Gout

Gout

What Is Gout?

Gout is a form of inflammatory arthritis that can commonly interfere with the joints in the feet. Gout is characterized by sudden and severe bouts of pain. A gout attack can cause swelling, pain, redness, and tenderness in one or more joints. 

The condition can make it extremely difficult to do anything on your feet. It typically affects the big toe but can be found in other joints, such as the ankle, foot, knee, hand, wrist, or elbow. An untreated gout attack can intensify, and the swelling/inflammation can cause damage to the affected joints or surrounding tissue.

A doctor or foot specialist can help in reducing the frequency of gout attacks by providing treatment options and pain relief. 

Symptoms

What Are the Symptoms of Gout?

Gout attacks are very painful and can develop quite suddenly, especially overnight. The symptoms you may feel during a gout attack involve the following:

  • Severe joint pain. Gout usually affects the big toe of the foot but can spread to other joints as well. 
  • Redness, swelling, inflammation, and stiffness in the foot 
  • Tenderness when touched 
  • Heat, or feelings of warmth from the affected joint 
  • Limited range of motion in the foot
  • Hypersensitivity of the affected area 

During the first gout attack, only one joint will typically be affected. Any attacks that follow may begin to affect other joints in the foot. A gout attack can last for days, but the time between attacks may be weeks, months, or years.



Gout

Causes

What Causes Gout?

Gout is caused by high levels of uric acid in your blood and tissue. When these uric acid levels in the bloodstream become too high, any excess uric acid becomes crystallized. Uric acid crystals then deposit themselves into the joints, which causes inflammation as a response. The inflammation is an attempt to defend the joints from the uric acid crystals. In some cases, uric acid crystals can deposit themselves in the kidneys, resulting in the development of kidney stones. 

The following factors can cause high levels of uric acid that lead to gout:

  • Your diet: Foods such as red meats, organ meats, seafood, alcoholic beverages, yeast/yeast extracts, or high fructose beverages may contain higher amounts of purine chemicals that are known to contribute to the rise of uric acid levels. 
  • Medical conditions: Kidney diseases, eating disorders, binge drinking, or leukemia are a few of the conditions that can lead to gout. 
  • Genetics: A family history of gout can be passed down to you. 
  • Medications: Water pills, also known as diuretics, can increase the levels of uric acid in your bloodstream, leading to gout. 
  • Weight gain/obesity: More purines get broken down to accommodate the sudden fluctuation in weight.

Diagnosis

How Do You Diagnose Gout?

Any severe pain experienced with gout attacks should be looked over by a healthcare professional. There a numerous things to consider during a gout diagnosis: 

  • A physical exam may be necessary to see the affected joints and whether the symptoms of redness, swelling, or heat are present. 
  • Blood work tests can be used to examine the amount of uric acid that’s in your bloodstream. 
  • A Doctor may need to draw fluid from the affected joint to look for uric acids. 
  • Imaging tests, such as x-rays or MRIs can be used to see if any other foot problems may be causing the inflammation.

Treatment

How Is Gout Treated?

In many ways, gout is treated similarly to rheumatoid arthritis. Gout treatment may include the following:

  • Medications for uric acid level reduction are prescribed to those who experience frequent gout attacks. These medications are often for long-term use.
  • Non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen, can reduce joint inflammation created by gout. 
  • Corticosteroids can be prescribed if the NSAIDs don’t work. While corticosteroids are also anti-inflammatory, they may have side effects.
  • Modifying your lifestyle by changing to a nutritional diet and losing weight can decrease the risk of uric acids building up. 
  • Stretching and strengthening exercises for your joints and muscles can prevent a gout attack, as well as assist in correcting any joint damages caused by gout. 
  • Supportive footwear may assist with any gout-related joint damages and alleviate pain brought on by gout attacks. 

The damages and pain resulting from gout can be counteracted by seeing a foot specialist. Our clinic is equipped with knowledgeable foot specialists that can fit you for custom orthotics.



Risk Factors

What Can Put Me At Risk of Gout?

There are certain factors responsible for putting you at risk of gout, such as the following:

  • Genetic predispositions can result in the risk of gout.
  • Kidney disease can play a role in developing gout; kidneys are responsible for the breakdown of uric acids.
  • Leukemia and other cancers can affect the metabolic process responsible for breaking down the uric acid. The chemotherapy drugs used in treating cancer can make the patient more susceptible to developing gout. 
  • Those dealing with type 2 diabetes can become more prone to gout attacks. 
  • Gender may play a role in developing gout, as the metabolic predisposition in men produces more uric acid than women. 
  • Individuals over 40 may start to see the effects of gout, beginning in their big toe.
  • Hyperlipidemia, a condition associated with obesity that involves high levels of fat in the blood, can cause too much uric acid. 
  • Medications involved in hypertension can result in elevated uric acid levels.
  • Receiving specific vaccinations may sometimes trigger a gout flare. 
  • Dehydration can produce effects that trigger the rise of uric acid.

Foods/Drinks

If you consume food or beverages with a high amount of purine, it can result in the development of gout. These may include the following:

  • Bacon
  • Fish
  • Liver
  • Turkey
  • Peas
  • Alcoholic beverages

The purine chemical in foods helps produce uric acid in your body. In most cases, uric acid will dissolve and exit through your urine. However, there are times when uric acid may accumulate in your bloodstream, causing a gout attack.

Complications

The risk factors associated with gout can develop more severe complications, such as:

  • Recurrent gout might have to be treated with medication to prevent future gout attacks. 
  • Advanced gout leads to the formation of urate crystals under the skin called tophi. Tophi can develop in other areas of the body, from the feet and Achilles tendon to hands and elbows. These areas can become swollen during gout attacks. 
  • Kidney stones can form as urate crystals accumulate in the urinary tract. It’s a common experience for those dealing with gout. 
  • Bursitis can develop as the inflammation with gout can spread to the fluid sac that cushions the knees or elbows. Bursitis can lead to permanent joint damage or infection.

Prevention

How Do I Prevent Gout?

Some of the factors associated with gout may not be preventable, as there are many elements at work. If you’re a gout patient, there are ways to help prevent gout or gout attacks.  

These prevention methods include:

  • A healthy diet with good nutrition
  • Avoiding foods that are high in purines
  • Maintaining a healthy weight
  • Staying active and practicing stretching and strengthening exercises to keep the muscles and joints in your feet and legs strong
  • Avoiding medications, such as diuretics, as they can cause gout
  • Addressing any foot conditions or abnormalities by seeing a foot specialist. They’ll be able to assess and treat your conditions.
  • Staying hydrated
  • Cutting back on alcoholic drinks

For those wishing to prevent a gout attack, try:

  • Anti-inflammatory drugs
  • Medications to reduce uric acid and promote its breakdown

Due to gout sharing many similarities with inflammatory arthritis, most of the treatments that help prevent arthritis can also be used to assist with gout.

If you’re struggling with gout, you may find the best possible solutions when you see one of our skilled foot specialists. We’ll be able to accommodate you with services that can prevent or treat gout. Book an appointment with us today and see what we can do for you.

PROFESSIONAL FOOT CLINIC

416-465-8737

Toronto, ON Chiropodist Academy Foot and Orthotic

752 BROADVIEW AVENUE Toronto, ON M4K 2P1 

Across from the Broadview Subway | Professional Family Foot Care