Important Facts You Need to Learn About Gout

Written by Bianca Charles on January 24, 2020

Last updated March 20, 2024

Gout is an inflammatory disorder caused by high levels of uric acid in the blood. Uric acid crystallizes in the form of urate crystals in the joints of hands, feet and elbows. Gout affects roughly 3 million Canadians each year.

Causes

Gout is caused by a combination of environmental and genetic issues. Most commonly, environmental triggers include diet with foods that have high levels of purines which then break down into uric acid. Foods that can lead to high levels of urate are red meats, seafood, refined or processed carbohydrates, sugary drinks and alcohol such as beer and hard liquor.

Gout was often called the “disease of kings” as only wealthy people would be afflicted due to their rich diet and excessive drinking. The most famous king to be afflicted with chronic gout was King Henry VIII. Genetic factors such as hyperuricemia can impact the frequency of gout attacks.

Hyperuricemia occurs when your body does not filter urate properly from the bloodstream, either from the kidneys or the gut. Another common issue is if your body doesn’t break down sugars properly, this can affect how urate is stored. The risk of gout increases with age, particularly in women. The role of estrogen helps to regulate urate in the body so after menopause, urate levels in women increases drastically. Certain medications may also lead to hyperuricemia, such as diuretics and cyclosporine.

Finally, conditions linked with hyperuricemia are high blood pressure, kidney disease, thyroid disease, diabetes and sleep apnea.

Symptoms

While your body is producing high levels of uric acid this stage is called Asymptomatic gout as there are no signs or symptoms. The next stage is Acute intermittent gout and it starts off with a painful swelling in the joint often in the middle of the night. Most people wake up with the feeling their joints or foot is on fire. Gout most commonly affects the joint of the big toe because urate crystals deposit at the furthest joint in your body – gravity also plays a role. However, gout can affect any joint, the ankle and elbow are also commonly affected joints. The pain and swelling of the joints is likely to be severe for the first 4-12 hours and then a lingering pain or discomfort can last for weeks. The affected joints are also noticeably different with a red, swollen, tender and warm appearance. As gout progresses and is left untreated, the range of motion of the joint is also limited due to the swelling and deposits of hard urate crystals lumps called Tophi which damage and affect the joint structure and the surrounding skin.

Gout vs. Rheumatoid Arthritis

Rheumatoid arthritis (RA) can have similar symptoms as gout but the causes are different. RA is an autoimmune inflammatory condition where your own body attacks healthy synovial cells inside your joints. This attack causes inflammation, pain and swelling and most often attacks the hands, wrists, ankles and knees.

Tests

Gout can be diagnosed clinically with the appearance of a red, hot and swollen joint but as well as the timeframe. Your family doctor will also check for urate crystals by running tests on the fluid from your joint, blood work and possibly order an x-ray.

Treatment

Depending on the stage of gout, your family doctor will prescribe medication to either help with the pain and swelling or to prevent further attacks. Medication to help relieve pain and swelling are NSAIDS, specifically Indomethacin, colchicine and possibly corticosteroids. These drugs are often prescribed for acute gout attacks.

For chronic gout, medications to help prevent further attacks are allopurinol and probenecid. Along with medication your family doctor will advise you to make some lifestyle changes such as reducing alcohol intake, losing weight and quitting smoking.

After a gout attack, it is advised to visit a chiropodist to assess the range of motion at the affected joint and see if your gait has been altered and affected.

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About Author: Bianca Charles

With 15 years of dedicated experience in podiatry, Bianca Carter offers a wealth of knowledge and expertise at Feet First Clinic. Throughout her career, Bianca has worked closely with leading chiropodists, continually deepening her understanding of all aspects of foot care.

