Gout is a complex form of inflammatory arthritis that causes sudden attacks of swelling and intense pain in the joints, known as gout flares. Although gout can affect joints and organs throughout the body, most flares start in the big toe or other foot joints. As a result, podiatrists are both experienced and adept at diagnosing this condition, as well as helping patients manage symptoms and prevent painful flares. It’s important to know about gout, including how the skilled podiatrists at Massapequa Podiatry Associates can help you keep it in check.
Causes and Risk Factors
Gout is caused by hyperuricemia—having too much uric acid in your body. This acid is a byproduct created as the body breaks down purines, naturally occurring chemical compounds found in red meats, organ meats, and certain types of seafood. Normally, the body processes uric acid and passes it through the 
urine. In people with gout, uric acid can build up in the bloodstream and form sharp, needle-like crystals in joints and surrounding tissue.
Gout is common and can affect anyone. However, factors that can increase your risk for the condition include:
- Eating a diet that includes a lot of red meat or shellfish and drinking alcohol (especially beer) and beverages sweetened with fructose
- Having medical conditions such as high blood pressure, obesity, diabetes, metabolic syndrome, and kidney and heart diseases
- Having family members who have gout
- Taking medications that can increase uric acid levels
Symptoms
If you experience big toe pain, gout could be to blame. This arthritic condition is characterized by flares that can last for up to two weeks, with the most severe pain typically occurring during the first 12 to 24 hours. Symptoms usually appear suddenly and can include:
- Intense, burning pain, often in the metatarsophalangeal joint where the base of the big toe meets the foot
- Redness, swelling, warmth, and tenderness of the affected joint or joints
- Limited range of motion and lingering discomfort
Gout symptoms often strike at night and can be bad enough to wake you from sleep. After a flare up, the condition can go into remission for months to years before occurring again. Subsequent flares can last longer, be more painful, and involve more joints—making proper management essential.
Diagnosis
Podiatrists can often diagnosis gout based on your symptoms and a thorough physical examination of the affected joint. They might also ask about a family history of gout or use other diagnostic tools such as:
- Joint fluid tests, which examine fluid from the affected joint under a microscope to confirm the presence of urate crystals
- Blood tests, which measure uric acid levels in the bloodstream
- X-rays, to rule out stress fractures or other causes of pain and inflammation
- Ultrasounds, which use sound waves to detect urate crystals in joints
Treatment and Flare Prevention
With proper treatment, you can usually start to feel relief from painful gout symptoms within just a few days. Treatment to resolve a flare may include:
- Medications to control pain and inflammation
- Medications to decrease uric acid and reduce the risk of gout complications
- Elevating the affected foot and wearing comfortable shoes
However, when it comes to managing gout and its symptoms, lifestyle changes often provide the best results. These include:
- Limiting or avoiding drinks sweetened with fructose or high-fructose corn sugar
- Avoiding high-purine foods such as red meat, organ meat, tuna, anchovies, sardines, scallops, trout, or mussels
- Avoiding alcohol, especially beer
- Staying active and maintaining a healthy weight
Gout can be different for every patient and requires an individualized approach to treatment. At Massapequa Podiatry Associates, our experienced podiatrists can create a gout treatment plan that's just right for you.
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