Having a gout flareup in your toe is like having your toe catch fire, and then putting out the fire by slamming it with a hammer.
-- an urgent care clinic patient quoted by Dr. Cranquis' Mumbled Gripes
Years ago, before I was diagnosed with diabetes and neuropathy, unexplained foot and leg pain was a common occurrence. Not being familiar with neuropathy at the time, I tried to guess what was causing the pain.
After being diagnosed with neuropathy, I began to understand that what I was experiencing was nerve pain due to high blood sugar. I now take the drug gabapentin daily, which helps. The pain is also more bearable when I have tighter control on my blood sugar levels.
At one point before my diagnosis, my mother suggested I might be experiencing the symptoms of gout. I had heard of gout, but didn't know much about it.
I know a lot more now.
The website of the U.S. Department of Health and Human Services' National Institute of Arthritis and Musculoskeletal and Skin Diseases (niams.nih.gov) says gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body, which can lead to:
• Sharp crystal deposits in joints
• Deposits called tophi that look like lumps under the skin
• Kidney stones from uric acid in the kidneys
Information on the website of the Centers for Disease Control and Prevention (search cdc.gov/arthritis for "gout") confirms that gout usually affects one joint at a time -- often the big toe -- and it's very painful.
There is no cure, the CDC says, but it can be effectively treated and managed (much like my neuropathy).
Times when symptoms worsen are called "flares." When there are no symptoms, that's "remission." Repeated bouts of gout can lead to gouty arthritis, which means it's getting worse.
Gout can be caused by a condition known as hyperuricemia, which means there is too much uric acid in the body. But hyperuricemia does not always cause gout, so if there are no symptoms, treatment is not required.
Our chances for having gout increase with factors that cause us to develop hyperuricemia. They include being obese, drinking too much alcohol, family history, eating or drinking foods high in fructose, using diuretics or water pills, and having a diet high in purines, which are found in red meat, organ meats and certain types of seafood.
Conditions like congestive heart failure, high blood pressure, diabetes and poor kidney function also carry a risk of gout.
Gout occurs more often in men because women tend to have lower levels of the acid. For men, gout is usually developed between the ages of 30 and 50. Women tend to start having a problem after menopause. Recent surgery or trauma has also been associated with an increased risk of gout.
The signs and symptoms can occur suddenly. It usually begins with intense joint pain in the big toe or the feet, ankles, knees, hands or wrists. The pain will likely be the most severe within the first four to 12 hours after it begins. Discomfort can linger for a few days or weeks.
Later attacks will likely last longer and affect more joints, which become swollen, tender, warm and red. And as the gout progresses, it can cause decreased joint mobility.
The disease should be diagnosed by a rheumatologist, a doctor who specializes in gout and other forms of arthritis. These professionals can recommend treatment and self-management strategies.
Eating a healthful diet and limiting alcohol intake, particularly beer and hard liquor, is a good start. Avoid overeating the high purine foods. Get about 30 minutes of exercise a day. The regular physical activity can also reduce the chronic diseases that put us at risk for getting gout.
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ActiveStyle on 09/11/2017