Foot Conditions A-Z

Gout

Gout is a form of arthritis -- inflammation that can cause an attack of sudden burning pain, stiffness, and swelling in a joint--caused by a buildup of uric acid in the blood. The most common sign of gout is a sudden attack of swelling, tenderness, redness, and sharp pain, which often occurs in the knees, ankles, the big toes and other parts of the feet. Attacks are sporadic and can last a few days or many weeks.

Causes

Most of the uric acid in the bloodstream is filtered and disposed of in the urine. But when uric acid accumulates in the blood, it forms crystals that gravitate to the joints. Common causes of this buildup include the following:

• Being overweight
• Drinking too much alcohol
• Taking certain medications such as diuretics
• Eating too much meat or fish, which are high in purines

Purines are natural substances found in every cell of the body and present in most foods. Eating too many foods high in purines leads to the overproduction of uric acid. Foods high in purines include high-protein foods such as organ meat (liver, kidneys, sweetbreads); anchovies, sardines, and herring; legumes (dried beans, peas); consommé and gravies; mushrooms, spinach, asparagus and cauliflower; and beer and other alcoholic beverages.

Prevention and Treatment

The best way to prevent gout is to prevent the buildup of uric acid in the blood. Changing your diet and avoiding foods high in purines may help lower your risk of having future attacks. Doctors recommend that people who have gout maintain a healthy body weight through moderate daily exercise and regulation of their fat and caloric intake.

Avoid diets that promise quick or extreme weight loss as they can increase uric acid levels in the blood.  The American Medical Association recommends a diet high in complex carbohydrates (whole grains, fruits, vegetables), low in protein (15 percent of calories from sources such as soy, lean meats, poultry), and no more than 30 percent of calories from fat (10 percent animal fat). Drink plenty of fluids and don’t overindulge in caffeinated drinks.

Shoes or boots that provide sufficient width in the toe box ensure minimal compression and rubbing of the big toe (the first metatarsal phalangeal joint), a common location for gout. Wearing inserts and/or orthotics that provide cushioning and proper arch support help reduce stress on the feet. 

Wearing padded socks can also reduce foot stress. Therefore, to ensure feet are optimally protected, IPFH suggests that you wear only properly selected and fitted, as part of an integrated approach,  padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help protect against injuries to the skin/soft tissue of the foot due to impact, pressure and shear forces.

Medical Considerations

Gout is typically not a serious condition, but it is important to see your doctor after an episode of gout, even if you are no longer in pain. This is because the uric acid accumulation that caused the gout attack may still be irritating the joints and could eventually cause serious damage. Your doctor can prescribe medications that will prevent and even reverse the uric acid accumulation. (Remember to take all medications as prescribed.)

Always talk to your doctor if you have soreness, pain, redness, swelling or other indications of persistent problems in any area of your feet for more than a few days