If you’re familiar with gout,, you probably know this painful condition by how it’s depicted on film, stage, or TV: a rich, aging, overweight man or woman with their foot wrapped in a bandage.
But that visual isn’t completely accurate. Gout isn’t limited to elderly or wealthy people, nor is it always located in the big toe. The more you know about gout, the easier it is to recognize its flares, whether they affect your big toe or not.
Dr. Kimberly Bolling is a compassionate and experienced internist who helps women and men with gout lead pain-free lives. She diagnoses and treats your joint pain at our office in Bowie, Maryland.
Do you think you have gout in your toe or elsewhere? Here’s a brief overview of gout.
While gout has its own distinct name and is a favorite condition to assign to overly fed characters in fiction, it’s actually just one of more than 100 forms of arthritis. Arthritis, in turn, is an umbrella condition that refers to many types of joint pain and dysfunction. In fact, you can have more than one type of arthritis at once, including gout.
Gout earned its name due to early ideas about how the affliction developed. The word “gout” derives from the old French word “gote,” which in turn came from the Latin “gutta,” which meant “a drop.” Old-world physicians believed that gout was caused by drops of morbid or viscous “humors” (bodily fluids) seeping from the blood into the joints, in line with the humoral theory of medicine.
As it turns out, those medieval doctors weren’t far from the truth. Gout is caused by “drops” of uric acid that collect in the joints’ soft tissues and then harden into needle-like crystals. Uric acid is a byproduct of eating foods that are high in a substance called purines.
High-purine foods contain compounds that break down into uric acid, potentially triggering gout flare-ups. Examples include red meat, shellfish, and alcohol.
If you eat too many purines, your kidneys can’t process and excrete them all. Or, your body may produce abnormally high amounts of purines and uric acid due to genetics. The excess uric acid travels in your bloodstream and eventually ends up in your joints’ soft tissues, where they crystallize.
So, if uric acid can travel to and collect in any joint, why does gout tend to develop in big toes? As it turns out, it has everything to do with how far away your big toe is from your heart.
Uric acid is most likely to crystallize at lower temperatures. Joints that are nearest your heart may be too warm to crystallize excess uric acid. But your big toe is the farthest point away from your heart and the coolest part of your body. The temperature in your big toe is just low enough to crystallize uric acid.
Nevertheless, no joint is safe from gout if you tend to consume or produce too many purines. You may be more susceptible to develop gout in other joints if you already have osteoarthritis, rheumatoid arthritis, or another type of arthritis.
Researchers suspect that joints already damaged by arthritis are perfect settings for housing uric crystals. You can develop gout in your:
Usually, gout afflicts just one joint at a time, which is why that stereotypical presentation of gout is a single foot wrapped and elevated, not two. However, it’s possible to have gout in more than one joint at once.
You’re more likely to develop gout if it runs in your family. Other risk factors include:
Gout tends to come and go, unlike other forms of arthritis pain, which is usually chronic. Whether you have another form of arthritis or not, if you notice sharp pains in your joints, be sure to get an evaluation for gout. We may order lab tests and X-rays to diagnose gout.
If you have gout, don’t despair. While you may need to give up some of your favorite high-purine foods, we help you find delicious, wholesome substitutes. We also encourage you to drink plenty of healthy fluids and add as much movement and exercise into your daily routine as possible.
Do you have stabbing pain in your big toe or other joints? Contact our caring team for a gout evaluation today by phoning our team directly at 301-352-0090, or click here to fill out the online appointment form.
