Gout: A Complete Guide

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Gout is a painful joint condition that can occur without warning, as well as reoccur frequently in people who contract it.

Gout in the foot and gout in the toe are some of the most common joint maladies, but even with their commonality, their causes are still hard to identify.

what is gout

As such, gout can be difficult to anticipate and equally difficult to prevent. Treatment of gout, however, is reasonably straightforward, even though the disease itself is not curable.

Learning more about gout is especially important if you think you may fall victim to it. This guide to gout will help you determine whether or not the pain in your big toe is the fault of this condition or something else.

A Brief History of Gout


Once referred to as the “disease of kings,” according to authorities at the American College of Rheumatology, gout has been troubling the joints of those who fall victim to it for as long as medical history has been recorded.

Medical practitioners of old considered gout a condition that only beset the rich, because of a proposed link between the arthritic condition and the food and wine that the wealthy could afford.

As medicine has improved, we’ve since discovered that there is no limit to the number of people gout can impact, as its causes vary. Overall, it can develop in nearly anyone if their joints become weakened.

Defining Gout

Generally speaking, gout is a form of arthritis. Gout forms in the joints when a person has a high level of uric acid in their blood.

This acid, according to the Centers for Disease Control and Prevention, develops crystals that reside in a person’s joints; these can cause extreme pain, redness, heat in the bone, and swelling.

The CDC also says that nearly 8.3 million Americans developed gout between 2007 and 2008, and that roughly the same number holds to this day.

Gout attacks often occur in the middle of the night, and most typically affects the joints in the foot, focusing in on the big toe. Gout in the big toe is the most common occurrence of gout.

Stages of Gout

Gout tends to develop in stages. There is always a chance that a person will only experience gout once in their life.

However, gout has a tendency to reappear in the joints where it has previously resided. As such, it’s important to understand the stages of gout’s development.

Asymptomatic Hyperuricemia

According to the writers at the Arthritis Foundation, asymptomatic hyperuricemia is the block of time that precedes a person’s first gout attack.

gout in foot

Asymptomatic hyperuricemia serves as the medical term for a heightened amount of uric acid in the blood. This state also occurs in people who are likely to develop kidney stones.

While there aren’t any physical symptoms that develop at this point in time, a person’s blood uric levels are severely elevated, to the point where the difference is noticeable in a medical examination.

At this point, a person may experience minor joint pain, but the crystals developing in the joints will otherwise be undetectable.

Acute Gout

The first gout attack a person experiences is referred to as “acute gout.” Because it is referred to as “acute,” the pain of this first attack is perhaps the worst a person will experience while suffering from gout.

This initial attack occurs when the uric acid levels in the body spike dramatically and move the crystals that have developed in a joint.

As a result, you will experience extreme pain for an extended period of time, usually between a week to ten days.

After this first attack, it’s recommended that you visit a doctor immediately in order to receive an official diagnosis and to seek out prescribed relief.

Interval Gout

Interval gout refers to the time between gout attacks. This is considered an anticipatory time period, as gout attacks are said to be expected after the first one has occurred.

According to the Arthritis Foundation, 60% of people who experience their first gout attack will fall victim to another within a year, whereas 84% will experience another attack within the next three years.

In this time, it’s advised that you do everything you can in order to change your lifestyle and make an attack less likely.

Chronic Gout

If a person’s uric acid levels remain high, then they’ll fall victim to chronic gout. This kind of chronic gout may cause low-level inflammation in the joints, and gout attacks will occur more frequently.

At this point, the presence of uric acid in the body may influence you to the point where severe joint damage occurs. Of course, at this point, the condition disrupts your life on a regular and long-term basis.

gout symptoms foot

Causes of Gout

What causes gout? The reason behind gout, as has been mentioned, is varied. There’s been little success in determining what specifically causes an increase of uric acid in the blood.

However, Deborah Weatherspoon of Heathline has identified some consistent pre-existing conditions in gout victims.

Genetics

While there isn’t a gene linked to the development of gout, people with family members who have developed gout previously are more likely to have their joints affected.

In this way, gout operates like standard arthritis; it has a genetic disposition.

Gender and Age

Men are also more likely to develop gout than women.

Weatherspoon claims that researchers believe women’s production of estrogen keeps them from developing gout until they hit menopause.

After age 60, the likelihood of women developing gout falls in line with men’s.

Other Health Conditions

People with high cholesterol, high blood pressure, diabetes, and heart disease, as well as anyone who may have had bypass surgery, are more likely to develop gout.

These conditions frequently pair with poor diet, which serves as another contributor to gout.

Medications

Medications which influence blood pressure are likely to increase a person’s chance of developing gout. The same can be said for medications that suppress the immune system, such as those prescribed for patients with psoriasis.

symptoms of gout in feet

Transplant recipients will also be more likely to develop gout, because of the medications they take in order to ensure their bodies don’t reject their transplants.

