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Gout

The Condition

Gout is recognized as one of the most painful and debilitating acute disease processes of the foot and ankle. An accumulation of crystallized uric acid occurs in the joint and leads to intense swelling, pain and redness. The great toe joint is most commonly affected and acute gout attacks often wake patients from their sleep. Patients often remark they can not even tolerate their bed sheets laying across their toe due to severe pain.

The Treatment

Two stages of treatment are required in order to help manage this disorder. First, recognition of the symptoms and quick evaluation by your podiatrist is essential. After a thorough physical and radiographic examination, your podiatrist will typically order a simple blood test to evaluate the uric acid content of your blood. Prescription medication and possibly injection therapy will be suggested to reduce acute pain and swelling associated with the attack. Second, follow-up care with your podiatrist and primary care doctor are essential to prevent the damaging long-term effects of this disease. Diet modification and maintaining a food journal will help you and your doctors determine which foods trigger the attacks. Medications to control uric acid production are available. They help to prevent the long-term damaging effects of the disease.

Frequently Asked Questions

Uric acid crystals are sensitive to temperature changes. As body temperature decreases, uric acid crystals can be deposited into joints. Typically, the feet and extremities are a cooler temperature than the body’s core. The big toe joint is the prime location for an attack.

No. Any joint in the body can be subject to the effects of an acute gout attack.

Avoiding foods high in purine content can help reduce the possibility of a gout attack. Shellfish, organ meats (kidney and liver), red meat, red wine and beer should be avoided in high concentrations as they have a high purine content.

Many factors including diabetes, high blood pressure, obesity, certain medications and even surgery can lead to an increased potential for developing gout.

If left untreated, chronic arthritic changes can develop and lead to complications that may require surgical care.

Once treatment begins you can expect to have a significant reduction in symptoms within 7-10 days. Most patients feel considerably better within 24-48 hours of initial treatment. Follow-up evaluation and management with your podiatrist is essential in managing acute gout.

Articles

What is Gout?This informational fact sheet describes diet modification to help avoid acute gout attacks.