Arthritis is inflammation of one or more joints in your body. It often occurs as a result of injury to the joint but can also be a part of the cartilage's normal wear and tear between your joints. The predominant symptoms of arthritis are pain, stiffness, and swelling in the affected area. Your foot has 28 bones and 33 joints – making it a vulnerable part of the body to get arthritis...Learn more
Gout in your foot what is it, and what can you do about it?
Your feet play a vital role in your daily life. They are, essentially, the things that get you out and about. It is easy to take them for granted and just count that they will get you to where you want to be. That is, unless you experience some kind of pain or inflammation that keeps you from doing the things you want to do.
Suffering from gout could do precisely that. Once known as ‘the disease of the kings,’ gout is a common ailment that affects millions of people in the United States today. Although people thought it was an ailment caused by the rich diets and large amounts of wine that the upper classes habitually indulged in, today it can affect anyone of any age (although it is more prevalent in middle-aged men and postmenopausal women
While gout symptoms show up in flares that last for a few weeks at a time, it can be extremely painful and even debilitating.
What is Gout
Gout is a kind of inflammatory arthritis that develops from a build-up of uric acid. Uric acid forms when your body breaks down purines – found in some structures in your body and certain foods and drinks.
A build-up of uric acid could be because your body either produces higher amounts of uric acid or doesn’t eliminate it efficiently. High levels of uric acid can lead to the formation of needle-like crystals in your joints. If you have gouty arthritis, these crystals could also be found in the synovial joint fluid. This joint fluid surrounds your joints and allows them to move smoothly. The presence of these uric acid crystals (monosodium urate) can cause pain and swelling, which results in inflammation as your body releases a chemical called cytokines. This chemical regulates your immune responses and inflammation. The inflammation occurs as your body starts fighting against the thing that is harming it – in this case, the uric acid crystals in your joints and the joint fluid.
Some risk factors could make you more prone to developing this kind of inflammatory arthritis. These risk factors include:
- Being a middle-aged man or postmenopausal woman.
- Having family members who have gout.
- Drinking alcohol, especially beer.
- Taking medications like aspirin, diuretics (or water pills), medication to lower blood pressure (like beta-blockers and angiotensin II receptor blockers), and cyclosporine.
- Having other medical conditions like:
- High blood pressure
- Thyroid disease
- Insulin resistance
- Metabolic syndrome
- Sleep apnea
- Kidney disease or poor kidney function
Different kinds of gout reflect the various stages of development of the disease. Asymptomatic hyperuricemia occurs when you have high uric acid levels in your blood, but you are not experiencing any symptoms. With asymptomatic hyperuricemia, urate crystals could still form and cause damage even if you don’t experience symptoms. It is difficult to know that you have heightened uric acid levels, which makes asymptomatic hyperuricemia challenging to diagnose. If you do, though, it would be a good idea to speak to your medical professional to find practical options to lower your levels of uric acid.
Acute gout attacks are sudden occurrences of intense pain and inflammation. These attacks are commonly referred to as flares and are usually acute instead of chronic. That means that you probably will not experience the symptoms all the time. Instead, they will show up sporadically as recurrent gouty attacks with no symptoms present in between gout attacks. If you do not treat the condition, these flare-ups could become more regular, with less time in between.
These painful gout attacks are worst between twelve and twenty-four hours after it starts and can last up to one or two weeks if left untreated. They could be triggered by events like drinking alcohol, using certain drugs or medication, stressful events, or cold weather.
The time between acute attacks is referred to as interval or intercritical gout. You might not be experiencing symptoms during this time, while more urate crystals are forming in your joints.
Chronic tophaceous gout could cause permanent damage to your joints and kidneys. Frequent gout attacks could lead to the development of chronic gout symptoms. A build-up of monosodium urate crystals can occur in the joints if you continuously have high uric acid levels. These crystals form hard lumps, called tophi under the skin. Tophi can damage bone and cartilage and permanently disfigure your joints if they go untreated. It is often combined with chronic arthritis. Tophaceous gout develops over long periods – around ten years and usually only if gout is left untreated.
