Common Foot Problems

What Is Gout?

Gout is a medical condition that causes redness and swelling in joints or tissues. Resulting from a build-up of uric acid, gout usually affects the big toe joint.

Elevated levels of uric acid crystallize in joints, causing a gout attack. Normally, uric acid is present in the blood and excreted in urine. But in patients with gout, elevated levels of uric acid crystallize in the joints. Purines are chemicals naturally found in our bodies and in food that metabolically break down to produce uric acid. Gout is developed when too much uric acid is produced, or when kidneys struggle to eliminate normal amounts of uric acid.

Gout can affect any joint in the body but most commonly involves the big toe. Uric acid is sensitive to temperature changes and crystallizes at cooler temperatures. Toes are most often affected by gout since they are located farthest from the heart and remain at cooler temperatures.

Genetics is the most common cause of gout, although stress, certain medications and vitamins are other risk factors for developing gout. For instance, the body is more likely to store uric acid when taking aspirin, some diuretic medications and the vitamin niacin, also known as nicotinic acid. Surgery, chemotherapy and medical conditions such as diabetes, obesity and high blood pressure also increase the likelihood of developing gout. Although more common in men aged 40 to 60, gout can affect younger men and women.

Certain foods and beverages with high levels of purines can increase levels of uric acid and trigger a gout attack. Some foods contain more purines than others. The chances of a gout attack may be reduced by limiting or avoiding shellfish, organic meats such as kidney and liver, red meat, red wine and beer.

A gout flare-up can be very unpleasant and include these symptoms:

  • Sudden, intense joint pain that usually begins during the night or upon arising.
  • Inflammatory symptoms - redness, tenderness, swelling and warmth over the joint.

When diagnosing gout, Dr. Radovic will obtain a thorough personal and family medical history, then examine the affected joint. X-rays and laboratory tests may supplement the exam to investigate any other possible causes of inflammation.

An initial gout flare up is normally treated with:

  • Prescription medications and injections to eliminate the pain, swelling and inflammation.
  • Foods and beverages with high concentrations of purines should be avoided to limit uric acid levels.
  • Stay hydrated by drinking lots of water and other fluids. Avoid alcoholic beverages which cause dehydration.
  • Rest your foot by avoiding standing and walking. Elevate your foot at or slightly above the heart level to help reduce swelling.

Treatment normally resolves inflammation and other symptoms of gout in three to ten days. However, a primary care physician should be consulted if gout symptoms are unresponsive to initial treatment, or if flare ups reoccur. 

The primary care physician will assess a treatment plan that possibly involves daily medication. Repeated gout attacks must be addressed to avoid arthritic joint damage from a build-up of uric acid over time.

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