Risk Factors For Gout
Obesity, excessive weight gain, especially in youth, moderate to heavy alcohol intake, high blood pressure, diabetes, and abnormal kidney function are among the risk factors for developing gout. Certain drugs and diseases can also cause elevated levels of uric acid. Also, there is an increased prevalence of abnormally low thyroid hormone levels in patients with gout.
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.
Certain factors make some people more likely to develop gout, according to the U.S. Centers for Disease Control and Prevention. Gout risk factors include:
Most Common Gout Attack Sites
The most common site for a gout attack is what is known as the bunion joint on the big toe. It is typically the first joint affected by gout. As gout worsens, the ankle, mid-foot, knee, and elbow can become common sites of gout attacks. Uric acid crystals can also collect in soft tissues and form lumps called tophi, most typically on the hands, fingers, elbows, and ears.
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Differences Between Men And Women
Sex differences play a role in which joints are affected:
- In men, about 85% of gout flare-ups affect joints in the lower extremities. About 50% of first-time gout attacks involve a big toe joint.8
- In women, a gout attack is most likely to occur in a knee.10 In addition, women may be more likely to get gout in the upper extremities.9
While women are less likely to get gout, they are more likely to have multiple joints affected by gout.13
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Genes And Family History
Research over the past decade has increasingly identified a link between a genetic predisposition and high uric acid levels. For example, in a 2012 study, researchers looking at a large number of peoples unique genomes found that patients with gout often shared a similar variation on a gene that affects kidney function. A 2018 study further identified several genes that influence how the body gets rid of uric acid.
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Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
Read more about the complications of gout.
Signs Your Pain Is Likely Gout And Not Something Else
If you develop sharp sudden pain in a single joint or a couple of joints, if the pain is so debilitating that it is hard to walk or wear shoes, and if you have risk factors for gout , theres good reason to suspect gout as the culprit. However, its important to see a doctor for a thorough exam and proper diagnosis.
Dr. FitzGerald cautions that issues unrelated to gout can cause an angry, inflamed joint. Gout may be confused with several other conditions that can cause similar symptoms, including:
- Pseudogout
- An infected joint
- Bacterial skin infection
- Rheumatoid arthritis
- Psoriatic arthritis
Pseudogout is caused by a different kind of crystal, calcium pyrophosphate. A flare of pseudogout can resemble gout, but it more often affects your wrist and knee, and is unlikely to involve the big toe. Like gout, pseudogout is also considered a form of inflammatory arthritis. Its more likely to affect people over the age of 40 and those who have a thyroid condition, kidney failure, or disorder that affects calcium, phosphate, or iron metabolism, according to the Cleveland Clinic.
Its also possible to have gout without the classic presentation of red, hot, sharp, burning, sudden pain in the big toe, foot, ankle, or knee. Some patients may have joint pain that is less acute.
People can also have high levels of uric acid but not develop symptoms of gout.
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Is Knee Pain Due To Gout Or Something Else
Most people with gout in the knee experience intense pain during a gout attack. Swelling may also be noticeable during an active flare, as well as redness and warmth.
The pain may develop in the night and hurt continuously for up to two weeks before the flare subsides, with the most intense pain in the first 24 hours. But if gout is not treated, typically with medication to lower uric acid levels, gout flares will recur and over time and affect more joints, including the knee.
Doctors cant say for sure why gout flares occur more often at night but, according to a 2015 study, it might be because your body temperature goes down at night, which could make uric acid more likely to crystallize.
Although the pain of a gout attack is distinct, there may be other reasons for your knee pain you should be aware of.
Pseudogout
Your knee pain could be caused by buildup of different kinds of crystals called calcium pyrophosphate . Doctors can examine fluid in your inflamed knee to determine if the crystals are uric acid or calcium pyrophosphate.
Gout And Your Kidneys
An overabundance of uric acid can lead to both kidney problems and gout. Uric acid that collects in the kidneys can form kidney stones, which can lead to complications like kidney disease and kidney failure, and also can indicate a likelihood of developing gout. If youve been diagnosed with gout, your uric acid levels are elevated and you should also be checked for kidney disease.
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What You Should Consume To Help Keep Gout At Bay
1) Drink plenty of fluids
Staying hydrated helps flush the uric acid out of your system, preventing kidney stones as well. You should drink at least eight cups of water a day and another eight of anything else, except alcohol .
2) Go Bananas!
Vitamin K that is present in bananas helps in liquefying uric acid crystals to flush them out of the body.
Bananas are also a rich source of Vitamin C, which helps reduce inflammation and lessen the pain.
Eating a banana or two every day can provide relief from gout and is also a great source of potassium, which helps stop cramping to boot.
3) A Bunch of Cherries a Day Keeps Gout away?
Yes! Here is some seriously good news for those of us looking for any excuse to consume cherries . Why cherries? The bottom line is that their antioxidant properties contain a pigment called anthocyanins, which can reduce inflammation and pain caused by gout. Cherries can be eaten fresh, or in the form of tarts and juice.
