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.
Reducing Gout Attacks With Lifestyle Changes
Immediate Gout Pain Relief: What Are Your Options
Generally, you can take simple steps to get the pain and swelling under control. Examples include ice, compression of the joint and rest from sport. Also, you need to keep well hydrated and avoid alcohol.
Medications from your doctor can help. Anti-inflammatory tablets such as ibuprofen can stop an acute attack if taken early. Similarly, a drug called colchicine can stop gout in its tracks if taken in the first 24 hours. Often, the dose of colchicine is one tablet three times a day decreasing to twice a day after a week as the pain settles.
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
Treating A Gout Attack
The methods of stopping an attack of gout can vary depending on the severity of pain. Your orthopedic physician may give you a shot of corticosteroids. They may also prescribe other types of medications that are specifically designed to treat gout. To ease the pain during a gout attack, rest the joint that hurts. Non-steroidal anti-inflammatory medicine may also be prescribed to help reduce the pain. The good news is that following treatment, relief from the pain and discomfort of a gout attack often begins within 24 hours. It is important to still make an appointment with your orthopedic physician even if your pain from gout is gone. The buildup of uric acid that led to your gout attack can still harm your joints. An orthopedic physician will help you get relief from the pain of gout attacks and learn ways to prevent flare-ups in the future.
*The blog is for general information and educational purposes only regarding musculoskeletal conditions. The information provided does not constitute the practice of medicine or other healthcare professional services, including the giving of medical advice, and no doctor-patient relationship is formed. Readers with musculoskeletal conditions should seek the advice of their healthcare professionals without delay for any condition they have. The use of the information is at the readers own risk. The content is not intended to replace diagnosis, treatment or medical advice from your treating healthcare professional.
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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.
Gout Remedies That Work
Gout is something that plagues more and more people every day, and its caused from uric acid buildup in the body. I want to go over my top six home gout remedies all-natural ways to beat gout symptoms but right before that, go over the diet that is crucial to get rid of gout, along with the worst food offenders.
So if you have gout, the first thing you have to do is eliminate the excess sugar and grains in your diet, as well as processed meat. That means you need to kick that sugar addiction, as sugar feeds yeast in the body and conventional grains turn into sugar. Meanwhile, those meats are full of unhealthy hormones and antibiotics, and theyre so acidic to your system. In terms of beverages, its important to stay away from alcohol. Diet- and drink-wise, those are the best things you can do right now to eliminate gout symptoms.
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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.
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
- starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.
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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
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.
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The Pain And Swelling Of Gout Can Be Easily Treated
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.
Symptoms Of Gout In Toes
In most people, the primary signs of gout appear in the joints of the big toe. The skin around the affected joint becomes yellowish, stretched, and bruised.
The affected area may become very sensitive to tolerate the touch of clothing or shoes. Gout attack in the big toe is referred to as podagra. It causes intense pain, swelling, redness, and inflammation in the affected toe joint.
Podagra may result from acquired injury or trauma to the joint. In addition to toe joints, recurrent gout attacks may affect other joints like knees, heels, elbows, hands, wrists, and fingers.
Some patients experience mild fever and sweating. Chronic gout attacks are longer-lasting and can lead to damage and deformities in the affected joint. The symptoms may last for 7-10 days. The main symptoms of gout are accompanied by some other symptoms like discomfort, fever, malaises, sourness, tachycardia, body pain, and itching sensation.
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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.
Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
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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.
The Right Treatment Plan
Over-the-counter medications such as ibuprofen , prescription anti-inflammatory drugs like colchicine , and prescription steroids like prednisone can help reduce joint pain and swelling during an acute attack or flare.
Long-term, your doctor may recommend urate-lowering therapy , which means taking medications such as allopurinol and febuxostat daily. There is the possibility of future damage to your joints if you dont control it, says Stanford Shoor, MD, a clinical professor of medicine and rheumatology at Stanford University.
ACR recommends ULT if you have tophi or evidence of joint damage, or if youve had two or more attacks in a year. But whether or not you start ULT after one attack depends a bit on how much we think youre going to have future attacks, FitzGerald says. If you dont have kidney disease or very high uric acid levels, it may be years before you have another attack, and you might not want to go on daily therapy.
The standard of care generally calls for whats called treat to target, starting with a low dose of ULT and adjusting it until your uric acid levels drop to a specific level. Newer ACR guidelines strongly recommend treatment that keeps uric acid concentrations below 6 mg/dL, which is low enough to keep the acid from crystallizing.
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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.
How To Get Gout Relief At Home
This article was co-authored by Siddharth Tambar, MD. Dr. Siddharth Tambar, MD is a board certified rheumatologist at Chicago Arthritis and Regenerative Medicine in Chicago, Illinois. With over 19 years of experience, Dr. Tambar specializes in Regenerative Medicine and Rheumatology, with a focus on Platelet rich plasma and Bone marrow derived stem cell treatments for arthritis, tendinitis, injuries, and back pain. Dr. Tambar holds a BA in Economics from State University of New York at Buffalo. He earned his MD from State University of New York at Syracuse. He completed his Internship, Residency in Internal Medicine, and his Rheumatology Fellowship at Northwestern Memorial Hospital. Dr Tambar is board certified in both rheumatology and internal medicine. He also holds Musculoskeletal Ultrasound Diagnostic and Interventional certifications from the American College of Rheumatology and the American Institute of Ultrasound in Medicine.There are 12 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 100% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 464,327 times.
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