What Are The Causes And Triggers Of Gout In The Ankle
The buildup of uric acid in the body is known as hyperuricemia. Your body produces uric acid when it breaks down purines. These are compounds found in all your cells. You can also find purines in several types of food, especially red meat and some seafood, as well as alcohol and some sugar-sweetened drinks.
Usually, uric acid passes through your kidneys, which help to eliminate extra uric acid in your urine. But sometimes theres too much uric acid for your kidneys to handle. In other cases, the kidneys cant process a typical amount of uric acid due to an underlying condition.
As a result, more uric acid circulates throughout your body, ending up in your ankle as uric acid crystals.
4 percent of adults in the United States. It tends to be more common in men because women usually have lower levels of uric acid. But after menopause, women start to have higher uric acid levels. As a result, women tend to develop gout at an older age than men do.
Experts arent sure why some people produce more uric acid or have trouble processing it. But theres evidence that the condition is often genetic.
Other things that may increase your risk of developing gout include:
- consuming a lot of high-purine foods
- consuming foods and drinks, especially alcohol, that increase uric acid production
- being overweight
Symptoms Of Gout In The Ankle
Gout symptoms are on a whole other level compared to a sprained ankle, cellulitis , tendonitis, or other ankle issues.
“The gout symptoms such as acute swelling/pain and erythema are typically much more severe,” says Dr. Seligman. “This is much different than chronic weakness or swelling.”
Seeking medical attention sooner than later is always recommended to get the pain under control.
Before we dive into the symptoms of ankle gout, know this: you shouldn’t use these symptoms to self-diagnosis ankle pain.
Always see a doctor when you have one of the symptoms or a combination of the following symptoms.
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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Take Caution With Supplements For Gout
As for the many supplements and other purported home remedies available for gout, including turmeric and bromelain, there is no significant evidence backing them up as of now, and theres no adequate evidence showing that supplements have any effect even comparable to that of medicines.
From my point of view, says Dr. Fields, the home remedy concept to gout is often harmful because it keeps patients from taking medications that we know are effective.
The First Twinge Of Stiffness Or Dull Ache
Gout ankle starts with a twinge of pain or a dull ache. Then along with the pain, stiffness starts to set in these are the first signs of gout and the alarm to take action. These gout symptoms in the ankle will only quickly get worse if left unattended.
The reason that an attack grows slowly, is because more and more uric acid continues to crystallize. Taking measures to alkalize neutralize the acidity helps to dissolve the crystals that have already formed, but more importantly, helps to keep the uric acid in solution and keep it from crystallizing in the first place.
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Can I Manage Gout
Although it cant be cured, gout can be managed effectively with medicine and lifestyle changes.
If your uric acid levels remain high after a gout attack, doctors may prescribe medication that can lower your levels. This can lessen your risk of long-term problems.
Self-care also is important if you have gout. A diet that avoids foods high in purine, high-fructose drinks, and alcohol can lessen your long-term risks. Losing weight also can lower your chances of gout. If you use medicines like diuretics, stopping that use can help prevent gout as well.
If you have a family history of gout or suspect you may have it, schedule an appointment with your doctor.
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.
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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.
Pain Relief Without Medicine
Use cold. If your pain isn’t too bad, try cold packs or compresses on the joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes several times a day. Do not apply ice to your hands or feet if you have nerve problems from diabetes or other causes.
Rest the joint. It’s a good idea to rest it until the pain eases up. You probably won’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object.
Drink water. When your body doesnât have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels normal.
Watch what you eat and drink. Foods that are high in substances called purines, such as some seafood, organ meats like liver, and fatty foods, can raise the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol — especially beer.
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Pain That Wakes You Up
More often than not, gout flare-ups happen in the middle of the night, interrupting a peaceful slumber with intense pain.
“It’s true, gout attacks are more common overnight,” Dr. Seligman says. But exactly why is a bit of mystery.
One theory: “It has been postulated that this relates to cooler body temperature at night,” she says.
The foot is cooler because it is the farthest body part away from the heart.
At cooler temperatures, uric acid turns into crystals and could settle into a cool spot like the foot and ankle.
Other theories center on sleep disorders that cause less oxygen in the blood, such as sleep apnea.
Natural Remedies Of Ankle Gout
- Drink more water As gout causes inflammation and swelling in joints, you need to drink much amount of water. By drinking water, you can reduce the swelling condition. Intake of more fluid will encourage your kidneys to discharge fluids. That is why you can alleviate swelling at your joints.
- Add ginger to your diet Ginger has anti-inflammatory properties, and thus, you may use it for gout treatment. To make this home treatment effective, you have to boil water and add one tablespoon of grated ginger. Then, apply ginger to the affected part. You must do it at least once every day for about 15 to 30 minutes. You may also drink the solution of water and ginger daily.
- Cherries Researchers have noticed that the consumption of cherries can minimize the gout risk. Cherries have anthocyanins that fight against inflammation. So drink cherry juice regularly to reduce your gout symptoms.
- Apply ice Cover an ice pack in a cloth and apply it to your affected part. This trick will help you in reducing inflammation. Leave the ice pack for 10 to 20 minutes.
- Apple cider vinegar It is another solution for your pain and swelling issues caused by gout. Add a spoon of vinegar to warm water. You will slowly get relief in this condition.
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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.
