Understanding Gout: Causes, Symptoms, and Risk Factors

What is Gout?

Gout is a type of arthritis that causes sudden and severe pain, swelling, and redness, most commonly in the joint of the big toe. It is also called Arthritis Uratica, or Podagra when it affects the joints of the foot and often manifests during sleep. It can later involve more than one joint, affecting men over the age of 40, 20:1 over women.

What causes Gout?

Gout is caused by the accumulation of needle-like crystals of uric acid known as monosodium urate crystals in the joints, leading to inflammation and pain. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected (Podagra) in about half of cases. It may also result in tophi deposits after years of gout attacks, kidney stones, or kidney damage. (Tophi are solid urate crystal collections and can lead to deformities or destructive changes in surrounding connective tissue). 

uric acid crystals gout foot infographic

Gout occurs from a combination of diet, other health problems, and genetic factors. It is seen more commonly in those who regularly drink beer or sugar-sweetened beverages; eat foods that are high in *purines; or are overweight.

How is Gout typically treated?

Treating gout involves both medication and lifestyle changes and should be individualized and tailored to each person based upon his or her needs. A healthcare professional can develop a treatment plan for a patient that is effective for managing the specific area affected by the gout and the degree of gout involvement.

What medications are used to treat Gout?

The first line of treatment for gout is usually nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and indomethacin, which can help reduce pain and inflammation during a gout attack. 

Colchicine is a medication that is used for the treatment of gout or to prevent an attack. It works by reducing inflammation. Colchicine isn't used that much nowadays because it can take up to 24 hours to have its full effect and the amount you can use during an attack is limited.

Corticosteroids such as prednisone may be prescribed for severe gout attacks when NSAIDs or colchicine are not effective. They work by reducing inflammation and can be taken orally or injected directly into the affected joint.

Uric acid-lowering medications, such as allopurinol, febuxostat, and probenecid are commonly prescribed to lower uric acid levels in the blood and prevent gout attacks. These medications work by either reducing the production of uric acid or increasing its excretion from the body.

Are there lifestyle changes that can help?

Lifestyle changes can play a significant role in managing gout. This may include avoiding foods high in *purines, which are broken down into uric acid in the body. Red meat, lamb and pork should be limited. Maintaining a healthy weight, staying hydrated, limiting alcohol consumption (especially beer and liquor), and exercising regularly are important lifestyle measures to employ in overall treatment.

*Purine is a colorless crystalline compound with basic properties, forming uric acid on oxidation. Concentrated levels of purines are found in seafood, organ and glandular meats (liver, kidney, sweetbreads), and alcoholic beverages (especially beer). 

Foods to eat and to avoid with gout infographic

To control gout naturally, your diet should contain fresh fruits and vegetables, low-fat dairy products such as yogurt and skimmed milk, nuts and nut butters, whole grains, potatoes, rice, whole-grain bread and whole-grain pasta, eggs (in moderation), olive oil, and flax and other seeds. Remember to drink plenty of water and other non-sugary, non-alcoholic drinks.

It's essential to work closely with a healthcare professional to develop a treatment plan that is safe and effective for managing gout for each individual.

What shoes should someone with Gout wear?

There are certain types of shoes and dress shoes that can be better for men with gout. Here are a few tips to keep in mind when choosing shoes:

Look for shoes with a wide toe box.

Shoes that are too narrow can squeeze your toes together and increase the risk of gout flare-ups. Look for shoes with a wide toe box that allow your toes to spread out naturally.

Choose shoes with good arch support.

Shoes with good arch support can help distribute your weight more evenly across your foot and reduce the pressure on your joints. This can be especially helpful if you have gout in your feet.

Avoid shoes with higher heels.

High heels are not typically worn by men, but shoes with a high heel or elevated sole can put a lot of pressure on your toes and forefoot, which can trigger gout flare-ups. Try to stick with low-heeled shoes or flats instead.

Consider shoes with a cushioned sole.

Shoes with a cushioned sole can help absorb shock and reduce the impact on your joints when you walk.

Opt for leather or other breathable materials.

Shoes made from leather or other breathable materials can help keep your feet cool and dry, which can be helpful if you have gout.

Overall, it's important to find shoes that are comfortable and provide adequate support. If you have gout, it's a good idea to talk to your doctor or a podiatrist for additional advice on choosing the right shoes.

To identify all the locations on your foot where you may experience gout pain consult our foot pain charts.

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