Gout Specialists
Podiatrists in Woodbury Heights, Haddon Heights, Voorhees, & Pine Hill, NJ
Prime Foot and Ankle Specialists provide expert diagnosis and treatment of Gout, relieving long-term pain.
This condition is an inflammatory arthritis caused by the buildup of uric acid crystals in the big toe. It is caused by "hyperuricemia," where too much uric acid is in the body. There are multiple potential causes for increased uric acid, including:
Being male and/or obese
Consume foods high in purines, e.g., red meat, organ meat, and certain seafood (tuna, trout, scallops, muscles, sardines, and anchovies)
Excess alcohol consumption
Excess fructose consumption
Certain medications, such as diuretics or cyclosporine
Certain health conditions, e.g., congestive heart failure, hypertension, insulin resistance, metabolic syndrome, diabetes, poor kidney function
It is often hereditary, with specific genes increasing susceptibility. Environmental factors, particularly diet, trigger the disease.
Gout Symptoms
It occurs in "attacks" that can last days or weeks, followed by long periods of remission — weeks, months, or years. The big toe is almost always involved. However, you can also experience it in the ankle, feet, and knee.
Symptoms affecting the joints include:
Intense pain
Swelling
Redness
Heat
If left untreated, it can become chronic. Uric acid buildup doesn't solely affect the joints. Hard lumps known as "tophi" eventually develop in your skin, soft tissue, and joints — and can cause permanent damage.
Diagnosing Gout
Most cases are diagnosed based on the history and examination alone. However, certain tests can help confirm the diagnosis — especially when the disease occurs somewhere unusually, like in the ankle, feet, or knee.
Diagnostic tests can include:
Joint fluid test. A needle is used to aspirate fluid from the joints. Under a microscope, urate crystals will be visible.
Blood test. Your doctor will order a blood test to measure uric acid levels in your blood. While high uric acid levels and the appearance of it in the ankle or feet are characteristic, high levels do not always cause this condition.
X-ray. Joint X-rays can help exclude other potential causes of joint inflammation.
Ultrasound. Sound waves can detect urate crystals in the joints or tophi.
Gout Treatment
The treatment works in two ways — relieve the initial pain and inflammation or prevent future attacks by reducing uric acid levels. If left untreated, this condition will eventually lead to gouty arthritis.
Treatment for short-term relief includes:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve).
Colchicine
Corticosteroids
These medications primarily work by relieving inflammation in the joints until the pain subsides. Afterward, your doctor is likely to prescribe a long-term, preventative Gout treatment, including:
Xanthine oxidase inhibitors, such as allopurinol (Lopurin, Zyloprim) and febuxostat (Uloric).
Probenecid (Probalan)
Alongside pharmacological treatments, your doctor will likely recommend lifestyle changes to reduce your uric acid levels and prevent future attacks. Common lifestyle advice includes:
Eat healthily. Reducing your alcohol consumption, avoiding purine-rich foods (like red meat, organ meat, and seafood), and overall losing weight can significantly decrease your risk of future flares. It's also advised to quit smoking, as this can exacerbate symptoms.
Get physically active to alleviate symptoms of Gout. Being active for 150 minutes of exercise per week is essential to reduce your weight and improve joint mobility. Choose moderate, low-impact activities like swimming, walking, or biking.
Protect your joints. Further joint injuries can worsen any underlying arthritis. Low-impact activities can help you lose weight without placing too much stress on the joints. Speak to your doctor about your options.
Your doctor may also want to perform a medication review if your prescription is suspected of being a contributing cause. Diuretics, aspirin, and blood pressure-lowering medications (like beta-blockers and angiotensin II receptor blockers) can all increase your risk of flare-ups.
Gout Surgery
Most cases are treated without surgery. However, in chronic cases, the treatment can rely on surgical intervention.
Surgical treatments primarily revolve around the removal of tophi from joints and other places.
These surgical procedures include:
Tophi removal surgery
Joint fusion surgery
Joint replacement surgery
The level of surgery recommended will depend on the extent of the underlying damage, especially in cases where conditions such as Gout may have contributed to joint deterioration.
Talk to our experienced podiatrist for valuable insights and comprehensive information about your options for effective treatment and management strategies.