The painful truth about gout

gout pain

If you’ve ever experienced gout, which is the accumulation of uric acid crystals in your body, you know just how horrific the pain can be.  

One person says his foot felt like it was on fire. Just having a bed sheet covering his foot was excruciating. Breanne Gendron, a nurse practitioner with OSF HealthCare, says other symptoms of gout include swelling in the big toe or other affected joints, reddish discoloration and tenderness to the touch.

“When people get an acute gout flare, it typically resolves in one to two weeks, whether you treat it or not," she says. "It's just that it's so painful that people come in and they need help because it's no good when you can't sleep at night and your foot or your ankle is in pain.”

For the past couple of decades, cases of gout have been on the rise in the U.S. and now affects more than 8 million people. It’s more common in men and prevalent in the Black population. The chance of getting gout increases as you age.

Risk factors include high blood pressure, diabetes, abnormal kidney function, alcohol intake and obesity, especially in younger people. Gendron says that leading a sedentary lifestyle also increases the risk of developing gout. There is also a genetic component to gout – if your parents had it you could get it too.

“You can get gout from a multitude of ways," Gendron adds. "Typically, men of an older age who are overweight are the most common people who develop gout. If you're a 70-year-old, overweight male with high blood pressure, diabetes and high cholesterol, you're much more likely to get gout than someone who doesn't have those things.”

The small joint at the bottom of the big toe is the most common site for an attack, but it can also affect ankles, knees, wrists, fingers and elbows. Gout attacks can last from hours to days, with or without medication. Sometimes it can last for weeks and most people who have it will likely have future attacks.

Changing your diet can help reduce the uric acid levels in your blood. Research has shown that consuming too much red meat or seafood can increase gout attacks, while dairy seems to reduce the risk. Losing weight can also help minimize reoccurring problems with gout.  

“There are foods that can contribute to gout flares, and they have purines in them – red meats such as pork and beef, liver and kidney or organ meats, seafood and alcohol," says Gendron. "People who drink alcohol daily and get a gout flare are going to get gout flares more often if they're unwilling to change the amount of alcohol that they're drinking.”

Gendron adds that in addition to minimizing your alcohol intake, staying well hydrated and increasing your Vitamin C intake can help prevent future attacks.

Gout is typically diagnosed during an exam. Blood tests will also determine uric acid levels. Nonsteroidal anti-inflammatory drugs will be prescribed, but if that doesn’t help, steroids such as prednisone or a Medrol dose pack, may be ordered to combat inflammation and pain.

Gendron says the bottom line when it comes to dealing with gout: how much pain can you tolerate?

“Gout is not an emergency type of issue. It is a quality-of-life type issue," she adds. "If you did nothing for gout, it would still go away. If you did not change your diet, you would have flares more often. But if you can tolerate the pain, you technically don't have to do anything about it, and it will still go away. Over time, though, you can develop chronic gout where it's just kind of always there and you have a low level of discomfort all the time.”

For more information on gout, visit OSF HealthCare.