Gout

We have discussed some previous causes of heel pain such as plantar fasciitis and calcaneal apophysits. One overlooked cause of heel pain is Gout. Commonly we will see gout in the big toe joint. It can also be seen in the heel less commonly. Gout is a build up of uric acid in the body. Some people may tend to overproduce these uric crystals and then there are the people who under produce them and the body is unable to get rid of the uric acid crystals. The uric acid then tends to buildup in joints in the body. This leads to a red, hot, swollen, and inflamed joint. This can be very painful. Typically people may describe the pain so bad that the bedsheets are unable to touch the foot. There are many different causes of gout ranging from genetics, drinking too much alcohol, eating a lot of shrimp, shellfish, and red meat. Certain medications can also cause gout. Most commonly are the water pills such as Lasix and HCTZ. Certain tests can diagnose gout as well. This can be confirmed by a looking at the synovial fluid in the joint and a simple uric acid blood test. However these tests are not always positive. Sometimes in an acute gout attack, the blood test comes back normal. X-Rays sometimes can take years before seeing the erosive changes it can take on a joint.

Untreated, and long term gout can lead to arthritis in the joint. This is why it is important to see your Podiatrist (if affecting the foot) and your Primary Doctor to manage the gout. Early treatment during an acute attack most commonly involves a cortisone injection and anti-inflammatory medicine. This helps dramatically reduce the inflammation within a 12-48 hour window. Long term treatment may consist of being placed on medicine that helps control gout and prevent future flare ups. One thing that must always be done is a diet change. Avoiding alcohol, red meat, shrimp, and shellfish can help prevent future flare ups. Gout was typically called "The Disease of Kings" and "Rich Man's disease" because it was believed back in the day it was caused by an overindulgence of food and drink. But now we know more about what the causes and treatment are of gout and how to avoid it. As always if you are having the above symptoms and are suspicious for gout in your foot please contact your Podiatrist to get some relief
http://www.podiatrycarespecialists.com/