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What Causes Gout In Foot And Toe

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Causes And Risk Factors

Gout occurs due to an excess buildup of uric acid, or hyperuricemia.

According to the National Institutes of Health , hyperuricemia is the main risk factor for developing gout. However, a quarter of those with hyperuricemia do not develop gout.

When the body breaks down purines, it produces uric acid. Typically, the kidneys remove a certain amount of uric acid in the urine. However, when they are unable to remove enough uric acid, uric acid crystals can form in the joints and soft tissues, causing swelling and pain.

Gout typically affects males more than females. However, females have higher levels of uric acid after menopause. NIAMS state that being older also the chance of developing gout.

Genetics can also increase the chance of developing gout.

According to the CDC , other factors that may increase the likelihood of gout include:

  • Diet: Food can play a role in the development of gout symptoms. Eating seafood, red meat, and drinking alcohol raises uric acid levels in the body.
  • Weight: Having overweight increases the chance of developing gout.
  • Medications: Certain medications, including diuretics and low-dose aspirin, are associated with gout risk because they increase the level of uric acid in the body.
  • Other medical conditions:High blood pressure, diabetes, and kidney disease can increase gout risk.

According to the National Health Service in the United Kingdom, some people with gout may develop complications, such as:

What Causes Plantar Plate Problems

Causes include:

  • The metatarsal bones shape: a short first metatarsal combined with either a long second and third metatarsal or both heightens the chance of suffering plantar plate issues
  • Placing too much weight on one of the metatarsals
  • Being pigeon-toed
  • Suffering from big toe arthritis or hallux valgus
  • Having undergone steroid injections in the area previously

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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.

Foot Gout Symptoms To Watch For

images of gout

Foot gout usually occurs suddenly, often at night. In most cases, flare-ups happen without warning. The best way to catch foot gout in its early stages is by knowing the symptoms. Symptoms of gout include:

  • Acute, intense pain within the joint
  • Discomfort for days after the severe pain subsides
  • Inflammation or swelling in the joint
  • Redness
  • Sensation of heat within the joint

People who suffer from this condition on a regular basis typically know the symptoms of gout and know to seek treatment at the first sign of a flare-up. Sometimes the symptoms are severe enough to bring on a fever of up to 101°F.

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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.

Whats The Outlook For People With Gout

Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.

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Where Does A Gout Attack Occur

Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.

The Wound Closed Anyway

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After all the pain that you felt, you will be relieved when the wound finally closes. Unluckily, however, this isnt the end of the risks that you are going to take. Its true that the bacteria will no longer have the capacity to attack from the outside. Tactlessly, the bacteria, which are thriving and breeding inside, may cause various conditions like septic arthritis. This may cause gout like condition and pain as the normally sterile joint cavity becomes fouled. Moreover, this may also cause bone spur. The nerves may grow back to the undesired and wrong places thus causing more agony.

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How Gout Affects Your Feet

Whilst Gout is not specifically a condition of the feet, it often affects toes and can cause associated foot problems which need additional treatment from a Podiatrist. Simply put, Gout is a form of inflammatory arthritis caused by too much uric acid in the bloodstream. This doesnt always lead to an attack, but if uric acid crystals form in or around a joint the pain can be excruciating. Gout is often regarded as a problem caused by rich living but this is not always the case poor diet, lack of exercise and dehydration can also play a role.

How Is Gout Diagnosed

In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.

Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .

Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy

There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2

Table 1: Diagnosing gout when no crystal identification is possible

Ideally, 6 of 10 features will be present of the following:

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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

Treatment For Gout In Toes


Seek prompt treatment as soon as you notice the signs and symptoms of gout in toes in order to avoid future complications. The diagnosis is made on the basis of an assessment of symptoms, physical examination of the affected joint, and some laboratory investigations such as determination uric acid levels in the blood and analysis of joint fluid for the presence of urate crystals.

Once the diagnosis is confirmed, the doctor generally prescribes medications like non-steroidal anti-inflammatory drugs, corticosteroids, and pain relievers. The medicines that lower uric acid can also be taken to get instant relief from the symptoms.

Along with conventional treatment, you should follow some precautionary measures and dietary changes. First of all, take maximum rest and donât put a strain on the affected joint.

Strictly stay away from alcoholic beverages, as they can worsen the condition. Drink enough amount of water to increase the elimination of uric acid through urine. Exclude high-purine foods from your diet. Understand in detail which foods are preferable in a gout diet and strictly follow the gout diet plan. Have regular exercises to strengthen the joints and to maintain healthy body weight.

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Pain Due To Ganglion Cyst

In the area of ??the instep, a kind of swelling of liquid content may appear , usually caused by some injury that conditions the exit of this joint fluid. Consequently, it accumulates in the soft tissues, forming what is known as ganglionic instep cyst.

The protrusion is usually painful and of variable size, from the size of a pea to the size of a golf ball.

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.

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Preventing And Treating Gout

When you first come to AllCare Foot & Ankle Center with gout symptoms, we conduct a thorough examination to determine the best course of treatment. We typically prescribe nonsteroidal anti-inflammatory medications to help control symptoms and prevent further joint damage.

If youve already had or continue to have multiple gout attacks, it can lead to a variety of health complications, including the erosion and destruction of your toe joint and the development of kidney stones. This is why preventing future gout attacks is essential for your overall health and wellness, not just for relieving the pain in your toe.

