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Gout in the toes and foot

What is Foot Gout?

Gout is a kind of arthritis that occurs from the buildup of uric acid in the tissues, tendons or a joint, causing an attack of sudden burning pain, stiffness and swelling usually in a big toe. It most frequently affects the big toe, but can also occur in other joints, tendons and tissues of the body as well, including the ankles, knees, hands and wrists.

It is most common during middle age and in men, but can also occur in women as well, particularly after menopause. About 1 in 200 people is affected by gout.

Causes of Gout

Gout is caused by deposits of crystallized uric acid in the joint; uric acid is present in the blood and eliminated in the urine. Uric acid is the result of the breakdown of purines – chemicals that are found naturally in our bodies and in food. Some people develop gout because their kidneys have trouble eliminating normal amounts of uric acid, while other people produce too much uric acid and develop gout.

Gout diagram

Gout is often inherited. There are also other additional factors that put you at risk for developing gout. These factors include:

  • Having high blood pressure.
  • Being overweight.
  • Having diabetes.
  • Drinking too much alcohol.
  • Eating too much meat and fish that are high in chemicals called purines.
  • Taking some medications such as water pills (diuretics).
  • Chemotherapy.
  • Stress.
  • Surgery.

Why does Gout Develop Specifically in the Big Toe?

Gout develops specifically in the big toe because uric acid is sensitive to temperature changes, at cooler temps, uric acid turns into crystals, and since the big toe is the part of the body that is farthest away from the heart, it’s also the coolest part of the body, and thus, the most likely target of gout.

Symptoms of Gout in the Big Toe

There are various symptoms of gout in the big toe (Usually only one of the big toes is affected.) They include:

  • Intense pain that comes on suddenly – usually in the middle of the night or upon getting up in the morning.
  • Signs of inflammation such as redness, swelling and warmth in the big toe.

Treatment by a Physician

In order to diagnose gout, a physician will ask you questions about your personal and family medical history, and then examine the joint that’s in pain. Lab tests and x-rays are sometimes ordered to determine if the inflammation is caused by something other than gout. Your doctor may also:

  • Prescribe anti-inflammatory drugs; to stop a gout attack, your doctor may give you a shot of corticosteroids or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often starts within 24 hours if you start treatment right away.
  • Advise you that you should apply ice or cooling lotions while you wait for your medication to take effect.
  • Adapt your existing footwear with orthoses that easily fit into your shoes and help redistribute pressure away from the affected parts of your foot.
  • Take a sample of fluid from your big toe to look for uric acid crystals. He or she may also do a blood test to measure the amount of uric acid in your blood.
  • Advise you that you should avoid standing and walking to give your foot a rest. Also prescribe that you elevate your foot- level with or slightly above the heart – to help reduce welling.
  • Prescribe a diet that restricts foods and beverages that are high in purines, since purines are converted in the body to uric acid. You will also most likely be encouraged to drink plenty of water and other fluids each day and avoid alcoholic beverages, which cause dehydration.

Other Preventive Tips

You can also prevent future cases of gout by doing the following:

  • Maintaining a healthy weight.
  • Making certain that you consume plenty of Vitamin C in your diet.
  • Avoiding alcohol/fizzy drinks.

Sources:

http://www.foothealthfacts.org/footankleinfo/gout.htm

http://www.scpod.org/foot-health/common-foot-problems/gout/

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