Have you seen the commercial for gout medicine where a flat boney foot is shown? Have you noticed no mention on the flat foot or why does gout usually attack the ankle or the big toe joint?
Let’s start with what I’ve learned a long time ago. Gout can be precipitated from an acute injury. This fact, now days seems to be mostly ignored as a cause. Why? I think because it is a world of let’s do testing and prescribe a prescription, etc. and we can all go home happy!
However, in my career, an injury was found to be the precipitating cause. The gout as well as the cause of the injury should be addressed. I have had many patients come in after work relating they were driving home and as soon as they got out of their vehicle, they had severe pain of the big toe joint. In eliciting a history and physical exam, I found out that they indeed did injure themselves when driving. How? By slamming on the brakes! When they did this, they jammed their big toe joint causing a severe compression, an injury. This stimulated the gout attack response.
Had their foot been in a biomechanically sound position, the big toe joint may not have jammed up on the brake as the joint can flex instead of jam. In deeper thought, with faulty biomechanics, the big toe joint commonly becomes jammed up during gait. The ankle can undergo extreme strain moments as well. This fault is typically found in higher arch feet and flat feet respectively. This would explain why the other joints are not the most common areas of gout attacks. Gout treatments, in my opinion, should always include a biomechanical evaluation to address any mechanical causes/attributions to gout attacks.
When found, functional orthotics that specifically address the function of the big toe joint, as well as the ankle, are paramount in aiding faster relief and further prevention of injury.
Simple Tips for Gout Attacks:
- Don’t ice a suspected gout attack. This can further crystalize the uric acid. (Think of crystalized uric acid as crushed glass. Glass in tissues = OUCH!)
- Magnetic therapy may assist relief by improving blood flow for healing.
- Topicals that have analgesia and anti-inflammatory properties may help.
- Do NOT take low doses of aspirin for gout.
- Do have a complete physical exam/testing to determine if you are an overproducer or underexcreter. The former is most common for Americans.
- Don’t ignore the disease as repeated gouty attacks in the same joint can cause serious joint breakdown with arthritis.