Red, Hot, Swollen Painful Big Toe?

Gout most commonly occurs in the big toe joint and is a type of metabolic and arthritic disorder in which there are elevated uric acid crystals within the joint. Uric acid is a byproduct of purines that are a part of many foods we eat, which explains why diet plays an important role in gout attacks. The clinical presentation of gout is often an appearance of a “sausage toe” with a red, hot, swollen painful joint. Gout attacks are usually sudden occurring without warning or any signs of trauma. These gouty attacks can be recurrent over the years.

The following are treatments that may be considered by your doctor or podiatrist for gout:

  • Diet – stay hydrated and avoid purine-rich foods such as alcohol, seafood, and red meats
  • NSAID – indomethacin or naproxen for acute gout attacks
  • Colchicine – anti-inflammatory for acute gout attacks
  • Allopurinol – for overproducer of uric acid and the treatment of the chronic gout
  • Probenecid – for undersecreter of uric acid and the treatment of chronic gout

Gout can be a very painful intense condition that can stiffen the joints but with treatments prescribed by your doctor such as in the above list will work well to resolve the gouty attack. Those who have chronic gout may have hardened deposits of uric acid crystals in the soft tissue causing a palpable lump called tophi. When this occurs, your doctor may suggest a fluid needle aspiration to remove the tophaceous substance. Often times, your doctor will also culture the tophaceous material and view it under a polarized light microscopy to confirm the diagnosis of gout by visualizing the urate crystals.

Most people can manage and prevent future gouty flare-ups once the diagnosis of gout is made in simply modifying diet and drinking lots of water. When you experience a sudden attack of gout, call your podiatrist as soon as possible to best treat this painful condition.

Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office