Patients often come into our Thousand Oaks, CA office with pain in their foot and assume that it is gout.  Gout affects approximately 1% of the population so it is not very common.  It occurs more often in men >40 yrs of age, however, women can get gout after menopause.  The incidence of gout in a healthy premenopausal woman is very low.

The most frequent presentation is in the big toe joint which becomes red, warm, swollen and is exquisitely tender.  It is painful even to light touch and can cause limping.  Acute attacks often strike in the middle of the night so patients wake up in the middle of the night with pain or the next morning.  If you have a swollen painful joint it could be arthritis or infection.  Infection is much more likely when there is some sort of opening to allow bacteria to get deeper such as a bug bite, cut, or injury.  If there is no opening, the chance of infection is fairly low.

Gout is caused by uric acid levels building up in the blood then precipitating in the joint.  Acute attacks always affect joints but can start to deposit uric acid in tissue in the ears, elbows or heels after years of chronic gout.  The swelling and redness are very obvious during a gout attack and the pain is very localized. 

Gout is exacerbated by certain foods such as organ meats (liver, pancreas), sea food, and alcohol.  Ice usually alleviates pain in the foot but with gout it can actually make it worse.  It can be helped by drinking lots of water, dairy products and cherry juice.  It is associated with high blood pressure, kidney disease and obesity.  It can also be caused by some medications such as low-dose aspirin (81 mg), some diuretics and some blood pressure medications.

So just to clarify- if you are healthy, not taking any medications and have never had gout before, the pain in your foot is probably not gout.  If your foot is not red, very swollen and/or exquisitely painful, it’s probably not gout.  If your pain is vague and generalized, it’s probably not gout.  Got gout? I don't think so. If, however, you think it may in fact be gout, be sure to see your podiatrist immediately to discuss treatment options.