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.
What Can Trigger A Gout Attack
Several things can cause the crystals to shake loose into your joint cavity, triggering an attack. These include:
- a knock or injury to the joint
- an illness that may make you feverish
- having an operation
- having an unusually large meal, especially a fatty meal
- drinking too much alcohol
- dehydration
- starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.
How You Can Manage And Prevent Foot Gout
Regardless of whether you have ever suffered from gout, you should know that managing the condition is not as simple as taking medication during a flare-up. You should talk with your healthcare provider about your lifestyle, diet, and overall health.
You may need to make changes in your lifestyle to prevent recurrence. You should always keep personal records of gout attacks to discuss with your doctor.
Exercising, eating healthy, maintaining an average weight, and avoiding things that increase your uric acid levels are all essential to preventing and managing gout.
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What Is The Fastest Way To Get Rid Of Gout
What Is the Fastest Way to Get Rid of Gout?
What Is Gout In Foot
Foot gout is a very common occurrence among gout sufferers. You probably had your very first flare in this area or have heard accounts from fellow sufferers who experienced the same. This is because gout commonly occurs in the big toe. Yes, it can affect other joints, but for the most part, gout targets the foot.
There is a similar condition to foot gout called hallux limitus. Its important not to confuse the two. They are both arthritis conditions, and the only difference is that hallux limitus is caused by the decomposition of cartilage around the big toe joint. With gout, however, the arthritis is caused by a buildup of uric acid in the blood which then gets deposited in the joint
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When To See A Doctor
Gout occurs without warning. Anyone experiencing intense pain on the big toe, followed by warmth, tenderness, redness or discoloration, should immediately seek medical attention.
If a person does not receive treatment for gout, it can lead to joint damage over time, including bone erosions and arthritis.
How Can I Treat My Foot Gout
Gout is easily treated. The main goal of treatment is to lower the uric acid levels in your body, decrease pain and other symptoms, and prevent further attacks or flare-ups.
If you only experience one episode of foot gout, your doctor may recommend a non-steroidal anti-inflammatory drug other than aspirin, such as ibuprofen or naproxen.
Aspirin is not used to treat gout because if can interfere with the excretion of uric acid crystals in your urine. Doctors have several ways to treat your gout, including:
- Anti-inflammatory medications or injections to reduce pain, swelling, and inflammation
- Corticosteroid injection into affected joint to reduce inflammation
- Suggesting a change in diet to eliminate or reduce intake of foods and beverages that are high in purines and protein because protein can increase your uric acid level
- Encouraging the patient to drink plenty of fluids each day, especially water
- Explaining the importance of avoiding alcoholic beverages
- Requiring you to stay off your feet
- Cold compresses
It is very important that you talk to a doctor if you are experiencing foot gout symptoms or a flare-up.
Symptoms will generally subside within three to ten days with treatment. If the problem is left untreated, or if gout continues to occur with treatment, the uric acid buildup can eventually cause arthritic damage to your joint.
In severe cases, your doctor may recommend surgically removing the uric acid crystals from your joint.
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Foot Gout Symptoms To Watch For
Foot gout usually occurs suddenly, often at night. In most cases, flare-ups happen without warning. The best way to catch foot gout in its early stages is by knowing the symptoms. Symptoms of gout include:
- Acute, intense pain within the joint
- Discomfort for days after the severe pain subsides
- Inflammation or swelling in the joint
- Redness
- Sensation of heat within the joint
People who suffer from this condition on a regular basis typically know the symptoms of gout and know to seek treatment at the first sign of a flare-up. Sometimes the symptoms are severe enough to bring on a fever of up to 101°F.
How Is Metatarsalgia Diagnosed
Your doctor will begin an exam for metatarsalgia by asking about your symptoms. He or she will also examine your foot manually. You may need an X-ray to rule out stress fractures or other problems that could be causing your pain. Other times an ultrasound or MRI may be ordered to assess the soft tissues surrounding your metatarsophalangeal joints.
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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.
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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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.
What Else Can Help
All the gout prevention tools we have discussed here not only help to reduce the risk of developing gout, but can help to treat gout flare-ups. There are also other treatments that can help during a gout attack which we look at in the Gout Treatment section.
If you want to know more about gout and the causes, symptoms, diagnosis and treatment for gout attacks in specific joints, choose from:
- Gout Foot including Podagra
Always remember, gout prevention is better than cure, so don’t wait until you have a gout attack, start reducing your risk now using the things we have discussed here.
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What Is The Treatment For Metatarsalgia
Simple measures can help to relieve the symptoms of metatarsalgia. These include:
- Resting with your feet elevated where possible.
- Simple painkillers such as paracetamol and non-steroidal anti-inflammatory painkillers such as ibuprofen may help to relieve pain.
- Seeing a podiatrist can help to see if you have hard skin build-up which is altering the way you weight bear.
Other treatment will depend on the underlying cause of your metatarsalgia. For example, if diabetes is the cause, you may need better control of your diabetes. If gout or arthritis is the cause, you may need treatment for these conditions. Surgery is sometimes needed to treat metatarsalgia if other treatments have failed. This will depend on the underlying cause – for example, straightening of hammer or claw toes or surgery for Morton’s neuroma.
