What Are The Symptoms Of Gout In Your Toe

Is There A Test For Gout

There is no one test for gout, and its symptoms are similar to several different conditions. To see if you have gout, your health care provider may:

• Ask you to provide your medical history, including:
• Your symptoms.
• Any other medical problems you have.
• Any medications you are taking.

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.

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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.

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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

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.

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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.

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 Increases Your Chances For Gout

The following make it more likely that you will develop hyperuricemia, which causes gout:

• Being male

What Causes Gout Pain

Picture a collection of glass shards pressing outward like needles. This is what it can feel like during a gout flare, when a buildup of uric acid in the blood forms microscopic crystals that grow in and around a joint. As the build-up increases, the immune system responds to these crystals, causing inflammation that leads to visible swelling, redness, and debilitating pain.

In some cases, a gout flare can even lead to a fever and look like an infected joint, Dr. FitzGerald notes. The treating doctor may need to look for possible source of infection, often by removing fluid from the joint to send to the lab to look for crystals or bacteria.

Uric acid is a byproduct of the body breaking down proteins called purines from your own cells and from certain foods such as red meat and shellfish. Alcohol and drinks sweetened with high fructose corn syrup are also high in purines. Normally, uric acid dissolves in your blood and is filtered out through your kidneys, but when your body produces too much uric acid or your kidneys fail to filter it, either due to familial causes or kidney disease, then the uric acid builds up and creates the needle-like urate crystals that cause gout and can also form kidney stones, according to the Mayo Clinic.

Certain factors make some people more likely to develop gout, according to the U.S. Centers for Disease Control and Prevention. Gout risk factors include:

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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.

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.

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Gout Joint Pain And Your Orthopaedist

If you have sudden, intense pain in your toeor pain in any other jointmake an appointment with your orthopaedist. Your orthopaedic provider can diagnose the problem and work with you to provide both immediate pain relief and long-term solutions. If youre diagnosed with gout, your provider may recommend cortisone injections and/or medications along with lifestyle changes. At Countryside Orthopaedics, we work to keep every patient active and feeling good, so you can stick with the activities you love. If gout or another joint condition is slowing you down, lets get it diagnosed and take the first steps to get it under control.

What Are The Symptoms Of Gout

An episode of gout is called a gout attack. Gout attacks are very painful and can happen quite suddenly, often overnight. During a gout attack, symptoms in the affected joint may include:

• Intense pain.
• Tenderness, even to light touch, such as from a bedsheet.
• Warmth, or a feeling like the joint is on fire.
• How long does a gout attack last?

A gout attack can last a week or two. Between gout attacks, you may have no symptoms at all.

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Foot Gout Management Causes Symptoms And Treatment

• Talking to Your Doctor

Gout is a form of arthritis that affects the joints, mainly the one located at the base of the big toe. Gout primarily affects the foot and toes, but it can affect any joint in your body, including your toes, wrists, elbows, heels, fingers, and ankles.

This condition is often very painful. Many patients describe gout as feeling like their toe is on fire. Gout occurs when deposits of uric acid crystals in a joint cause painful inflammation. Uric acid is a waste product that normally passes through the kidneys and leaves through our urine.

When too much uric acid is producedthat is, when new uric acid is produced faster than old uric acid can be disposed ofthe result can be gout.

A gout flare causes swollen, red, hot, stiff joints and intolerable pain. Gout mainly affects men, but studies show that women become increasingly susceptible to the condition after menopause.

Initially, foot gout flares up and goes away within days. But if the condition worsens or is left untreated, the flare-ups last longer and occur more often. Normally, a persons uric acid range is 2.6 to 7.8 milligrams per deciliter .

Gout occurs when uric acid builds up in your blood. High levels of uric acid in your body can also cause kidney stones and permanent joint or kidney damage. Gout most often occurs in people over the age of 30.

Is There A Connection Between Gout And Turf Toe

If you are predisposed to gout or have multiple risk factors, joint injury may trigger a gout attack. Even stubbing your toe can cause a gout attack if there are enough uric acid crystals in your cartilage already.

If you have gout, its important to take precautions for your feet and joints when you exercise. Continuing to manage your condition over time is important.

