Gout In Ankle: Causes Symptoms Treatment And Prevention
Written byEmily LunardoPublished onNovember 10, 2017
Gout in the ankle or ankle gout is an inflammatory condition of the joint leading to swelling, pain, and redness of the ankle. Gout is a complex form of arthritis that can affect anyone, with over eight million Americans suffering from the condition today. Men are typically affected more, but postmenopausal women become increasingly susceptible in their later years.
The most common joint affected by gout is the big toe, but joint pain may also be experienced in the knees, hands, ankles, and wrists. Having gout in the ankle can be very debilitating as it encumbers your ability to walk normally.
This article will answer the question what causes gout in the ankle, giving you a better understanding of the intricacies of the condition to better treat it.
Related: Is gout in elbow common? Causes, symptoms, and treatment of elbow gout
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.
Gout Frequently Flares In Your Knee But You May Not Always Know That Your Knee Pain Is Due To Gout Heres How To Tell Since Prompt Treatment Can Reduce Your Risk Of Complications
Knee pain can be a common symptom of several types of arthritis, as well as many other conditions or injuries. If your knee stiffness is accompanied by a burning pain and is warm to touch, you may have a gout flare in the knee.
Though gout is most often associated with the big toe, gout tends to flare in areas that already have arthritis, says Robert Keenan, MD, a rheumatologist with Articularis Healthcare in Summerville, South Carolina. Although gout can strike in many different joints, as a general rule, gout works its way up the body. If its not treated, it works its way up from the big toe, through the ankle, to the knee, and then to the lower spine and so on.
Gout can affect both knees, but typically is felt more strongly in one knee say, where you may have arthritis wear-and-tear to begin with.
Learn more about what causes gout in the knee, as well as ways to treat the pain and prevent it in the future.
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Immediate Relief Expert Care
Gout pain in your toes and feet can be extremely uncomfortable. While these home remedies may offer temporary relief, you might need professional care.
If you begin fevering, this is often a sign of infection. Dont wait to come in.
Weve got a full team ready to help, right away. Visit our contact page to make a quick appointment or give us a call today at 239.936.5400.
How Is Pseudogout Treated
The type of pseudogout treatment depends on several factors, including your age, other medications youâre taking, your overall health, your medical history, and how severe the attacks are. Drugs to treat pseudogout include:
- Anti-inflammatory painkiller drugs, also calledNSAIDs, generally are prescribed to treat sudden and severe pseudogout attacks. NSAIDs — like ibuprofen and naproxen — usually reduce inflammation and pain within hours.
- Corticosteroids may be prescribed if you canât take NSAIDs. Steroids also work by decreasing inflammation. They can be injected into the affected joint or given as pills.
- Colchicine, a gout drug, is sometimes used in low doses for a longer period of time to reduce the risk of repeated attacks of pseudogout.
Anti-inflammatory medications are usually continued until the pseudogout attack goes away. Symptoms are often better within 24 hours after treatment begins.
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What Does A Gout Attack Look And Feel Like What Would A Foot Or Toe With Gout Look Like
When gout occurs, the joint tends to be extremely painful and is warm, red and swollen . The inflammation that is part of a gout attack is systemic, so that fever and chills, fatigue and malaise are not uncommonly part of the picture of a gout attack.
Figure 6: Toe with Acute Attack of Gout
Gout attacks can occur in joints that look normal, or in joints that have easily visible deposits of uric acid. These deposits are called tophi and can be in numerous locations, but especially on the feet and elbows. In Figure 9, the little finger of the right hand is bandaged since fluid was just removed from it, which demonstrated innumerable uric acid crystals.
Figure 7a: Tophi on Foot
Figure 7b: Tophus Over Achilles’ Tendon
Figure 8: Tophus on Elbow
Figure 9: Tophi on Hands
Figure 10: Large Tophus of Finger
While some gout attacks will solve quickly by themselves, the majority will go on for a week, several weeks, or even longer if not treated. Since gout attacks are usually quite painful and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.
Other Symptoms Of Gout Include:
While visible symptoms and painful joints are key symptoms of gout, high levels of uric acid can also present itself in different forms.
Speaking exclusively to Express.co.uk, Dr Sumera Shahaney, GP and Head of Clinical Operations at Thriva said:” High uric acid levels are also associated with kidney stones, of which the symptoms include: pain and aching in your lower back, abdomen, or groin, foul-smelling urine thats painful to pass and feelings of nausea.”
