The holiday season is finally here. It’s a time for gathering with friends and family. It’s a time to ditch that diet and indulge in decadent foods and drinks. It’s a time to be jolly. It’s not the time to experience foot pain. However, if you have severe pain in your foot without any cause, you may have gout.
Gout is a type of that most commonly affects the foot, especially the big toe joint. It is caused by crystallization of uric acids in poorly perfused areas. Uric acids are a common byproduct of purines, which are special chemicals found is certain foods. Hence, a diet rich in purines can lead to gout. Examples of such foods include high quantities of meats like beef, pork, and lamb. Fish, seafood, and even gravy also contain increased levels of purines. Alcoholic beverages like red wine and beer can also cause gout. In fact, one beer a day may increase your risk of gout up to 50%. Medications that increase incidence include low dose aspirin, niacin, immunosuppressants, and diuretics. Chronic diseases associated with gout include alcoholism, obesity, hypertension, CAD, and hypertriglyceridemia.
What does Gout Feel Like?
Typical symptoms include a red, hot, swollen joint with intense pain. Pain is not always associated with trauma to the area. In fact, many patients have no trauma and pain presents in the middle of the night. Symptoms last for about 3 to 5 days but can persist up to several weeks.
Gout is generally diagnosed clinically according to sudden onset and symptoms. However there are other diagnostic tests that can be performed. It can be diagnosed with a blood test to check uric acid levels. Uric acid levels above 7 mg/dL are indicative of an acute gouty attack. However, blood test results can be misleading. People with high uric acid levels may be asymptomatic. Others may have low levels but have associated symptoms. Another test that can be performed is a joint fluid analysis where a needle is used to draw fluid from the affected joint. The fluid is then sent for analysis and examined under a microscope which may reveal urate crystals. Lastly, x-ray imaging can be done to help rule out other causes of joint inflammation.
Once a proper diagnosis has been made, Gout can be treated by medications. Most times a nonsteroidal anti- inflammatory drug can be prescribed to decrease the inflammatory process in the joint. If patients have stomach pain or stomach ulcers, another option is an oral or injectable corticosteroid. Patients may also be given a prescription for Colchicine. This is a plant-derived medication that inhibits the production of uric acid at a molecular level. However, at high doses, this medication can cause gastrointestinal issues. If patients have frequent gout attacks, they should get worked up by their primary doctor and placed on prophylactic medication.
‘Tis the season to be jolly….. not gouty. If you have a red, hot, swollen joint with intense pain, don’t hesitate to make an appointment with one of the doctors at University Foot and Ankle Institute. We specialize in the treatment of gout. Allow us to treat your pain so you can enjoy your holidays.
Happy Holidays from all of us to you!
If you would like to make an appointment with our foot and ankle specialists, please call (877) 989-9110 or visit us at www.footankleinstitute.com.
Dr. Redkar specializes in foot and ankle pathology and is available for consult at our West Hills location.