What Could Be My Problem
Gout is a form of arthritis caused by a buildup of uric acid crystals in the joints. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration and marked tenderness.
The small joint at the base of the big toe is the most common site for an attack. These painful attacks usually subside in hours to days with or without medication. In rare instances, an attack can last for weeks.
Reduced Range Of Motion
Whether youre having an attack or have endured permanent damage, your joints will not fully function. Due to inflammation or damage, your range of motion may be hindered. This means that both the distance and direction that a joint can move, will essentially decrease. This is especially common within ones knee joints, however, some simple exercises can help prevent stiffness. If youre experiencing inflamed joints, its best to seek advice from your physician. Its important to remain active, reducing the possibility of overly stiff joints.
Can It Lead To Any Complications
If left unmanaged, gout-related inflammation can cause permanent damage to your ankle joint, especially if you have frequent flare-ups.
Over time, lumps of uric acid crystals, called tophi, can also form around your ankle. These lumps arent painful, but they can cause additional swelling and tenderness during a flare-up.
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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.
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:
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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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Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
Uric Acid Is The Cause
When there is an overabundance of uric acid in the blood it is called gout. Usually, having too much uric acid in the blood is not harmful. In fact many people with high levels in their blood never know about it. When uric acid levels in the blood become extremely high, the uric acid may start to form crystals. These crystals most commonly form in the joints, especially the joints in the big toe. Your odds of experiencing the pain of gout are higher if you are overweight, drink excessive amounts of alcohol, or have a diet that is comprised of meat and fish that are high in chemicals called purines.
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How Uric Acid Crystals Form
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The build-up of uric acid crystals begins with purines, a chemical compound found in many foods.
- When the body metabolizes purines, it produces a substance called uric acid.
- The uric acid enters the bloodstream.
- The kidneys filter the blood and normally filter out excess uric acid. This uric acid is then excreted via urine or stool .10
- If the kidneys cannot adequately filter out excess uric acid, or if the body produces too much uric acid, there will be too much uric acid in the bloodstream.
- Too much uric acid in the bloodstream is called hyperuricemia.
- In some people, hyperuricemia leads to the formation of uric acid crystals that collect in joint tissue, leading to painful symptoms.
An inability to adequately process and excrete uric acid accounts for an estimated 90% of gout cases.9 Other cases occur because a body produces too much uric acid.
Patients With Gout Need To Stay Active To Maintain Cardiovascular Health And Protect Joints From Long
Should I walk or engage in any exercise when I have gout? Many people with gout ask themselves this question. And the answer is yes except during a painful gout flare, according to Maura Daly Iversen, PT, MPH, DPT, SD, FAPTA, a physical therapist and behavioral scientist/clinical epidemiologist with a primary focus in rheumatology and Dean of the College of Health Professions at Sacred Heart University in Fairfield, Connecticut.
When in a gout flare, even the pressure of a bed sheet can be extremely painful, Dr. Iversen says. Most patients feel better by elevating their feet and resting and thats okay.
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Effective Medical Treatment For Gout
The American College of Rheumatology released gout management guidelines in 2012 and updated them in 2020. They recommend drugs classified as urate-lowering therapy for those who have experienced two or more gout attacks in a year as well as for those with joint damage from gout.
Specifically, the organization recommends allopurinol as a first-line treatment for all gout patients, even those with chronic kidney disease. Next in line is febuxostat both are a class of drugs called xanthine oxidase inhibitors.
In addition, the guidelines recommend use of anti-inflammatory medications including NSAIDs, prednisone, or colchicine along with the other medication.
Choose The Right Footwear
Because gout often affects the big toe, midfoot, and ankle, choosing good footwear is important. Dr. Iversen says a physical therapist can help evaluate the best footwear for a patient with gout based on evidence that shows specialized footwear provides benefits for patients by changing the alignment of the leg and foot, influencing the activity of the muscles of the foot, and your gait pattern . These modifications are designed to decrease the pressure on your joints.
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Joints Affected By Gout
Gout can affect any joint, but some joints are more likely to be affected than others. Joints commonly affected include the big toe, the foots instep, heel, ankle, and knee.2 Less often, gout affects the elbow, wrist, fingertips, or spine.2–7
Gout is acute, painful swelling in the joints from uric acid buildup. Common areas include the foot and big toe.
Exercising Helps Control Gout By Lowering Uric Acid Levels To Prevent Gout Attacks
Researchers have found that fat in the body carries more uric acid than muscle. Thus, when you reduce body fat, you can reduce uric acid levels in your blood, Dr. Iversen notes. Building cardiovascular health through exercise is also very important for people with gout because they have a higher risk of developing high blood pressure, according to Harvard Health. Gout is also strongly associated with developing coronary artery disease.
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Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
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The Role Of Uric Acid
Uric acid is produced when your body breaks down purines, which are substances naturally found in your body, as well as in protein-rich foods. At normal levels in your blood, uric acid is a powerful antioxidant and does not cause any damage. The body keeps uric acid at a set level by excreting it through the kidneys and in urine.