Diet

As previously mentioned, a person’s diet can influence whether or not they fall victim to gout.

A poor diet, such as one that would contribute to the need for bypass surgery or a diet heavy on red meat and shellfish, have both been noted to contribute to gout.

Soda has also been said to contribute to gout’s development.

Alcohol

Consuming two liquor drinks a day, or more than two beers a day for more than five days in a row, not only weakens a person’s liver, but it will increase the chance for said person to develop gout.

This is because the individual’s immune system and nervous system will be repressed, due to the large amount of alcohol in their body.

Here’s a video explaining more on gout.

Symptoms of Gout

The symptoms of gout in feet, as has been discussed, include:

  • Intense pain.
  • Swelling and tenderness.
  • Redness in the skin.
  • Heat in the muscle and joints.
  • Joint stiffness.

Even though gout tends to impact one joint at a time, the pain you experience as a result will last over a great deal of time. As such, the symptoms become extremely noticeable and unpleasant to endure.

Gout symptoms in the foot will also make it extremely difficult to walk, and this impacts your daily life.

According to the writers at WebMD, if gout goes untreated for a significant amount of time, then the conglomerated crystals will form noticeable lumps beneath a person’s skin.

While these lumps won’t cause you any additional pain, they can eventually form into kidney stones. Who wants more conditions stacked on top of each other? As such, it’s wise to seek out a doctor.

Diagnosing Gout

Because the symptoms are so severe and distinct, it’s a little easier to diagnose gout than other types of arthritis. Diagnosing gout ahead of an actual attack, though, can be more challenging.

While most medical professionals will test a person for hyperuricemia, high levels of uric acid in a person’s bloodstream does not guarantee that they will develop gout.

Both before and after an attack, you’ll need to visit your doctor in order to have your vitals taken and to receive a diagnosis.

Doctors will need to test your joint fluid, according to James McIntosh of Medical News Today, in order to determine your uric acid levels, while also looking for unusual bacteria that may be causing your joint pain.

McIntosh elaborates, saying that a blood test, ultrasound, or CT can also determine whether or not your joints have been weakened and if gout is the cause of your joint pain.

How to Treat Gout

The most efficient gout treatments involve anti-inflammatory medications, steroids, and pain medication.

McIntosh elaborates on this, saying that while these medications will attend to the symptoms of gout, they won’t necessarily cure a person of gout in the long run.

Rather, prescribed medications will help with pain management more than anything else.

symptoms of gout in feet

Curing Gout

Unfortunately, gout cannot be cured. According to the writers at HealthXChange, it is a long-term disease, especially if untreated, and can only be controlled.

If a person manages to lower their uric acid levels, they’ll be less likely to fall victim to gout attacks, but there will always be a risk of another one occurring.

Managing Gout

Managing gout, however, is entirely doable. If a person combines the previously noted medications with an improved lifestyle, they can lower their uric acid levels and decrease the likelihood of future attacks.

There are a number of ways to accomplish this, and while many are lifestyle changes, it is extremely difficult to prevent a gout attack without the assistance of medication.

Healthy Diet

According to Natalie Butler of Healthline, red meat and shellfish can contribute to the likelihood of a person developing gout.

By removing these foods from your diet and limiting the amount of liquor that you drink, you can both improve your general health and lower your chances of experiencing another attack.

Physical Activity

Physical activity is also very helpful for improving your personal health and limiting potential gout attacks.

The Center for Disease Control and Prevention recommends that you get 150 minutes’ worth of exercise a week to prevent a gout attack.

These minutes should be divided into thirty-minute sessions, spread across five instances a week. While this is also the standard amount of exercise that an average healthy person should try to manage over the course of a week, this behavior will keep your joints moving and prevent them from locking up.

symptoms of gout in feet

Pain Medications

As we’ve touched on earlier, pain medications and prescriptions that lower a person’s uric acid levels are extremely helpful for managing the symptoms of gout.

Floranne Enste of Practice Pain Management recommends NSAIDs like Aleve, colchicine, and corticosteroids for the treatment of gout.

While some of these medications won’t require a professional script, it’s still best for your health if you visit a doctor. They will be able to identify the root cause and rule out more severe treatments, should that be necessary.

You can handle this problem at home, but there’s a risk of misdiagnosing your condition or treating it more softly than needed.

This video explains more on treatments for gout.

Conclusion

Gout, then, is less complex than it may have seemed originally. It remains an extremely painful condition for those who contract it, even if its causes are parallel with many other conditions and illnesses.

Even though the symptoms of gout are extremely noticeable, you’ll still need to visit your general practitioner if you think you may have developed it.

Without a proper diagnosis, you won’t be able to treat your gout effectively.

The most important thing you can do, if you have been diagnosed with gout, is work with medical practitioners to determine how best to manage your pain and uric acid levels.

While it will be painful, you don’t have to let gout control the way you live your life.


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