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August 12, 2024

Managing Bunions: Treatment Options and Lifestyle Tips for Relief

Dealing with bunions can be a pain—literally. For those managing bunions, finding effective solutions can greatly improve quality of life. Let's dive into various bunion treatment options and explore lifestyle tips that can help alleviate discomfort and prevent further issues. Bunion Treatment Options: Finding What Works for You When it comes to managing bunions, there's no one-size-fits-all approach. Remember, they are bony protrusions and can vary in pain level and size. While they can occur in both men and women, they are most common in women. Non-surgical bunion treatment is often the first line of defense. Non-Surgical Bunion Treatment Ill-fitting and unsupportive footwear - particularly narrow shoes and high heels - is one of the most common causes of bunions. A chiropodist can suggest footwear for bunions that provide ample toe space and cushioning. They'll help you discover fashionable footwear for sensitive feet from your local Toronto foot clinic. Additionally, they can do a biomechanical assessment to determine if custom orthotics can help manage the bunion's progression and reduce your pain. A chiropodist can also recommend bunion cushioning techniques and products, such as: Silicone toe separators Bunion aligners Rigid, yet walkable, bunion splints These non-invasive measures can help reduce pressure on the affected area and offer bunion pain relief. Lifestyle Tips For Bunion Relief and Preventing Bunion Progression As with any foot condition, lifestyle changes go a long way! Implement simple bunion exercises into your routine to strengthen the muscles around the joint. To give it your best shot, refer to these 5 simple exercises for bunions! It is also strongly recommended that you avoid high heels. If you have a special event, visit your local foot clinic to talk about comfortable heel and wedges you may be able to wear, for a limited amount of time. In addition, avoid activities that put excessive pressure on your feet, such as long periods of standing on hard surfaces. You can try beginner-level, low-impact yoga to keep moving, but make sure it isn't too intense for your feet. Surgical Solutions In severe situations, bunion surgery from a podiatrist or orthopaedic surgeon can offer significant relief. Surgery realigns the toe joint, providing a long-term solution and eliminating the need to accommodate the bunion at all times. However, it's crucial to consult with a healthcare professional to determine if surgery is the right step for you. Most of the time, surgery is only an option for severe bunions as it can be a lengthy and inconvenient process for you. In addition, there's no guarantee the bunion will not return: some studies indicate a reoccurence rate of up to 25% after bunion surgery. It's important to note that bunion surgery alone isn't going to permanently get rid of your bunions: you still need to do non-surgical bunion treatment options after surgery to prevent reoccurence, namely: Wear proper fitting footwear and avoid high heels Strengthen and condition the muscles in your feet and ankles Address any underlying biomechanical issues to reduce pressure and strain on the affected joint.

July 25, 2024

What’s A Crossover Toe: Understanding Causes, Symptoms, and Treatment Options

Foot pain can be debilitating, affecting our ability to walk, exercise, and perform daily activities comfortably. One common foot condition that causes discomfort and requires attention is crossover toe. This blog post delves into crossover toe, its symptoms, and available treatment options. First off, we'll explain exactly what is a crossover toe. What is a crossover toe? Crossover toe, also known as floating toe or floating fifth toe, is a type of deformity in which the toe drifts out of its normal position and crosses over or under a neighbouring toe. The condition is also known as overlapping toe. The condition generally affects the fourth and fifth toes, leading to pain, swelling, and difficulty wearing shoes comfortably. However, any combination of toes may become an overlapping toe. Roughly 7% of adults—men and women equally — have overlapping toes of some sort. Symptoms of crossover toe Toe pain: Discomfort is often felt at the base of the affected toe, especially when walking or standing for long periods. Swelling and inflammation: The affected area may become swollen and inflamed due to the abnormal positioning of the toe. Uncomfortable shoe fit: Shoes may feel tight or uncomfortable, especially in the toe box area where the affected toe rubs against adjacent toes or the shoe itself. Visual appearance: The affected toe may appear to cross over or under the adjacent toe, giving it a visibly different appearance than the other toes. Corns: Corns will often form on top of crossover toes due to excessive friction and rubbing on the affected toes. Causes of crossover toe Crossover toe can develop due to several factors, including: Foot injuries: Joint and ligament damage caused by unhealed trauma and foot injuries can change the toes' alignment over time. Additionally, arthritis, including rheumatoid arthritis, can shift the alignment of your toes as it progresses and damages the joints. Foot structure: People with high arches or flat feet are prone to developing overlapping toes. Genetics: Overlapping toes may also be inherited. Many conditions that make one prone to developing an overlapping toe, like arthritis and Morton's toe, have genetic contributing factors. Improper footwear. Wearing shoes that are too short, too narrow or too tight can force the toes into an unnatural position and curl up, which will ultimately lead to the development of a crossover toe. Treatment options for crossover toe Footwear adjustments: Proper-fitting footwear is one of the most important ways to manage a crossover toe. Switching to shoes with a wider toe box can ease pressure on the affected toe and reduce discomfort. You should also make sure you have sufficient space at the end of your shoes (typically 1 cm) for your toes to properly splay. If shoes are too short, your toes will curl up. Many companies, like ASICS, APEX and Saucony, offer a wide-width options to give your feet the extra room it needs. Shoes with a mesh or soft upper are also recommended, as this will reduce pressure and friction on the top of the toes. Orthotics Custom orthotic inserts or pads can help support the arch and redistribute pressure across the foot. This can help promote proper toe alignment and reduce pressure on the crossover toes so that they don't get worse. Foot and Toe exercises: Performing specific exercises to strengthen the muscles and tendons around the toes can improve flexibility and prevent the condition from progressing. Splinting or taping: A foot specialist can tape the affected toe to encourage proper alignment and reduce pain. You can also buy a splint or toe spacer to help stabilize and align the toe. Corn and Callus Treatment: Since crossover toes are extremely prone to corns and calluses, it is very important to see a licensed chiropodist for routine foot care. A chiropodist can safely debride any corns and calluses on your crossover toe, which will reduce pain and irritation.