Leading A Gout Free Life
In order to avoid gout attacks, your gout physician may prescribe a medication to reduce the buildup of uric acid in your blood. In most cases patients take this medicine for their entire life, but there are things that you can do reduce the chances of needing a lifetime of medication. Pay special attention to what you eat. This can help you manage the buildup and uric acid and reduce the frequency and duration of your gout attacks. Eating appropriate amounts of a healthy variety of foods to keep your weight under control and to get the nutrition you need. Try to avoid frequent or daily meals consisting of meat, seafood, and alcohol. As always you should drink plenty of fluids, especially water.
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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.
How Is Ball Of Foot Pain Diagnosed
Sometimes pain in the ball of your foot goes away on its own after a few days. If your pain persists for more than a few days after resting and changing your footwear, or if the pain is severe and accompanied by swelling or discoloration, be sure to make an appointment with a doctor.
The doctor will examine your foot, both while youre standing and sitting, to look for what is causing pain in the ball of your foot. They may also want to see the way you walk. They will ask you questions about your lifestyle, including:
- how long you have to be on your feet each day
- what type of shoes you generally wear
- if youre involved in any new activity
The doctor may also order an X-ray to determine whether you have a stress fracture or muscle tear. As with any foot injury or health concern, let your doctor know if you have diabetes. Ball of foot pain may require more immediate attention for people with diabetes.
The doctor may also order additional tests to check for gout, arthritis, bursitis, or Mortons neuroma.
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How Is Ball Of Foot Pain Treated
There are many home remedies for ball of foot pain. If your symptoms arent caused by a larger health condition, such as Freibergs disease or diabetes, your doctor will probably recommend some or all of the following. You could experience relief in a matter of days.
Rest your foot when you can, especially after periods of activity. Use an ice pack for 20-minute intervals every 2 to 3 hours. The ice may help alleviate inflammation and reduce swelling.
Wear comfortable shoes. If you wear high heels, your doctor will probably recommend that you change your footwear. Youll also want to make sure that your shoes fit properly. Tight shoes can cause your feet to misalign while you stand and walk, creating improper balance.
Exercise. While you may not want to participate in running or certain high impact sports during this time, targeted stretches might ease pain and increase flexibility and strength. You may want to practice your stretches a few times a day until you feel pain relief.
Use orthotic inserts. Depending on the level of severity, your doctor may prescribe orthotic inserts or recommend commercial shoe inserts. Orthotic inserts are made to help align the foot and provide extra cushioning. A pad under the ball of the foot may ease pain as well.
Do I Need Any Investigations
If you have metatarsalgia, your doctor will usually try to establish the cause for the pain. They may be able to identify the cause just by listening to you, asking you questions and examining your foot. However, they may also suggest one or more of the following investigations:
- Blood tests. These can check for diabetes, arthritis and gout.
- X-ray of your foot. This can show a problem with the bones or joints in your foot.
- An ultrasound scan may be used to detect Morton’s neuroma.
- Other tests. Occasionally more detailed tests, such as a magnetic resonance imaging scan of your foot, are needed.
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How Is Gout Treated
Gout is typically treated with medication. Nonsteroidal anti-inflammatory drugs can help stop the inflammation and pain. Examples of NSAIDs include ibuprofen and naproxen. If you take NSAIDs, there is an increased risk of ulcers, bleeding and stomach pain. Colchicine can also be an effective drug for treating gout. However, complications include vomiting, diarrhea and nausea. Colchicine is usually given to patients who cannot take NSAIDs.
Steroids are commonly used to battle the painful form or arthritis. Just like the medications described above, steroids help combat pain and inflammation. Steroids can either be taken orally or be injected directly into the joint. Common symptoms include bone thinning, weaker immune systems and poor wound healing. Steroids are typically given to patients who cannot take NSAIDs or colchicines.
How Is Sesamoiditis Treated
- Rest. Sesamoiditis is a repetitive stress injury, so the first thing to do to begin healing is to stop the activities that are causing the stress. You will need to keep pressure off of the injury until symptoms ease.
- Restriction. Your healthcare provider might recommend temporarily strapping or taping the big toe. For more severe cases, they might suggest a short leg fracture brace to restrict movement.
- Ice and elevation. These are used to help reduce inflammation. Use ice indirectly, either in an ice pack or wrapped in a towel.
- Soft tissue therapy. Your healthcare provider may use therapeutic ultrasound, moist heat or soft tissue massage to help rehabilitate the tissues.
- Physical therapy. If your foot has been restricted by a brace or bandaging, your healthcare provider may recommend physical therapy afterward to restore range of motion.
- NSAIDs. These can help with inflammation and pain management. Your healthcare provider will help you determine if NSAIDs are right for you.
- Steroid Injection. In rare, severe cases, your healthcare provider might give you a steroid injection directly into the injured tissue to relieve pain and inflammation.
- Surgery. In rare cases of chronic sesamoiditis, when symptoms dont resolve over time, surgery might be a last resort. Removing one of the sesamoid bones can bring relief.
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Arthritis / Acute Gout Attack
Gout is a form of arthritis, hence it causes pain and discomfort in the joints. A typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint. The clinical presentation of acute gouty arthritis is not subtle with very few mimics other than a bacterial infection.
The joint most commonly involved in gout is the first metatarsophalangeal joint , and is called podagra. Any joint may be involved in a gout attack with the most frequent sites being in the feet, ankles, knees, and elbows.
An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack takes approximately 7-14 days.
An accurate and colorful discription of a gout attack was elegantly written in 1683 by Dr. Thomas Sydenham who was himself a sufferer of gout:
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.
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