Dear Foot Blogger Chick,
I have terrible pain in my big toe! It is amazing how much a toe can hurt. It hurts at the base of my toe and is swollen and red. What could it be? I know that I have not stubbed it lately. It hurts so much that I can’t put on my shoes. What are your thoughts? If it helps, I am male and in my 50s.
Shoeless in Sheboygan
I have many thoughts and some of them apply here. Hmmm… Male and in 50s with a toe joint that really hurts and is swollen. You know how horse racing is the sport of kings? I think that you may have something else that used to be associated with kings – gout.
Gout is really interesting. Yes, I just said that gout was interesting. I don’t know why but when I think of it, I think of scenes of royal men with their toe wrapped up and propped up on a royal foot stool. It seems that because the royals were associated with gluttonous eating that through history they have been associated with gout.
Here is my first gout surprise –
Gout is a form of arthritis. I had no idea. Fortunately, for those who suffer from gout, it is highly treatable. Gout is usually found in men between the ages of 40-60. In 10 percent of the cases, it is found in woman after menopause. Gout is caused by a having a high level of uric acid in your body. It can be hereditary or it can be found in conjunction with other problems like high blood pressure, high cholesterol, diabetes, or obesity.
The high level of uric acid forms crystals that affect the joints. Why do some of us have this high level and others don’t? Well, it is felt that in some people their kidneys are not removing the uric acid or that their bodies are creating too much uric acid, or a combination of both. The disease can be building in your body for years before you have an attack. The first time you have an attack, it can be fairly short lived – maybe 24 -48 hours. But as attacks continue untreated they will get more severe and will last longer. It can lead to deformity of the joint. Gout does not just affect the toe joint. It can also affect the ankle, the finger, the elbow, the wrist, or the knee although usually just one joint at a time.
It is thought that certain foods can help trigger an attack. Shellfish, red meat, turkey, and processed meat seem to be some of the culprits. The biggest trigger is alcohol. So when you think of that king on his throne swigging a giant mug of ale and eating a turkey leg, it is the perfect storm of ingredients for a susceptible male.
When you are having a gout attack, there are medicines both over the counter and prescription that can help. Depending upon the doctor’s evaluation, there are both prescription and behavior modifications that can be made to help prevent further attacks. You know what that means, right. Yes, eat right, lose weight, exercise. Yes, in some cases doing those things that we just resolved to do in the new year will help alleviate gout.
If your doctor has any doubt about whether the inflammation and pain are gout or another type of arthritis, there are two ways to tell. The first is to take a sample of the fluid from between the joint and check it for the presence and level of uric acid. There is also a drug that can be taken for gout that will give quick relief. If you take the drug and feel better, you have gout. If you take the drug and don’t feel better fast, then you don’t.
What is the take away here? Gout is a very painful but treatable form of arthritis. If you are experiencing sudden pain and swelling in a joint, get to the doctor and have it evaluated. The first time it happens, the pain will go away and the tendency (or is it just me) will be to forget about it once it is gone. Don’t do that, go and get it checked out. You want to stop the progression of the disease as soon as possible.
Foot Blogger Chick
If you have questions, don’t hesitate to send them to firstname.lastname@example.org or leave them in the comment section below. I am not a doctor but I check with one before answering questions.
Trivia Question of the week– AARP has a list of seven famous people who have suffered from gout. Of those listed is a photographer known for his work in black and white. Can you name him?
Find the answer on our Facebook page – Evanston Podiatric Surgeons – on Friday, January 18th. While you’re there, please take a moment to “like” us.
Follow us on twitter – @EvPodiatric and the answer will be tweeted on Friday morning as well.
The very nice doctors at Evanston Podiatric Surgeons have opened a new location! They are very excited to have an office on the “Magnificent Mile” in Chicago. So, if live or work downtown, help is even closer! Stop in and say “Hello and Congrats”. They would love to meet you. They are really that friendly!
Mag Mile Foot and Ankle Institute
333 N. Michigan Avenue Suite 1825
Chicago, IL 60601