There is a condition that presents similar symptoms to gout, called pseudogout. In this condition, the crystals that form are calcium pyrophosphate. Because a different compound causes it, pseudogout requires different treatment from gout.
Understanding the Link Between Gout and Your Kidneys
Your kidneys filter uric acid, and that means gout and kidney disease are related. Kidney disease could cause gout, and on the other hand, gout could cause kidney disease.
Your kidneys filter your blood to remove waste and extra water to make urine. Your urine then flows to your bladder to be excreted. When you have high uric acid levels, it can build up in your kidneys and form urate crystals or urate acid kidney stones. These crystals can damage and cause scarring to your kidneys. It is believed that this damage and scarring of your kidneys could lead to kidney disease or kidney failure if you experience untreated gout for an extended period.
Symptoms of Gout
Asymptomatic hyperuricemia, or asymptomatic gout, is when you have high uric acid levels in your blood but don’t experience any symptoms. When you experience an acute gout attack or gout flare caused by uric acid crystals in your joints, symptoms usually arise suddenly, often during the night. There might be periods between these flares when you don’t have any symptoms.
Acute gout often develops relatively quickly and lasts for between three to ten days. As the disease progresses, the symptoms might be similar to that of rheumatoid arthritis. However, the two diseases are distinct and require different treatments.
Severe joint pain.
Gout manifests as severe pain in your affected joints. It can affect any joint, including your ankles, knees, elbows, wrists, and fingers, but is most often felt in the joint of your big toe. Gout pain could be debilitating, affecting your ability to walk, and even the weight of a bedsheet or sock on your foot might be intolerable.
Restricted range of motion.
You might experience limited range of motion in the affected joint due to both pain and stiffness. Redness and inflammation.
The area might become swollen, warm, and tender, and the skin might be red.
The Affected Joint: Your Foot and Your Big Toe
Your big toe helps you to walk, run, bend over, stay stable on your toes or the balls of your feet, and help with your balance in general. The joint that connects the long bone in your foot to your big toe is called the metatarsophalangeal – that’s a mouth full! The Metatarsophalangeal (MTP for short) bends whenever you take a step. This helps your foot to roll forward and push off the ground. When you do this, your MTP carries about 50% of your body weight.
Gout often affects this joint first – causing extreme pain and, often, difficulty walking or moving around. Uric acid is pretty sensitive to temperature changes. Colder temperatures increase the chances of crystals forming. Your big toe is the coldest part of your body because it is so far away from your heart your blood has already cooled down a bit once it reaches your poor big toe. Because your big toes are generally colder, it makes the large joint in your big toe the most likely place for uric acid crystals to form.
Treating Gout in Your Foot
Gout is usually treated with medication. Medication could either be used to manage pain and inflammation or to lower the uric acid levels in your blood to prevent future gout attacks.
Medications for managing pain include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine. NSAIDs can help to reduce inflammation and pain in your affected joints and the surrounding tissues. High doses of short-acting NSAIDs tend to give you the quickest relief.
Corticosteroids are an option for persons who cannot take NSAIDs. You can take corticosteroids orally, or your doctor can inject it directly into the muscle or affected joint.
Colchicine can decrease the swelling and lessen the build-up of uric acid crystals in your joints.
There are also medications that you can use to help prevent gout and gouty flare-ups. Medications called xanthine oxidase inhibitors (like allopurinol) could be used to decrease uric acid levels in your blood. Other medications like probenecid can help your kidneys to remove uric acid from your body.
Managing Pain with Medication and Other Techniques
Essential oils are oils extracted from plants, believed to have therapeutic properties. Some oils that are thought to provide pain relief and anti-inflammatory effects directly related to gout include:
- Lemongrass oil.
- Celery seed oil.
- Yarrow oil extract.
- Olive leaf extract.
- Chinese cinnamon oil.
These oils can be inhaled by making use of an essential oil burner or diffuser. You can also apply the diluted oil directly to the affected area. Oils placed directly on the skin could cause irritation and need to be mixed and diluted with a carrier oil. While you can drink tea made from these plants, the essential oils should not be ingested. Consult your doctor before you start a new alternative therapy.