July 18, 2024

Morton’s Toe: When Your Second Toe Is Longer Than Your Big Toe

Feet come in all shapes and sizes, and while many people have heard of common foot conditions like bunions or flat feet, there's another lesser-known but equally interesting foot characteristic called Morton's foot or Morton's toe. The condition occurs when the second toe is longer than the big toe, leading to potential biomechanical implications and foot-related issues. Let's delve into Morton's Foot, its potential effects on foot health, and how to manage it. What is Morton's foot/toe? Morton's Foot, also known as Morton's toe/foot or Greek foot, is a foot structure in which the second toe is longer than the big toe. The big toe is the longest in a typical foot, followed by the second toe. (Despite sharing the same name, Morton's neuroma and Morton's toe are not the same.) However, in individuals with Morton's foot, the second toe extends beyond the big toe, sometimes significantly. The condition is quite common. As many as 40%+ individuals have a longer second toe than a big toe. Potential biomechanical implications But here's the twist: while Morton's foot is generally considered a variation of normal foot anatomy rather than a medical condition, it can have some surprising biomechanical implications that affect gait and foot function. Let's explore these potential issues associated with Morton's foot. Added pressure on the second toe The longer second toe may bear more weight during walking or standing, leading to increased pressure and potential discomfort or pain in the ball of the foot, which may contribute to clawing of the toe and hammertoes. Gait changes Morton's foot can alter the distribution of weight and pressure across the foot, potentially affecting gait mechanics and posture. This may contribute to overpronation, increasing the risk of injuries such as plantar fasciitis, shin splints and bunions. Footwear challenges Finding the right footwear can be a real challenge for individuals with Morton's foot. Shoes often fail to comfortably accommodate the longer second toe, leading to issues such as rubbing, irritation, or the development of thickened or ingrown toenails, corns or calluses on the affected toe. How to manage Morton's foot While Morton's Foot may not require medical intervention, there are steps individuals can take to manage associated discomfort or mitigate potential issues proactively: Choose footwear wisely. Opt for shoes with a wide toe box to comfortably accommodate the longer second toe—Asics is a great choice for a roomier and wider toe box. Avoid narrow or pointed shoes that can squeeze or crowd the toes. Consider orthotic support. Custom orthotic inserts or insoles can offset pressure on the toes and support the foot. This can alleviate any discomfort associated with Morton's Foot and improve your overall foot mechanics. Foot-strengthening exercises. Engaging in exercises to strengthen the muscles of the foot and ankle can help improve stability and support, reducing the risk of overuse injuries or discomfort associated with Morton's foot. Regular foot care. Practicing good foot hygiene and monitoring for signs of irritation or injury can help prevent complications such as corns, calluses, or ingrown toenails on the longer second toe.

