Gout is a type of arthritis that is caused by having too much uric acid in the joints. Uric acid is a substance that forms when your body breaks down a substance called purines. Uric acid usually dissolves in your blood and passes through your kidneys into your urine. In people with gout, uric acid builds up and forms sharp crystals that can collect around the joints. This causes pain and swelling in the affected joints.
The pain can be very intense and can occur suddenly for no apparent reason. It often affects the big toe joint and it usually occurs at night. The affected joint becomes red, feels hot and hurts a lot. It will be more painful if you touch it. Other parts of the body where gout attacks occur include the top of the foot and the ankle joint. Gout can affect other joints in your body but it is most prevalent in the foot.
Gout is most common in people who are overweight, drink alcohol or have
high cholesterol. Men have gout more often than women do, although women
are more likely to have gout after menopause. In addition, some people
who eat foods that contain a lot of purines are prone to gout attacks.
Some of these foods are salmon, sardines, liver and herring.
Some medicines can also make gout more likely. These include:
• certain diuretics (“water pills”)
• niacin (a B-complex vitamin)
• aspirin (taken in low doses)
• cyclosporine (brand names: Sandimmune, Neoral, SangCya)
• some drugs used to treat cancer
Call us immediately. Tell our receptionist that you have a red, hot big
toe joint (or other joint) and she will get you in right away. In the
meantime, you should rest and not walk if you can avoid it. Putting a
hot pad or an ice pack on the joint may ease the pain. Avoid any
pressure on the foot – even the weight of sheets can be painful.
Medicines that you can take without a prescription that reduce
inflammation, such as aspirin or ibuprofen may help.
When you come to the office we will evaluate your foot to determine if
the problem is gout or some other problem (such as an infection). We may
have a blood draw done to check for infection and also to check the
level of uric acid in your blood. Once we are confident the problem is
gout we will prescribe medication that usually relieves the pain fairly
rapidly – it will usually resolve completely within a few days. We will
also provide treatment to limit the pain while you wait for the medicine
to take effect.
If you don’t get treatment, a gout attack can last for days or even
weeks. If you keep having more attacks, more joints will be affected,
and the attacks will last longer.
If you have gout attacks for many years, you may develop soft tissue
swellings of uric acid crystals called tophi in your joints. Tophi
usually form on the toes, fingers, hands and elbows. You may also get
kidney disease or kidney stones. Over time, the bone around a joint may
be destroyed by gout.
Once we have taken care of your current pain, we will likely refer you
to your primary care physician. He or she may prescribe medicines to
prevent future gout attacks. These medicines can wash the uric acid from
your joints, reduce swelling and keep uric acid from forming.
If you are overweight, lose the weight. If you have high blood pressure
or high cholesterol, get treatment and follow a low-salt, low-fat diet.
Stay away from alcohol and foods that are high in purines. Drink lots of
water. It can help flush uric acid from your body.
Call us immediately in our Seattle office if you
think you might be having a gout attack affecting the foot. Let our
receptionist know the problem. We want to see patients with
gout right away so that we can help eliminate the pain
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All pages on this website © 2005-2013
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.
