Gout: causes, symptoms & treatment

What does gout feel like?

Although gout can occur in many areas of the body, the big toe is most commonly afflicted. A gout attack can manifest quickly in your big toe, often in the middle of the night. Gout flares are characterized by rapid swelling in the joint. Your afflicted joint may also look red or feel warm to the touch. Joint pain from gout is often significant, resulting in pain even if the area is touched gently.

Sometimes, a gout flare may be confused with rheumatoid arthritis. They are both inflammatory conditions that cause similar symptoms. However, rheumatoid arthritis results from an autoimmune attack, and gout does not.

Being able to tell the difference between the two conditions can help you receive proper treatment. A treatment plan for gout is critical because, while a gout attack usually lasts a few days and then subsides on its own, multiple gout attacks could have long-lasting consequences for your joints.

What causes Gout?

Gout is caused by a build-up of urate crystals in the toe joint. Urate crystals are formed by excess uric acid in the blood. Uric acid is a natural product of the normal digestion of purine, but some medical conditions can result in increased levels of uric acid in the blood. 

If your uric acid levels are already high, eating purine-rich foods can trigger gout flares. 

Normally, your kidneys eliminate uric acid through urination. However, kidney disease, infection, or even genetics can make the kidneys less effective at eliminating uric acid. Some people just produce too much uric acid for their kidneys to process.

Gout progresses through stages. The first stage is when crystals caused by high blood levels of uric acid begin to cluster around joints. During the second, or acute stage, symptoms of gout set in. During the third stage, you may go through times of remission in between attacks. The fourth stage is chronic gout, during which you experience regular bouts of pain and tophi—hard lumps of crystals—form on the joints.

While some people are genetically predisposed to developing gout, there are many other things that can contribute to gout attacks.

Other health conditions 

Certain health conditions, such as high blood pressure (hypertension), obesity, diabetes, kidney disease, and stress can increase your risk of gout as they impact how your body processes uric acid.

Medical treatments 

Those who have undergone surgery or chemotherapy can be affected by an increased risk of gout attacks.

Medications, supplements, and diet

Some medications and vitamins can make you more prone, such as aspirin, diuretics, and niacin. Even diets high in red meat, shellfish, kidney, liver, red wine, and beer can contribute to gout as these foods contain a lot of purine.

Is gout hereditary? 

Gout can be inherited. However, doctors aren’t sure which genes exactly cause gout to manifest. So far, research has indicated the genes SLC2A9 and ABCG2 have the strongest correlation with the condition. 

Why are the big toes usually affected in a gout attack?

This is a very common and interesting question! Liquid uric acid becomes a solid only at low temperatures. Because the human body has a harder time regulating the temperature of its extremities, with the toes being the smallest and farthest away from the heart, your toes are often the coldest part of your body. Still, your ankles, knees, and fingers can develop gout. 

How is gout diagnosed?

If you’re experiencing symptoms of gout, it’s important to see our doctor right away. While primary care doctors or rheumatologists can diagnose gout, the foot experts at University Foot & Ankle Institute are uniquely qualified to handle problems of the feet. Generally, UFAI providers will take your medical history, conduct a physical exam, and take X-rays of your foot to see if the joint has sustained any lasting damage.

A gout specialist can take a fluid sample from the joint, if necessary, and have it sent to the lab for testing. A pathologist can then check for uric acid crystals to help diagnose gout.

How do you treat gout?

There are various treatment options when it comes to managing the side effects of gout and alleviating pain. To reduce the inflammation and relieve the pain in your joints, your foot and ankle specialist will prescribe either oral or injectable nonsteroidal anti-inflammatory drugs (NSAIDs). Your gout doctor may inject a steroid into the joint to manage severe irritation.

However, if you have one gout attack, it’s an indication that your body has excess uric acid in your blood. Figuring out what’s causing the excess uric acid levels and managing the root cause is an important step in lasting relief. 

