This page on gout foot pain was last reviewed or updated on 13 July 2010.
You have a sharp pain in your foot, and you've wondered if it is gout. But is it? Foot pain is not necessarily a gout joint pain. The pain could be caused by a number of other conditions which can quite easily be confused with gout because of somewhat similar symptoms - the inflamed and sore area; the reddish - purple colour (color); the sharp, stabbing pain.
It could be cellulitis, bursitis, osteoarthritis, pseudo gout and many others. Even a broken foot has been thought to be gout. And to confuse matters more, bursitis can be caused by gout. If bursitis is suspected the doctor needs to do an aspiration test on the bursa sac to see if the sac's inflammation has been caused by deposited gout crystals. The bursa, when crystal infected, behaves like a gout affected joint. The MSU gout crystals can get into the sacs and inflame them in their usual manner. Sometimes people have gone for months without getting the correct diagnosis of their foot pain.
Do an aspiration test So, we'll repeat here what's been said on a number of www.best-gout-remedies.com's pages. The real test for gout is a joint aspiration (aka arthrocentesis) where fluid and tissues are removed from the affected area, placed under a polarising (polarizing) lens in a microscope magnified to 200x or 400x, and when this happens the tiny needle shaped crystals can be seen. Even this test can be difficult to do if the affected joint is small.
Pseudo gout crystals cannot be seen in this test, so crystals mean it won't be pseudo gout. X rays do not show the MSU gout crystals, but they do show pseudo gout crystals, tophi and bone erosion by tophi. A blood uric acid test which shows a high level of serum uric acid, is indicative of gout, but doesn't confirm it, because you can get gout attacks at even normal levels of uric acid. And higher, above normal, levels don't necessarily lead to gout.
Cellulitis will not reveal crystals, neither will osteoarthritis. Bursitis can mean gout crystals in sacs in the feet, and gout crystals will probably also show up in other areas of the foot. Gout is immediately caused by these MSU crystals, formed from uric acid, and these are its sole hallmark. Without them, there is no pain, at least from gout. Identifying them as MSU crystals is the job of the microscope's operator.
Don't rue the day and don't delay. The best doctor to see about gout is a rheumatologist.
WILL FOOT GOUT CAUSE A BROKEN FOOT?
There are many bone joints in the feet, small enough to be extra favoured (favored) by gout's attention, including the big toe joint, gout's favourite (favorite) resting place. Gout tends to attack the ends of bones i.e. where there's a joint. If tophi develop in these locations, over time (but we are talking about years here, not months), it will eventually erode bones and destroy the joint and its cartilage, tendons, ligaments.
Tophi can be deposited in the bursa of the Achilles tendon, the tendon that connects the heel to the calf muscle - more about this on the heel gout page
If medications won't remove the tophi by lowering uric acid sufficiently, at some stage surgery might be used.
WHAT KIND OF GOUT FOOT PAIN CAN YOU EXPECT?
If you have foot gout, but not in your big toe's joint, what can you expect? The usual gout symptoms of intense pain, inflammation, very sore, swollen feet, and a shiny reddish - purple stain on the skin. These symptoms could cover the whole foot, or just parts of it such as below the ankle towards the heel, or around the instep. Gout likes to deposit crystals in a joint, possibly because joints are colder, but it could form them anywhere, except possibly areas that are venous (i.e. areas where there are many veins). Its pain can remain even after the swelling subsides. And the foot remains tender.
PRESCRIPTION (R.X.) MEDICATIONS FOR GOUT FOOT PAIN
The NSAID indomethacin (Indocid) and colchicine (Colcrys) are the two main stand-bys for dealing with the immediate problem. Indomethacin to deal with pain and swelling, colchicine to halt the attack. Colchicine must be taken in low doses. There are new gout drugs currently under development that will, it's hoped, be better in ending pain and attacks than colchicine.
If your initial tablet or capsule prescription doesn't work, get an injection into the affected area of indomethacin or a corticosteroid such as prednisolone, or triamcinolone. This should kill the pain.
ARE THERE ANY SPECIAL MEDICINES FOR LONG TERM FOOT GOUT TREATMENT?
No. Because gout's needle shaped crystals are the same where ever they are deposited, except that they vary in size, there aren't any different medicines for long term foot gout treatment. Controlling or curing gout means getting the uric acid level down to below 5.0 mg/dL - 6.0 mg/dL, at which point gout's crystals begin to dissolve and further attacks are less likely. Neither is it the case that a certain cause of gout will lead to an attack in a specific area. Over-production of uric acid, for example, could mean any attack in any of gout's usual places. So could under-excretion, and so on.
TREATING GOUT FOOT PAIN WITH HOME REMEDIES - THOUGHT OF CABBAGE FOR GOUT?
There's a section on the ankle gout page which deals with home remedies such as ice and Epsom salts.
But here's another, which to some readers will seem a very oddball way of dealing with gout foot pain. But some people have said this helps. The world of gout scientific research is not bursting with information on this topic, as with most natural remedies, but what have you got to lose?
You wrap the foot in cabbage leaves - use the outer leaves of a common green cabbage.
As yet we haven't heard personally of any successes with the leaves of cabbage for gout, but we mention it in the hope it might help people who try it. This idea was first noticed a long time ago. In 1805, Dr. James Parkinson, the gout sufferer who is better known for giving his name to Parkinson's disease, included wrapping the affected area in a cabbage leaf in his book Observations on the Nature and Cure of Gout. In those days they used cabbage leaves because they thought the relief came from perspiration.
"By closely surrounding the part affected with a cabbage leaf, the vapour (vapor) exuding from the part is so confined and condensed, as frequently to occasion (cause) a very free perspiration from the part, and a very rapid alleviation of the complaint."
The complaint was gout pain. However, in 1805 they did not know about enzymes. There are modern explanations which say there is an enzyme in cabbage leaves that can dissolve gout crystals. (Red cabbage is a good food for gout, but used for a different reason).
This could be tried on any gout affected area of the body. You chill or freeze the cabbage leaves, then attach them tightly to the affected part. Cover them with a cloth until the leaves have thawed and are wet and limp. Repeat, if you think you can get more benefit. Another version is that you boil the leaves first, drain, and apply them to the affected area, again covered with a cloth. Repeat again.
If any reader has any degree of success with this method, please let us know using the form on the Contact Us page.
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