have previously enjoyed, if they don’t seem to be able to keep up with their playmates or if they complain of any pain or discomfort, it’s time to make an appointment at our Jamesburg or Metuchen office. Our board certified foot and ankle surgeon, Dr. Elliott M. Perel, has a great deal of experience treating all types of pediatric foot and ankle problems. In most cases, early diagnosis and treatment results in a better outcome, so don’t delay. 

By Monroe Foot & Ankle Care
January 12, 2016
Tags: neuromas  

A common cause of pain in the ball of the foot, which we treat often at Monroe Foot & Ankle Care, is a neuroma. A neuroma occurs when a nerve swells, becoming larger than the space it inhabits. The long bones that run down the length of your foot from your toes are called metatarsals. Nerves run between the metatarsals and split at the base of your toes and this is the site most commonly affected. When the nerve gets compressed (from shoes that don’t fit properly or a repetitive activity) or is traumatized (from a wound or surgery), a neuroma can form.

Symptoms of Neuromas

In addition to pain in the ball of your foot—which can be quite severe at times—neuromas may also produce a burning or tingling sensation in your foot as well as numbness in one or two of the toes. The pain may come and go but will be aggravated by anything that puts pressure on the nerve. You may also experience a popping sensation when you walk.

Diagnosis and Treatment

There are several conditions that mimic the symptoms of a neuroma, including: arthritis, stress fractures of the metatarsals and inflammation of the tendons in the toes, as well as nerve damage in other parts of the foot, ankle, knee, hip or back. That’s why our board certified foot and ankle surgeon, Dr. Elliott M. Perel will start with a detailed medical history, including information about the symptoms you are experiencing now. A thorough examination of the foot will also be conducted and digital x-rays will likely be ordered (which can be done right in our Metuchen or Jamesburg office) to rule out other possible disorders.

There are several options available for treating neuromas and the foot doctor will choose the one that is right for you. Often cortisone injections are given to shrink the swelling of the nerve. Orthotics may also be prescribed to correct any structural or mechanical problems that may be compressing the nerve and causing the condition. In the majority of cases, these treatments will alleviate the pain and the progression of the neuroma. In severe cases, chemical destruction of the nerve or neuroma surgery may be the only options.

As with most foot disorders, the earlier you seek treatment, the less invasive the treatment and the better the outcome. If you are experiencing any symptoms of a neuroma, contact one of our Middlesex county offices for an appointment.

By Monroe Foot & Ankle Care
January 05, 2016
Tags: hallux limitus   gout   turf toe   hallux rigidus  

Now that the cold days of winter have finally caught up with us, you notice that your big toe is achy and stiff. It’s particularly noticeable when you are on your feet or bending or squatting down to put something away. The joint at the base of the big toe seems swollen and inflamed. At first, the pain would subside when you would sit down and get off your feet for a while, but now it seems to be more constant. If this scenario describes your symptoms, you may be experiencing hallux limitus.

Causes of Hallux Limitus

Hallux limitus is actually a form of osteoarthritis—the degenerative, “wear and tear” form of the disease. Faulty foot mechanics are most often to blame as the reason the arthritis affects the big toe. People who have fallen arches or the tendency to roll their ankles inward when they walk are more likely to develop this disorder. Hallux limitus can also be brought about by an inflammatory disease such as gout or rheumatoid arthritis. An injury, such as severely stubbing your toe, can also be the starting point for hallux limitus. Jobs that require a person to do a lot of bending and squatting can lead to overuse of the big toe joint and cause or worsen the condition.

How to Get Relief

Hallux limitus is a progressive disease. Left untreated, the joint will get stiffer and stiffer until you are no longer able to straighten the toe. At this point, the condition becomes hallux rigidus and usually the only course of action at that point is surgery. At Monroe Foot & Ankle Care, our board certified foot and ankle surgeon, Dr. Elliott M. Perel, will start by asking questions about your symptoms and doing a complete examination of your toe and foot. Several other disorders, including gout, turf toe and bunions can have similar symptoms and need to be ruled out. X-rays will most likely be ordered to gain a clearer picture of the toe and can show how much arthritis is present.

With a confirmed diagnosis, treatment can begin. The foot doctor may prescribe oral anti-inflammatory medications and/or corticosteroid injections to relieve pain and inflammation. Modifications to footwear and the addition of custom orthotics may take pressure off the toe. Physical therapy may also help.

The sooner treatment begins, the more likely that you’ll be able to avoid or at least delay the need for surgery. If you are having pain and stiffness in your big toe, contact either our Metuchen or Jamesburg office and make an appointment today.

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241 Forsgate Dr., Suite 206
Jamesburg New Jersey, 08831

Podiatrist - Jamesburg, MONROE FOOT & ANKLE CARE, P.C., 241 Forsgate Dr., Suite 206, Jamesburg New Jersey, 08831 732-521-2155