Gout in Foot: Causes, Symptoms, Preventions and Treatments

What is gout?

Gout is a form of arthritis characterised by sudden, severe pain, redness, and tenderness in joints. It results from the accumulation of uric acid in the body that leads to the formation of uric acid crystals in the joints, usually affecting the big toe but can also impact other joints like the ankles, knees, and wrists. 

Symptoms of gout

• Intense joint pain: 

  • The most common symptom is intense, sharp pain, usually in the big toe but can occur in any joint (feet, knees, ankles, elbows, wrists, and fingers).

• Redness and swelling: 

  • The affected joint may become red, swollen, and warm to the touch.

• Limited range of motion: 

  • As the inflammation progresses, the joint may become stiff, reducing mobility.

• Lingering discomfort: 

  • After the severe pain subsides, discomfort in the joint may last from days to weeks.

• Recurring attacks: 

  • A gout attack is characterised by sudden, painful swelling in a joint, usually in the big toe. Gout attacks often recur, affecting other joints like the ankle, knee, or fingers if not managed properly.

Are you experiencing any of the symptoms above? Suspect that you may have gout? Request for an appointment with our specialists at Thomson Medical for an accurate diagnosis and a personalised treatment plan. 

Causes of gout

Several factors can trigger a gout attack or worsen the condition. Understanding these precipitating factors is key to managing and preventing gout flareups.

Diet high in purines

Purines are natural compounds that play essential roles in the body. They are a key component of DNA and RNA, helping to store and transfer genetic information. Examples of purines include adenine and guanine, which are vital for these functions. Purines are also crucial for energy production, as they are part of ATP (adenosine triphosphate), the body’s main source of energy.

In addition to these important roles, purines are found in certain foods. When digested, they break down into uric acid. Excess uric acid can form crystals in the joints, leading to painful gout attacks. Foods high in purines include:

• Red meats (like beef, lamb, and pork)

• Organ meats (such as liver and kidneys)

• Shellfish (like shrimp, crab, and lobster)

• Certain fish (including sardines, anchovies, and mackerel)

• Alcohol, especially beer

• Sugary drinks with high fructose corn syrup

Alcohol consumption

Alcohol, particularly beer and liquor, interferes with the elimination of uric acid. Additionally, it also raises the body's production of uric acid. The accumulation of excess uric acid leads to the formation of more uric acid crystals in the joint, increasing the risk of gout attacks.

Dehydration

The primary way the body eliminates uric acid is through urination. Without adequate water intake, urine production decreases, leading to a buildup of uric acid in the bloodstream, which results in an increase in the concentration of uric acid in the bloodstream and the risk of crystal deposits in joints. Staying hydrated helps to flush uric acid through the kidneys and out of the body.

Obesity and weight gain

Being overweight or obese increases the body’s production of uric acid and reduces the body’s ability to eliminate it. Rapid weight gain can also trigger gout attacks. 

Certain medications

Certain drugs can increase uric acid levels or reduce its elimination, leading to gout. These medications include:

• Diuretics (water pills): 

  • Commonly used to treat high blood pressure or heart failure, diuretics increase uric acid concentration in the blood.

• Aspirin (low-dose): 

  • Regular use of low-dose aspirin can interfere with the kidneys' ability to excrete uric acid.

• Immunosuppressive drugs: 

  • Drugs like cyclosporine, often used in organ transplant patients, can raise uric acid levels.

• Niacin: 

  • A vitamin that lowers cholesterol levels can also raise uric acid levels. 

Trauma or surgery

Physical stress, such as injury or surgery, can trigger a gout attack. Even minor trauma to a joint may cause uric acid crystals to accumulate in that area, leading to pain and inflammation. 

Stress

Physical and emotional stress can sometimes trigger a gout attack, possibly due to hormonal changes that affect uric acid levels. 