July 15, 2024

Aging Feet: Common Changes and How to Adapt

Just like the rest of your body, your feet change with age. There are many age-related foot conditions that can target anyone at any time, but are more likely to occur in our golden years. With proper care, foot health in older adults doesn’t have to be too challenging and your aging feet can step out in downtown Toronto with confidence (and more importantly, in comfort). Why Aging Feet Become Vulnerable Studies show that one of the reasons musculoskeletal foot conditions, toe deformities and ankle problems are more common in older adults aged 65-74 is due to ill-fitting footwear. Poorly fitted shoes not only wreak havoc on your feet, but if you’ve worn them for double the amount of years a younger adult has, then they’ve had more time to cause foot issues! The math speaks volumes and is one of the many reasons wearing good shoes from a young age is so important. A change in size and shape also signifies your feet are getting older. Your body’s ligaments and tendons lose their ability to “spring back” which causes fallen arches (flat feet). This also relates back to ill-fitting footwear; if you aren’t aware of your foot changes, you can wear shoes that are too small without realizing it. Your skin also becomes thinner when you get older, and your nails more brittle and fragile. Your toenails can also get thicker, but not in a healthy way. Their weakening can invite unwanted problems like fungal infections and skin conditions. Lastly, it's only natural for a little wear and tear to set in after years of walking on your feet - after all, we only get one pair! This can cause degradation in many of the 33 joints in the foot. Common Foot Ailments In Elderly People: Bunions Hammertoes Plantar fasciitis Osteoarthritis Gout Type 2 diabetes and diabetic neuropathy (commonly occurs after age 45) Calluses Corns Toenail fungus Elderly-onset rheumatoid arthritis (a different type of RA than the one that targets younger adults) Foot Care Tips and Footwear For Seniors Managing foot problems and caring for aging feet is achievable when you do the following: Wear shoes that fit well! Many foot conditions feel better and more manageable when you wear orthopedic shoes, shoes for sensitive feet or the best shoes for seniors. Also, find shoes with the right level of shock absorption to protect your joints. Consider custom orthotics. Perform regular, low-impact exercises and stretches to keep your feet strong and flexible. Yoga and swimming is a great idea, but there are also exercises for arthritis. Keep your feet clean and moisturized. Get medical pedicures to maintain your nail health. Manage conditions like gout with proper dietary health and learn the role of nutrition in foot health. Try other products and medical devices like bunion pads, correctors, etc. Learn more about age-defying foot care.

July 1, 2024

Gout and Dietary Health: What to Eat to Manage Flare-Ups

Gout is one of the most painful foot conditions and types of arthritis. It also has a deep connection to the foods and drinks you consume on a regular basis. The benefits of good nutrition are two-fold: they can help with gout prevention and manage your flare-ups. Let’s look at the science behind a gout diet, what to avoid, and what delicious and nutritious foods you can add to your daily menu. Gout and Dietary Health: What to Avoid Gout management and prevention through diet mainly involves avoiding purine. This is a chemical compound found in food and drink. It leads to high uric acid levels (hyperuricemia) that then form the crystals around the joints that trigger inflammation and ultimately result in the onset of a gout attack. Arthritis-Health tells us there is no way to fully avoid purine since it is found in the cells of virtually everything we consume. But you can maintain a low-purine diet by avoiding foods and drinks with high levels. One of the main culprits is alcohol. Not only does it contain a lot of purine, but it can prevent your body from metabolizing and eliminating uric acid. Beer has the most purine compared to spirits and wine. However, fortified wine, stouts and ports are also high in purine. Other drinks to sip sparingly include high-sugar juices and sodas — there is a lot of purine in high-fructose corn syrup! When it comes to food, seafood like sardines, anchovies and shellfish are full of purine, as are red meats, organ meats and processed meats like hot dogs, salami, etc. Of course, everything in moderation is key, but these proteins should be avoided when you have other alternatives. The Best Gout-Friendly Foods The word "diet" can be frustrating because it represents restriction. But sometimes for our health, we have to do what's best for us. This is the case for a gout diet. Remember, the lifestyle changes you make to control this condition don’t mean that you can’t enjoy delicious foods. Here is a list of just some of the nutrient-dense and low purine foods you can have: Eggs Nuts and legumes Fresh fruit with natural sugars. Be careful of preserves, packaged, or canned fruits as they often sneak in high-fructose corn syrup. Tomatoes Poultry Salmon Leafy greens Popcorn Whole grains Low-sugar desserts When planning your new menu, you may be surprised to see a lot of healthy foods, like mushrooms, asparagus and cauliflower, have moderate purine levels. It’s okay to eat them on occasion. Another simple thing you can add to your diet to prevent gout flare-ups is to drink enough water! The Arthritis organization recommends a daily intake of 8 cups of water and to increase your intake to 16 glasses if you are experiencing a flare up. Click here to learn what foods are great for general foot health; just be sure to double check purine levels.

