Nov 8, 2010

Gout: Painful, Annoying and Treatable

Gout. Sounds like something building contractors use to fill up holes, doesn’t it? The reality is gout is no laughing matter. It can wake you up in the middle of the night in screaming pain. It hurts to wear shoes, to walk. It puts you on the defensive around small children and pets who might inadvertently hit your inflamed foot.

Gout is not life-threatening, but it is joy-threatening. It’s a little black cloud that puts your personal alarm system on high alert, and that in itself is pretty draining. Here’s the good news: There are new treatments that are, with some lifestyle adjustments, effective. Even better, gout is often preventable.

So, what exactly is gout?

Surprisingly, gout is a form of arthritis that exclusively targets one specific place on your body – your big toe. It’s known for sudden severe attacks of pain around the large joint of the big toe. Many of my patients report waking up in the middle of the night in screaming pain and feeling like their big toe in on fire. Shoes, even socks, are painful to wear.

These attacks can last a few days or several weeks, and can spread to other joints in the feet, knees, ankles and hands. Generally speaking, gout only gets worse, so it’s best to see a doctor earlier rather than later.

Basically, gout occurs when you have unusually high levels of uric acid in your blood, which then forms sharp, needle-like urate crystals that accumulate around a joint to cause pain and inflammation.

Statistically, men between the ages of 40-50 are more prone to gout than women, as are those with a family history of gout. People who consume more than two alcoholic drinks a day, who have high blood pressure, diabetes, arteriosclerosis or hyperlipidemia are also candidates for gout. Left untreated, the urate crystals that cause gout can lead to kidney stones – a bullet you really want to avoid.

Snyder Stuart Podiatry Centers regularly – and successfully — treats patients with gout. At your first appointment, we will diagnose what may be happening with your inflamed toe. Sometimes a blood test to measure the uric acid level in your blood or a joint fluid test to confirm the presence of urate crystals is necessary. Quite often, however, we can determine with a simple examination and interview if the problem is gout.

Once it’s established that gout is the problem, we determine which medication is best for you to treat gout and to prevent further attacks. Generally, we start with a non-steroidal anti-inflammatory drug (NSAIDs) at a higher dose to stop the attacks, then a lower daily dose to prevent further attacks. Usually this does the trick, but if necessary, there are more powerful medications available to us.

Medication aside, one of the most powerful ways to control gout is also the same path to preventing this disease – by adjusting your diet. This includes (1) eliminating all alcohol, (2) doubling your intake of water and (3) cutting back to five ounces of protein (fish, meat and poultry) a day. That’s doable, isn’t it?

Also, new studies have shown that sensible quantities of coffee, cherries and Vitamin C have shown to reduce the uric levels, though we don’t know why.

If you or someone you know is suffering from gout, give us a call. We can set up an appointment, check out what’s going on, and then move you on to a healthier – and pain-free – path!

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