When we think of gout, we might think of Renaissance-era royalty and indulgent feasts. But gout is still very much with us in the 21st Century. Gout is actually a type of arthritis that can affect any joint in the body. But it often strikes first in the form of sudden pain in your big toe. Here’s a look at what causes gout, how to treat and prevent it, and why our big toe is so susceptible.
What Is Gout?
Gout is a type of arthritis created by a buildup of uric acid in the tissues or joints. Uric acid is a waste product found in your blood. When all is going well, your body eliminates it in the form of urine. But if you’re producing too much uric acid or your kidneys aren’t removing waste as they should, it can build up in crystals in your joints. Gout can also be a warning sign for other potential health problems since high uric acid levels are also linked to diabetes and kidney stones.
What Are The Symptoms of Gout?
The primary warning sign of gout is intense joint pain that comes on suddenly (often in the big toe joint). As the Mayo Clinic describes it, some patients wake up in the middle of the night feeling like their toe is on fire. Other symptoms include redness, swelling, and a limited range of motion in the joint.
Why Does Gout Affect the Big Toe?
According to the American College of Foot and Ankle Surgeons, gout is most common in the big toe joint because uric acid is sensitive to temperature changes. The foot is farthest from the heart and is the coolest part of the body, so that big toe joint can be a canary in the coal mine when it comes to gout.
What Causes Gout?
Gout is most common in men in their 40s and 50, but it can also occur in women and other age groups. Causes of gout include:
- Genetic risk factors
- Some medications, including diuretics which cause the body to eliminate higher levels of water.
- Foods with high levels of purines. Purines are natural chemical compounds found in some foods. They’re not necessarily unhealthy but can lead to the production of uric acid as your body digests them. High-purine foods include:
- Red meats and organ meats
- Some kinds of seafood
- Sweetened drinks, especially those containing high-fructose corn syrup
What Are The Treatments for Gout?
Most physicians recommend managing gout with lifestyle and diet changes. There are also medical interventions available for controlling and preventing gout pain. Treatment and prevention approaches include:
- Topical creams, like Voltaren, often provide immediate pain relief during a gout attack.
- Prescription medications, including the anti-inflammatory drug colchicine for pain. Providers may also recommend different drugs that regulate uric acid production for patients with recurring cases of gout.
- Injections including cortisone to relieve pain and inflammation.
- Dietary restrictions to reduce high-purine foods. Replace those foods with a diet high in whole grains, fruits, vegetables, nuts, and legumes. Your doctor may recommend switching from red meats to poultry and low-fat dairy foods for protein.
- Hydration: drink plenty of fluids to help eliminate uric acid. Water, milk, and tart cherry juice are the best choices.
- Immobilize and elevate the foot to reduce swelling and inflammation.
Gout, Joint Pain and Your Orthopaedist
If you have sudden, intense pain in your toe–or pain in any other joint–make 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 you’re 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, let’s get it diagnosed and take the first steps to get it under control.