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.
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 .
Its Not Gout What Is It
pt Health Foot pain
Although many of us try to ignore aches and pains, having these sensations in your big toe can be concerning when they interfere with your ability to do basic activities like walk or take the stairs.
Youve heard of gout before, and your big toe hurts, so is that whats causing your pain?
Did you know that there are differential diagnoses for gout? This means the symptoms you thought were caused by gout could actually be caused by a different condition. If youre looking for a reason your big toe hurts thats not gout it could be a condition called hallux limitus.
Lets take a look at what hallux limitus is and how its different from gout, its symptoms and causes, and how to treat this bothersome big toe pain thats not 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.
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.
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Rheumatoid Arthritisandosteoarthritiscan Also Be Confused With Gout
Its important that you visit a licensed foot doctor to diagnose your condition and prescribe the best course of action. Harford Lower Extremity Specialists has the tools and the expertise to help! Please fill out our contact form, call our offices to schedule an evaluation at 836-0131, or click the Schedule An Appointment button below.
Symptoms In The Big Toe
The pain experienced is severe, and the symptoms get worse within 12 hours. Immediate gout pain relief of the big toe joint can take place within one or two weeks.
- Intense burning or throbbing joint pain followed by redness, swelling, discoloration, and feels warm to the touch.
- Rapid onset of symptoms
- Shiny skin over the affected joint
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The Pain And Swelling Of Gout Can Be Easily Treated
IBJI
October 17, 2012 | Blog
Gout is actually a form of arthritis that commonly affects the big toe in men. It may cause a sudden burning pain in one of your joints, or stiffness and swelling in one or more joints. Attacks of gout can happen repeatedly unless it is treated. Eventually, gout attacks can cause long-term damage to your tendons, joints, and soft tissues.
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.
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Toe Pain Signs And Symptoms To Watch Out For
Apart from the evident pain in the toe region, there are many signs and symptoms which characterize this condition. The symptoms will vary with the underlying cause of the disease. The common symptoms of toe pain are as follows.
*All individuals are unique. Your results can and will vary.
- A burning feeling in the region of the toes
- Difficulty in moving the toes
- Numbness, , and swelling in the toe region
At certain times, toe pain can occur along with certain other serious conditions. You may experience confusion, high body temperature, shortness of breath, and soreness of the toes.
In such a case, it is necessary that you seek immediate medical help.
Natural Treatments For Gout
Most conventional doctors will tell you that the only way to treat gout is to take drugs such as corticosteroids, NSAIDs, Zyloprim, or a mixture of others, which all come with harmful side effects. I highly recommend treating gout by eating specific foods and taking herbs to combat the pain and discomfort. Not only are holistic techniques less expensive compared to prescription drugs, but they also pose fewer health risks.
I tell my clients that the easiest way to start a gout-friendly diet is by including ginger in your food daily. This root not only boosts your immune function, but it also has anti-inflammatory and pain-relieving properties! Just eat it fresh or steep it in tea.
Research has also shown that drinking a glass of tart Montmorency cherry juice daily can help clear excess uric acid from the body in just a few hours. This powerful juice possesses anti-inflammatory and antioxidant properties.
Many natural remedies have been shown to reduce the pain and inflammation associated with gout. One of the most successful herbs shown to help ease gout is dandelion root. Used in Traditional Chinese Medicine and Ayurveda, dandelion root acts like a diuretic so it increases urination, removing excess uric acid from the bloodstream. In addition, it helps the kidneys clear out waste, salts, and excess water.
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What Is Hallux Limitus And How Is It Different From Gout
Hallux limitus is the initial stage of a gradual onset of arthritis in the big toe, which causes the range of motion in the big toe to be limited.
Hallux rigidus is used to describe the later stages, where the big toe becomes rigid and difficult to move or flex. Both hallux limitus and rigidus are caused by the decomposition of cartilage around the joint of the big toe, which causes pain and limited range of motion.
Although the pain can feel similar to gout, gout is a type of inflammatory arthritis that occurs when uric acid found in the blood stream gets deposited and becomes crystalized in the joint at the base of the big toe.
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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What Else Should I Ask My Healthcare Provider About Gout
Consider asking your healthcare provider:
- What is causing the gout?
- Do I have any joint damage?
- What can I do to prevent future attacks?
- Can any gout medications help me?
- How long will I need to take gout medications?
A note from Cleveland Clinic
Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.
Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.
References
How Can An Attack Of Gout Be Treated
The management of an acute attack of gout is very different from the prevention of subsequent attacks.
Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.
There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.
If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.
Table 2: Medications to treat acute attacks of gout
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When To See A Foot Doctor About Gout:
- Sudden intense pain in a joint in your feet
- Lingering, discomfort from a few days to a few weeks
- Inflammation and redness the affected foot joint becomes swollen, tender, warm and red
- Limited range of motion in your feet
Gout that goes untreated can lead to worsening pain and joint damage
Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.
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 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.
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.
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The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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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What To Do During An Attack
You should:
- 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.