What’s Causing your Foot Pain?
Why Your Feet Hurt
Your big toe is beet-red, swollen, and startlingly hot to the touch. And ithurts. Is it something out of a summer sci-fi movie? A terrible ingrown toenail? We wish. It's gout, a form of arthritis that a growing number of women are becoming all too familiar with.
"I've seen more women coming in for gout treatment in their postmenopausal years," says Patience White, MD, MA, vice president of public health at the Arthritis Foundation and professor at the George Washington University School of Medicine and Health Science. "Most women don’t think they can get it. They say, ‘Gout? How did I get gout?’ "
Thanks to conditions associated with gout, such as obesity, type-2 diabetes, metabolic syndrome, and heart disease, more than 8 million Americans have had a bout with gout. And while gout remains more common in men, women have started to catch up. The shift in estrogen levels after menopause is also thought to be a trigger.
So what is gout, exactly? This form of arthritis results from having high levels of uric acid in the blood because your kidneys aren't able to efficiently get rid of it. The uric acid then crystallizes and is deposited into a joint—most often the big toe, because it's furthest away from the center of the body and therefore cooler, says Alan Friedman, MD, a member of the board of directors of the American College of Rheumatology Research and Education Foundation. And when uric acid builds up in a joint, your white blood cells attack it, releasing chemicals that cause heat, redness, and swelling—not to mention intense pain.
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That kind of acute gout attack typically lasts about 10 days—but if you don’t treat the underlying causes, you could find yourself dealing with it on a regular basis. And more gout can lead to permanent joint damage.
Here’s what you need to know:
1. You'll know something's wrong."Gout usually shows up as one very painful, swollen, red, hot joint," says Dr. Friedman. "It's not subtle at all." While gout often occurs in the big toe, it can also affect other joints such as the ankle or knee.
2. You shouldn’t pop an aspirin for the pain.Doing this during an attack makes it much worse, Dr. White says. You can, however, take an anti-inflammatory with ibuprofen or naproxen.
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3. Some food and drink can trigger attacks.Chowing down on red or cured meats, drinking alcohol, and being dehydrated are common triggers for gout attacks. But once you've had gout, you can't make it stay away just by cutting out burgers and beer—you may need medication to control your symptoms long-term, says Dr. White.
4. Your regular MD might not cut it.A rheumatologist can diagnose gout by extracting fluid from the joint, and will help you devise a plan to prevent and treat future attacks. "We want patients to have a strategy," Dr. Friedman says. "If you're having at least three attacks a year, you should be on some kind of prevention plan." Your rheumatologist can prescribe medications to normalize your uric acid levels, as well as prescription anti-inflammatories or steroids to treat acute attacks.
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