Big Toe Joint: Gout

The 26 Review

  • What is Gout? Gout is a form of arthritis caused by the buildup of uric acid which crystalize in joints and soft tissue
  • Causes hereditary genes, diet high in meat, seafood, cheese, and alcohol
  • Symptoms pain, stiffness, redness and swelling, visible bump, limited range of motion in big toe
  • Diagnosis physical examination and X-Ray imaging
  • Treatment oral and topical anti-inflammatory medications, steroid injection, diet modifications, surgery

Let’s take a closer look…

While gout has been called the disease of kings, it is not something that should be dismissed as an ailment of royalty. Gout can and does occur in people from all walks of life, though it tends to have a higher prevalence in men than women. Gout is a form of arthritis caused by the buildup of uric acid in the body, which then crystalizes and forms needle-like crystals in joints and soft tissue. These crystals cause inflammation, which results in pain and swelling in the affected area. One of the most common places gout occurs is in the big toe, although it can occur anywhere in the body where there are joints, including the wrists, elbows, shoulders, knees, ankles, or feet. If you have gout or think you may have gout, read on to learn about its symptoms and how to treat it effectively.

Causes

The exact cause of gout is unknown but there are some contributing factors which may help explain why you develop gout. As previously mentioned, gout is a form of arthritis caused by the buildup of uric acid in the body. Consuming foods and beverages that contain high levels of purines can also trigger a gout attack. Some foods contain more purines than others and have been associated with an increase of uric acid production within the body. Overtime, the accumulation of crystallized uric acid within the body can lead to a painful experience known as a gout attack. Meat and seafood may increase your risk of gout, whereas dairy products may lower your risk. Consider exercising daily and regulating your fat and caloric intake.

Symptoms

The main symptom of gout is severe pain in and around a joint – usually one of your toes, but it can also be a thumb, foot or knee. The joint becomes red and swollen as blood collects in and around it. In some cases, there is no specific joint involved and a gout flare-up occurs in the soft tissue of the food. A gout attack will usually subside in 24 to 48 hours but can reoccur during that time. It may seem like there’s no rhyme or reason to what triggers an attack – it’s not always related to alcohol consumption, diet or having had too much food – although these are often associated with an attack. If you’re suffering from an acute bout of gout, it could be caused by any number of things including seafood (especially shellfish), meats, cheeses, and alcohol consumption.

In individuals who have suffered with gout chronically, painful flare ups may also be accompanied by changes in the affected joints structural integrity. Overtime, uric acid accumulates in the small foot joints and can slowly cause the joints to deteriorate and breakdown. This can lead to bone-on-bone arthritic pain, loss of joint motion, stiffness, and difficulty walking. The affected joints can also change shape and become enlarged or prominent. If the accumulation of crystallized uric acid (also known as gouty tophi) is so severe, it can actually create a sore and break through the skin.

Diagnosis

Routine blood work including a uric acid level analysis is commonly obtained and can coincide with a gout diagnosis, however, the blood work results are not always consistent and can be misleading. Therefore, clinical presentation interpreted by a physician’s clinical experience and x-ray are the primary ways this condition is diagnosed. X-rays (Link to Therapy Page: X-Ray) will typically demonstrate soft tissue swelling around the big toe joint or affected area of tissue. Enlarged bone formation and spurring on the top of the joint may be present but not always. In some cases, loose bone chips and fragments of bone may be seen floating within the joint. In severe cases the affected tissue can break open and a white and clear fluid may exude from the wound.

Treatment For Gout

While there is no cure for gout, it is possible to manage attacks with a number of different options including natural treatments and medications. Home remedies including drinking cherry juice and drinking plenty of water can provide relief from symptoms of a gout attack. Drinking ten to twelve glasses of water can help flush out excess uric acid from your body. Applying heat opposed to ice to the affected area may also provide some temporary relief. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as over the counter ibuprofen are effective in reducing inflammation and relieving pain in mild gout flare-ups. For more severe cases, prescription medication such as oral steroids or gout specific medications such as Colchicine and Allopurinol can help manage attacks. These medications can generally ease your symptoms within a few days, but they do have side effects that should be discussed with your prescribing physician.

If chronic gout has altered the joint and surrounding tissue structures overtime, surgery may be a viable option to help alleviate pain and other associated problems. When gouty tophi have built up and developed into soft tissue nodules, these can be removed. In more severe cases when the big toe joint becomes enlarged or stiff with lack of motion, various bone procedures are an option to consider including Bunion Repair or a joint replacement procedure.

By lowering your risk factors (and noting warning signs), you can try to prevent an attack from occurring altogether. Below is a list of foods to consider altering your diet with that can help prevent a gout attack.

Foods to Enjoy

• Fat and non-dairy fat products, such as yogurt and skim milk

• Fresh fruits and vegetables, nuts, peanut butter, and grains Fat and oil

• Potatoes, rice, bread, and pasta

• Eggs (in moderation)

• Meats like fish, chicken, and red meat are fine in moderation (around 4 to 6 ounces per day)

• Vegetables: Green leafy vegetables

Foods to be Cautious With

• Beer and grain liquors (like vodka and whiskey)

• Red meat, lamb, and pork in excess

• Organ meats, such as liver, kidneys, and meat extracts such as gravy

• Seafood, especially shellfish like shrimp, lobster, mussels, anchovies, and sardines

• High-fructose products like soda and some juices, cereal, ice cream, candy, and fast food

Display your feet with confidence.

As summer approaches, ride around w/the confidence to hang your feet.