How Does Gout Affect The Feet And Ankles
Feb 16, 2019 | Conditions
Gout is a painful form of inflammatory arthritis which affects the joints. Although it can impact the joints of your wrists, fingers, and elbows, it is the joints at the base of the big toe and the ankles which are mainly affected.
Gout attacks happen suddenly, and in mostcases, the affected joint is tender, red, and swollen, and can be extremelypainful.
If left untreated, a person can sufferfrom repeated attacks of gout. Men and obese adults over the age of thirty areat a greater risk of developing gout.
Posterior Tibial Tendon Dysfunction
PTTD, also known as adult-acquired flatfoot, occurs when you have an injury or inflammation to the posterior tibial tendon. The posterior tibial tendon connects the inner foot to a muscle in the calf. PTTD can cause arch pain if the posterior tibial tendon is no longer able to support the arch.
With PTTD, arch pain is likely to extend along the back of the calf and inner aspect of the ankle. You may also have ankle swelling. Pain typically occurs during activities, such as running, not afterward.
You may need to wear an ankle brace or custom shoe insert to treat PTTD. Physical therapy may also help. In some cases, you may need surgery to treat the condition.
How Is Foot Gout Diagnosed
If you are experiencing sudden bouts of intense pain in your joints, or if you feel you are experiencing the symptoms of foot gout, you should see your doctor immediately. Early detection can improve your chances of catching the gout during its early stages and successfully treating the condition.
Your doctor will perform a number of tests on you and ask questions about your family history, medical history, personal habits, and diet. He or she may also perform a joint fluid test. During this test, a needle is used to draw fluid from your affected joint for analysis. Your doctor may also order a blood test to measure your uric acid levels.
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The More Gout Builds Up The More Harm It Can Do
Out-of-control chronic gout can be painful and unpredictable, and cause permanent damage. Even after gout flares end, uric acid crystals from gout stay in your body, settle in your joints, and damage your bones. Uric acid crystals can also build up in vital organs like the kidneys. If you have gout and kidney disease, its important to take control of gout because gout can lead to kidney disease progression.
Which Foods Cause Gout
Foods high in purines from animal and seafood sources are thought to be a key element of increasing uric acid precursors. Interestingly, purines can also be found in high concentrations in vegetables such as beans and mushrooms, but these have not been found to be related to the risk of hyperuricemia.
New evidence over the last decade has shown that some of the foods that were previously thought to be associated with gout, like meat, may not have such a strong relationship as originally thought. Overall, your gout risk may be raised by consuming large quantities of:
- Some seafoods, like shellfish, shrimp, tuna, mussels, lobster, sardines and salmon
- Red meats like bacon, liver, beef, pork, turkey, veal and lamb
- High-fructose corn syrup, which is often found in processed foods including biscuits, syrups, chutneys and sauces, though the evidence is mixed on this one with only one American study finding a relationship between high consumption and gout
Before you decide to cut out food groups from the list above, according to Arthritis Australia, there is little evidence that avoiding these purine-rich foods can significantly reduce gout attacks and by cutting them out, you may miss out on important vitamins and minerals, particularly when it comes to meats and seafood. We recommend making these decisions together with your GP, dietitian or nutritionist.
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Once Thought To Be A Disease Of The Upper Class Gout Can Affect Anyone Caused By The Buildup Of Uric Acid Salts In The Joints The Big Toe Is The Most Commonly Affected Area
Gout or bunion? Intense pain will usually indicate gout, but only your podiatrist can make a proper determination Normally, uric acid dissolves in your blood, passes through your kidneys, and exits your body via urine. But in some people, uric acid isn’t eliminated properly, and levels become too high. This excess uric acid builds up around the joints, causing inflammation, swelling, and severe pain, which is why Gout is classified as a form of arthritis.
Most patients experience their first gout attack in the middle of the night – they wake up to a throbbing pain in the joint just below the big toe , which is frequently swollen as well. Gout may also appear in the arch of your foot, , heel, knee, wrist, fingers, or elbow.
Symptoms of Gout
- Severe pain and a hot feeling in the affected joints, usually appearing first in the . Pain from an untreated gout attack can last for a week or more and then subside, but pain will return within 3 months
- Red skin area around the joint may appear red or purplish
- Fever
- Stiffness in the joint
- Itchy skin as the gout attack subsides, skin around the joint may itch and peel away
- Small lumps appear around the elbows, hands, or ears
Why some people with high uric acid levels develop Gout and others don’t is not completely understood, but one or more of these factors are thought to contribute:
Diagnostic Evaluation Of Gout In Foot
What goes into a gout diagnosis? These procedures are options:
- Joint aspiration. Fluid is withdrawn from the joint and inspected for crystals and bacteria.
