Have you recently been awakened in the night to an awful pain in your foot, so painful that even having a blanket on your toe is excruciating? Do your joints look inflammed, red, or feel warm to the touch?
Odds are, if you are experiencing this type of pain, then you have gout, a disorder caused by the build-up of uric acid in joints. Uric acid is also the culprit of kidney stones, another painful disorder. Uric acid is found in our bloodstreams, and is typically eliminiated through our urine, but for those who have gout, the acid accumulates and crystals form in our joints. Our kidneys are the ones responsible for breaking down uric acid. Some people also produce too much uric acid and are prone to such disorders.
So why does uric acid tend to build up in our big toe joints? Uric acid is sensitive to temperature changes, and what body part is furthest away from the heart? Your feet! Your feet are the coolest parts of your body since it takes the longest for blood to reach these limbs.
Gout can be an inherited trait, but other conditions can be predispose you to this, including high blood pressure, diabetes, obesity, stress, certain medications and vitamins, surgery, and chemotherapy. If you are taking diuretic medications, certain vitamins, or aspirin, you may notice an increase in gout attacks. Men ages 40-60 years old are most often affected by gout, but it can occur in younger men and women.
Your diet also has a large impact on gout attacks. Foods and beverages that contain a large quantity of purines, like shellfish, organ meats (kidneys, liver), red wine, beer, and red meat are known producers of purines, which create more uric acid.
A podiatrist can diagnose gout by taking personal and family histories, with an examination of the joint. A X-Ray or laboratory test may be needed to make a final decision.
Gout treatment can be non-invasive and severely help with attacks. Your podiatrist will recommend the follow courses of action:
1. Medications to reduce the swelling, pain, and inflammation.
2. A specific gout diet that will help you avoid purines in food.
3. Drink plenty of fluids, which help flush out your system. This includes copious amounts of water.
4. Avoid standing when attacks occur and elevate your foot is possible to reduce swelling.
If these treatments do not work, a podiatrist may need to perform surgery to remove the crystal build-up and to prevent an arthritic joint problem. See your podiatrist for all medical questions.
Dr. Tina Boucher, DPM, is celebrating her fourth year in practice in November, 2010. She has moved to a bigger office and now has on-site X-Rays, the Aetrex Shoe System, and will soon be introducing Electronic Medical Records to ease paper comsumption.
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