June 6, 2024

Toenail Thickening: Why it Happens as We Age

Our feet and toes change in various ways as we age. One of these changes is toenail thickening. For some of us, toenail thickening can be more than just a minor inconvenience. It can make it difficult to cut and maintain our toenails, and can even cause pain and discomfort. In this article, we'll explain the causes of thickened toenails, and some possible treatments. Why Do Toenails Thicken with Age? Nails are made from a protein called keratin, which is produced at the nail plate at the base of the nail. Nail growth happens when nail cells multiply within the base of the nail and are pushed forward. However, as we age, the growth rate slows down, so the nail cells just pile up on top of each other, which causes them to get increasingly thicker. Toenail thickening is often a result of several factors: Reduced blood circulation The most common cause of toenail thickening is decreased blood circulation to our feet. This diminished circulation means fewer nutrients and oxygen reach the toenails, causing them to thicken over time. Age is one of the risk factor for reduced blood circulation to the feet. Natural wear and tear Years of use can damage our toenails. Factors such as ill-fitting shoes, repetitive stress from activities like running or walking, and even minor trauma can contribute to thickening. Essentially, when our toenails experience trauma, they thicken to protect themselves. As we age, wear and tear on our toenails can accumulate, which can cause them to thicken. Fungal infections Older individuals are more prone to fungal infections of the toenails, which can cause thickening, discoloration, and brittleness. These infections often thrive in warm, moist environments like sweaty shoes or communal areas. Underlying health conditions Medical conditions like psoriasis, diabetes, and peripheral arterial disease can also influence toenail health. These conditions affect circulation, which in turn slows toenail growth and causes toenails to thicken. Tips for toenail care as you age As you age, proactive steps can be taken to maintain healthy toenails and minimize thickening. By following these tips, you can feel more in control of your foot health and well-being. Regular trimming Toenail thickening can make trimming and maintaining your toenails extremely difficult. Fortunately, a licensed chiropodist is trained to specifically deal with this. A licensed chiropodist can ensure your toenails are trimmed properly to prevent ingrown toenails, promote healthy toenail growth and reduce thickening. A licensed chiropodist can also use special tools over the toenail to thin it out, which will make the toenail easier to cut and maintain. Best of all, this is all done in a sterilized environment, so you don't need to worry about fungal infections (did you know 52% of people get fungal infections after visiting nail salons?) If you decide to trim your toenails at home, make sure you invest in quality toenail clippers and avoid cutting them too short. Proper foot hygiene Wash your feet daily with soap and water, ensuring they dry thoroughly, especially between the toes. Also, wear flip flops in public spaces to avoid contracting fungal infections. Comfortable footwear Choose shoes that fit well and provide adequate support. Avoid narrow or tight shoes that can put pressure the toenails and contribute to thickening. Moisturize regularly Apply moisturizer to your feet to keep the skin and nails hydrated. This can prevent cracking and thickening of the toenails, especially in dry climates. Foot protection Wear protective footwear in risky environments like communal areas or outdoors. This can help prevent injury and reduce the risk of fungal infections. Manage underlying conditions If you have underlying health issues like diabetes, it's important to remember that they can be effectively managed. By working closely with your healthcare provider, you can improve foot circulation and reduce the risk of complications like toenail thickening.

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Important Facts You Need to Learn About Gout

Causes

Symptoms

Gout vs. Rheumatoid Arthritis

Tests

Treatment

Everything You Need for Healthy Feet - All Under One Roof

About Author: Bianca Charles

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Related Posts

Managing Bunions: Treatment Options and Lifestyle Tips for Relief

What’s A Crossover Toe: Understanding Causes, Symptoms, and Treatment Options

Morton’s Toe: When Your Second Toe Is Longer Than Your Big Toe

Aging Feet: Common Changes and How to Adapt

Gout and Dietary Health: What to Eat to Manage Flare-Ups

Toenail Thickening: Why it Happens as We Age

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