FACT SHEET
Gout
Gout is one of the most common forms of arthritis or inflammation of a joint. It most commonly affects the big toe joint, but can affect any joint. Gout usually starts as an acute attack of pain and swelling that often occurs overnight.
The pain experienced from Gout is extremely severe. A good analogy I read comparing gout pain to regular arthritic pain was as follows; ‘Put your foot in a vice and turn it as tight as possible – This is arthritic pain, now give it another twist – This is Gout’.
An initial gout attack usually subsides in a week or so and after the first attack there may be intervals of many months or even years before there are other attacks. Over time these attacks tend to become more frequent and more severe and eventually may involve other joints. Eventually, without treatment, a state of chronic or continuous joint symptoms may develop with progressive joint damage.
What Causes Gout?
Gout is related to the physiology of uric acid, which is a chemical that is a natural part of the normal breaking down and building up of food and body tissues. Uric acid is normally dissolved in the blood, but when it’s high, microscopic crystals may be deposited in the joint. These crystals then set up the acute inflammation.
What Causes High Uric Acid?
Some people just have higher levels and it is hereditary, however Obesity, high alcohol intake and foods containing Purines (which are broken down into uric acid) are the most common causes.
What is the Treatment?
The first aim of treatment is correcting the factors that lead to the high levels of uric acid. This involves a combination of diet and drugs, which is why it is important to see your Doctor and or Dietician for advice and management on what you should reduce or avoid totally. Being overweight is a risk factor, so weight loss may be very important.
When an acute attack of gout occurs, anti-inflammatory drugs are usually very effective to help gain control of the gout symptoms in the first 12-24 hours (these drugs have no effect at lowering uric acid levels). Rest and elevation of the foot is also important.
Over the longer term, if diet changes are not lowering uric acid levels, drugs can be used to lower the levels (these drugs have no effect during an acute attack). The drugs must be taken on a continuous and long term basis if they are to be effective.
Can your Podiatrist help?
During a severe acute attack not a lot can be done, as the foot is almost impossible to touch, however once the pain has subsided, your podiatrist can assist by helping to control abnormal foot motion.
Sometimes a simple innersole is all that is required to help deflect weight away from the painful joint, however more often than not your podiatrist would discuss a more customized Foot Support using a combination of softer and firmer rubber type materials.
