With the vast increase in food quality at all levels of developed society, the prevalence of gout is on the increase. Gout can affect many parts of the body, but a lot of reported gout cases primarily affect the joint of the big toe, a condition sometimes referred to as 'podagra'. Other joints in the foot also at risk. With this in mind, here are the basic facts on the causes of gout, and ways it can be treated.
What causes gout?
Gout is caused by elevated levels of uric acid in the blood. Uric acid is a natural byproduct of various bodily functions including digestion, and generally it is excreted in the urine after being filtered out of the blood by the kidneys. However, excessive levels of uric acid in the blood can damage the kidneys and render them unable to filter out sufficient quantities of the acid. This acid subsequently leaves crystalline deposits in the tissues of the joints, which can cause the following symptoms:
- Swelling of affected jointed, accompanied by red and tender skin, and pain ranging from moderate to excruciating. The affected skin may feel hot to the touch, and may begin to flake and peel in cases of extreme swelling.
- Firm, pale lumps that develop beneath the skin, known as tophi. A tophus generally appears years after the onset of gout, and can cause discharge from the skin, pain, joint immobility and damage to adjacent bones.
As you can imagine, having either one of these conditions affecting your feet, never mind both, can be severely debilitating. In addition, gout can also cause fever and fatigue, and if left untreated for too long can cause kidney stones and even kidney failure. Needless to say, it's in your best interests to have gout treated as soon as possible.
How can gout be treated?
Gout symptoms generally manifest in the form of 'attacks', periods of acute swelling and pain with an unpredictable duration. As such, there are two stages of gout treatment: alleviate the symptoms of attacks or undergo a long-term treatment.
The following treatments are administered to fight acute gout attacks:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and indomethacin, are administered to alleviate pain and inflammation around the joint. These cannot be administered, however, in advanced cases where the kidneys have been significantly damaged.
- Colchicine, a mildly toxic plant extract, is given to patients who cannot tolerate NSAIDs, and it performs the same functions. However, gastrointestinal upset is a common side effect.
- Corticosteroids, injected directly into the affected joint(s) of the food are effective, but cannot be administered for prolonged periods due to various nasty side effects that can result.
- Cold packs, for instance a bag of ice wrapped in a towel, will help numb the pain and pressure on the foot (heat packs are ineffective). Applying ice directly to the swollen joint will likely damage the thin skin over the joint.
- Rest and recuperation will generally help an attack pass more quickly, and with the amount of pain that walking or even slight movements of the affected foot can cause, the patient generally has no choice but to rest.
The following treatments are used to treat gout over the long term and reduce the likelihood of further attacks, as well as the appearance of tophi:
- Xanthine oxidase inhibitors are drugs that reduce the body's production of uric acid, and can be tremendously effective if taken for long enough periods. Bear in mind that some inhibitors can actually worsen the symptoms of gout attacks if they occur before they have had time to take effect.
- If you are intolerant of xanthine oxidase inhibitors, pegloticase can be used as an alternative. This drug is generally injected directly into the affected joint, and is usually very effective at preventing gout attacks. It does, however, have a relatively high rate of side effects, including inducing dangerous autoimmune responses.
- Other medications such as probenecid, sulfinpyrazone and benzbromarone can also be prescribed, though they are generally considered less effective.
- Lifestyle changes can also contribute significantly to reducing the incidence of gout attacks, such as adopting a healthier diet, losing weight, and starting regular exercise. Low-impact exercises, such as swimming, are recommended to avoid damaging the affected joints in the feet. You should also limit your intake of alcohol, seafood and organ meats, as these foods can dramatically raise uric acid levels in the blood.
- For more information on your options, consult resources like Balance Podiatry.