- Blood tests. White blood cell count, ESR , triglycerides, and kidney function may be elevated.
- X-ray. An x-ray of the affected joint is likely to appear normal during an initial acute episode, but in chronic gout, bone erosion and overhanging edges may be seen.
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Can Gout Affect The Arch Of The Foot
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Does Gout Cause Pain In The Heel
Goutyarthritis, much familiar called gout, occurs when there is a lot of uric acid in the body. As with most arthritis, it is a painfulcondition affecting joints of the body. The metatarsal-phalangeal joint locatedat the base of the big toe is the frequent area affected by this arthritis. Sometimesgout occurs in the knees, ankles, wrists, fingers, and elbow. Does it alsoattack the heel and cause heel pain?
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How Is Gout In The Ankle Diagnosed
If you think you might have gout but havent been diagnosed, try to see a doctor while youre having symptoms. Gout is easier to diagnose when youre in the middle of a flare-up thats causing swelling, redness, and other visible symptoms.
During your appointment, your doctor will likely ask you several questions about your diet, any medications you take, and whether you have a family history of gout. This can help to rule out other potential causes of your symptoms, including an infection or rheumatoid arthritis.
Your doctor may also order a blood test to check your uric acid levels. But some people have high levels of uric acid and dont develop gout. Others have typical uric acid levels but still develop gout. As a result, theyll want to do some other tests as well.
An X-ray, MRI, or CT scan of your ankle can also help to eliminate other possible causes of joint inflammation. Depending on your exam, they may also order an ultrasound to check for the presence of crystals in your ankle.
Finally, they might do a joint fluid test. This involves taking a small sample of joint fluid from your ankle with a small needle and looking at it under a microscope for any uric acid crystals.
Based on the results of your exam and tests, they may refer you to an inflammatory arthritis specialist called a rheumatologist for treatment.
Theres no cure for gout, but a combination of medications and home treatments can help to manage ankle pain and reduce the number of flare-ups you have.
How Is Heel Bursitis Treated
Heel bursitis treatment depends on whats causing your pain. Treatment may include:
- Orthotics: Heel wedges encourage proper walking form and reduce irritation in your heel. You can buy heel wedges in a store. Your healthcare provider can also make custom heel wedges for your foot.
- Physical therapy: Stretching your Achilles tendon will take pressure off your heel bursa. Calf stretches, toe-to-wall stretches and heel drop stretches may all provide relief. Calf, ankle and foot exercises strengthen your Achilles tendon and the surrounding area. This also takes pressure off your bursa.
- Corticosteroids: In rare cases, your healthcare provider may inject a corticosteroid into your heel. This will decrease inflammation.
- Surgery: Surgery is rarely needed. However, if your pain hasnt improved in six to 12 months, you may have to see a foot and ankle surgeon. They may surgically remove the affected bursa .
- Antibiotics: If an infection caused your bursitis, your healthcare provider will prescribe oral antibiotics.
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Tips To Keep A Gout Attack At Bay
When agout attack hits, its usually swift, severe, and obvious somethings wrong. Often starting at night, the joint of your big toe is typically the source of sharp and intense pain.
Fortunately, gout often responds well to medication, but this is only useful when you have some on hand. Otherwise, youll need to cope with the pain of the attack until you can see a doctor and get a prescription. Even then, it may take six to 24 hours for full relief from the symptoms of your attack.
Its possible to modify your lifestyle to reduce the risk of future attacks. Contact podiatristErrol Gindi, DPM for an examination and consultation to learn more about your condition. As sharp as it is, its possible to get past the pain of gout.
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What Causes Gout Pain
Picture a collection of glass shards pressing outward like needles. This is what it can feel like during a gout flare, when a buildup of uric acid in the blood forms microscopic crystals that grow in and around a joint. As the build-up increases, the immune system responds to these crystals, causing inflammation that leads to visible swelling, redness, and debilitating pain.
In some cases, a gout flare can even lead to a fever and look like an infected joint, Dr. FitzGerald notes. The treating doctor may need to look for possible source of infection, often by removing fluid from the joint to send to the lab to look for crystals or bacteria.
