Gout is an arthritis that can attack the joints very quickly. It is caused by excessive uric acid in the blood stream. The uric acid can form hard crystals in the joints. In the foot it commonly affects the small joint at the base of the big toe. The toe can look swollen and red, it can feel very painful and stiff. It can also other joints such as the ankle and knees. Gouty attacks can last from a few hours to days and very rarely weeks. Gouty attacks cause significant foot pain, impairment and disability.
Risk factors for developing gout are excessive drinking, being overweight, high blood pressure, abnormal kidney function and certain foods such as meat and fish. Gout affects men more than women.
How is it diagnosed and treated?
A descriptive history will hint at the presence of gout. A reliable method for diagnosing gout is joint aspiration, where the fluid is drained from the joint to detect the presence of uric acid crystals. This is performed under a local anaesthetic using a syringe and needle. Your doctor will recommend some lifestyle changes to help prevent any future gout attacks. In an acute gout attack your doctor may prescribe anti-inflammatories and other medications to decrease the level of uric acid in the blood.
Your podiatrist will discuss with you appropriate footwear choices, these can significantly offload high-pressure areas in the feet and improve walking and pain levels. Key areas to include are adequate cushioning and support.