What is Gout? Understanding Gout Causes, Symptoms, and Treatment.

March 19, 2024
OrthoNJ
Left hand holding right wrist joint and swelling around joint from gout

What is Gout?

Gout is actually a type of arthritis caused by the buildup of uric acid crystals in the joints, which leads to inflammation and intense pain. Uric acid crystals accumulate in joints and lead to gout due to a condition called hyperuricemia, which occurs when there is an excessive amount of uric acid in the bloodstream. Multiple factors contribute to the buildup of uric acid crystals.

What Causes Gout?

The primary cause of gout is an excess of uric acid in the bloodstream. Uric acid is a byproduct generated when your body breaks down purines, substances found in certain foods and beverages. When the uric acid levels become too high, they can crystallize and deposit in the joints, triggering the sudden onset of inflammation and pain known as gout attacks.

Overproduction of Uric Acid 

The body produces uric acid as a byproduct of the breakdown of purines, substances found in certain foods and beverages. If the body produces excessive uric acid or cannot efficiently eliminate it through urine, uric acid levels in the bloodstream can rise, leading to the formation of uric acid crystals.

Dietary Factors

Consumption of purine-rich foods, such as sugary beverages, red meat, seafood, and sugary beverages, can contribute to elevated uric acid levels. Alcohol, particularly beer, and spirits, is also known to increase uric acid production and well as decrease its excretion, making individuals more susceptible to a gout attack.

Obesity 

Excess body weight is also associated with higher levels of uric acid in the bloodstream. Adipose tissue (fat cells) produces substances that increase uric acid production and decrease its elimination, contributing to hyperuricemia and gout risk.

Genetics

Some individuals can have a genetic predisposition to hyperuricemia and gout. Inherited conditions, such as familial hyperuricemia or certain enzyme deficiencies, can affect the body's ability to metabolize purines and excrete uric acid efficiently.

Medical Conditions

Certain medical conditions, such as kidney disease, can impair the kidneys' ability to filter and excrete uric acid and can increase the risk of hyperuricemia and gout. A cluster of conditions known as metabolic syndrome, which includes high blood pressure, obesity, insulin resistance, and abnormal lipid levels, is associated with elevated uric acid levels.

Medication

Some medications, such as diuretics (water pills), aspirin, niacin, and certain immunosuppressants, can interfere with uric acid excretion, leading to increased uric acid levels in the bloodstream and, therefore, a higher risk of gout attacks.

Overall, the interplay of these factors contributes to the buildup of uric acid crystals in the joints, triggering the sudden onset of inflammation, pain, swelling, and other symptoms characteristic of a gout attack. Managing these risk factors through lifestyle modifications, dietary changes, and appropriate medical treatment can help reduce the likelihood of gout attacks and improve overall joint health.

In What Part of Your Body Does Gout Cause Issues?

Gout typically manifests in the joints, particularly in areas where uric acid crystals tend to accumulate. The most common site is the big toe joint, known as podagra, but it can also affect your other joints in the feet, ankles, knees, elbows, wrists, and hands. 

Gout Symptoms

Intense pain: Gout attacks often begin suddenly and are characterized by excruciating pain in the affected joint. The pain is typically most severe within the first 12-24 hours.

Swelling and inflammation: Your affected joint may become swollen, red, and tender to the touch.

Limited mobility: Gout can cause stiffness and difficulty moving the affected joint.

Warmth: The skin over your affected joint may feel warm to the touch.

Gout Foot: How Gout Affects the Feet

Gout commonly affects the feet, particularly the big toe joint. Gout symptoms in the foot are similar to those experienced in other joints but may be more pronounced due to the pressure exerted on the feet during walking and standing.

the feet of a man suffering from gout

Gout Treatment

Treatment for gout aims to relieve pain, reduce inflammation, and prevent future attacks. 

Treatment may include:

  • NSAIDs, Nonsteroidal anti-inflammatory drugs, are used to reduce pain and inflammation during gout flares.
  • Colchicine, a medication that can help reduce inflammation and pain associated with gout attacks.
  • Corticosteroids, which may be prescribed for severe gout attacks when NSAIDs or colchicine are not effective.
  • Lifestyle modifications include maintaining a healthy weight, staying hydrated, and avoiding purine-rich foods and alcohol.

Medications such as allopurinol or febuxostat lower the uric acid levels in the bloodstream and prevent future gout attacks.

When are Gout Symptoms Serious?

While gout attacks can be extremely painful, they typically resolve within a few days with appropriate treatment. However, frequent or untreated gout can lead to complications such as:

Joint damage

  • Chronic gout could cause permanent damage to the affected joints. This damage can lead to deformity and decreased mobility.

Kidney stones

  • Uric acid crystals can also form kidney stones, which often cause severe pain and can even require medical intervention.
Doctor checking patient's foot for gout symptoms

When to See a Podiatrist for Gout Symptoms

If you experience symptoms of gout, such as sudden and severe pain, swelling, and redness in a joint, it's essential to consult with a podiatrist or healthcare provider. We have multiple podiatrists at our ONJ divisions who can diagnose gout based on your symptoms, medical history, and physical examination and recommend appropriate treatment to relieve pain and prevent future attacks. 

Additionally, if you have recurrent gout attacks or underlying health conditions such as kidney disease or diabetes, one of our ONJ podiatrists can work with you to develop a comprehensive management plan to minimize the impact of gout on your foot health.

You don't have to stay in pain. Contact one of our ONJ divisions to schedule an appointment.

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