“MY FOOT HURTS EVEN WHEN MY SHEETS TOUCH IT!!”

If this is a complaint that you have, you may have a condition called GOUT. Gout has various other names, such as metabolic arthritis or Podagra. Almost 1 million people in the United States have Gout.

Even Benjamin Franklin, who lived from 1706 to 1790, had Gout. Gout plagued Franklin so much, that he even wrote an essay titled, “Dialogue between Franklin and The Gout” on October 22, 1780. Other famous people afflicted with gout include President Thomas Jefferson, King Henry VIII of England, Charles Darwin, Alexander the Great, and Voltaire.

What is Gout?
Gout is a buildup of uric acid crystals in and around joints in the body. Gout only attacks one joint at a time. A gouty attack is when these uric acid crystals in the joint buildup, causing exquisite pain, redness and warmth. The joint can become so sensitive, that even the slightest touch can elicit an excruciating amount of pain.

A common complaint is, “My foot hurts even when the sheets touch it.” These attacks can last from hours to days. An acute gouty attack is self-limiting, however medication is necessary in most cases to reduce the pain and the inflammation.

Gout can occur in any joint; however, there are joints that are more commonly affected. These include the big toe, ankles, knees, wrists, and elbows. Rarely, uric acid has also been found in the ears, vocal cords, and the spinal cord.

How does the uric acid build up in the joints? Gout essentially is a metabolic disorder. It happens when the body has a malfunction in processing and eliminating uric acid sufficiently; it can also happen when the body has a genetic tendency to generate more uric acid than the body needs. The uric acid that gets deposited in the joints turn into crystals called tophi. This tophi can become very painful, especially during an acute attack of Gout.

Risk Factors for GoutSome people are more at risk of getting gout than others.

Some of the risk factors of gout include:
1. Obesity
2. Moderate to High Alcohol Consumption
3. Abnormal Kidney function
4. Hypertension
5. Some prescription drugs may also exacerbate gout.

DIAGNOSIS & TREATMENT:
Diagnosis of gout can be made by your podiatrist, by just inspection of your big toe or ankle joint. A more definitive diagnosis can be made by joint aspiration of the fluid in the joint. This fluid is taken from the joint and sent for pathology to identify the uric acid crystals. Blood Tests to check for the uric acid in the blood can also be done.

It is essential to go to your podiatrist or doctor if you have symptoms that are similar to gout. If left untreated, multiple acute gouty attacks can lead to a chronic condition of gout. This can further lead to decrease in kidney function, and the formation of kidney stones.

Your podiatrist may treat a gouty attack with pain relievers and Anti-inflammatory medication as a first line of treatment. Some medications can also lower the blood uric acid by preventing uric acid production in the body.

PREVENTION:
Once gout is diagnosed, there are many ways to prevent any further attacks of gout. These include weight loss, decrease in alcohol consumption, sufficient fluid intake, and a change in diet.
Foods rich in purine (the product which is converted to uric acid in the body) should be avoided. There are many foods rich in purine. These include, shellfish, meat, organ meat (liver, kidney, etc), fried foods, roasted nuts, etc… You can speak with your podiatrist regarding what foods to avoid, and what foods to moderate if you do have gout. Acid forming foods should also be avoided.

If you have any or all of the above symptoms of pain and tenderness, redness or inflammation, consult your Podiatrist immediately.

Diagnosis, Treatment and more importantly Preventing future attacks of gout is essential in keeping your body healthy.

If you have any questions or concerns about the foot or the ankle, please email drsharonjoag@gmail.com