My Big Toe Woke Me Up!

Gout is a type of arthritis that occurs when uric acid settles in the joints.  It most often affects the big toe, knee, or ankle joints.  Most often gout symptoms appear in acute gouty attacks with pain that feels throbbing, crushing, or excruciating that starts during the night.  The joint typically feels warm, appears red and hurts to touch (even to lay a sheet or blanket over the joint).  After the first episode, people usually have no symptoms and can go months or years between attacks.  Gout attacks may lead to chronic gouty arthritis.


Gout is caused by higher than normal levels of uric acid in the body.  This can develop from the body making too much uric acid or failing to reduce the levels of uric acid.  If too much uric acid enters the fluid around joints uric acid crystals can form.  It is the crystals that cause the joint to swell up and become inflamed causing the pain.  Not everyone with high uric acid levels has gout.  The exact reason why crystals from is unknown but certain groups are at a higher risk.  Gout may run in families.  It is also more common in males, postmenopausal women, people who drink alcohol, and take certain medicines.


Gout is treated in a few ways.  Doctors typically suggest taking ibuprofen as soon as symptoms begin and may prescribe a strong painkiller for attacks.  If several gout attacks a year, signs of gouty arthritis, or uric acid kidney stone are present, a doctor may prescribe Allopurinol or Probenecid to decrease uric acid levels in the blood.  Some diet and lifestyle changes can also help prevent gouty attacks.  These changes include avoiding alcohol, oils, organ meat, and limiting how much meat is consumed during each meal.  Eating carbohydrates is importing as well as avoiding fatty meals.