Could That Ache In Your Big Toe Be Gout?

Gout is a complex form of arthritis most common in men, though post-menopausal women are also susceptible. We explain the symptoms and provide tips to reduce your risk.

You wake in the night with the sensation that your big toe is on fire. The joint at the base of your toe is so swollen and tender that even the weight of the sheet feels too painful to endure.

You may be experiencing an attack of gout: sudden severe pain, redness and tenderness, often located in the joint at the base of the big toe. Gout is caused by the accumulation of urate crystals in a joint. Urate crystals form when your body produces too much uric acid or when your kidneys excrete too little uric acid. When uric acid builds up in the blood, needle-like urate crystals form in a joint or surrounding tissue, causing pain, inflammation, and swelling.

This complicated form of arthritis can affect anyone, though it is most common among men. The symptoms of gout are intense and almost always occur suddenly, without warning.

  • Acute joint pain. Although gout often affects the large joint at the base of the big toe, it can also affect other joints in feet, ankles, knees, hands, and wrists. The pain is most severe in the 12 to 24 hours following the onset of the attack.
  • Lingering discomfort. Usually, the sudden pain of an attack subsides within a day, but joint discomfort may linger for as long as several weeks.
  • Inflammation. The affected joint is swollen, tender, and red.

A number of factors contribute to high levels of uric acid in the body, including the following:

  • Excessive alcohol consumption. Men who have more than two drinks a day, and women consuming more than one drink a day increase their risk of gout.
  • Medical conditions. Untreated high blood pressure, as well as diabetes, high levels of fat and cholesterol in the blood, and arteriosclerosis (narrowing of the arteries) can contribute to developing gout.
  • Medications. People taking low-dose aspirin, or thiazide diuretics to treat hypertension, are at higher risk for an increased uric acid level.
  • Family history. If gout runs in your family, you are more likely to develop the condition.
  • Age and sex. Gout occurs more often in men between the ages of 40 and 50, because they have higher levels of uric acid than women. However, after menopause, women’s uric acid levels—and risk of gout—rises.

If you experience the symptoms of gout, consult your physician. Gout can be treated with medications and dietary changes. Without treatment, gout can lead to recurrent gout attacks, risk of joint damage, and kidney stones.

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