Clinical trials have found that drugs such as allopurinol, colchicine, and pegloticase can decrease your body’s production of uric acid and help your kidneys more effectively expel uric acid through urination. Generally, patient care for gout includes both medications and lifestyle changes.

Gouty tophi removal surgery 

Gouty tophi are nodules of crystallized uric acid typically found in the soft tissue just under the skin. When the tophi are small, you may not notice them, but as they grow, they can become painful, restrict joint movement, and, in rare cases, cause infections. While these nodules are often harmless and can be treated with medication, tophi removal surgery may be recommended in advanced cases.

The link between gout and heart disease

The connection between gout and cardiovascular disease is essential for patients and healthcare professionals to be aware of. Even if a patient is already undergoing treatment for their heart disease, such as by taking statins, their risk of cardiovascular mortality is still increased.

Uric acid levels associated with gout are also linked to an increased risk of cardiovascular disease, including heart attacks, strokes, and heart failure. In addition, people with gout often have other risk factors for heart disease, such as obesity, high blood pressure, and diabetes. Therefore, it is important for people with gout to manage their condition and reduce their risk of developing heart disease by maintaining a healthy weight, controlling their blood pressure and cholesterol levels, and avoiding smoking and excessive alcohol consumption.

Searching for a gout specialist near me? UFAI is the right choice for your gout treatment 

The physicians at the University Foot and Ankle Institute have decades of combined experience treating all forms of arthritis of the foot and ankle. Using the latest technologies available, many of which we helped develop, we can accurately diagnose and treat your gout and the painful symptoms accompanying gout attacks. 

New patients or individuals concerned about gout symptoms in the greater Los Angeles area are encouraged to call or schedule a consultation; please call (877) 736-6001 or make an appointment now.

We are conveniently located through the Los Angeles area with locations in or near Santa Monica (on Wilshire Blvd.), Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Santa Barbara, Granada Hills, and Valencia California, to name a few.

 

 

Gout FAQs

What does gout look like? 

Gout is a painful form of arthritis that typically presents with distinct visual and physical symptoms, including swollen joints (usually the big toe) that can be red, tender and warm to the touch. In some cases, the skin over the affected joint may peel or flake.

 

What foods cause gout?

Dietary choices can play a significant role in managing gout symptoms. Some foods and beverages are known to contribute to gout:

• High-Purine Foods: Foods rich in purines include red meat (especially organ meats like liver and kidneys), shellfish (such as shrimp, lobster, and crab), and some types of game meats.
• Alcohol: Spirits and beer, in particular, have been associated with a higher risk due to their purine content and their ability to interfere with uric acid removal from the body.
• High-Fructose Corn Syrup and Sugars: Excessive consumption of sugary foods and drinks can raise uric acid levels and contribute to gout. This includes candies, cakes, and other sweets.
• Processed Foods: Processed foods that are high in sugars, refined carbohydrates, and unhealthy fats can contribute to gout by promoting inflammation and insulin resistance.
• Certain Vegetables: While most vegetables are safe to consume, some high-purine vegetables like asparagus and spinach should be eaten in moderation by individuals with gout.

 

Is gout an autoimmune disease?

Gout is not classified as an autoimmune disease. It is a form of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints. Autoimmune diseases occur when the body's immune system mistakenly attacks its own tissues.

 

Does walking on gout foot make it worse?

Walking on a gout-affected foot may potentially worsen the condition, and it can exacerbate the pain and discomfort. It's not uncommon for individuals with gout to have difficulty bearing weight on the affected foot during a flare-up.

 

Does gout go away on its own?

Gout flare-ups do not typically go away on their own without treatment. While a gout attack may eventually resolve, it often requires medical intervention. 

 

How long does gout attack last?

The duration of a gout attack can vary and depends on several factors, including the severity of the attack, how promptly it is treated, and individual differences in response to treatment. A typical attack may last from 3 to 10 days. 

 

Is gout contagious?

No, gout is not contagious. 

 

What are some tips to prevent gout flair-ups?

Read our 16 tips to prevent and deal with gout.