If something can make you dread the coming night, it’s not a monster under the bed: it’s gout in the toe. A flare can attack in the middle of sleep, creating a searing, painful wake-up call. The affected toe can often feel so tender and swollen that even the pressure of a blanket resting on it can be excruciating. What causes this pain, and what can be done about it? That’s where we can help.
Gout is a complicated form of arthritis. It most frequently affects the joint of the big toe, but is not limited to the joints in the foot. The primary culprit in this painful condition is uric acid, a substance that is naturally produced when the body breaks down purines in our food. This acid is usually dissolved into the blood and passed out of the body through urine. However, if too much is produced or not enough is passed out of the body, the acid can build up and form sharp, impeding crystals around the joint.
The pain of an attack can be intense and last for quite a long time. The first hit of pain might last up to 12 hours, followed by a general discomfort that can last anywhere from several days to several weeks. An attack can also be accompanied by redness and inflammation, and the joint’s range of motion may be reduced as well.
Risk Factors for Gout
Conditions that affect the body’s uric acid levels and ability to remove it are the first suspects when determining the causes of gout. Sometimes the condition has a genetic factor, so family history will be considered. Diseases such as diabetes and kidney problems can also have an effect, as do certain medications. Males and overweight individuals also have a higher risk of suffering attacks.
Perhaps the greatest influence on one’s uric acid levels, however, is diet. Purines, the substances that break down into uric acid, are found largely in foods such as meats, seafood, and certain vegetables. Alcohol has also been known to increase uric acid levels in the body. In fact, in times past this disease was considered a disease of the upper class, since only they could afford enough of these foods to cause an attack!
Cooling Down the Flares
Treatment for gout primarily depends on keeping uric acid levels low. Medications are available that can block acid production or increase its removal, which can certainly help. Changes to lifestyle and diet, however, will also likely be necessary. This often does not mean one has to eliminate meats and alcohol from their menu entirely, but moderation will be key.
If and when a flare does happen, medications such as anti-inflammatories and colchicine can help reduce the immediate discomfort and lower the risk of future attacks.
If you or a loved one is left writhing at night from burning toe joint pain, schedule an appointment with Dr. Evan Merrill or Dr. Adam Gerber at Southern Oregon Foot & Ankle, as soon as you can. If gouty arthritis is the cause, it can grow worse and even spread to other joints over time unless action is taken to address the issue. We can help you determine the best ways to reduce uric acid and keep nights much more restful. Call our Medford, OR office at (541) 776-3338 to take the first step toward help.