Help Is That Pain In My Toe Gout
When you suddenly feel a sharp, stabbing pain in your big toe, your first thought probably isnt gout. After all, gouts the condition that stereotypically affects rich people who eat rich foods. But if you dont remember injuring your toe and it throbs painfully, you might be just rich enough for gout.
At Rheumatology Center of New Jersey, our expert team of rheumatologists treats gout and other forms of arthritis and joint pain at our four New Jersey locations: Somerville, Princeton, Flemington, and Monroe. If your big toe hurts, here are a few clues that it might be gout.
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.
What Causes Gout In The Big Toe
Gout is a type of arthritis that commonly occurs in the big toe. It can also cause pain in the ankles, knees, and elbows. A buildup of uric acid that develops into crystals is the cause of gout in the big toe. A person is more likely to get gout in the big toe if he is obese or overweight, drinks too much alcohol, or is on certain medications. Some people also have a genetic propensity to produce excess uric acid.
Many people have high levels of uric acid in their blood but still do not get gout in the big toe. The human body produces uric acid when it breaks down purines, which are found in the body and also come from foods such as asparagus and mushrooms. Typically, the uric acid travels from the blood to the kidneys and out of the body in urine. In some cases, the kidneys do not pass enough uric acid into the urine so that it builds up and crystallizes in the joints, leading to gout. Eating too many foods that are high in purine can cause uric acid to build up as well.
The hard uric acid crystals are what cause pain from gout in the big toe. The crystals can cause sudden, intense pain in the big toe or another joint. The toe may swell and turn red. Pain from an attack of gout can last for months or years.
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When Should I Worry About Toe Pain
If youve noticed a significant change in your toe pain while wearing different types of shoes, you should see a podiatrist. An improperly fitting shoe may be the cause of your pain. If the pain is sharp and radiates up the big toe, this may indicate a possible fracture of the metatarsal bone. This type of fracture requires an x-ray for diagnosis.
Big Toe Joint Is Swollen But Not Gout
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Gout Attack Vs Chronic Gout
It is possible to have a gout flare-up and never experience another. Repeated instances of acute gout are called chronic gout17.
The treatment goals for a gout attack are different than those for chronic gout. When treating a gout attack, the goal is to relieve pain and inflammation. When treating chronic gout, the goal is to prevent future gout attacks and long-term joint damage.
While some people with chronic gout may get frequent gout attacks, others may have years in between attacks. If chronic gout is not treated, attacks may become more frequent and/or last longer.
Left untreated, a gout attack will usually resolve itself within a few days or weeks. Chronic gout can permanently damage a joints tissues and decrease its range of motion. For this reason, it is important to recognize symptoms, understand risk factors, get an accurate diagnosis, and treat and prevent gout.
What Are Future Possible Treatments Of Gout
Fortunately, present medications are successful in the vast majority of gout patients. But some patients cannot tolerate our present arsenal of gout medications. For others, these agents are not sufficiently effective. Therefore, new treatments are continually being sought. Some of the more promising include anakinra, rilonacept, canakinumab, BCX4208 and arhalofenate.
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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.
Causes And Aggravating Factors Of Sesamoiditis
Overuse of the big toe tendons is the most common cause of sesamoiditis, although it can also be exacerbated by other causes.
The following conditions are commonly linked to the development of sesamoiditis-like inflammation:
- The presence of a poorly treated foot bunion
- Arthritis of the foot
- Recurrent inflammation of the tissue near the sesamoid bones
- Wearing shoes with thin soles or high heels
- Regular practice of sports that are hard on the big toe area, such as dancing or basketball
- Arch deformity such as flat or cavus foot
Because various plantar diseases can induce sesamoiditis, it is strongly advised that you seek medical advice.
If thats the case, the medical professional will be able to pinpoint the pathology or lesion thats causing the discomfort.
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What Does The Future Hold For Gout
Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.
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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Why Does Gout Affect The Big Toe
According to the American College of Foot and Ankle Surgeons, gout is most common in the big toe joint because uric acid is sensitive to temperature changes. The foot is farthest from the heart and is the coolest part of the body, so that big toe joint can be a canary in the coal mine when it comes to gout.
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.
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When To Contact A Doctor
In cases of mild pain or pain that gets better over time, it is not usually necessary to seek guidance from a doctor. Many sprains will heal on their own during a period of rest.
