Gout is a form of inflammatory arthritis. If you have an attack of gout, it tends to strike first in your big toe. However, gout can also affect other joints in your feet and joints elsewhere in your body, typically your ankle, knee, wrist or finger.
Multiple joints can be affected during an attack of gout, but it’s most common in the joints at the ends of limbs, for example in the feet and fingers.
You usually get severe pain and the affected joint may swell up and become red and hot. The pain often starts during the night and builds quickly.
Gout is far more common in men than women, and is more common as you get older.
Causes of gout in feet
A build-up of uric acid causes gout in the soft tissue (cartilage) at the end of bones. The uric acid forms crystals, and if there are too many of these they may burst out of the tissue and fill the space between bones (your joint). They can cause friction around the joint and tissue which can, in turn, cause pain and swelling.
Uric acid is found in your blood naturally and is waste from the breakdown of a chemical called purine. Purines are present in certain food and drink, such as red meat, seafood and alcoholic beverages, especially beer.
Uric acid usually leaves your body via your pee, but if your body produces too much of it or your kidneys can’t get rid of it properly, then the uric acid in your blood will form into crystals. These may then settle near your joints.
is most likely to affect your big toe, as it’s at the end of a limb and a part of your body that’s colder or more affected by temperature changes. Uric acid crystals are more likely to form in the parts of your body that are colder. It’s for this reason that gout may also strike in your finger.
Risk factors for gout
There are a range of factors that may increase your risk of developing gout. These include:
- your genes — if a parent or grandparent has or had gout this may increase your risk and make it more likely that your kidneys won’t be able to process uric acid properly
- being overweight or obese — the more excess weight you have, the more uric acid your body produces. This can lead to the build-up of uric crystals around your joints, which cause friction and inflammation
- your gender — men are 4 times more likely to get gout compared to women. The female hormone oestrogen helps the kidneys to process uric acid, making gout less likely in women. However, women are more likely to develop gout after the menopause, when their oestrogen levels fall
- being on certain medications — your kidneys may find it harder to get rid of uric acid from the body as a direct result of taking certain medications, for example, diuretics (or water pills) and ACE inhibitors, which are used to treat
- having certain conditions — these include and chronic kidney disease, though the link between gout and these conditions is not entirely clear
- eating certain foods or drinks — high-purine foods include red meat, shellfish and oily fish like sardines, processed food and ingredients containing yeast extract, like Marmite. Alcoholic drinks like beer, too. Limiting these types of food and drink may lower your risk of an attack of gout
How long does gout last?
An attack of gout will usually last for between 3 and 10 days, after which your symptoms — pain, redness and swelling around the joint — should pass.
However, you’re likely to have more attacks in the future so it’s important to see a doctor for proper treatment.
What to do if you have gout in your foot
If you have an attack of gout, you should:
- put ice on the joint to help the swelling
- try to keep your leg and foot raised, and rested
- stay hydrated with water, but avoid alcohol
- try to stay calm as stress can make it worse
- book an appointment to see a doctor
When to see a doctor for gout
If you think you’ve had a gout attack and never experienced it before, see a doctor. They should be able to make a diagnosis and rule out other possible causes for your symptoms.
If you have gout, a doctor may prescribe medications to help relieve swelling and inflammation, such as
or colchicine. These can be used to help ease symptoms during an attack of gout, but you should get further guidance from a doctor before taking any of these medications.
Non-steroidal anti-inflammatory tablets or capsules (NSAIDs), like ibuprofen, should be taken for no more than a week to 10 days at a time, unless you've spoken to a doctor. If you use a gel, mousse or spray form of the medication, don't use this for more than 2 weeks without talking to a doctor.
Take oral NSAIDs with food or a drink of milk to reduce the risk of irritating your stomach.
You should also talk to a doctor or pharmacist before taking NSAIDs if you’ve ever had:
- bleeding in your stomach
- a stomach ulcer
- a hole (perforation) in your stomach
- a health problem that means you have an increased chance of bleeding.
People with the following conditions should also talk to a doctor before taking these medications:
- liver problems like fibrosis or cirrhosis
- heart disease or heart failure
- kidney failure
- Crohn's disease
- ulcerative colitis
- chickenpox or shingles
You should avoid NSAIDs if you’re pregnant, trying to get pregnant or have high blood pressure.
Your doctor may also prescribe you medications to protect your stomach if you’re over the age of 65.
You shouldn’t take these NSAIDs if you’re allergic to them, or you have experienced allergic symptoms like wheezing or skin reactions after taking another medication from this group.
You should call a doctor or ambulance immediately if you've taken more than the maximum dose of NSAIDs or if you experience any of the following side effects:
- nausea and vomiting
- pain in your stomach
- feeling tired or sleepy
- black poo and blood in your vomit – a sign of bleeding in your stomach
- ringing in your ears (tinnitus)
- difficulty breathing or changes in your heart rate (slower or faster)
- feeling generally unwell
Please see a doctor before taking these medicines and get a prescription, if required.
A doctor may also encourage you to make
to help reduce your risk of further attacks. This may include:
- eating a balanced diet
- drinking less alcohol
- limiting high-purine food and drink
- getting plenty of exercise
- taking medication that helps to keep your uric acid levels low
If you have an attack of gout and you have had one before, take your medication as prescribed by a doctor — or make an appointment if you’re worried.
- gout can affect your big toe joint and other joints, typically your ankle, knee, wrist or finger
- gout is caused by a build-up of uric acid in the soft tissue (cartilage) at the end of bones
- gout is far more common in men than women, and is more common as you get older
- if you think you’ve had a gout attack and never experienced it before, see a doctor
- a doctor may encourage you to make certain lifestyle changes to help reduce your risk of further attacks