Gout Pain in the Foot

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What is gout?

Gout is the most common type of inflammatory arthritis found in the body.  Gout is caused by the buildup of uric acid crystals in a joint.  The most common area of the body to develop gout symptoms is the foot, especially in the first joint of the big toe.  Pain from gout often comes on suddenly and can last from a few days to a few weeks.  The affected area is often very painful, red, inflamed and warm to the touch. 

The propensity of gout for the foot was recognized by the ancient Greeks who referred to it as podagra, literally “foot-grabber”1

What are possible causes?

Gout is caused by a combination of genetic and environmental factors. When the uric acid levels in the bloodstream are too high, painful crystals may form in the joints.  Uric acid is a naturally occurring substance in the body which is formed from digestion of foods that contain purines. Therefore, foods that are high in purines are one of the major causes of gout.  Some of the other factors that have been implicated in the occurrence of gout include:

  • Male sex
  • Metabolic syndrome
  • Abnormal walking biomechanics2
  • Certain medications (i.e. aspirin and diuretics)
  • Hypertension
  • High alcohol consumption (2 or more drinks per day)
  • Obesity and weight gain
  • Stress
  • Kidney dysfunction
  • Having family members who have gout

Approaches for treatment:

Dietary and lifestyle changes often make the biggest differences in causing and relieving the symptoms of gout. Some of the foods that have been implicated in causing gout include:

  • Red meat
  • Dairy
  • Alcohol
  • Seafood (i.e. canned tuna, sardines, lobster, shrimp)
  • Purine-rich vegetables (i.e. asparagus, spinach, cauliflower)
  • Sugary foods/beverages
  • Coffee
  • Some fruit (i.e. oranges)

Prescription medications such as Allopurinol are commonly prescribed for gout but are not typically seen as good long term solutions to the condition and do have potential side effects.

In addition to dietary changes, some of the other things that may help alleviate gout symptoms include:

  • Decreasing stress – Excess stress will take its toll on the body and increase inflammation.  Having a good, healthy stress reliever can make a big impact on pain and overall well-being.
  • Exercise – Exercise has been shown to decrease stress, decrease inflammation and aid in weight loss.
  • Herbal remedies and dietary supplements – There are many dietary supplements and herbs that may be beneficial in the treatment of gout.7 Some other natural remedies that may improve symptoms include, magnesium, turmeric, celery, cherry juice, ginger, dandelion, and hibiscus.

Can it be helped through chiropractic, PT, Acupuncture?

It depends.  Typically lifestyle modification and dietary changes will have the biggest impact on reduction of symptoms and long term recurrence of gout.  Chiropractors, physical therapists and acupuncturists typically have a significant amount of nutrition included in their college curriculum and are therefore qualified to help make dietary changes to help with the gout healing process.  There is some research that suggests that the treatment of gout with acupuncture may be more effective than with traditional medicine.8 

Is it chronic?

If the cause of gout is not addressed then gout can become a chronic condition.  Luckily, we know what causes the formation of the uric acid crystals in the joints and can therefore take action to make sure this isn’t a condition that becomes chronic.  Many of the comorbidities that are associated with gout will also improve with appropriate lifestyle modification. 

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  1. Roddy, Edward. “Revisiting the pathogenesis of podagra: why does gout target the foot?.” Journal of foot and ankle research 4.1 (2011): 13.
  2. Rome, Keith, et al. “Functional and biomechanical characteristics of foot disease in chronic gout: a case-control study.” Clinical biomechanics 26.1 (2011): 90-94.
  3. Annemans, Lieven, et al. “Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000–2005.” Annals of the rheumatic diseases 67.7 (2008): 960-966.
  4. Thottam, Gabrielle E., Svetlana Krasnokutsky, and Michael H. Pillinger. “Gout and metabolic syndrome: a tangled web.” Current rheumatology reports 19.10 (2017): 60.
  5. Kuo, Chang-Fu, et al. “Global epidemiology of gout: prevalence, incidence and risk factors.” Nature reviews rheumatology 11.11 (2015): 649.
  6. Lee, Won Bock, et al. “Acupuncture for gouty arthritis: a concise report of a systematic and meta-analysis approach.” Rheumatology 52.7 (2013): 1225-1232.
  7. Chan, Marion Man-Ying, Chi-Tang Ho, and Hsing-I. Huang. “Effects of three dietary phytochemicals from tea, rosemary and turmeric on inflammation-induced nitrite production.” Cancer letters 96.1 (1995): 23-29.
  8. Lu, Wei-wei, et al. “Update on the clinical effect of acupuncture therapy in patients with gouty arthritis: systematic review and meta-analysis.” Evidence-Based Complementary and Alternative Medicine 2016 (2016).