Uric acid is a byproduct of the body breaking down proteins called purines from your own cells and from certain foods such as red meat and shellfish. Alcohol and drinks sweetened with high fructose corn syrup are also high in purines. Normally, uric acid dissolves in your blood and is filtered out through your kidneys, but when your body produces too much uric acid or your kidneys fail to filter it, either due to familial causes or kidney disease, then the uric acid builds up and creates the needle-like urate crystals that cause gout and can also form kidney stones, according to the Mayo Clinic.
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What Causes Gout Of The Foot
Gout of the foot is a type of arthritis that often affects the joint at the bottom of the big toe, causing severe pain even when there is no pressure on the foot. This condition is caused when uric acid builds up in the body. If uric acid accumulates in the fluids that surround a joint and forms crystals, the crystals aggravate the joint, causing pain and swelling.
In the past, gout was called the âdisease of kingsâ because it seemed that only royal or noble families were wealthy enough to afford the types foods and amounts of alcohol that were thought to cause it. In fact, during certain time periods, and as recently as the turn of the 20th century, having gout added to a personâs social prestige. Today, while changes in diet may be part of the treatment recommended for gout, medications are also used treat it. In addition, having gout does not have the prestige that it did in the past.
Although the mechanics of how gout of the foot develops are known, the exact causes are less understood. It occurs more commonly in men than in women, although the odds of a woman developing gout increase after she becomes postmenopausal. There is evidence that the condition may have a genetic factor and run in families. Drinking alcohol and taking certain types of water pills may also increase the risks of developing gout.
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Treatment For Gout In The Heel
There is no cure for gout, but treatment to limit attacks and control painful symptoms are available.
If your doctor diagnoses gout, they will most likely suggest medication and certain lifestyle changes based on findings in the testing and your current health.
Certain medications treat gout attacks or flare-ups. Others reduce the risk of potential gout complications.
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Gout In Heel Diagnosis
Heel pain may be confused with other conditions, which can misguide the treatment. Therefore, it is necessary to get the condition diagnosed correctly. The laboratory investigations involve the aspiration of synovial fluid from the heel joint and analyze it for the presence of needle-shaped gout crystals under a polarizing microscope.
Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot
As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.
The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.
Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.
Figure 5: Location of Gout Attacks
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When Foot Pain May Mean Arthritis
Learn about the various causes of foot pain, including different kinds of arthritis.
Many forms of arthritis and related conditions affect the joints of the foot as well as the skin and toenails. Here are some possible diseases that may cause problems for feet, toes and heels.
Osteoarthritis
Osteoarthritis is the most common form of arthritis. Also known as wear and tear arthritis, OA is a chronic condition caused by the breakdown of the cartilage, which cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub together, causing stiffness, pain and loss of joint movement. In the foot, OA most commonly affects the big toe, but it can affect the ankle joints and joints of the heel bone, inner and outer mid-foot. Aging and obesity make OA more likely in the feet.
Juvenile Arthritis
Juvenile arthritis is the term used to describe the joint diseases that affect children 16 years and younger. There are different types of JA that can cause pain and swelling in several joints, including ones in the feet.
Gout
Lupus
Lupus is a chronic autoimmune disease that causes the bodys immune system to mistakenly attack healthy tissues, including the joints. The wrist and small joints of the feet are most commonly affected by lupus. In some cases, the toes can also turn blue from sensitivity to cold, a symptom ofRaynauds phenomenon.
Psoriatic Arthritis
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How Can You Prevent Arch Pain
Many of the home remedies for arch pain can also be used to help prevent pain from returning.
- Wear supportive shoes with shoe inserts or arch supports, and avoid going barefoot or wearing unsupportive shoes, like flip-flops. Wearing unsupportive footwear on hard surfaces for prolonged periods creates many of the conditions that lead to arch pain.
- Stretch. Begin a regular regimen of stretching exercises. Stretching your calves and the rest of your legs can help your feet, too, so dont forget to include these areas. Invest in anti-fatigue mats. If you regularly stand in the same spot for extended periods of time, these mats can help reduce your risk for foot pain. Consider putting one on the floor in front of your kitchen sink if you spend a lot of time doing dishes. If you have a standing desk, get one for work, too.
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Causes Of Pain In The Ball Of Your Foot
The ball of the foot absorbs an enormous amount of pressure when you walk, work, exercise, and even when you just stand up. This nearly constant stress can cause the components of the foot to become stretched and pinched, causing conditions like capsulitis and neuroma with severe pain, numbness, and discomfort.