If you suspect you have gout you should always reach out to a medical professional for advice or treatment.
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Causes Of Gout In Ankle
As said before, gouty arthritis is a condition that occurs in the human body due to the accumulation of a substance called uric acid in the bloodstream.
This abnormal accumulation of uric acid in the bloodstream happens due to excess workload on the liver and kidneys.
When this happens it leads to the deposition of uric acid crystals all over the body mainly over the joints.
Initially the uric acid deposits as a solution. But on long-standing, the uric acid solution becomes uric acid crystals.
Slowly it starts pressuring the nearby parts of the joints like tendons, cartilage, muscles, nerves, and blood vessels.
This ultimately leads to damage of the joint tissues and thus creates unwanted and unbearable pain along with swelling.
Gout may happen in all the joints of the body but primarily it affects the base of the big toe and the ankle joints.
The ankle joint is the principal joint for balancing the whole body.
And as gout occurs initially in the ankle joints it creates much trouble for the person in performing the day-to-day daily tasks.
Expert Tips For Exercising When You Have Gout
Having gout doesnt mean you cant be active or even run on a regular basis, the key is to increase your workout intensity gradually, Dr. Iversen recommends, adding that you should consult your physician and physical therapist before starting any exercise routine.
She suggests these five gout-friendly workout tips to start and keep moving with gout:
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Symptoms And Signs Of Gout In Foot
An attack of gout is often sudden. Symptoms:
- It may present with excruciatingly painful swelling of joints in the big toe, it is known as Podagra. The joint may be stiff and appear red or purple, very swollen, and tender to even light touch. Other gout sites include the instep, wrist, ankle, fingers, and knee.
- Skin may peel and itch as healing begins.
- An attack often begins at night the acute phase lasts up to 12 hours. If untreated, the inflammation may last up to two weeks. In 10 percent of people, acute episodes present in more than one joint.
- Kidney stones precede the onset of gout in 14 percent of patients.
- Chronic gout may develop, and it may affect more than one joint, mimicking rheumatoid arthritis.
- Tophi are soft tissue swellings caused by urate buildup in chronic gout. They may be found in the ear, fingers, toes, kneecap, and elbow.
Some people have a single attack of gout, others are affected intermittently, often when they have overindulged or experienced dehydration.
COMPLICATIONS OF GOUT IN FOOT
Its rare for complications of gout to develop, but they do happen and can include severe degenerative arthritis, secondary infections, kidney stones and kidney damage, nerve or spinal cord impingement, and joint fractures.
Gout In Ankle: Symptoms And Home Remedies
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Arthritis is basically a joint disorder that causes inflammation in one or more joints of the body. As such there are more than 100 types of arthritis.
But the most common ones can be classified as osteoarthritis, rheumatoid arthritis, ankylosing spondylosis, gout, etc.
What Is Gout?
In medical terms, gout is a complex form of inflammatory arthritis condition which is caused due to the build-up of uric acid.
Although it can affect varied body parts, it is most common in the joints of the foot and big toe.
The first and foremost diagnostic tool helpful for ruling out gout in the foot or ankle is by proper physical examination.
With mere examination, most experienced physicians can confirm the existence of gout in the ankle joint.
In case of a doubtful diagnosis, you can go for a complete blood test added with levels of blood uric acid check-up. Most of the time blood test will give you a clear diagnosis of the condition.
In case if the blood reports also fail to rule out gout in the foot then your doctor can use other diagnostic tools like imaging techniques.
The major imaging techniques which help in confirming the ankle gout are X-rays, CT-Scan, MRIs, etc.
Even sometimes the tests like bone density test and bone biopsy also help in confirming gout in the ankle and foot.
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Managing A Gout Flare
Gout flares are unexpected and painful heres how to get a handle on them.
Few things in life are more painful than a gout flare, so if youre awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, youll want to act fast. Heres what you can do when a gout flare starts to ease the pain and reduce the risk of others.
Take Medicine You Have on Hand. Start treatment immediately with over-the-counter ibuprofen or naproxen , but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of flares, continue to take that drug.
Ice Down. Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.
Let your doctor know what is going on right away. She may prescribe a new medication, or have you come to the office for a joint fluid test or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of a flare can lessen its length and severity.
Get a Cane. Walking with a cane during an acute gou flare can help keep pressure off your painful joint.
