Gout
What Is It?
Gout is a type of arthritis caused by a buildup of uric acid in the body. When uric acid levels become too high, sharp crystals can form in the joints, leading to sudden episodes of intense pain, swelling, redness, and warmth. It often affects the big toe joint but can also involve the midfoot, ankle, or other joints.
The key to treatment is to control uric acid levels which can often involve primary care intervention with medication.
What Makes It Worse
- Eating foods high in purines (red meat, organ meat, shellfish)
- Drinking alcohol, especially beer or spirits
- Dehydration (not drinking enough water)
- Being overweight or having metabolic conditions (high blood pressure, diabetes)
- Certain medications (like diuretics/water pills)
What Helps
During a Flare
- Rest the affected joint and avoid walking if possible
- Elevate the foot to help reduce swelling
- Take prescribed medications as directed by your primary care doctor
Long-Term Management
- Stay well-hydrated (aim for 8–10 glasses of water daily)
- Limit alcohol and reduce intake of high-purine foods
- Maintain a healthy body weight
- Take uric acid–lowering medication if prescribed (such as allopurinol)
- Wear supportive shoes to protect painful joints
Summary
Gout is a painful arthritic condition that is caused by elevated levels of uric-acid, which can be from under excretion or over production.
The keys to controlling this condition are assessments/tests to differentiate your specific cause of gout, followed by lifestyle changes.
Conservative treatment will involve steroid injections into acute flare ups, medical management by primary care physician, lifestyle change, and possibly shoe gear modification.
Surgery is an option once all conservative measures are exhausted. Joint arthrodesis (fusion) is often the best surgical choice for full resolution.
