Gout is a condition that occurs when uric acid is present in large amounts in our body. A gouty attack usually presents as a red, hot, swollen and painful joint. Uric acid is a normal byproduct of our body, but when it is present in large amounts it may form crystals in our joints which can cause excruciating pain. High concentrations of uric acid can be due to our body not breaking down uric acid properly or our kidneys failing to rid it from our body in the form of urine. When we eat certain foods like red meat, organ meat and beer we are at increased risk for what we call an acute gouty attack.
Most people have no idea they have gout until they have a gouty attack of the joint leading them to visit a good podiatrist. People with long standing gout can develop arthritis in their joints and may need a doctor in midtown NYC to explain options to alleviate their painful joint. The most common joint affected in gout is the big toe joint thus foot doctors are often the first physicians to diagnose gout.
Gout should always be evaluated with a thorough consultation and examination by your podiatrist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
Common Causes of Gout
The process of digestion creates uric acid when it breaks down purines. Foods high in purines are organ meat, red meat, beer, sardines and other foods and should be limited if you have been diagnosed with gout. If your kidneys are healthy, the uric acid that’s processed is broken down in your blood and passes through your system as waste. If kidneys are not healthy, uric acid can build up and cause problems.
If your body cannot properly break down uric acid or if your kidneys can’t remove enough of it, it builds up in your blood. This condition is called hyperuricemia, and your midtown NYC foot doctor will provide a clinical work up complete with lab testing to ensure a proper diagnosis. Hyperuricemia is not necessarily dangerous by itself, but it can lead to the formation of uric acid crystals, which can end up developing into gout.
Hyperuricemia can be caused (or made worse) by your diet. If you eat too many foods that are high in purine — such as liver, steak, dried beans, anchovies or dried peas — you put yourself at risk. Drinking alcoholic beverages, especially beer, can raise your uric acid levels as well.
Gout often appears without warning and at night. Sudden, intense pain in your big toe is a sign of a gout attack. Gout is sometimes hard to distinguish from an infection because of the similar appearance of the two thus should be evaluated by a good podiatrist. Symptoms that your NYC foot doctor typically observes in gout are:
- Intense joint pain: You first feel it in your big toe, then in your other joints. The most severe pain comes in the first four to 12 hours.
- Lingering discomfort: After the worst pain goes away, some discomfort lingers for a few days to a few weeks. If untreated, the attacks become more frequent and severe.
- Inflammation and redness: Your affected joints are swollen, warm, red and tender.
- Limited range of motion: Your joints become stiff as your gout becomes more advanced.
Make an appointment with a NYC’s leading foot doctor when the first shooting pain appears in your toe. Your primary care physician should refer you to a good podiatrist to assess your condition and prescribe gout treatment.
You are more likely to produce excess uric acid under certain conditions, or if you have certain underlying diseases. Two of the most common risks associated with gout are diet and obesity. Several other factors contribute as well:
- Medical conditions: Untreated high blood pressure and chronic diseases such as diabetes, metabolic syndrome or heart and kidney diseases all can lead to gout.
- Medications: Thiazide, a diuretic blood pressure medicine, and low-dose aspirin, as well as the anti-rejection medications if you’ve undergone a transplant, increase uric acid.
- Age and sex: At higher risk are men between the ages of 30 and 50, although women after menopause, primarily after age 50 also fall into this category.
- Trauma or recent surgery: These two events have been shown to present an increased risk of developing gout.
- Family history: If your relatives have had gout, you’re more at risk to develop the disease.
- Obesity: If you’re overweight, your body produces more uric acid, which puts a strain on your kidneys, greatly increasing your risk of developing gout.
It’s estimated that six million adults age 20 or over have reported having gout at some time in their lives. Your foot doctor in NYC often makes recommendations for changes to your diet and lifestyle to improve your condition, especially if you catch it at an early stage.
The Four Stages of Gout
Gout follows a four-stage progression. Many people do not know they have gout for years before symptoms start. It is important to visit a good podiatrist to lower your chances of developing severe arthritis. The stages of gout are listed below:
- Asymptomatic hyperuricemia: You have high levels of uric acid in your blood, but no symptoms. No gout treatment is required at this stage.
- Acute gout or gouty arthritis: You have sudden attacks of intense pain, mostly at night. You may experience swelling in your joints, caused by the uric acid crystal accumulation. The symptoms are triggered by stress, another illness or alcohol and drugs. You may not have another attack for months or years after the initial attack.
- Interval or intercritical gout: This is the time between acute attacks when you have no symptoms.
- Chronic tophaceous gout: The most serious and disabling stage of gout, it builds over a long period without treatment by a good podiatrist. Ten years or more can pass before you reach this stage. By now, you have permanent joint damage and possibly even kidney damage.
If you get treated for gout at the earliest stages, you’re able to live a normal and productive life with no physical restrictions. The goal of treatment by your midtown NYC podiatrist or foot doctor is to ease the pain of acute attacks, help prevent future attacks, and avoid kidney stones and the formation of tophus nodules.
Treatment aims at preventing the affected joints from further damage. A good podiatrist recommends a course of treatment that works for your particular situation. Often, the first remedy suggested is to lose weight.
Other gout treatments include:
- NSAIDS: Non-steroidal, anti-inflammatory drugs are the most commonly prescribed remedies for the pain and inflammation of gout, but these medicines have no affect on the buildup of uric acid in your body.
- Corticosteroids: Strong anti-inflammatory hormones, most commonly known as prednisone, bring rapid relief from the pain and inflammation of an attack. In a week or so of treatment, you may feel completely better.
- Colchicine: This medication helps alleviate your symptoms when anti-inflammatories don’t help. Your podiatrist or foot doctor in midtown NYC may prescribe this to treat hyperuricemia.
- Other medications: A good podiatrist uses other drugs to treat underlying conditions.
Gout can be controlled through diet and exercise. Lose weight and avoid low-carb, quick-loss diets. Avoid alcoholic beverages. Avoid foods that are high in purines. Your good podiatrist can give you the information you need to stay healthy while you work to control your disease.
All symptoms should always be evaluated with a thorough consultation and examination by your podiatrist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
Important Reminder: This information is only intended to provide guidance, not definitive medical advice. Please consult foot doctor about your specific condition. Only a trained, experienced board certified podiatrist or foot specialist can determine an accurate diagnosis and proper treatment.
Do you have any questions about Gout treatment in NYC? Would you like to schedule an appointment with an internationally recognized, top NYC Podiatrist and foot doctor, Dr. Sophia Solomon of Manhattan Foot Specialists? Please contact our office for consultation.
Dr. Sophia Solomon, Podiatrist (NYC Foot Doctor)
New York, NY 10010
(Between Madison Ave & Park Ave)
☎ (212) 389-9918