Gout In Ankle: Causes Symptoms Treatment And Prevention
Written byEmily LunardoPublished onNovember 10, 2017
Gout in the ankle or ankle gout is an inflammatory condition of the joint leading to swelling, pain, and redness of the ankle. Gout is a complex form of arthritis that can affect anyone, with over eight million Americans suffering from the condition today. Men are typically affected more, but postmenopausal women become increasingly susceptible in their later years.
The most common joint affected by gout is the big toe, but joint pain may also be experienced in the knees, hands, ankles, and wrists. Having gout in the ankle can be very debilitating as it encumbers your ability to walk normally.
This article will answer the question what causes gout in the ankle, giving you a better understanding of the intricacies of the condition to better treat it.
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Gout: Pseudogout Symptoms Treatment And Prevention
Gout is a condition in which monosodium urate crystals are formed in a joint, causing it to become red, hot, painful, and swollen in a short amount of time. The underlying cause of this is hyperuricemia, or too much uric acid in the blood, which causes sharp needle-like crystals to develop in regions with sluggish blood flow, such as the joints and renal tubules. If a human has recurrent Gout Attacks over time, the joint tissue might be destroyed, resulting in arthritis.
Let’s look at Gout in more detail, including its definition, treatment, and causes.
Table of Content
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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
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What Causes Ankle Gout
Gout occurs due to the accumulation of urate crystals in the joint, causing inflammation and intense pain. These crystals can form when you have high uric acid in the blood . Your body innately produces uric acid when it breaks down purines-substances that are found naturally in the body, as well as in certain foods, such as steak, organ meats, and seafood. Other foods that promote higher levels of uric acid include alcoholic beverages and drinks sweetened with fructose .
In a normal individual without gout, uric acid dissolves in the blood and passes through the kidneys to be expelled in the urine. But sometimes, the body produces too much uric acid, or the kidneys excrete too little of it. When this happens, uric acid can build up, forming sharp, needle-like urate crystals that become deposited in a joint or surrounding tissue causing pain, inflammation, and swelling.
Uric acid crystals tend to form in cooler temperatures, which is why they tend to form in the distal extremities, such as the hands and feet, which have a higher likelihood of becoming colder than the rest of the body.
Possible medical and health triggers of gout include:
- Intense pain
- Possible fever
Symptoms tend to recur anywhere from six months to two years after the initial episode, with approximately 60 percent of gout patients having a recurrence within one year.
Who Gets Ankle Gout
So why is this old disease coming back to life, and who is at risk for it?
Whether gout strikes your foot, ankle, hand, or other joint, the recent spikes in gout could be due in part to weight gain.
A March 2021 study published in Arthritis Research and Therapy revealed gaining weight through adulthood was associated with a higher risk of gout.
An earlier study, published last year in Arthritis & Rheumatology, discovered overweight people were 85 percent more likely to have higher levels of uric acid than people who were at a healthy weight.
Here are some other things that make you more likely to get gout:
- Genetics, especially if a first-degree relative has gout
- Being male
- Being postmenopausala decline in female sex hormones reduces protection against elevated uric acid levels
- Regularly eating and drinking high-purine foods, like veal, bacon, turkey, venison, liver, trout, codfish, anchovies, sardines, herring, haddock, scallops, muscles, liquor, beer, wine, and high-fructose beverages
- Having a chronic health condition, such as diabetes, congestive heart failure, and high blood pressure. Chronic kidney disease is a big risk factor because the kidneys don’t work efficiently to filter uric acid out of the body
- Taking medications that can lead to higher uric acid levels, such as diuretics and immunosuppressants
Certain ethnicities, especially people who are Black, have a higher prevalence of gout and are less likely to receive the proper care and treatment.
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The Role Of Uric Acid
Uric acid is produced when your body breaks down purines, which are substances naturally found in your body, as well as in protein-rich foods. At normal levels in your blood, uric acid is a powerful antioxidant and does not cause any damage. The body keeps uric acid at a set level by excreting it through the kidneys and in urine.
It is possible to have hyperuricemia and not develop gout. About two-thirds of people with elevated uric acid levels never have gout attacks. It is not known why some people do not react to abnormally high levels of uric acid.
Why Does My Ankle Hurt
Figuring out why your ankle is throbbing can be a guessing game.
Was it from rolling your ankle in the backyard yesterday? Or could it be tendonitis from the extra miles you can this week?
Maybe it’s from gout, a type of arthritis sometimes known as “the disease of kings” because only the monarchs of yesteryear could afford the food and drinks that are known to exacerbate its symptoms.
Gout cases have been on the rise in recent years due to the increasing obesity rate, although anyone can get gout. Just as the royalty’s diet was to blame for many gout symptoms recorded in history, our modern diets are one reason the disease is on the rise.
And while historically gout was associated with the big toe, the condition is becoming more common in other placesjoints like the hands, foot, or ankle.
Diagnosing ankle symptoms isn’t always easy. Even some doctors mistake ankle pain for something other than gout.
“Patients are often misdiagnosed with sprains, cellulitis, and other disorders when gout is unrecognized due to both severe pain and appearance,” explains Victoria Seligman, MD, a rheumatologist with UCHealth Rheumatology Clinic Cherry Creek in Denver.
And while an ankle sprain, tendonitis, osteoarthritis, and other issues share similar symptoms with gout, there are some signs and symptoms that are clearly due to gout in the ankle.
Here’s how to know when your ankle symptoms are due to gout and how to treat them.
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