Foot gout, also known as podagra, is an extremely painful form of inflammatory arthritis that usually attacks the big toe. Podagra can make simply walking a few steps an excruciating experience. If you’re suffering a podagra attack, you know: Relief is needed, as quickly as possible. And make sure to see your general doctor or podiatrist about it immediately.
Here is some information on the causes and symptoms of podagra, as well as risk factors, treatment options, and tips on how to prevent this problem from occurring.
Why Podagra Happens
Podagra occurs when uric acid crystals accumulate in a joint. While podagra is the term to describe gout in the big toe, just about any joint in the body is susceptible, such as a finger, elbow, knee, or ankle.1
Uric Acid and Purines
Uric acid is formed by the breakdown of purines, which are chemicals commonly found in seafood, meat, and other foods. The kidneys normally remove this acid with no problem. But there are times where they either become overwhelmed, because there’s too much uric acid, or they can’t remove it fast enough. When this happens, uric acid turns into sodium urate crystals. The more these crystals accumulate, the higher the likelihood that gout will result.2
Crystals don’t normally cause problems right away, but over time, they can irritate the lining of the joint, which leads to inflammation. This, in turn, leads to swelling and redness around the affected joint, and, ultimately, severe pain. Podagra accounts for more than half of the reported cases of gout.3
Symptoms can appear suddenly, especially at night, and can gradually worsen over a period of a few hours. Pain will usually last for anywhere from 5-10 days, and, unfortunately, it’s not at all uncommon for sufferers to experience another attack within a year. As time goes by, and more crystals form, attacks may increase.4
Podagra can affect anyone for any reason, but there are a few contributing factors that pose a higher risk. Here are just a few of them:
There are certain types of medicines that can increase uric acid levels in the body and increase the risk of a podagra attack as a result. These include water pills (diuretics), aspirin, niacin, and beta-blockers.
While men tend to be more susceptible to podagra at a younger age, women tend to develop the condition after menopause, due to a rise in uric acid. The risk tends to equal out between the genders after the age of 60.
Alcohol, red meat, sugary drinks, and seafood tend to be high in purine, and thus increase the risk of developing podagra.
Excess body weight
Obese people are more likely to suffer from podagra than those who are normal weight.
High blood pressure, high cholesterol, and certain other medical conditions can increase the risk of podagra.5
Managing a Podagra Attack
There are some things you can do to help alleviate the discomfort associated with a podagra attack. At the first sign of a problem, take whatever kind of over-the-counter pain medicine you may have at home. Stay away from aspirin, however, because that could actually make your symptoms worse.6
- Ice: Wrap some ice in a towel and apply it to the area for 20-30 minutes at a time, several times each day. Never apply ice directly to the skin, because that can lead to substantial damage.
- Hydrate: Drink plenty of water (8-16 cups a day) to help flush the uric acid out of your system, and avoid alcohol. You should definitely not drink any beer because of its high purine levels. In addition, alcohol may increase the amount of uric acid in the blood.7
- Elevate: Elevate the foot when you’re resting to reduce swelling, and get a cane or use crutches to keep weight off of the affected toe. Even the slightest touch can cause extreme pain, so keep your bed sheet off of the toe at night, and keep the affected foot bare as much as possible.
Diagnosis and Treatment of Podagra
If you are suffering from a bout of podagra so severe that you can’t find any relief through the use of over-the-counter pain medications, you should see a doctor. They will thoroughly examine the area and possibly take a sample of fluid for analysis. Blood tests, ultrasound scans, and x-rays may also be needed to confirm a diagnosis.
Medications are commonly prescribed to help ease the symptoms of gout and block the formation of crystals. Others inhibit the formation of uric acid, and some help the kidneys better eliminate uric acid altogether.
Preventing Another Podagra Attack
One of the most effective ways of preventing another bout of podagra is by changing your diet and getting plenty of exercise. Keep your consumption of processed foods and carbohydrates to a minimum, and turn to foods that are lower in uric acid content. These include:9
- Whole grains
- Low-fat dairy products (like skim milk)
- Plant oils (canola, olive, and sunflower)
You should also try to lose some weight if you are obese and have recurrent podagra attacks. Losing weight will help reduce the uric acid in your system, and you’ll get the added benefit of boosting your overall health. Talk to your doctor about putting together a safe, realistic weight loss program.
Podagra can be excruciating, but if you take fast action to get the treatment you need and take the right precautions at home, you will have a much better chance at getting through an attack with the least amount of discomfort possible. And with a few lifestyle changes, you might even be able to lower your risk of having another attack!