Sudden changes in uric acid levels

A rapid increase or decrease in uric acid levels can provoke a gout attack. This can happen due to:

• Fasting or crash dieting

• Starting or stopping medications that affect uric acid levels (e.g. diuretics, urate-lowering drugs) 

Kidney disease

Your kidneys help filter uric acid out of the bloodstream. Chronic kidney disease or other issues impair the kidneys, leading to a build-up of uric acid in the blood, thereby increasing the risk of gout.

Genetics

Genetics may influence how much uric acid your body produces and how effectively your kidneys remove it. A family history of gout can make someone more susceptible to developing the condition.

Medical conditions

Other health conditions that may contribute to higher uric acid levels and gout include:

• Hypertension (high blood pressure)

• Diabetes

• Metabolic syndrome

• Hypothyroidism

• Psoriasis 

Learn more about metabolic syndrome, the 3 highs (high blood pressure, high cholesterol and high blood sugar) here.

Treatments for gout

Medications

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): 

  • These include ibuprofen or naproxen, which help reduce inflammation and pain.

• Colchicine: 

  • This is an anti-inflammatory drug that is effective in reducing pain, especially if taken early during an attack.

• Corticosteroids: 

  • When NSAIDs and colchicine aren't appropriate, doctors can prescribe medications like prednisone.

• Urate-lowering drugs: 

  • These include allopurinol and febuxostat, which reduce uric acid production and are prescribed for long-term management.

Home remedies for gout

• Rest: 

  • Resting the affected joint will prevent further irritation.

• Elevating the limb: 

  • Keeping the joint elevated helps reduce swelling.

• Dietary adjustments: 

  • Reduce consumption of purine-rich foods like red meat, shellfish, and alcohol, especially beer.

• Hydration: 

  • Drink plenty of water to help flush uric acid out of your system.

• Weight management: 

  • Losing weight can reduce uric acid levels and lower the risk of gout attacks. 

If you are suffering from the symptoms of gout, consult with a specialist from Thomson Medical to discuss which treatment plan suits you best.

How to prevent gout?

Dietary changes:

Avoid or limit foods high in purines, such as red meats, organ meats, shellfish, and sugary beverages, while eating more low-fat dairy products, fruits, and vegetables, especially those rich in vitamin C, which may help reduce uric acid levels.

Exercise and weight loss:

Regular exercise can help maintain a healthy weight and reduce the risk of gout. Obesity increases the risk of gout attacks.

Limit alcohol consumption:

Alcohol, particularly beer, can increase uric acid levels and trigger gout attacks.

Stay hydrated:

Drink plenty of water to help the kidneys eliminate uric acid from your body more effectively.

Medication:

If you have frequent gout attacks, your doctor may prescribe medications to lower uric acid levels and prevent future attacks.

FAQ

What is the root cause of gout?

Gout is caused by high levels of uric acid in your blood. When there is too much uric acid, it can accumulate in your joints and turn into urate crystals, which cause the pain and inflammation of a gout attack. 

Can gout be cured?

Gout can be managed, but there is no cure. However, with proper treatment and lifestyle changes, attacks can be minimised and symptoms can be controlled.

How is gout diagnosed?

Gout is diagnosed through a combination of physical examination, reviewing symptoms, and tests such as joint fluid analysis and blood tests to measure uric acid levels. 

Who is at risk of developing gout?

Gout is more common in men, especially those over the age of 40. However, women, especially post-menopausal women, can also develop gout. Factors like genetics, obesity, and certain medical conditions (like kidney disease) increase risk.

How long does a gout attack last?

A gout attack usually peaks within 24 hours and can last from a few days to several weeks if untreated.

Can gout cause long-term damage?

If left untreated, gout can lead to joint damage and the development of tophi (hard, uric acid deposits under the skin), leading to chronic arthritis.

Is gout the same as rheumatoid arthritis?

No, gout is caused by uric acid buildup, while rheumatoid arthritis is an autoimmune disorder. Both cause joint pain but have different underlying mechanisms.

Can I continue to exercise with gout?

During a gout attack, it's important to rest the affected joint. However, regular, gentle exercise between attacks can help with overall health and weight management, reducing the likelihood of future attacks.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Book an appointment with Thomson Medical today.