Gout is a common type of arthritis. The symptoms of gout include painful swelling and inflammation in one or more of the joints due to a build up of excess uric acid crystals. In around 50% of cases gout affects the big toe, but it can develop in any joint in the body.

Gout can be a painful condition which often affects men rather than women. Most commonly it is people over 50 who are affected and it is sometimes described as a ‘disease of the elderly’. Whilst it can occur in young males and females, it is rare. The symptoms of gout include sudden intense throbbing pain accompanied by redness and swelling as well as episodes of attack, with the attacks lasting approximately 3-5 days and these attacks may occur in the middle of the night.

Due to swelling you may benefit from a wider pair of shoes than you normally wear.

Cause

Uric acid is a waste product that is produced during the process of metabolism. If the kidneys are unable to filter the uric acid as normal, and levels become very high, it may crystallize and deposit into joints causing an inflammatory reaction. Gout may be inherited or acquired and even minor foot injury may also trigger an attack of gout. Other contributing factors include obesity, stress and most commonly, over indulgence in alcohol.

Treatment and Prevention

Treatment for gout involves relieving the symptoms of pain and trying to prevent further episodes. The application of ice or cooling lotions during the initial stage of an attack may be beneficial. The application of warm, moist compresses may also be of benefit to relief the symptoms at a later stage of the attack. In the long term, it is recommended that a patient reduces their alcohol consumption as well as avoiding protein rich foods such as liver and kidney. If the symptoms of gout occur, people should seek immediate advice from a registered podiatrist, their general practitioner or a dietician.

A podiatrist would be able to diagnose gout, using a patient history and an examination, an x-ray or a blood test. The podiatrist may recommend a course of medication to your GP which will provide immediate relief from the symptoms. A medication is often used to treat gout and, in extreme cases, the chiropodist may recommend surgery to remove gouty deposits. The outlook for people with gout is good as long as people use their medication as directed and make the recommended lifestyle changes, such as changing their diet and reducing their consumption of alcohol. Over time, many people reduce their uric acid levels sufficiently so that they no longer experience any symptoms.

For persistent sufferers orthoses and shoe stretching can help to alleviate the symptoms, wearing comfortable footwear, protective shields and padding can also relieve pressure from the affected toe.

If the problem persists, consult your clinician.

Verified by Professor Wesley Vernon OBE, Head of Podiatry Service and Research Lead Sheffield Primary Care Trust. Chair of Healthy Footwear Group.