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Gout | Gouty Arthritis

Once thought to be a disease of the upper class, Gout (also known as gouty arthritis) can affect anyone. Caused by the buildup of uric acid salts in the joints (a normal byproduct of your diet), the big toe is the most commonly affected area.

Gout or bunion? Intense pain will usually indicate gout, but only your podiatrist can make a proper determinationGout or bunion? Intense pain will usually indicate gout, but only your podiatrist can make a proper determination Normally, uric acid dissolves in your blood, passes through your kidneys, and exits your body via urine. But in some people, uric acid isn't eliminated properly, and levels become too high. This excess uric acid builds up around the joints, causing inflammation, swelling, and severe pain, which is why Gout is classified as a form of arthritis.

Most patients experience their first gout attack in the middle of the night - they wake up to a throbbing pain in the joint just below the big toe (the same area where bunions develop), which is frequently swollen as well. Gout may also appear in the arch of your foot, ankle, heel, knee, wrist, fingers, or elbow.

Symptoms of Gout
(Some patients experience no symptoms, which unfortunately may develop into chronic gout)

  • Severe pain and a hot feeling in the affected joints, usually appearing first in the big toe. Pain from an untreated gout attack can last for a week or more and then subside, but pain will return within 3 months
  • Red skin – area around the joint may appear red or purplish
  • Fever
  • Stiffness in the joint
  • Itchy skin – as the gout attack subsides, skin around the joint may itch and peel away
  • Small lumps (tophi) appear around the elbows, hands, or ears

Why some people with high uric acid levels develop Gout and others don't is not completely understood, but one or more of these factors are thought to contribute:

  • Genetic predisposition (men are more likely than women to develop gout)
  • Obesity or overweight
  • High alcohol consumption, especially beer
  • Diet high in red meat, shellfish, heavy sauces
  • Extremely low calorie diets
  • Rapid weight loss
  • Overuse of aspirin
  • Overuse of the vitamin niacin
  • High blood pressure
  • Psoriasis
  • Chronic kidney disease
  • Long term use of diuretic medicines
  • Medicines taken by transplant patients
  • Tumors
  • Surgery
  • Myeloma
  • Hemolytic anemia
  • Lead poisoning
  • Hypothyroidism

Attacks of gouty arthritis are extremely painful. If you experience sudden and intense pain in your big toe or anywhere else in your foot or ankle, make an appointment with the PA Foot and Ankle Associates office immediately for a thorough evaluation. If you leave gout untreated, it may become much worse.

Gout can be controlled with prescription medications and diet, and ice helps alleviate pain and swelling during an acute phase. In some cases, specially-made shoes are prescribed to relieve the pain associated with gout.