This page about shoes for gout patients was last reviewed, or updated, on 25 March 2014.
If you are living with gout, shoes must be well chosen because most people will have at least one gout attack in a foot, even if they have more elsewhere. However, a 2011 New Zealand study (1) into the question of the best and worst shoes for gout, probably the first study of its kind, found that nearly half of the participating gout sufferers were not wearing the right shoes. The corollary of course is that just over half did wear the right footwear for gout.
WHAT TO WEAR?
So when considering footwear for gout what are the major factors? The prime one, above all else, is to allow the foot and toes plenty of space. This is true when you rest your feet during a gout attack, and it is true when life is normal, whatever your age, sex or lifestyle. Why is the space needed?
One reason is because the crimping, pinching and pressure caused by tight fitting footwear can impede blood circulation around the toes and feet. Sluggish flowing blood is more likely to form and deposit crystals. A gout attack begins because needle shaped crystals form. And the toes are the number 1 recurring gout attacks location by far. Gout in the foot attacks, and more specifically in the ankles, are in the top five.
Can tight fitting shoes actually trigger gout attacks? Yes they can. Especially if you walk too far in them. Many gout sufferers know this from bitter experience.
Some kinds of shoes, specially designed for gout sufferers, also allow maximum air circulation around the feet.
A second consideration is that it is especially important to avoid pressure on the crucial big toe joint (where the big toe meets the main body of the foot) aka the 1st metatarsophalangeal joint of the big toe. If you are not particularly aware of it, have a look at this joint. It is gout's favourite (favorite) location, so treat it well.
OTHER SHOES FOR GOUT CONSIDERATIONS
What are other considerations? The conventional wisdom is that shoes for gout should be sturdy - for control and stability (in case you bump or bash your feet). They should be comfortable, have good cushioning, and have well padded insoles. In other words, you give your feet as soft a ride as possible. A lack of these features means footwear is inadequate for a gout sufferer. This sounds like common sense but the New Zealand study showed that many gouty folk don't know this well enough.
This small study was among 50 gouty people, who were recruited from long term gout sufferers attending rheumatology clinics in Auckland. Many of these would have been Maoris with gout in the foot. They are among the world's most gout-prone people.
Not light and tight In the study the worse their footwear, the worse their foot impairment. These findings are in tune with what many gouty folk say. Lightweight, over-worn, tight footwear will not give your feet a comfortable enough ride, and protection. When there's no protection, if you get a bash, twist or bump….. that shock can set off a gout flare in people living with gout, and in those close to a first gout attack.
Also consider wearing shoes that are sufficiently wide to allow for some increased swelling and avoid crimping. Shoes which narrow at the front, in the style of the Winkle Pickers of the 1960's, or Chisel Toe (the front narrows to a chisel shape), and Pointy shoes today, are unfriendly to gout sufferers. They'll crimp and push the big toe towards the others, and maybe bend it. Insoles boost the padding and comfort, but watch for them eating up too much space in the crucial big toe shoe area.
Gout sufferers often recommend 4x wide shoes, and shoes that are wide at the front, (square or round) to avoid pressuring the big toes.
Be prepared Although the majority of gout attacks begin at home, often at night, they can of course begin anywhere. So be prepared, especially if your attacks usually begin outside your home. And try to own shoes that you can wear comfortably during the later stages of a conventional gout attack when you can walk, as long as your doctor recommends it.
CHOOSING SHOES FOR GOUT SUFFERERS
Good gout shoes choices Sneakers (trainers); walking shoes; Oxfords (aka Balmorals); thick sole sandals. Things to look for - good cushioning and insoles (knocks are less likely to trigger attacks); space for air circulation; no pressure points; thick soles; and the shoes should have a large front box for the toes' area.
Poor gout shoes choices Thin sole sandals, flip-flops, slippers,
moccasins; any tight-fitting shoes, including narrow toed shoes such as
chisel toe shoes, and women’s high-heeled shoes. As far as high-heeled
shoes are concerned, shoes should not be tight-fitting (for the reasons
explained above) and it's doubtful that stretching the ankle is a good
idea. It might be, or become, the shock that triggers gout. Gout often
spreads from the big toe to the ankle. Stretching the ankle might
Avoid shoes with thin soles – you want protection from what's on the ground. If high heels, or other shoes, puts pressure on the knee or other joints, the same could happen.
Check with the shoe retailer if you can return shoes you have purchased but have found unsatisfactory. Think protection and comfort, not fashion. Give fashion the boot! Allow plenty of time to help you make the best choice. Be prepared to spend more on shoes than you may have formerly. Well chosen shoes won't get thrown away a few weeks later, and will be money well spent, if they help.
If you haven't given
thought to this question of the right shoes for gout, take time now to
consider how well your shoe collection meets these criteria. If you have a
rheumatologist/podiatrist, s/he will have footwear tips to pass on. Your
neighbourhood (neighborhood) GP (PCP) may not.
How to improve your awareness of good and bad shoes for gout? Read this article again, and other articles about footwear for gout. When out and about, pay attention to people's footwear and ask yourself if what's being worn, is good for gout sufferers.
Shoes for gout references
(1) Abstract. Keith Rome PhD, Mike Frecklington BSc (Hons) Pod, Peter McNair PhD, Peter Gow FRACP, MBChB, BMedSci, Nicola Dalbeth MBC,MD,FRACP. Footwear characteristics and factors influencing footwear choice in patients with gout.Arthritis Care & Research DOI: 10.1002/acr.20582.