The CDC has five recommended self-management strategies for arthritis, including gout. They recommend at least 150 minutes of physical activity every week. Low impact exercises like walking, riding a bike, or swimming is best if you have arthritis. They are also good options during the times when you do not experience a gout flare. Exercising not only helps you to maintain your weight but also helps to maintain good joint health.
Heat or ice and elevation.
When you are experiencing an arthritic gout flare, you might find that elevating and applying either heat or ice to the affected toe helps. Heat soothes the area and reduces inflammation, while ice creates a numbing effect and reduces pain. Elevating your foot can help to reduce the swelling. Rest the foot and stay off of it if possible to prevent further damage and allow the affected joint to heal.
Your diet could affect whether you experience a gout attack and how often you experience them. Some foods naturally contain high levels of purines, which gets broken down into uric acid in your body. These include:
- Food high in fructose (fruit sugar).
- Food with high-fructose corn syrup.
- Red meat, including pork and veal.
- Organ meats like liver, kidney, tongue, and sweetbreads.
- Seafood like cod, scallops, salmon, shrimp, lobster, sardines, anchovies, and mussels.
- Alcohol, especially beer, and notably in men.
- In some cases, even non-alcoholic beer could increase your chances of developing gout.
- Fruit juice.
Other foods are believed to lower the uric acid levels in your blood. These include:
- Tart cherries.
- Apple cider vinegar.
- Milk thistle seeds.
- Nettle tea.
- Skim milk.
Be sure to discuss alternative therapies with your doctor or natural health practitioner to establish what could help you and how much you would need to consume.
When you are overweight, your body makes more uric acid – and your kidneys don’t eliminate it so well. Maintaining a healthy weight could help you prevent gout and arthritis development. If you already have gout, shedding some pounds could help lower your uric acid. Cutting the extra weight can also take some pressure off your feet too. Be aware, though, that fasting and rapid weight loss could temporarily increase your uric acid levels.
Protect your joints.
Gout is a form of arthritis. Any injury to a joint could make that joint more susceptible to developing arthritis, and in the case of the joint in your big toe – gout.
Wearing Shoes When You Have an Acute Gout Flare
Gout can be intensely painful, so much so that even putting on a sock can be excruciating. Wearing the right kinds of shoes can help reduce the pain you experience with gout and other kinds of arthritis affecting your feet, allowing you a better quality of life.
Managing your pain and taking care of your body to regulate your uric acid levels is essential. So much so that you might not even have given thought to how the shoes you wear affect your gout symptoms. Or perhaps you have been looking and struggling to find shoes that are comfortable and good to wear. The shoes you wear, especially if they don’t fit well or are worn out, could increase your gout symptoms.
Gout is extremely painful, and you don’t need the added irritation of uncomfortable shoes on top of that. The good news is that some shoes are better for feet with gout than others. The best shoes for people suffering from gout need to fit well (with a wide toe box to give your toes adequate room), provide plenty of cushioning, and should be lightweight. KURU footwear ticks all those boxes. Plus, they look pretty good – if we do say so ourselves!
Some shoes might feel super comfortable in the store and then wear out after a short while, not so with KURU footwear. Our unique ULTIMATE INSOLES are made from space-age foam. They use the heat of your feet to mold around your foot – creating a custom orthotic inner that supports your foot where you need it the most. The more you wear them, the more custom and comfortable the fit.
Our toe boxes have enough room not to cramp your toes – or your style! More space upfront means your toes can move freely and naturally. This can give you some relief when you are in a gout flare. More than that, roomy toe boxes means space for your toes so that you don’t get a flare from a scrunched up big toe.
Gout flares can be extremely painful and interfere with your daily activities. Taking care of your body by eating less food that is high in uric acid is a good way to lower your blood’s uric acid level. Medications and alternative therapies can be combined to take care of the pain and inflammation caused by a gouty flare. While you are doing all you can to ease your pain and increase your comfort, don’t forget to consider looking at the shoes you wear. Comfortable and supportive shoes with large and roomy toe boxes can go a long way in not only helping your sore feet – but also in protecting them from avoiding future flare-ups.