We recommend the following to help prevent future gout flare ups:

  • Drink plenty of fluids
  • Limit or avoid alcoholic drinks
  • Reduce meat, poultry, and seafood in your diet
  • Consume more low-fat dairy products for protein
  • Lose weight, if necessary

The common symptoms of gout arent something you should ignore, and we can help you get it under control. Give us a call at our Arlington or Dallas offices, or request an appointment online today.

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During A Foot Gout Flare

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If you are experiencing a gout flare-up and are unable to reach your doctor, there are a few things you can do to help reduce the symptoms:

  • At the first sign of symptoms, take ibuprofen or naproxen
  • Drink plenty of water
  • Rest and elevate your foot immediately
  • Place cold compresses on the affected area

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Am I At Risk Of Having Gout

Youre more likely to have a gout attack if you:

  • are male
  • have a family history of gout
  • have elevated levels of uric acid in the blood
  • drink too much alcohol
  • eat a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
  • are overweight or obese
  • use diuretics
  • have type 2 diabetes, high blood pressure or high cholesterol these conditions can mean that your kidneys are less able to flush out the urates
  • have kidney disease

How Are Plantar Plate Problems Diagnosed

Your consultant will invite you to give a full explanation of your symptoms at your initial appointment and guide you towards the most appropriate course of treatment. It may be that X-rays are performed to assess the alignment and state of the foot bones, along with an ultrasound and/or MRI scan to establish if there has been a plantar plate tear.

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How Are Gout Attacks Prevented

Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.

How To Relieve Pain In The Instep Of The Foot

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To relieve pain in the instep of the foot you can easily use the following measures until the doctor assesses you:

  • RICE method is the most used: rest, ice, compression and elevation of the affected limb. especially ice is responsible for vasoconstriction and therefore reduces pain and inflammation.
  • You can use lukewarm water baths with a tablespoon of salt alternated with cold water, you must first place your feet in the warm water for 3 minutes and then in the cold water. This method allows you to relax your feet and reduce inflammation.
  • Perform stretching massage with a bottle from the heel to the fingers for 10 minutes and repeat it every hour until the pain has disappeared.
  • Perform massages with moisturizing cream or oils such as argan, rose or almond.
  • Do not wear footwear, go barefoot at home, on a flat surface. This will strengthen and tone the feet.
  • Chamomile tea has anti-inflammatory properties, you can take it to soothe the pain in the instep or perform a massage with the tea on the top of the foot.
  • You can also use massages or baths with sage, thyme or rosemary for pain.

This article is purely informative, in lorecentral.org we do not have the faculty to prescribe medical treatments or make any type of diagnosis. We invite you to go to a doctor in case of presenting any type of condition or discomfort.

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Pain In The Instep Of The Foot: Causes And Treatment

May 31, 2019, 10:57 pm

Anatomically, the instep is the dorsal area or the upper part of the foot, is composed of 28 bones and 9 extensor tendons that come from the leg. This particular area may be affected usually due to the impact it receives when walking or performing different activities, especially because it is an exposed area it is estimated that it must support an equivalent to 2 times our body weight.

The most common causes related to pain in the instep are tendonitis and pain due to bone deformity, such as cavus foot and flat foot. If you want to know more about the pain in the instep of the foot: causes and treatment , we invite you to continue reading this article.

  • Cuboid.
  • Metatarsals

On the other hand, it has 9 extensor tendons that allow you to pull the toes upwards and that come from the leg. Two tendons for each finger from the first to the fourth finger and a tendon for the fifth finger.

Risk Factors And Potential Causes Of Gout

Gout strikes men more often than women until women undergo menopause, and then women experience increased risk. Being overweight or obese, having recent surgery, and experiencing a trauma also increase your risk, as well as your family history.

Your body produces uric acid when it breaks down purines a substance found naturally in your body, and also in high-protein red meat, organ meat, and certain types of seafood. In addition, alcoholic drinks, beer, and beverages sweetened with fructose can raise your natural uric acid levels. When your body either creates too much uric acid or excretes too little, it can lead to gout. Hundreds of years ago, gout was called the disease of kings because the average peasant couldnt afford such rich food and drink.

Medical conditions like untreated high blood pressure, diabetes, heart disease, and kidney disease can also increase your chances of developing gout, as does taking certain medications, such as thiazide diuretics and low-dose aspirin.

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Medications For Acute Gout

  • Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen , ibuprofen , celecoxib , indomethacin and many others. These agents reliably decrease the inflammation and pain of gout. However, patients with ulcers, hypertension, coronary disease, and fluid retention must be careful with these agents, even for the short courses needed to resolve a gout attack. The doses of non-steroidal anti-inflammatory agents needed to resolve a gout attack are on the higher side, since full anti-inflammatory effect is needed. See examples of dosage in Table 2. Over-the-counter dosage levels, for example, ibuprofen at 200mg, two tabs three times a day, are often insufficient.
  • Corticosteroids, such as prednisone and methylprednisolone , are anti-inflammatory agents that are quite effective against gout attacks. Anti-inflammatory steroids are very different in action and side-effects as compared to male hormone steroids. Anti-inflammatory steroids have long-term risks, such as bone thinning and infection, but their risk for short-term therapy is relatively low. These agents can raise blood pressure and blood sugar, so can be a problem for those with uncontrolled hypertension or uncontrolled diabetes mellitus.
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