How Do You Get Gout
How do you Get Gout?
Before we can answer the query how do you get gout? we need to explain what gout is. Gout is a specific form of arthritis that is characterized by extreme pain, stiffness, redness and heat in the region and usually accompanied by swelling in the affected area. Without treatment, these episodes are repeated and can cause lasting damage to joints, tendons and surrounding tissues. Gout is more prevalent in men, but a general rule is that it can effect women after menopause.
So how do you get gout?In order to get gout, uric acid levels in the blood must be excessive. Bear in mind, however, that not all people with excessive uric acid levels will develop gout. Gout only occurs when the uric acid deposits crystals in the joints, typically in the big toe, or knees. You will be more susceptible to developing gout if you are overweight, consume excessive amounts of alcohol or have a diet that includes meat and fish that are rich in purines. Purines will be explained later. Some medications, such as those designed to reduce water retention can also result in a gout condition.That’s how you get gout.
Purines
Foods to avoid – How do you get Gout?
It is not enough to know How do you get gout? it is also necessary to understand which foods may be causing the problem. It should be noted at this point that there is no cure for gout and the approach is to treat the symptoms only or to recommend a diet that is low in purines.
How do you get Gout!
Symptoms Of Heel Pain Due To Uric Acid
Anyone can get gout, although its most common in individuals with the risk factors we covered earlier The symptoms of gout in the heel are subtly different from those of plantar fasciitis in the heel:
- Redness, swelling and tenderness that is most pronounced where the heel meets the ankle. You are also likely to notice symptoms at the base of the big toe.
- Often, gout symptoms will flare-up in the middle of the night
- During a flare-up, your heel will feel so hot and painful to the touch that even wearing socks is excruciating
- Pain that is less intense but lingers after a gout attack flare-up of pain
- Increasing difficulty moving the joint
As a general rule of thumb, pain from plantar fasciitis will improve with rest, while pain from gout will flare up during long periods of inactivity and rest.
When Is Surgery Considered For Gout
The question of surgery for gout most commonly comes up when a patient has a large clump of urate crystals , which is causing problems. This may be if the tophus is on the bottom of the foot, and the person has difficulty walking on it, or on the side of the foot making it hard to wear shoes. An especially difficult problem is when the urate crystals inside the tophus break out to the skin surface. This then can allow bacteria a point of entry, which can lead to infection, which could even track back to the bone. Whenever possible, however, we try to avoid surgery to remove tophi. The problem is that the crystals are often extensive, and track back to the bone, so there is not a good healing surface once the tophus is removed. In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered.
Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase , since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus.
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The Pathology Of Gout
Gout is primarily a metabolic disorder in which uric acid accumulates in blood and tissues. When tissue levels reach saturation, needle-like crystals form, causing inflammation. This occurs most commonly in the cooler joints, notably the metatarsophalangeal joint of the big toe.
Many people with hyperuricemia never develop gout, but those with the highest levels are most likely to suffer episodes. Hyperuricemia may also lead to kidney stones.
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.
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What Is The Main Cause Of Gout
When uric acid builds up, it causes gout. It is normal to have some uric acid in your blood, but people with gout create too much of it. Or their kidneys cant get rid of it very well.
Certain foods are high in a natural chemical called purine, which is broken down into uric acid in your body. Ditto with fructose, the sugar in sweetened drinks.
When uric acid levels get too high, sharp, needle-like crystals form. They get into the joint or surrounding tissue. This causes inflammation, pain, redness, and swelling.
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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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.
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.
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What Does It Mean When Your Foot Arch Hurts
Plantar fasciitis is the most common cause of arch pain and one of the most common orthopedic complaints reported. Its caused by inflammation, overuse, or injury to the plantar fascia. The plantar fascia is the ligament that connects the front of your foot to your heel.
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
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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.
What Are The Signs And Symptoms
- It usually starts with a sudden onset of intense pain, in one or more joints, such as the big toe joint. If you have gout, you will likely have swelling and redness and pain in the joint of your big toe. Weightbearing activities such as walking can worsen the pain.
- Many people often say they first notice pain in the middle of the night or upon arising in the morning.
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Medications That Can Trigger Gout
Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.
Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.
Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:
- chlorothiazide
may have high levels of the hormone insulin. This can cause too much uric acid in the body, triggering gout symptoms in your joints.
Lifestyle Changes To Help Foot Gout
Treating foot gout in the long-term requires a combination of lifestyle changes and medications. After you have taken the right medication to treat your gout flare and manage uric acid levels, you should be taking steps to correct your lifestyle. Theres only so much pills can do so its important to accompany it with habits that support your condition.
Start with your weight. You probably have gout because you are overweight or obese. You want to lose the excess fat since that contributes to the strain you feel on your feet. Exercising regularly and cutting back on food intake can significantly help with your goal of losing weight.
Only go for real whole foods and avoid items that trigger your gout such as processed foods. I recommend the 80-10-10 diet where 80 percent of your daily calories consists of complex carbohydrates, 10 percent as protein and the final 10 percent as fat.
Its important that you learn how your body reacts to each food item as every person has a different physiology. What may trigger an attack on you may do nothing for the other person. Start by eliminating common culprits such as sugar, alcohol, seafood, and organ meats.
You may need to keep a diary to track your food and medication. That way whenever you have a gout attack in your foot, you can trace back what you ate and learn what caused the trigger.
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What Kind Of Doctor Should You See For Gout
The best kind of health professional to see for gout is a Rheumatologist, a specialist in the diagnosis and treatment of arthritis and other inflammatory joint conditions. If you are unable to visit a rheumatologist immediately a general doctor, nurse practitioner or orthopedist can also provide expert consultation on your gout.
Pain And Swelling Are Gouts Calling Cards
The most frequent signs of a gout attack are swelling, tenderness, redness, and a sharp pain in your big toe. These attacks are most common at night when you are sitting still and laying flat on your back. While gout usually manifests in the big toe, you may also experience gout attacks in your foot, ankle, or knees. The attacks can be short or long, anywhere from a few days to weeks and you may not have another attack may for months or years.
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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 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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How Long Does Gout In The Ankle Last
Gout flare-ups can last for several hours at a time, but you may feel pain in your ankle for days or weeks. Some people only have one flare-up in their life, while others have them several times a year.
Keep in mind that gout is a chronic condition, meaning it lasts for a long time and requires ongoing management. Dietary changes and medications can make a big difference, but youll also be at risk of having a flare-up.
Keep in mind that it can also take some time to find the right combination of diet changes and medication that works for you. Dont be discouraged if things dont seem to be improving right away.
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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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
Symptoms Of Foot Gout
A gout flare in the foot can be sudden and extremely painful. It feels like your big toe is on fire as it feels hot, swollen, and tender. The first 36 hours are the worst but after that, the pain lessens and lingers, but it doesnt entirely go away until after a week or two.
Once you experience a gout attack, call your doctor right away. They will provide you with medication to help lower uric acid levels and prevent it from worsening.
You may have difficulty walking or wearing shoes when you have foot gout. Its pretty common for gout sufferers to walk slower, have reduced stride length, and less pressure on the midfoot. This is because gout in the foot can be very painful and walking in such a manner can help lessen the pain.
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