Gout, commonly thought of as “big toe pain”, is an extremely painful form of arthritis that has been around since ancient history. Gout had been referred to as the “disease of kings” because it had been associated with the overindulgence of food and wine that only a king could afford. This assumption is incorrect, as gout can affect anyone along with various risk factors. It is reported that gout affects approximately 5 to 6 million people in the United States, and is steadily rising.
What is gout? Gout is a sudden and severe attack of pain with redness and tenderness in the joints, and is usually at the base of the big toe. Gout is an inflammatory arthritis resulting from hyperuricemia which means a higher than normal level of uric acid in the body. This is caused either from overproduction in the body or under-excretion out of the body of uric acid. Urate crystals accumulate in the joint causing inflammation and intense pain, which leads to a gout attack.
Under normal circumstances, uric acid dissolves and passes through your kidneys to excrete out of the body. With high levels of uric acid build-up, needle-like, sharp urate crystals form in the joint or surrounding tissue causing pain, swelling, and inflammation. Gout can result in the deterioration or destruction of the joint.
Where is gout? The first symptoms are usually an intense painful swelling in a single joint, most often the feet, and most commonly the big toe. An acute attack has been described as “waking up in the middle of the night feeling like your toe is on fire”. Even your bed sheet resting on it may seem unbearable.
Common risk factors:
- Men more than women
- Alcohol use, particularly beer
- Diet high in purines (i.e., red meat, seafood, organ meat, asparagus, mushrooms)
- Family history
- Kidney disease
- Organ transplants
- Certain medications and medical conditions
How do I minimize my risks?
- Stay well-hydrated with water
- Limit sweetened beverages with high fructose corn syrup
- Limit alcohol intake to 2 drinks/day for men, 1 drink/day for women
- Eat a balanced diet, with protein intake more from low-fat dairy, eggs, or nut butters
- Limit meat, fish, and poultry intake to 4 to 6 oz./day
- Choose healthy portions to attain desirable body weight
- Weight loss if needed.
After the holiday season, no one wants to suffer from an unwanted gout attack. The American College of Rheumatology acknowledges that medications are the most effective way to treat gout symptoms, and that diet and lifestyle modifications alone are not likely to prevent gout attacks. However, one can still have a meal fit for a king while following some simple dietary guidelines as listed above. This may help protect against attacks as well as prolong symptom-free periods.
Should you experience foot or toe pain, it is best to see your local podiatrist quickly since medications are appropriate for an acute attack. This will allow you to enjoy your holiday season pain-free.