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
How Is Gout Diagnosed
Your health care provider will get your complete medical history and do a physical exam. She may run these exams and tests to diagnose gout:
- Ajoint fluid analysis to see if uric acid crystals are present. This is the only certain way to diagnose gout.
- Tests to measure uric acid levels in blood and urine
There are many conditions with symptoms similar to gout. Be sure to see your doctor for a diagnosis.
First Foods That Can Help
- There are actually several types of foods that may help protect against gout attacks. These include low-fat dairy foods, complex carbohydrates, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
- You don’t necessarily have to drink only wateryou can choose non-sweetened juice, tea, and coffee too.
- Any kind of fluid that keeps that blood flowing and urine flowing is a good choice, says Lona Sandon, PhD, RDN, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
Next up: The foods to avoid. Read on for a list of potentially problematic eats.
Scallops are okay for an occasional indulgence, but you should cut back on themand all types of meat and seafoodduring a flare-up, says Sandon. These animal foods are rich in purines, which your body breaks down into uric acid.
You have a little more freedom in your food choices when your gout is at bay, but its still a good idea to keep meat and seafood intake to a minimum4 to 6 ounces daily at most.
All meat is not created equal when it comes to purine content: White meat is generally better than red.
But it is okay to eat some types of red meat once in a while. Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin.
And lamb chops are a better choice than leg meat.
Organ meats, such as liver, kidneys, and sweetbreads, are a major no-no.
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Medications For Gout Attacks
To treat gout attacks and to prevent future ones, you doctor may recommend these medications:
Nonsteroidal anti-inflammatory drugs
Colchicine is a medication that your doctor may prescribe based on its proven effectiveness in reducing heel gout pain.
If NSAIDs or colchicine arent appropriate for you, your doctor might recommend corticosteroid medications, either in pill form or via injection, to control inflammation and pain.
An example of this type of medication is prednisone.
Soothing Your Foot When Gout Strikes
If a gout attack makes your big toe hurt, there are several things you can do to make your foot more comfortable, in addition to taking your gout medication.
- Avoid wearing shoes, slippers and restrictive hosiery. You could even cut off the top of a sock to avoid putting your big toe under pressure.
- Wrap an ice pack in a towel and apply it to your big toe for short periods. Doing so should soothe the area and reduce the swelling.
- When you lie down, elevate your foot with the aid of cushions or pillows, so that its slightly higher than your chest, as this can also keep the swelling at bay.
- Leave your foot uncovered overnight.
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Gout Remedies That Work
Gout, a little-known type of arthritis, can cause searing pain in your toes, feet and other joints. If youre at risk and you might be if a relative suffers from the disorder it can come on with little warning. Read on to learn about the best gout remedies available, as well as alternative treatments that relieve gout pain while limiting side effectsGout isnt making a comeback it just never went away.You may think this illness, once known as rich mans disease because it was thought to come from eating fatty foods, disappeared with Charles Dickens. In fact, its the most common inflammatory arthritis in men over 30 and women are just as susceptible after menopause.It often comes on suddenly in the night, turning your big toe into a poker of pain red, hot and swollen.Gout is caused by a buildup of uric acid a waste product left by dead cells in the blood, either because your body produces too much or excretes too little. The uric acid eventually crystallizes, forming tiny needles that work into joints, leading to intense pain and swelling.
Points To Remember About Gout
- Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away.
- With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis.
- The most common symptom of gout is pain in the affected joint, such as the big toe.
- Your doctor may recommend taking medications to manage the cause of your gout and treat active gout flares, and making changes to your diet and lifestyle.
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What To Do During An Attack
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
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Gout In Your Big Toe: Practical Steps To Relieve The Pain
Nov 13, 2017 | General |
Imagine suddenly waking up in the middle of the night with excruciating pain in your big toe. Youd find it difficult to walk, and even the gentle pressure of a duvet resting on the affected foot would be agonising. It sounds like a nightmare, doesnt it? Sadly, this scary situation is a reality for many people who suffer from a type of arthritis known as gout. Thats why its crucial to understand what causes the problem, as well as how to manage and prevent it.
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Lets think about this from the perspective of a machine less complicated than our bodies: your car. Gasoline is its nutrition, and maintenance and mechanical work is its exercise. Take any old rust bucket and give it those two things, and it will go from a creaking wreck to running smoothly.
Drugs would be adding nitrous to the car. Yes, nitrous can help your rust bucket shoot from 0 to 150 on the freeway. But what happens after that? Will it still hold up without proper fuel or maintenance?
The bottom line is that what you put in your body underpins the conditions for gout being present in the body.
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What Happens At Your Appointment
The GP may ask about your diet and if you drink alcohol.
They may refer you to see a specialist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.
The blood test will find out how much of a chemical called uric acid there is in your blood.
Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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Time To Call The Doctor
A gout attack will usually go away in about 3 to 10 days. But you can feel better sooner if you treat it. To be sure that you have gout, see your doctor. Theyâll examine you, and they might do some tests.
These test help your doctor know if you have gout, or something else with similar symptoms:
- Joint fluid test. Fluid is taken from the painful joint with a needle. The fluid is studied under a microscope to see if the crystals are there.
- Blood test. A blood test can check the level of uric acid. A high level of uric acid doesnât always mean gout.
- X-ray. Images of the joints will help rule out other problems.
- Ultrasound. This painless test uses sound waves to look for areas of uric acid deposits.
It’s Easy To Get The Care You Need
See a Premier Physician Network provider near you.
If you havegout, youre all too familiar with the sudden, burning joint pain that a gout attack can bring on most commonly in the big toe.
Gout a type ofarthritis is caused by too much uric acid in the blood. Usually, having an excess of uric acid isnt harmful. In fact, many people with high levels in their blood never get gout. But when uricacid levels in your blood are too high, the uric acid may form hard crystals in your joints.
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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 .
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 hasnt 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 545-0100.
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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:
- 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.
Risk Factors And Potential Causes Of Gout
Gout strikes men more often than women until women undergo menopause, and then women experience increased risk. Being overweight or obese, having recent surgery, and experiencing a trauma also increase your risk, as well as your family history.
Your body produces uric acid when it breaks down purines a substance found naturally in your body, and also in high-protein red meat, organ meat, and certain types of seafood. In addition, alcoholic drinks, beer, and beverages sweetened with fructose can raise your natural uric acid levels. When your body either creates too much uric acid or excretes too little, it can lead to gout. Hundreds of years ago, gout was called the disease of kings because the average peasant couldnt afford such rich food and drink.
Medical conditions like untreated high blood pressure, diabetes, heart disease, and kidney disease can also increase your chances of developing gout, as does taking certain medications, such as thiazide diuretics and low-dose aspirin.
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Reduce The Pressure Reduce The Pain
Gout cant be cured, but it can be managed effectively and ensuring that your feet receive expert care plays an important part in that process.
Our London podiatrists can help to relieve the pain caused by gout in your big toe with prescription orthotics. These custom-made shoe inserts are designed to make the affected area more comfortable by reducing the pressure its under. Whats more, we can offer expert advice on which shoes youll find most comfortable.
Podiatric padding and foot shields can be beneficial when gout strikes. In addition, if the swelling has led to sores, ulcers, calluses, etc., we can treat those issues too.
For expert help to relieve the foot pain caused by gout, please call Feet By Pody today on 0207 099 6657 or book a podiatry appointment online.