Gout Attacks Aren’t Just in Your Head—They’re in Your Feet

What is Gout?

Gout is a form of inflammatory arthritis caused by a buildup of uric acid crystals in the joints. Uric acid is a byproduct of purine metabolism—purines are substances found naturally in the body and in certain foods like red meat, seafood, and alcohol (especially beer).

In most people, uric acid dissolves in the blood, travels through the kidneys, and exits the body in urine. But for some, uric acid levels build up, forming needle-like crystals in the joints. The result? Sudden, intense pain, often in the big toe.

Symptoms: What Gout Looks (and Feels) Like

A gout flare typically presents as:

• Sudden, severe pain in a joint—most often the big toe, but it can affect the ankle, knee, or other joints.

• Redness and swelling over the joint.

• Heat and tenderness, often so intense that even the pressure of a bedsheet can be unbearable.

• Limited range of motion due to pain and inflammation.

Symptoms often come on overnight and may resolve within a few days to a week—but without treatment, flares can become more frequent and last longer.

Diagnosis in the Podiatrist's Office

In my clinic, diagnosis is primarily clinical. I look for:

• Rapid onset of pain and swelling, typically in the big toe

• Redness and warmth over the joint

• History of similar episodes, diet, alcohol use, or kidney issues

In some cases, I’ll order blood tests to check uric acid levels or imaging (like X-rays or ultrasound) to rule out other conditions or look for tophi (crystal deposits in soft tissues).

Treatment Options for Gout

Acute Gout Flares:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Like ibuprofen or naproxen.

• Colchicine: A medication specifically for gout that can reduce inflammation if taken early.

• Corticosteroids: Either oral or injectable, useful when NSAIDs or colchicine aren't an option.

Long-Term Management:

• Uric acid-lowering medications: Allopurinol or febuxostat can help reduce future flares.

• Lifestyle changes:

  • Limit purine-rich foods and alcohol.

  • Drink plenty of water.

  • Maintain a healthy weight.

• Regular monitoring: Blood tests to check uric acid levels.

Prevention: How to Keep Gout at Bay

Preventing gout flares is just as important as treating them. Here are key steps I recommend to my patients:

1. Maintain a Healthy Diet

• Limit red meats, shellfish, and organ meats

• Avoid high-fructose corn syrup (commonly found in soda)

• Reduce or eliminate alcohol, especially beer

• Emphasize vegetables, low-fat dairy, whole grains, and lean proteins

2. Stay Hydrated

• Drinking plenty of water helps flush excess uric acid from the body.

3. Maintain a Healthy Weight

• Losing excess weight can lower uric acid levels and reduce the risk of flares.

4. Monitor Medications

• Review any medications with your doctor, especially diuretics or aspirin, to see if they may be contributing.

5. Regular Check-Ups

• Routine bloodwork can help monitor uric acid and catch problems early.

When to See a Podiatrist or Healthcare Professional

You should seek medical attention if:

• You experience sudden, intense pain in your foot or toe.

• The joint becomes red, swollen, and warm with no known injury.

• You have repeated flares or a history of gout and your symptoms are worsening.

• You’re unsure if it’s gout or another condition—proper diagnosis is essential.

• You notice hard lumps under the skin (called tophi)—these are signs of chronic gout and require specialized care.

As a podiatrist, my role goes beyond just treating pain—we focus on protecting your mobility, identifying risk factors, and creating a long-term care plan to keep your feet healthy.

If you’re in the DFW or Plano area and dealing with joint pain, stiffness, or limited mobility, it could be signs of gout. Early diagnosis is key. Contact our Plano office today with Dr. Gireesh Reddy or Dr. Sirisha Pokala by calling (469) 573-3427 or by booking an appointment online.