Condition Spotlight: Gout

diagram of foot showing where gout can affect the foot

Gout is a condition that causes pain to the joints that is often misdiagnosed or mismanaged.

It is a painful and debilitating condition that requires intervention and treatment as soon as possible.

What is Gout?

Gout is a common form of arthritis that is characterised by pain, heat, swelling and redness of the affected joint.

It can occur anywhere in the body, however, it is most common in the feet – particularly at the base of the 1st toe.

The range of motion within the joint often becomes restricted during a gout attack.

The build up of uric crystals also affects the synovium within the joint, which is a lining that helps to lubricate joints.

In severe cases, gouty tophi can arise. Gouty tophi are chunks of uric acid crystals that can be seen under the skin and often break open to cause a wound or sore.

What does Gout feel like?

Patients who have experienced gout say that the joint feels hot, swollen and very painful.

A gout attack is just as it sounds – patients will say that the pain came on very quickly and unexpectantly.

What causes Gout?

Gout is caused by the build up of urate crystals within the joint.

Uric acid is produced when the body breaks down purines – a chemical found in meat, seafood, red wine, beer and sweetened fruit drinks.

Uric acid is usually dissolved in blood and expelled from the bloodstream by the kidneys.  However, sometimes the body produces too much and the kidneys cannot get rid of it all.

The uric acid can then crystalise and build up in the joints.

Who does Gout affect?

Gout can affect up to approximately 6% of the population worldwide.

Men are more susceptible to gout than women, and the incidence of gout within the population increases with age.

Research suggests that there may be a genetic predisposition associated with gout.

Research also suggests that certain medications can affect the body’s ability to process uric acid, such as aspirin.

Other risk factors can include obesity, stress, and other health conditions like diabetes.

How is Gout diagnosed?

The first step to correctly diagnosing gout is thorough history taking.  This will involve us asking you when the pain started, what it feels like and whether it has ever happened before.

The clinical signs of gout often provide enough evidence to support the diagnosis, however, other assessments can help to confirm this.

Gout can also be diagnosed through an x-ray and/or blood tests. An c-ray will show the build up of uric acid within the joint.  Blood tests will assess the amount of uric acid circulating within the blood.

How is Gout treated?

The first step to treating gout is with medication from your GP.

This may include medications ranging in strength and type, including anti-inflammatories, corticosteroids, and colchicine. These can help in reducing the severity of the gout symptoms.

If gout attacks are common for you, you may need to begin taking other medications to help prevent future gout attacks.

It is also often helpful to think back and document what you ate or drank, as this can help you modify your diet in the future to prevent any attacks.

If you are struggling with your diet, seeing a dietician can help you manage this.

So, when it comes to gout, how do we help you here at Watsonia Podiatry?

Our primary focus for gout treatment is to help reduce your pain.  This may be through the following:

  • Footwear modifications 

This might include educating you on the best type of footwear to wear during a gout attack or alternative lacing techniques to help reduce the pressure on your toes.

  • Simple exercises

Range of motion exercises can be prescribed after a gout attack to essentially get the joint moving again once your pain has subsided.

  • Management of gout tophi

In severe cases, gout tophi may cause breakages in the skin, and consequently wounds can form if it is not managed properly.  We can help to clean and dress these wounds in an aseptic/clean and safe environment to help them heal.  We can also refer to chronic wound services for further assessment if required.

 

If you suffer from gout, or any pain or discomfort in your feet and/or lower limbs, come visit us here at Watsonia Podiatry. One of our superstar podiatrists will be able to get you on your road to recovery. You can book an appointment with us by calling us on 03 9432 2689 or you can book online here.