Clinical Corner

In our clinical corner this quarter our podiatrist Glen Foley looks at the common condition of Gout.  

Gout is a common and complex form of arthritis that can affect anyone. It’s characterised by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints—most often at the base of the big toe. These attacks can occur suddenly, often waking a person in the middle of the night with the sensation that their toe is on fire.

What Is Gout?

Gout is caused by elevated levels of uric acid in the blood, a condition known as hyperuricemia. Uric acid is a waste product formed when the body breaks down substances called purines, which are found naturally in the body and in certain foods. When there is too much uric acid, it can form sharp, needle-like crystals in the joints and surrounding tissues, leading to inflammation and intense pain.

Common Risk Factors

Several factors can increase your risk of developing gout, including:

• Diet: Eating foods high in purines, such as red meat, shellfish, and sugary drinks.

• Alcohol consumption, especially beer and spirits.

• Obesity, which leads to increased production of uric acid.

• Medical conditions such as hypertension, diabetes, kidney disease, and heart disease.

• Medications, including diuretics (water pills), low-dose aspirin, and certain immunosuppressants.

• Genetics: A family history of gout can increase your risk.

Symptoms of Gout

• Intense joint pain, often starting in the big toe.

• Lingering discomfort after the most severe pain subsides.

• Inflammation and redness around the affected joint.

• Limited range of motion as the disease progresses.

 Attacks typically last 3–10 days and may recur, often becoming more frequent and severe without treatment.

Effective Treatments for Gout

Treatment focuses on relieving acute attacks, preventing future flares, and lowering uric acid levels.

1. Acute Attack Management

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Colchicine: Reduces gout inflammation if taken early in an attack.

• Corticosteroids: Pills or injections to reduce pain and swelling.

• Orthotics & footwear: to offload the joints.

 2. Long-Term Management

• Uric acid-lowering medications: These medications are typically taken after an acute attack has resolved and are used continuously to prevent flares.

 3. Lifestyle and Dietary Changes

• Limit purine-rich foods: Red meat, organ meats, and seafood.

• Avoid sugary beverages and alcohol, particularly beer.

• Stay hydrated to help flush uric acid from the body.

• Maintain a healthy weight and exercise regularly.

• Manage other health conditions like high blood pressure and diabetes.

 While gout can be extremely painful, it is one of the most manageable forms of arthritis with proper treatment and lifestyle modifications. Understanding your risk factors, recognizing symptoms early, and working with your healthcare provider can help you live a full, pain-free life despite the condition.