The Arthritis Foundation recommends contacting a doctor for joint symptoms that do not improve after 3 days or if a person has several joint symptoms within a single month.
It is also important to consult a doctor if the pain is severe or sudden and unexplained. A medical professional should examine the foot when there are signs of fracture, such as bruising around the big toe.
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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Gout Doesnt Have To Be A Pain
Gout attacks can be recurring. Over time, the condition can harm your joints, tendons, and other tissues if not treated correctly. The best course of action with the fewest side effects is to follow a gout-friendly diet and limit your intake of red meats, seafood, and alcohol. If you suffer from gout and want to try a holistic approach to treating the disease, be sure to check with your doctor to make sure this is the right course of action for you.
Ellis, R., Fighting the agony of gout with a daily glass of cherry juice, Daily Mail, September 28, 2014 .Treatments and Remedies for Gout, Mercola , last accessed May 5, 2017.Gout: Facts and Information, Mercola , last accessed May 5, 2017.
Your Toe Is Red Swollen And Painful
Gout is caused by uric acid crystals that collect in your joint, causing inflammation. If you have gout, you may feel like your toes being stabbed by needles. Your toe could also be swollen and red. When you touch your toe, it may feel hot.
Gout usually affects just one big toe joint, but it can affect other joints in the same foot and leg, such as your toe joints, ankle, and knee.
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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.
Treating Toe Joint Pain
The correct treatment for toe joint pain will depend on what is actually wrong with the foot. Typical things that help include:
- Exercises: strengthening and stretching the foot and ankle
- Orthotics: inserts for your shoes to correct foot position
- Steroid Injections: to reduce pain and inflammation
- Ice Packs: to reduce pain and inflammation
- Supports: tubigrip compresion bandage or ankle/foot supports of splints
- Toe Stretchers: specially designed inserts that sit between your toes
You can find out lots more about the treatment options for each of these types of toe joint pain by reading the full articles mentioned above.
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Could That Ache In Your Big Toe Be Gout
Gout is a complex form of arthritis most common in men, though post-menopausal women are also susceptible. We explain the symptoms and provide tips to reduce your risk.
You wake in the night with the sensation that your big toe is on fire. The joint at the base of your toe is so swollen and tender that even the weight of the sheet feels too painful to endure.
You may be experiencing an attack of gout: sudden severe pain, redness and tenderness, often located in the joint at the base of the big toe. Gout is caused by the accumulation of urate crystals in a joint. Urate crystals form when your body produces too much uric acid or when your kidneys excrete too little uric acid. When uric acid builds up in the blood, needle-like urate crystals form in a joint or surrounding tissue, causing pain, inflammation, and swelling.
This complicated form of arthritis can affect anyone, though it is most common among men. The symptoms of gout are intense and almost always occur suddenly, without warning.
- Acute joint pain. Although gout often affects the large joint at the base of the big toe, it can also affect other joints in feet, ankles, knees, hands, and wrists. The pain is most severe in the 12 to 24 hours following the onset of the attack.
- Lingering discomfort. Usually, the sudden pain of an attack subsides within a day, but joint discomfort may linger for as long as several weeks.
- Inflammation. The affected joint is swollen, tender, and red.
Joints Affected By Gout
Gout can affect any joint, but some joints are more likely to be affected than others. Joints commonly affected include the big toe, the foots instep, heel, ankle, and knee.2 Less often, gout affects the elbow, wrist, fingertips, or spine.2–7
Gout is acute, painful swelling in the joints from uric acid buildup. Common areas include the foot and big toe.
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The Role Of Medication In Prevention Of Gout
Table 3: Medications to pevent attacks of gout
Standard medications in preventing gout attacks
i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8
ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.
Table 4: Reasons to use medication to lower uric acid
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.
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Prescription Treatment For Severe Big Toe Arthritis
If proper self-care and home treatment fail to provide adequate relief, your physician may progress to other forms of treatment:
- The first is typically a prescription-strength anti-inflammatory, which can be quite effective at mitigating symptoms.
- If anti-inflammatories fail, cortisone injections used occasionally can provide long-term relief depending on the stage.
- Finally, surgery may be required and can range from bone spur removal , great toe joint fusion , or even replacement of the great toe joint .