Gout – ugh – sounds like a terrible thing to have and a terrible thing to have in your FOOT, especially as a runner.  When you have gout as a close friend had, you need to be careful with your exercise as the resulting swelling can cause a lot of pain.

I turn as I so many times have in the past to Dr. Nicole Hayward, podiatrist on what gout is and what to do:

“Gout is a disorder that results from the build-up of uric acid in the tissues or a joint. It most often affects the joint of the big toe.

Causes
Gout attacks are caused by deposits of crystallized uric acid in the joint. Uric acid is present in the blood and eliminated in the urine, but in people who have gout, uric acid accumulates and crystallizes in the joints. Uric acid is the result of the breakdown of purines, chemicals that are found naturally in our bodies and in food. Some people develop gout because their kidneys have difficulty eliminating normal amounts of uric acid, while others produce too much uric acid.

Gout occurs most commonly in the big toe because uric acid is sensitive to temperature changes. At cooler temperatures, uric acid turns into crystals. Since the toe is the part of the body that is farthest from the heart, it’s also the coolest part of the body – and, thus, the most likely target of gout. However, gout can affect any joint in the body.

The tendency to accumulate uric acid is often inherited. Other factors that put a person at risk for developing gout include: high blood pressure, diabetes, obesity, surgery, chemotherapy, stress, and certain medications and vitamins. For example, the body’s ability to remove uric acid can be negatively affected by taking aspirin, some diuretic medications (“water pills”), and the vitamin niacin (also called nicotinic acid). While gout is more common in men aged 40 to 60 years, it can occur in younger men as well as in women.

Consuming foods and beverages that contain high levels of purines can trigger an attack of gout. Some foods contain more purines than others and have been associated with an increase of uric acid, which leads to gout. You may be able to reduce your chances of getting a gout attack by limiting or avoiding shellfish, organ meats (kidney, liver, etc.), red wine, beer, and red meat.

Symptoms
An attack of gout can be miserable, marked by the following symptoms:

  • Intense pain that comes on suddenly – often in the middle of the night or upon arising
  • Signs of inflammation such as redness, swelling, and warmth over the joint.

Diagnosis
To diagnose gout, the foot and ankle surgeon will ask questions about your personal and family medical history, followed by an examination of the affected joint. Laboratory tests and x-rays are sometimes ordered to determine if the inflammation is caused by something other than gout.

Treatment
Initial treatment of an attack of gout typically includes the following:

  • Medications. Prescription medications or injections are used to treat the pain, swelling, and inflammation.
  • Dietary restrictions. Foods and beverages that are high in purines should be avoided, since purines are converted in the body to uric acid.
  • Fluids. Drink plenty of water and other fluids each day, while also avoiding alcoholic beverages, which cause dehydration.
  • Immobilize and elevate the foot. Avoid standing and walking to give your foot a rest. Also, elevate your foot (level with or slightly above the heart) to help reduce swelling.

The symptoms of gout and the inflammatory process usually resolve in three to ten days with treatment. If gout symptoms continue despite the initial treatment, or if repeated attacks occur, see your primary care physician for maintenance treatment that may involve daily medication. In cases of repeated episodes, the underlying problem must be addressed, as the build-up of uric acid over time can cause arthritic damage to the joint.”

Thanks Nicole and I bow to your expertise on the things that I do not know.

Trials of Miles,

Coach Nick

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You can quickly link to all the rest of my blog posts on foot/leg injuries:

  1. Sesamoid Injuries in the Foot
  2. Shin Splints
  3. Achilles Tendonitis
  4. Ingrown Toenails
  5. Ankle Sprains
  6. PTTD’s – Posterior Tibial Tendon Dysfunction
  7. Plantar Faciitis
  8. Chafing

 

 

 

Nickolas Joannidis
Nickolas Joannidis
I have been running for over 35 years, having done practically every possible racing event or distance from the 100 meters through the marathon. I competed in varsity high school cross country and track at Saddle Brook High School in the mid-1980's, varsity cross country and track at Division II Pace University and finished well over 200 road races since then, including 20 marathons with a lifetime best of 3:14:50. I was the president of the Hoffmann LaRoche corporate running team for 7 years, growing the team from 25 to over 90 during his tenure. I coached many of these runners to achieve their goals, whether they were beginners or advanced. In 2011 I was an assistant coach for the Fair Lawn Recreation track team, helping the 10 to 14 year old group. I am currently personally coaching dozens of runners, from beginner levels to advanced levels and getting them to be prepared to meet their goals.

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