Gout

Gout is a common, but complex, form of arthritis that can affect anyone. It’s a condition that has risen significantly over the past 20 years and now affects some 8.3 million Americans. 

Symptoms

Gout is a common form of inflammatory arthritis that is very painful. Symptoms of a gout attack include:

  • Sudden, severe attacks of pain, swelling, redness, and tenderness—most often in the big toe joint, but it can occur in other parts of the foot as well.
  • Warmth, swelling, reddening of the skin, and tenderness—often at the base of the big toe.
  • Often occurs with a tingling sensation that progresses to an intense burning pain in your toes or feet.
  • Pain in other joints like the ankles, knees, wrists, elbows, and fingers. 
  • Severe joint pain within 4 to 12 hours after a gout attack first occurs. 
  • Discomfort lasting for days to weeks after the severe pain goes away. 
  • Recurrent attacks often last longer and affect more joints as the disease progresses.
  • Difficulty moving your joints as you normally would.
  • Gout will likely flare up again after the initial resolution. For this reason, correct diagnosis and treatment is important.

Causes

There are two known causes of gout: overproduction of uric acid or underexcretion by the kidneys. When urate crystals accumulate in a joint, it causes inflammation of the joint fluid. Urate crystals form when you have high levels of uric acid in your blood and an inability to excrete them in your urine. Uric acid is naturally created by your body during break down purines. Purines are found in certain foods, for example: organ meats (hearts, liver, kidney), leafy greens (collards, turnip, mustard), and shellfish (shrimp, scallop, crab). In addition, alcohol such as brown liquor and beer and drinks with high fructose promote increased levels of uric acid in your body. 

Your body usually dissolves uric acid in your blood and passes through your kidneys to your urine. However, sometimes your body produces too much uric acid or your kidneys excrete too little acid. As the uric acid builds up, it forms sharp urate crystals in a joint or its surrounding tissue which hinders the joint’s ability to move freely thus causing friction and pain.

Risk Factors of Gout

Certain factors can make you more likely to have increased levels of uric acid in your body. These include:

Diet
  • A diet rich in red meat, shellfish, beverages with fructose, and alcohol increases the risk of gout. 
Medical Conditions
  • Untreated high blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome
  • Heart disease
  • Kidney disease 
  • Family history
Age and Sex
  • Men experience gout more frequently than women
  • Men are more likely to develop gout between the ages of 30 and 50
  • Women generally develop it after menopause

Symptoms

Symptoms of a gout attack include:

  • Warmth, swelling, reddening of the skin, and tenderness—often at the base of the big toe.
  • Pain in other joints like the ankles, knees, wrists, elbows, and fingers. 
  • Severe joint pain within the first 4 to 12 hours after a gout attack first occurs. 
  • Discomfort lasting for days to weeks after the severe pain goes away. 
  • Recurrent attacks often last longer and affect more joints as the disease progresses.
  • Difficulty moving your joints as you normally would.

Diagnosis

Gout is generally diagnosed clinically based on symptoms and the appearance of the joint. But there are tests that your provider may use to help diagnose gout:

  • Joint fluid test through joint fluid aspiration-this is considered gold standard testing but is invasive and oftentimes painful.
  • Blood tests
  • Imaging such as x-ray or ultrasound.

Gout Treatment

Immediate treatment for a gout flair includes:

  • Prescription anti-inflammatory medications
  • Joint injections
  • Casting with shoe modifications

 

Long term treatment of gout may include oral medications prevents gout complications by lowering the amount of uric acid in the blood. Your doctor will help you decide the correct medication depending on the frequency and severity of your symptoms. 

Although medications are the most effective treatment for gout, lifestyle choices can be an effective way to prevent recurrent flare ups. 


Some of these changes are:

Choosing Healthier Drinks
Limit alcoholic beverages and drinks with fructose. Nonalcoholic beverages, especially water, should be consumed instead.

Avoiding Foods High in Purines
Red meat and organ meats are especially high in purines. Anchovies, sardines, mussels, scallops, and tuna are also rich in purines. Low-fat dairy products are a better source of protein for those prone to gout. 

Exercising Regularly
Keeping your body at a healthy weight can reduce your risk of gout. Try low-impact activities like walking, biking, and swimming, which will be easy on your joints.

If you have a foot injury or a condition that’s getting worse, don’t live with the pain.

Treat Gout at Keir Foot & Ankle Specialists

Keir Foot & Ankle is the trusted place to receive treatment for gout in Beverly, Mount Greenwood, Morgan Park and the Far South Chicago suburbs. We diagnose gout and find the proper treatment for gout attacks, preventing future flare-ups, and reducing the risk of complications.

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