Gout

What is gout?

Have you experienced sudden, severe attacks of pain, tenderness or redness in the joint at the base of your big toe? It could be gout. Gout is actually one of the most painful types of arthritis. This occurs when there is too much uric acid present in the body, and it can affect anyone. Men in their 40s and 50s are more likely than women to get gout, however women are more susceptible after menopause.

How do I know if I have gout?

The symptoms and signs of gout are usually acute, they appear suddenly without warning. A lot of the time the attack will occur at night. There are many symptoms of gout:

  • Sharp, severe pain in the joints: This pain can be experienced in the hands, wrists, ankles, knees or feet. The big toe is most commonly affected. Sometimes patients describe the area as being warm or hot. Inflammation can also occur.
  • Gradual decrease in pain: This type of arthritis can last for over a week if it’s untreated, then usually goes away within the next week or two.
  • Peeling, itchy skin: As gout gradually subsides, the skin near the affected area may begin to itch and peel.
  • Inflammation and redness: Gout usually causes tender, swollen and red joints in the area that’s experiencing the most pain.
  • Purplish or red colored skin: This may cause the patient to think he or she has an infection.
  • Fever: In some cases, gout can cause body temperature to elevate.
  • Decrease in flexibility: The joint affected could feel harder to use, or have limited movement.

What causes gout?

Increased levels of uric acid (hyperuricemia), in the blood are the cause of gout. When this happens, severe pain, inflammation and a gout attack occur. When the body breaks down chemicals called purines, uric acid is produced. These purines are found in the body as well as in foods such as organ meat, asparagus, mushrooms and herring.

Uric acid usually dissolves and goes away, however if the body is producing too much, or if the kidneys aren’t getting rid of enough uric acid it will build up. When the acid accumulates, it results in sharp crystals that look similar to needles. These cause pain, swelling and inflammation in the affected areas.

The following factors can also contribute to a gout attack:

  • Being overweight or obese
  • Losing weight quickly
  • Consuming excessive amounts of alcohol
  • Diets high in foods with purines, like seafood and meat
  • Diets very low in calories
  • Using aspirin regularly
  • High blood pressure
  • Psoriasis
  • Surgery

How is gout treated?

Gout is typically treated with medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help stop the inflammation and pain. Examples of NSAIDs include ibuprofen and naproxen. If you take NSAIDs, there is an increased risk of ulcers, bleeding and stomach pain. Colchicine can also be an effective drug for treating gout. However, complications include vomiting, diarrhea and nausea. Colchicine is usually given to patients who cannot take NSAIDs.

Steroids are commonly used to battle the painful form or arthritis. Just like the medications described above, steroids help combat pain and inflammation. Steroids can either be taken orally or be injected directly into the joint. Common symptoms include bone thinning, weaker immune systems and poor wound healing. Steroids are typically given to patients who cannot take NSAIDs or colchicines.

Can I do anything at home to relieve gout pain?

Besides seeing your podiatrist, there are things you can do to ease the pain and swelling caused by gout. Raise and rest the affected limb, and use a splint to immobilize the joint. Also, do not exercise vigorously. Try keeping the joint cool by applying an ice pack wrapped in a towel. Remember, don’t apply cold items directly onto the skin. Lastly, do not cover the joint.

How do I prevent gout?

There are medications available to reduce the risk of future gout attacks. These medications are usually taken after the gout attack is over. Medications are used to:

  • Reduce uric acid production: A drug called Allupurinol can reduce the amount of acid the body produces. This lowers the chances of a gout attack reoccurring. Patients have experienced rashes or have had a low blood count after taking Allupurinol.
  • Remove uric acid more successfully: Probenecid is a medication that helps the kidneys eliminate uric acid more efficiently which in turn lowers the uric acid levels in the blood. This reduces the chance of another gout attack. Rashes, stomach pain and kidney stones have been experienced as side effects.

Lastly, you can change your eating habits. Nutrition hasn’t been proven to reduce the risk of gout, however, it makes sense not to eat too many foot items that are high in purines. Reduce your intake of fats, alcohol and foods that are more likely to increase the amount of uric acid in the body. Try to eat less meat, bacon, mussels, sardines and yeast.  Cutting back on alcohol, especially beer can also be helpful.

Are you afraid you may be suffering from gout? The podiatrist at NorthPointe Foot & Ankle Care can help. The staff has been serving the Berkley, Southfield, Royal Oak, Oak Park, and Ferndale areas for 30+ years. Schedule an appointment via our website, or by calling (248) 545-0100.