If you have gout, or know someone that does, you’ll know how excruciating and unbearable the pain is when you have a ‘flare up’ or an ‘attack’ of gout. Gout is a type of arthritis that is typically mistaken for osteoarthritis – the ‘wear and tear’ kind of arthritis. Its mechanism of action is very different, as are the symptoms and treatment.
What is gout?
Gout is a type of arthritis where small crystals of uric acid form in and around a joint, causing inflammation, pain and swelling. Uric acid is found in the blood as we break down chemicals naturally present in our food called purine. Sometimes the kidney’s have difficulty processing and excreting the uric acid at a normal rate, or the production of uric acid is just too high. Either way, we are left with too much uric acid in our blood stream.
In people who suffer with gout, when the uric acid levels build up, crystals form. The crystal deposits can eventually lead to joint destruction and nodules or lumps on the joint called tophi.
What does it feel like?
Gout has a very rapid onset, usually overnight. The affected joint(s) become very red, warm, swollen, painful and tender to touch (even the bed sheets can be intolerable). Gout is prevalent in the feet, usually affecting the big toe (90% of initial gout attacks). Gout may also be experienced in the ankles and knees, and less commonly in the elbows, hands and other joints.
An episode of gout will usually last about one week with no treatment. It is possible for considerable time (months or even years) to pass between gout attacks. However, if not managed well, episodes of gout can intensify and become more frequent, leading to permanent joint damage.
What are the risk factors for gout?
Risk factors for gout include:
- Age. Men between 30-60 years old and post-menopausal women are more likely to develop gout.
- Gender. Men are more likely than women to develop gout.
- Family history. If you have someone in your family with gout, you may be more likely to develop it as well.
- Diet. Eating too much purine-rich food raisers your risk for gout. Red meat, organ meat and certain fish contain a lot of purines. There are lots of other theories surrounding food types such as salt, tomatoes, and shellfish.
- Alcohol consumption. Drinking more than 2 standard drinks per day puts you at higher risk of gout.
- Medications. Some medications, such as diuretics, can put you at risk of gout.
- Other health conditions. High blood pressure, sleep apnoea, thyroid disease and kidney disease can all raise your risk of gout.
How is gout diagnosed?
Diagnosis is typically based around a review of your medical history, a physical exam and your symptoms. A doctor will base the diagnosis on your description of your joint pain, as well as how red, hot and swollen the area is.
A doctor may also request pathology to assess the level of uric acid, or will refer you for an x-ray.
How is gout treated?
During a gout attack, ice and medication can be helpful in reducing pain and inflammation. Longer term prevention of gout will involve a consultation with your GP to discuss any medications that may help, and review of any dietary changes or lifestyle changes.
If you suffer from recurrent gout you will benefit in the long term from making healthy changes to your lifestyle including:
- Maintaining a healthy body weight
- Cutting down on alcohol consumption
- Staying hydrated
- Exercising regularly
If you are having pain associated with gout, your podiatrist can ensure you aren’t adding additional pressure to the joint and that your shoes are helping and not hindering your pain and mobility.
If you have gout and are worried about your foot health, be sure to give us a call on (02) 4323 9100 or you can book online.