Gout can be excruciatingly painful when an ‘attack’ or ‘flare up’ starts. Gout is a type of rheumatic arthritis, and this can often be confused with the ‘wear and tear’ arthritis we often see - osteoarthritis. The mechanism of action is very different - as are the symptoms and treatment.
Gout is a type of inflammatory arthritis resulting from too much uric acid in the blood. Uric acid gets in the blood as we break down the purines naturally present in our food. Sometimes the kidneys have difficulty processing and getting rid of uric acid at a normal rate, and sometimes the production of the uric acid is just too high. Either way, we’re left with much more uric acid than we should normally have.
Long ago, gout was referred to as the ‘Rich Man’s Disease’ because it was noted that it was primarily those that were well off that developed gout. This was because certain foods contain much higher levels of purines - like red meats, shellfish, red wine and beer - which the rich could afford much more of. This still holds true today, in the sense that if you’d like to lower your chance of having a flare up of gout, you should cut back on these foods.
A gout attack happens when the uric acid crystallises in a joint and for 90% of those with gout, this will occur at their big toe among other joints. This is because uric acid crystallises in cooler temperatures and our feet are often the coldest part of our body. The pain of a gout flare can be intense and comes on suddenly and unexpectedly - day or night. The joint will feel warm, red and swollen.
Aside from consuming high levels of purines, genetic factors also often come into play. That is, if one of your family members has gout, you’re more likely to develop it too. Other factors include diuretic medications, aspirin and niacin (all which impair the body’s ability to remove uric acid from the blood), stress, diabetes, high blood pressure, surgery and obesity, among others. While gout can occur at any age, it typically affects men aged between 30 and 60 years old.
After a confirmed diagnosis of gout, your GP will run through with you any medications that may help, any dietary changes and anything else they see fit. We recommend taking small steps to reduce the likelihood of flares such as wearing warm socks and keeping your feet warm, staying active (when you don’t have a flare) to help other contributing factors to gout such as obesity, stress and diabetes. If you’re having a flare, make sure you don’t add additional pressure to the joint and that your shoes are helping and not hindering your pain and mobility!
At South Burnett Podiatry, we can help gout by creating custom padding or orthotics for you that can reduce the pressure from the affected joints that tend to flare up. This can make it significantly more comfortable for you when the flares do occur. Ultimately, controlling the cause of your gout and working to optimise body conditions is the best way to manage the symptoms.