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The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)
Figure 3: Progression of Gout
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Can I Get Gout In My Ankles
One of the most debilitating and emotionally discouraging conditions for our patients is gout. Frisco patients that suffer from gout are often immobilized for hours or even days because of the pain. Many have to use crutches to move around. Gout most commonly impacts the joints of the big toe but it is absolutely possible for gout to strike in the ankle. Here, we are going to look at a few of the possible reasons why that might be. But if youre suffering from gout, your best course of action is to call Dr. Verville today at . Be sure to also take a to see some of the wonderful things that our patients have to say about Dr. Verville.
Do I Have Gout Or Tendinitis
Asked by Chontelle, Houston
I am 35, female and have elevated levels of uric acid. My doctor wants me tested for gout in my left ankle, but the pain in my ankle didn’t start until I began using it to overcompensate for my other injured leg by limping. Will the black cherry concentrate I’ve heard about in pill form lower the uric acid levels, and how can I tell the difference between gout and tendinitis?
Conditions ExpertDr. Otis BrawleyChief Medical Officer,American Cancer Society
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The Role Of Diet In Gout Prevention
Dietary control may be sufficient in a patient with mildly elevated uric acid, for example, 7.0 mg/dL
For those with a higher level, for example, 10.0 mg/dL, diet alone will not usually prevent gout. For the latter, even a very strict diet only reduces the blood uric acid by about 1 mg/dL- not enough, in general, to keep uric acid from precipitating in the joints. The cutoff where patients with gout seem to dramatically reduce their number of attacks is when their uric acid level is taken below 6.0 mg/dL.4
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 To Treat Gout In The Ankle
The following are various remedies for gout in the ankle. By addressing gout in ankle symptoms before they get out of control, it can help mitigate pain and swelling. It is recommended to speak to your doctor about particular distressing pain caused by gout as they can provide better-tailored gout ankle treatment.
After Repeated Ankle Sprainsand No Memory Of Turning His Anklethis Man Knew Something Strange Was Going On He Was Right: He Had Gout
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Francis cant remember a time when he wasnt active. The 42-year-old martial art teacher who is a coach for a traveling volleyball team in his spare time has always been an athlete. But then, in his mid-30s, Francis began experiencing severe pain in his ankle, yet he couldnt remember rolling it or running into anything. Actually, Francis had goutsomething it took nearly six years for him and his doctors to diagnose.
At first it really seemed like just a sprain. It would take me out of normal life for a few weeks, and Id shuffle around to keep weight off the foot, Francis says. Then it began happening more oftenbut I still thought it was a repeated sprain. He tells Readers Digest that he cycled through debilitating ankle and knee pain for the next five to six years, chalking up the chronic issue to getting older.
Finally, Francis realized there had to be another explanation. I went to see an orthopedic surgeon for answers, and he did an MRI and exam. He said it looked to be a sprain because the joint was inflamed and angry. We put a brace on it and waited for it to get better.
His ankle continued to bother him. A few months later, a family friend that worked for the surgeon mentioned that it might be gout, and thats when I got tested. There are several things that can trigger ankle pain, and its important to know the causehere are 11 reasons why your ankle might be hurting.
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What To Do If You Think You Have Pain Due To Gout
The good news is that there are effective medications to treat gout, Dr. FitzGerald says. In some mild cases, gout can be self-managed with lifestyle changes, such as weight loss if needed and eating fewer high-purine foods .
However, many people with gout should be on a preventive medication to lower uric acid levels and stop flares from occurring. According to the 2020 gout treatment guidelines from the American College of Rheumatology, uric acid-lowering medication is recommended for people who:
- Have two or more gout flares a year
- Have gout tophi
- Have evidence on X-rays of joint damage due to gout
The guidelines, of which Dr. FitzGerald is a coauthor, recommend a treat-to-target strategy, which means treating gout with medication until a target uric acid level is reached.
Unfortunately, gaps in quality care for gout continue to persist and many patients do not take uric acid-lowering medication, which can leave people suffering the intense and persistent pain of gout without relief. This is why it is important to seek medical care if you experience pain that you think could be gout, Dr. FitzGerald stresses.
Gout can be diagnosed several ways, including:
- Removing fluid from the joint to identify urate crystals.
- Using ultrasound to identify several common characteristics of gout, such as collections of crystals in or around joints.
- Using dual-energy CT to detect urate crystal deposits in cases that are more advanced.