It is possible to have hyperuricemia and not develop gout. About two-thirds of people with elevated uric acid levels never have gout attacks. It is not known why some people do not react to abnormally high levels of uric acid.
Build Muscle With Strength Exercises
Having strong muscles can protect your joint from wear and tear, especially for joints affected by gout. Beyond weight training, simple resistance exercises can be effective to build muscle. For example, try an elastic resistance band by holding each end and putting your foot in the middle, then repeat your flexibility exercises while pushing against the force of the band.
The key with any exercise after a gout flare is to go slow and listen to your body, Dr. Iversen stresses.
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What Can Increase Your Risk
A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, it’s still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level don’t.
Other factors that may increase your risk of developing gout are outlined below.
Can You Remove Gout
It should be fairly evident why youd need to get rid of gout, but could it be truly probable?
Sure is usually, but theres not a one-size fits all solution.
In the next section, well end up being going over whats worked ideal for us!
You wont want to miss out on this free training video.
NOTICE: Id highly recommend going to your doctor or seeing a specialist about this situation, since we arent experts. See our medical disclaimer for more details.
We dont know what will work for you, but we know whats worked for us and others
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How Long Gout Pain Lasts
Characteristically, gout pain comes on rapidly and the joint becomes red and swollen, with the swelling reaching a peak within the first 24 hours of the attack, Dr. FitzGerald explains.
At first, gout usually affects just one joint, but can affect more than one joint, sometimes adjacent joints. Flares typically resolve on their own over the next seven to 14 days. Treating a gout flare with medications can help it resolve faster. Medications for gout flares typically include:
- Non-steroidal anti-inflammatory drugs , such as ibuprofen or naproxen
- Colchicine
- Glucocorticoids
A gout attack may occur only one or two times a year or even only a few times ever. However, gout can become chronic, leading to frequent attacks and flares that occur at least a few times a year or never completely resolve. Chronic gout can damage and deform joints and can sometimes be mistaken for other inflammatory diseases like rheumatoid arthritis.
Is There A Connection Between Gout And Turf Toe
If you are predisposed to gout or have multiple risk factors, joint injury may trigger a gout attack. Even stubbing your toe can cause a gout attack if there are enough uric acid crystals in your cartilage already.
If you have gout, its important to take precautions for your feet and joints when you exercise. Continuing to manage your condition over time is important.
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Can I Manage Gout
Although it cant be cured, gout can be managed effectively with medicine and lifestyle changes.
If your uric acid levels remain high after a gout attack, doctors may prescribe medication that can lower your levels. This can lessen your risk of long-term problems.
Self-care also is important if you have gout. A diet that avoids foods high in purine, high-fructose drinks, and alcohol can lessen your long-term risks. Losing weight also can lower your chances of gout. If you use medicines like diuretics, stopping that use can help prevent gout as well.
If you have a family history of gout or suspect you may have it, schedule an appointment with your doctor.
Differences Between Ra And Gout
Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life.
However, a close look at initial signs and which joints are involved will clearly differentiate these two diseases. The best way to know whether you have RA or gout is to make an appointment with your doctor for a diagnosis.
Specific signs that distinguish the diseases:
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Who Is At Risk Of Gout
Gout is sometimes called the disease of kings because of a false link to overindulgence in food and alcohol. Anyone can get the condition, but certain factors can increase your risk:
- Gender: Males are more likely to get gout than females.
- Age: Middle-aged and older men and women after menopause are more at risk for gout.
- Obesity
- Family history
- Diet: A diet high in purines, which are broken down into uric acid, can lead to gout. High purine foods include meats like bacon, turkey, veal, venison, and liver, and seafood like anchovies, sardines, mussels, codfish, scallops, trout, and haddock. High fructose foods and drinks such as soda pop also can increase your risk.
- Alcohol use
What Increases Your Chances For Gout
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
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Causes And Risk Factors
Gout occurs due to an excess buildup of uric acid, or hyperuricemia.
According to the National Institutes of Health , hyperuricemia is the main risk factor for developing gout. However, a quarter of those with hyperuricemia do not develop gout.
When the body breaks down purines, it produces uric acid. Typically, the kidneys remove a certain amount of uric acid in the urine. However, when they are unable to remove enough uric acid, uric acid crystals can form in the joints and soft tissues, causing swelling and pain.
Gout typically affects males more than females. However, females have higher levels of uric acid after menopause. NIAMS state that being older also the chance of developing gout.
Genetics can also increase the chance of developing gout.
According to the CDC , other factors that may increase the likelihood of gout include:
- Diet: Food can play a role in the development of gout symptoms. Eating seafood, red meat, and drinking alcohol raises uric acid levels in the body.
- Weight: Having overweight increases the chance of developing gout.
- Medications: Certain medications, including diuretics and low-dose aspirin, are associated with gout risk because they increase the level of uric acid in the body.
- Other medical conditions:High blood pressure, diabetes, and kidney disease can increase gout risk.
According to the National Health Service in the United Kingdom, some people with gout may develop complications, such as: