Posts for category: Gout
One of the most common foot issues in the world is known as a gout flare-up. A gout flare-up is considered one of the most painful things a person can experience. While there a wide array of medications you can take to help with gout, caused by uric acid, many people like to know how this happens in the first place.
Gout is caused by something called uric acid. Uric acid is caused when a person eats certain types of food, such as some nuts and certain types of fish. When you eat these things your body breaks down certain chemicals in the food and produces uric acid as a byproduct. Some people are more prone to not being able to process the uric acid created, and therefore more susceptible to having an issue with gout. Most people are able to pass the uric acid through their urine, but some are not. This leads to a buildup in the body.
Uric acid is commonly found in joints. Here at Advanced Foot and Ankle Care we see it a lot in toe or ankle joints. To test for the uric acid levels in your body, your primary care doctor would need to perform a blood or urine test. Blood taken from the top of the hand or near the elbow joint are preferred. While there are many different types of medication that can help keep your uric acid levels in check, eating a diet low in food that can trigger a gout flare-up is also key.
If you watch TV, chances are you’ve seen the commercial with the middle-aged gentleman carrying around a large vial partially filled with a green liquid. The advertisement is for a new medication designed for the treatment and prevention (prophylaxis) of gout. To my knowledge, Uloric is the first medication to be approved by the FDA for gout prophylaxis in approximately 30 years. This commercial has caused an increased awareness as well as a concern to many people who have had pain in their feet that they believe may be attributed to gout.
While this particular advertisement focuses on the big toe joint, which is the most common area, gout can occur nearly anywhere in the body. I have personally seen gout attack non-joint areas such as the web spaces just above the toes. Gout is precipitated by a high amount of uric acid in the blood that will leak out of the bloodstream and typically settle in a joint. Upon settling it becomes crystallized into condensed bunches called tophi.
Acutely this will cause the affected area to be swollen, hot, red, and painful. Many patients relate that anything that touches the area, even the rubbing of a sheet across the area will cause severe pain. Chronically, long after the acute pain is gone, the gouty tophi can erode the joint surface causing arthritic pain to the area.
This type of arthritis is on the rise – particularly among men. More than 8 million people have it, and the rates have doubled in the last 50 years. Gout is no respecter of persons. It can strike anyone including famous people and professional athletes. When he wasn't lopping off his wives' heads, King Henry VIII of England was coping with attacks of gout. David Wells, the left-handed pitcher who played for the New York Yankees and Toronto Blue Jays has struggled with gout throughout his baseball career. Maurice Cheeks, coach of the Philadelphia 76ers and Portland Trail Blazers, who played 15 seasons in the NBA with 4 All-Star appearances, was 46 when he started experiencing severe pain secondary to gout.
How is it treated? At Advanced Foot & Ankle Care Centers of Ohio we typically will treat an acute flare of gout with a cortisone injection to the area. This has been found to give the most relief the fastest. Other medications that help are non-steroidal anti-inflammatories such as Indomethacin. Colchicine is another effective medication but is not prescribed as often as is commonly causes severe diarrhea. I will usually check the blood uric acid level. If it is elevated I will give the patient the option of taking a long-term medication such as Uloric or Allopurinol that will decrease the amount of uric acid in the bloodstream. Either one of these medications must be taken on a daily basis to help prevent future arthritis due to gout as well as the recurrence of a gout attack. If you feel that you may have gout or have had gout in the past and would like to discuss options for treatment, please feel free to make an appointment at any one of our 4 locations in Huber Heights, Troy, Piqua, or Sidney.