Gout is a type of arthritis in which small crystals form inside and around the joints. It causes sudden attacks of severe pain and swelling and can be extremely painful and debilitating, but treatments are available to help relieve the symptoms and prevent further attacks. Any joint can be affected by gout, but as podiatrist we commonly see the big toe joint being affected.
Signs and symptoms:
> severe pain in one or more joints
> the joint feeling hot and very tender
> swelling in and around the affected joint
> red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Gout is caused by a build-up of a substance called uric acid in the blood. If you produce too much uric acid or your kidneys don’t filter enough out, it can build up and cause tiny sharp crystals to form in and around joints. These crystals can cause the joint to become inflamed (red and swollen) and painful.
> obesity, high blood pressure and/or diabetes
> familial tendency
> kidney function impaired
> eating foods that cause a build-up of uric acid
At David Brown Podiatry we do not directly treat gout but we offer treatments for the effects gout may have on your feet such as; corns, callus or compensations due to altered gait. Your GP will give you medication if needed to treat the pain you experience and offer advice on reducing the chance of further attacks which could include:
> weight loss/management
> drinking plenty of water may reduce your risk of an attack and of urate forming crystals in joint tissues. Drinking a glass of skimmed milk every day may also help to prevent attacks of gout
> drinking too much alcohol, especially beer and spirits, may increase your urate levels and your chances of having a gout attack.
> limiting your intake of foods that are particularly high in purines may be helpful
Foods high in purines include:
red meat and offal – for example beef, kidneys, liver, sweetbreads
oily fish – for example anchovies, fish roes, herring, mackerel, sardines
foods rich in yeast extracts – for example Marmite, Bovril, Vegemite.
> Vitamin C encourages the kidneys to get rid of more urate, so a diet rich in vitamin C may be helpful. This is another reason to make sure your diet includes plenty of fruit and vegetables
With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout – and as a result have no further attacks. However, lifelong treatment is usually required.
If you have any of the above symptoms then a visit to your GP is advised.