4) Munch on Celery
Celery is claimed to be one of the best foods to treat gout. Celery decreases uric acid levels and has anti-inflammatory properties, which reduce redness and swelling. However, celery could be harmful if you are excessively sensitive to salt. It is advisable to consult your doctor before munching on celery on a regular basis.
5) Put on the Juniper
6) Get into Nettle Leaf Tea
What Part Of The Foot Does Gout Affect
The medical condition that is referred to as gout is a painful ailment that affects the feet. More specifically, the joints in the big toe are typically distressed if this form of arthritis develops. It can cause severe pain and discomfort and may lead to joint deformities if it is not treated early. It occurs as a result of excess uric acid that exists in the blood levels. This may produce crystals that lodge in the joints of the big toe. This condition is typically caused by eating foods that are high in purine levels. These often include red meat, shellfish, and alcohol. There are methods that can be implemented, which may prevent gout attacks from occurring. These can consist of losing weight, performing a daily exercise routine, and eating healthy foods. If you are having pain in the big toe and surrounding areas and would like additional information about how gout affects the feet, please consult with a podiatrist.
Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact Dr. Thomas Madden from Advanced Foot Care Center. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.
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Treating And Preventing Gout Pain
Gout pain is generally treated in two ways:
- Medications to relieve gout attacks in the short-term
- Preventive medications taken regularly to lower uric acid and stop gout attacks from occurring
While inflammation-fighting drugs are used to relieve pain during gout flares, different medicines are used to lower uric acid levels to prevent future attacks. These include:
- Allopurinol
- Probenecid
Another medication called pegloticase may be recommended for people with chronic gout who have not responded to other uric acid-lowering medication.
While many people with gout can be treated by their primary care physician, if gout is not responding to medication or is progressing with worsening or frequent flares or developing tophi gout deposits, then your primary care physician may refer you to see a rheumatologist who specializes in treating diseases that affect joints, muscles, bones and the immune system.
Taking medication to reduce uric acid levels and reduce the risk of gout progression is important, Dr. FitzGerald stresses. If you have risk factors for bad gout, such as kidney disease, or are experiencing frequent attacks, early treatment is better.
How Can A Gout Attack Be Prevented
Diet plays a key role diet in gout prevention: Since foods can directly set off gout attacks, patients with gout should receive counseling as to which foods are more likely to induce attacks. Losing weight is often also helpful. However, as important as diet is in gout, for most people with gout diet, and even weight loss, are not enough, and medications will be needed to get to their uric acid goal.
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Where Does A Gout Attack Occur
Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.
When Asked How Long Does Gout Last Most People Would Say A Few Days To A Few Weeks
How long does gout last? Your symptoms, treatment, and diet all come into play.
A gout attack can cause sudden and very severe joint pain. It frequently starts in the joint of a big toe and may wake you up at night. Even having a sheet resting on your toe can be painful. A gout attack can make you miserable. It may last from three days to up to two weeks. Taking medication usually helps reduce the pain and may shorten the attack. But even without medication, a gout attack usually goes away within ten days.
Once you have had an attack of gout, you need to start treatment to prevent another attack, because gout often comes back. Without treatment, you can expect another attack within two years. People with frequent attacks can develop a type of long-term gout that does not go away. It can cause painful lumps in or near joints and can cause damaging deformity of a joint. The good news is that treatment works well. Gout is very controllable for most people.
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If You Are Having Repeated Attacks See Your Doctor
Some patients can go a long time between attacks. In fact, for 62 percent of patients the next attack will be more than a year away, and some won’t have another attack in the next 10 years. However, if you begin to have more frequent attacks, talk to your doctor about escalating treatment. People think its normal to have flares every now and then, but its not. The gout can be doing damage to your joints. It means you still have too much uric acid, says Shakouri. In particular, ask about allpurinol. It wont help with an acute attack but will help prevent future attacks by reducing uric acid production.
Managing Symptoms Of Gout
Medications are available to help you manage symptoms of gout. These include nonsteroidal anti-inflammatory drugs, such as indomethacin , ibuprofen , and naproxen . Side effects of these medications can include bleeding, stomach ulcers, and stomach pain. If your symptoms dont respond to these medications, your doctors may recommend other drugs to stop an attack and prevent future attacks.
Colchicine can reduce gout pain, but side effects may include nausea, diarrhea, and vomiting.
Corticosteroids such as prednisone also reduce inflammation and pain. These prescription medications can be taken orally or injected into your joint. Side effects include mood changes, elevated blood pressure, and water retention.
There are medications that block the production of uric acid and others that help your body remove uric acid, such as allopurinol and probenecid, respectively.
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What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
What Does The Future Hold For Gout
Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.
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What Are The Symptoms Of Gout
An episode of gout is called a gout attack. Gout attacks are very painful and can happen quite suddenly, often overnight. During a gout attack, symptoms in the affected joint may include:
- Intense pain.
- Tenderness, even to light touch, such as from a bedsheet.
- Warmth, or a feeling like the joint is on fire.
- How long does a gout attack last?
A gout attack can last a week or two. Between gout attacks, you may have no symptoms at all.