First identified by the Egyptians in 2640 BC, podagra (acute gout occurring in the first metatarsophalangeal joint) was later recognized by Hippocrates in the fifth century BC, who referred to it as ‘the unwalkable disease’. Throughout history, gout has been associated with rich foods and excessive alcohol consumption. Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the ‘disease of kings’. Unfortunately, if you have ever had gout, or known anyone that has, you will be sure to note it doesn’t feels much like royal treatment.
Although it can occur in a variety of joints of the body gout is most common in the big toe joint. Gout is caused by an excess of uric acid which is produced in our bodies as a byproduct of purine metabolism. The excess of uric acid occurs when we make too much or we don’t get rid of it fast enough. When uric acid accumulates in a joint it can form crystals called monosodium urate which causes an inflammatory reaction that is extremely painful and potentially destructive to the joint. The pain is so severe that classically a patient will grimace and wince in pain when someone just looks at the joint let alone touches it.
Once gout is confirmed, our office can identify what medications can be properly given to reduce the pain and what can be done to prevent further damage. Up to 62% of patients have a recurrent attack within 1 year of the first, and if the excess uric acid level goes untreated for a longer period it is nearly certain a second attack will occur.
If you think you have, or have had, a gout attack it is critical to get it evaluated by a specialist. Please schedule an appointment with Dr. Jay Larson at Sole Foot and Ankle Specialists, to confirm that the pain is in fact due to gout.