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Gout Frequently Flares In Your Knee But You May Not Always Know That Your Knee Pain Is Due To Gout Heres How To Tell Since Prompt Treatment Can Reduce Your Risk Of Complications

Knee pain can be a common symptom of several types of arthritis, as well as many other conditions or injuries. If your knee stiffness is accompanied by a burning pain and is warm to touch, you may have a gout flare in the knee.

Though gout is most often associated with the big toe, gout tends to flare in areas that already have arthritis, says Robert Keenan, MD, a rheumatologist with Articularis Healthcare in Summerville, South Carolina. Although gout can strike in many different joints, as a general rule, gout works its way up the body. If its not treated, it works its way up from the big toe, through the ankle, to the knee, and then to the lower spine and so on.

Gout can affect both knees, but typically is felt more strongly in one knee say, where you may have arthritis wear-and-tear to begin with.

Learn more about what causes gout in the knee, as well as ways to treat the pain and prevent it in the future.

What Causes Gout In The Knee

Gout develops when the body has high levels of uric acid, a normal waste product. This is known as hyperuricemia.

Uric acid is normally excreted through the body via the kidneys, but in some people, levels can remain high and uric acid can start to accumulate and crystallize in various joints. When these uric acid crystals affect the joint in the knee, it can cause gout symptoms in the knee, making the knee joint red, swollen, and hot to the touch. The buildup of uric acid can also impair the knee joints full range of motion, which can make it difficult to walk.

A number of factors can influence your risk for gout.

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Signs & Gout Symptoms

As mentioned above, the first sign of gout symptoms may be the sudden onset of severe pain in one of your big toes or other joints. In fact, this first attack often occurs at night and causes enough pain and discomfort to awaken you. Many individuals experience pain so severe that even lying under a sheet may become unbearable.

For some, the pain may go away on its own in a week or 10 days, only to recur in the weeks or months following. For others, the pain may last for extended periods of time, or slightly ebb and flow over weeks or months.

Typically, the pain is at its greatest in the first 12 to 24 hours of the attack however, this can vary depending on your diet and other factors. In addition to severe pain in the big toe, other common gout symptoms include:

• Severe pain in joints including feet, ankles, knees, hips, wrists, hands, fingers and back where even the weight of a sheet or clothing is intolerable.
• Noticeable discoloration in the joints they may become deep red or even purple at onset, and change color through the attack.
• Joints that are swollen and stiff and hot to the touch.
• A fever of up to 102.2F, with or without chills.
• Joints that are inflamed and tender accompanied by decreased mobility.
• Lingering discomfort as the joint pain and inflammation can last for days or weeks.
• Hard lumps or bumps at the joints.

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.

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Medications For Gout Attacks

To treat gout attacks and to prevent future ones, you doctor may recommend these medications:

Nonsteroidal anti-inflammatory drugs

Initially, your doctor might suggest over-the-counter NSAIDs, such as naproxen sodium or ibuprofen .

If these OTC medications arent enough, your doctor might prescribe more powerful NSAIDs such as celecoxib or indomethacin .

Colchicine

Colchicine is a medication that your doctor may prescribe based on its proven effectiveness in reducing heel gout pain.

Side effects of taking colchicine, especially in large doses, can include diarrhea, nausea, and vomiting.

Corticosteroids

If NSAIDs or colchicine arent appropriate for you, your doctor might recommend corticosteroid medications, either in pill form or via injection, to control inflammation and pain.

An example of this type of medication is prednisone.

Nodules Under Your Skin

Untreated gout can cause deposits of urate crystals under your skin . These feel like hard nodules and can become painful and inflamed during gout attacks. As tophi build up in joints, they can cause deformities and chronic pain, limit mobility, and can eventually destroy your joints entirely. The tophi may also partially erode through your skin and ooze a white chalky substance.

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What Are The Risk Factors For Gout

Risk factors for gout include:

• being male
• taking medications that increase water excretion by the kidneys
• being overweight
• eating a diet with a lot of meat, offal and shellfish
• having kidney disease, high blood pressure, diabetes or abnormal levels of fat and cholesterol in the blood
• drinking a lot of alcohol, especially beer, port or spirits
• going on a crash diet or fasting
• being of Maori or Pacific Islander origin, which can predispose a person to high uric acid levels

Gout is more common in men than in women, and among women it’s more common after menopause. It’s more likely to occur in older people, but can affect anyone.

It can also affect people with certain types of blood disorder and people in treatment for cancer.