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Foot Gout — Management, Causes, Symptoms, and Treatment

Dr. Steven Miller

Reviewed by
Dr. Steven Miller

Gout is a form of arthritis that affects the joints, mainly the one located at the base of the big toe. Gout primarily affects the foot and toes, but it can affect any joint in your body, including your toes, wrists, elbows, heels, fingers, and ankles.

This condition is often very painful. Many patients describe gout as feeling like their toe is on fire. Gout occurs when deposits of uric acid crystals in a joint cause painful inflammation. Uric acid is a waste product that normally passes through the kidneys and leaves through our urine.

When too much uric acid is produced—that is, when new uric acid is produced faster than old uric acid can be disposed of—the result can be gout.

A gout flare (attack) causes swollen, red, hot, stiff joints and intolerable pain. Gout mainly affects men, but studies show that women become increasingly susceptible to the condition after menopause.

Initially, foot gout flares up and goes away within days. But if the condition worsens or is left untreated, the flare-ups last longer and occur more often. Normally, a person’s uric acid range is 2.6 to 7.8 milligrams per deciliter (mg/dL).

Gout occurs when uric acid builds up in your blood. High levels of uric acid in your body can also cause kidney stones and permanent joint or kidney damage. Gout most often occurs in people over the age of 30.

Foot Gout Symptoms to Watch For

Foot gout usually occurs suddenly, often at night. In most cases, flare-ups happen without warning. The best way to catch foot gout in its early stages is by knowing the symptoms. Symptoms of gout include:

  • Acute, intense pain within the joint
  • Discomfort for days after the severe pain subsides
  • Inflammation or swelling in the joint
  • Redness
  • Sensation of heat within the joint

People who suffer from this condition on a regular basis typically know the symptoms of gout and know to seek treatment at the first sign of a flare-up. Sometimes the symptoms are severe enough to bring on a fever of up to 101°F.

foot gout

Why Do I Have Gout?

Gout is caused by a build-up of uric acid in your blood, a condition called hyperuricemia. When a person’s uric acid levels rise, so does the risk of a gout flare-up.

Uric acid is always present in our blood, and it is eliminated when we urinate. When someone has gout, the uric acid builds up and crystallizes within the joints.

Foot gout can also be attributed to heredity. The National Institute of Arthritis and Musculoskeletal and Skin Diseases conducted a study showing that 18 percent of people who develop gout have a family history of the condition.

Numerous other medical conditions also increase the risk of developing gout. These conditions include:

  • Diabetes
  • Obesity
  • Kidney disease
  • Sickle cell anemia

Other risk factors for developing gout include:

  • Alcohol consumption
  • Consumption of foods rich in purine
  • Exposure to lead in the environment
  • Being male
  • Medication

When you drink alcohol, you increase the concentration of uric acid in your body. When this happens, you increase your risk of developing gout. Abusing alcohol can also affect other parts of your body, including your kidneys, which are responsible for eliminating uric acid.

Certain medications such as aspirin, diuretics, and levodopa can also interfere with your body’s ability to remove uric acid, causing a build-up.

How is Foot Gout Diagnosed?

If you are experiencing sudden bouts of intense pain in your joints, or if you feel you are experiencing the symptoms of foot gout, you should see your doctor immediately. Early detection can improve your chances of catching the gout during its early stages and successfully treating the condition.

Your doctor will perform a number of tests on you and ask questions about your family history, medical history, personal habits, and diet. He or she may also perform a joint fluid test. During this test, a needle is used to draw fluid from your affected joint for analysis. Your doctor may also order a blood test to measure your uric acid levels.

How Can I Treat My Foot Gout?

Gout is easily treated. The main goal of treatment is to lower the uric acid levels in your body, decrease pain and other symptoms, and prevent further attacks or flare-ups.

If you only experience one episode of foot gout, your doctor may recommend a non-steroidal anti-inflammatory drug other than aspirin, such as ibuprofen or naproxen.

Aspirin is not used to treat gout because if can interfere with the excretion of uric acid crystals in your urine. Doctors have several ways to treat your gout, including:

  • Anti-inflammatory medications or injections to reduce pain, swelling, and inflammation
  • Corticosteroid injection into affected joint to reduce inflammation
  • Suggesting a change in diet to eliminate or reduce intake of foods and beverages that are high in purines and protein (e.g., organ meats such as liver or kidneys, peas, beans, and large amounts of red meat) because protein can increase your uric acid level
  • Encouraging the patient to drink plenty of fluids each day, especially water
  • Explaining the importance of avoiding alcoholic beverages
  • Requiring you to stay off your feet
  • Cold compresses

It is very important that you talk to a doctor if you are experiencing foot gout symptoms or a flare-up.

Symptoms will generally subside within three to ten days with treatment. If the problem is left untreated, or if gout continues to occur with treatment, the uric acid buildup can eventually cause arthritic damage to your joint.

In severe cases, your doctor may recommend surgically removing the uric acid crystals from your joint.

During a Foot Gout Flare-Up

If you are experiencing a gout flare-up and are unable to reach your doctor, there are a few things you can do to help reduce the symptoms:

  • At the first sign of symptoms, take ibuprofen or naproxen
  • Drink plenty of water
  • Rest and elevate your foot immediately
  • Place cold compresses on the affected area
  • Call your doctor or contact a friend who may be able to take you to a doctor

How You Can Manage and Prevent Foot Gout

Regardless of whether you have ever suffered from gout, you should know that managing the condition is not as simple as taking medication during a flare-up. You should talk with your healthcare provider about your lifestyle, diet, and overall health.

You may need to make changes in your lifestyle to prevent recurrence. You should always keep personal records of gout attacks to discuss with your doctor.

Exercising, eating healthy, maintaining an average weight, and avoiding things that increase your uric acid levels are all essential to preventing and managing gout.

Talking to Your Doctor

Here are some questions you may want to ask your doctor about gout:

  • What changes can be made in my diet to reduce flare-ups?
  • Will surgery rid me of gout forever?
  • Based on my lifestyle, what are the chances of gout recurring?
  • How long will it take to reduce symptoms?
  • What new symptoms should I watch for after treatment?
  • If my gout returns, what diagnostic tests will be administered?

Medical References:

  1. Arthritis Today, Gout - What is Gout - Gout Treatment, http://www.arthritistoday.org/conditions/gout/all-about-gout/what-is-gout.php
  2. U.S. Library of Medicine, Gout, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/
  3. American Medical Association "Family Medical Guide" 4th Edition (John Wiley & Sons, Inc. 2004) 149; 1004-1005
  4. H. Winter Griffith, MD "Complete Guide to Symptoms, Illness & Surgery" (The Berkeley Publishing Group, 2006) 340
  5. M. Beers "Merck Manual of Medical Information" 2nd home edition (Pocket Books, 2003) 391-394; 90

This page was last updated on November 20th, 2015



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