Urgent Care for Gout in Seattle – Same Day Treatment
Acute gout is a common problem we treat in our Seattle foot and ankle clinic. Call our office at (206) 344-3808 and we will help you with your gout the same day Monday – Friday. You can also schedule appointments online on our patient portal, but same day appointments are not always available online.
Symptoms of Gout
Sudden onset of painful joint – pain often noticed at night or when you wake up in the morning.
Redness – your joint will often appear bright red and look like an infection.
Swelling – typically notice moderate swelling around the affected joint.
Location – great toe joint most common site but gout can occur at other joints. At deeper joints you may not notice as much redness and swelling.
What Should I Do if I Have a Gout Attack?
Call us immediately. Tell our receptionist that you have a red, hot big toe joint (or other joint) and we will get you in right away. In the meantime, also try these pain relieving hints:
- Rest and avoid walking
- Put a hot pad or an ice pack on the joint
- Avoid any pressure on the foot – even the weight of sheets can be painful
- Try over-the-counter anti-inflammatories such as aspirin or ibuprofen
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 draw blood to check for infection and the level of uric acid in your blood. Once we are confident the problem is gout, we will prescribe medication to relieve 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.
What Is Gout and Why Does It Hurt So Much?
Gout is a type of arthritis caused by 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 normally dissolves in your blood and passes through your kidneys into your urine. With gout, uric acid builds up and forms sharp crystals that can collect around the joints causing pain and swelling in the affected joints – most often the big toe joint and the top of the foot. The pain can be very intense, occur suddenly, and for no apparent reason. The affected joint becomes red, feels hot, and hurts a lot. It will be more painful if you touch it. Gout can affect other joints in your body, but is most prevalent in the foot.
Video: Best Treatments for Gout Pain
Foot and Ankle Joints Are Most Commonly Affected by Gout
Gout affects the joints of the foot and ankle more than other part of the body primarily because the foot is the coolest part of the body, as an extremity, and gout crystals most often deposit in cooler areas. It is often thought that only the big toe joints are affected by gout, but that is not true. While big toe joints are the most likely to be affected, all of the joints of the foot and ankle are common areas for gout attacks.
The most common joints to be affected include:
- Big toe joint
- Joints on the top of the foot
- Ankle joint
- Who Can Get Gout?
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, people who eat foods high in purines may be more prone to gout attacks. Some of these foods include beer, red wine, red meat, shellfish, salmon, sardines, liver, oysters and herring.
Medicines Can Increase Risk of Gout
Some medications may increase your risk of gout including:
- Some diuretics (“water pills”)
- Niacin (a B-complex vitamin)
- Aspirin (taken in low doses)
- Cyclosporine (brand names: Sandimmune, Neoral, SangCya)
- Some cancer treatment drugs
Excess Weight Can Aggravate Gout
Studies in the last few years have shown that the best way to prevent gout attacks is to lose weight. Obesity has long been known to be a risk factor for gout, but recent studies show that it is much more important than was once thought. A 12-year study of more than 47,000 middle-aged men found that the heavier the men, the greater the risk of gout and those who reduced their weight dramatically cut their risk of gout.
The greater the weight gain, the greater the risk of gout occurring. Men who gained at least thirty pounds since they were 21 had twice the risk of developing gout compared to men who did not gain weight. The authors of the study reported that “weight loss greater than 10 pounds since the beginning of the study was associated with a substantially reduced risk of gout.” We have detailed information on our website about the effects of obesity on the feet.
Video: Understanding Gout
What Can I Do to Avoid Gout Attacks?
Once we take care of your current gout attack pain, we will likely refer you to your primary care physician so they can consider medication to prevent future gout attacks. These medicines can wash the uric acid from your joints, reduce swelling, and keep uric acid from forming. We also recommend, if you are overweight, to shed excess pounds. 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. And be sure to drink lots of water – it can help flush uric acid from your body.
How Does Diet Affect Gout?
Your diet can play a large role in the cause and prevention of gout attacks. Every person who has suffered gout should consult with their primary care physician and a registered dietitian. If you don’t have a primary care physician, we can provide recommendations.
Is a registered dietitian preferable to a nutritionist for gout?
We suggest you see a Registered Dietitian. “Nutritionist” is a not a very well defined title and may be used by many people with various forms of training. A registered dietitian, on the other hand, has a Bachelor’s degree (or higher) in nutrition or a related field and has gone through an internship at a health care facility. They must pass a certifying examination before they can be licensed as a registered dietitian. Below is a list of registered dietitians to whom we often refer.
Will insurance cover diet and nutrition counseling?
Most insurance companies cover individual nutritional counseling. For those without medical insurance, many of the RDs listed below have payment plans and sliding scales.
- Seattle Area Registered Dietitians
- Swedish Nutrition Clinics in Ballard, Edmonds, Issaquah and First Hill in Seattle
- Food/Sense in Burien (Danielle VenHuizen, MS, RD)
- FitFirst in North Seattle (Jess Mullen, RD)
- Crave Health in Kirkland (Ashley Besecker, RD, CD)
(Note to Seattle Dietitians: We are looking for registered dietitians to add to our referral list. We like to meet first to discuss patient care. If you are interested, please contact our office so we can set up a time to talk.)
What If I Don’t Get Gout Treatment?
If you don’t get treatment, a gout attack can last for days or weeks. If you continue to have 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 develop kidney disease or kidney stones and, over time, the bone around a joint may be destroyed by gout.