Gout is a form of arthritis that occurs as a result of the build-up of uric acid in the body and joint fluid. The actual build-up of the uric acid can result when the body has difficulty eliminating uric acid through the kidneys and urine or, in some cases, when the body produces too much uric acid. It can lead to serious discomfort and pain. At the West Vancouver Foot Clinic, you will get your gout under control. Schedule an appointment with us to diagnose and treat gout and your feet in West Vancouver.
Gout starts with a sudden onset of intense pain in one or more joints, usually the big toe joint of the foot. The pain is accompanied by redness, swelling and warmth over the joint. While symptoms most commonly occur in the big toe joint, any joint may be involved.
The diagnosis is based on a personal and family history evaluation. Blood tests often are performed to determine uric acid levels, and the joint fluid is examined to look for uric acid crystals. X-rays also may be performed to examine both the bones and joints to rule out abnormal changes associated with gout.
The treatment of gout starts with establishing the correct diagnosis. Oral anti-inflammatory medications are most often used to manage acute attacks. While over-the-counter drugs may reduce symptoms, they are rarely strong enough to treat acute pain, swelling and inflammation. Your doctor must establish which of the two primary causes (producing too much uric acid or not eliminating it properly) is involved in order to treat gout with the appropriate medication. If gout attacks continue despite medical treatment, if there are excessive deposits of gouty crystals within a joint, or if arthritis causes continual discomfort, surgical treatment may be necessary to remove the crystal (tophi) and repair the joint.
Certain foods that are high in purines can increase uric acid levels and thus bring on an acute attack of gout. These foods include:
Some medications such as diuretics (water pills), which are often used to control high blood pressure or reduce swelling, also may cause an acute attack of gout. Stress, infection, and trauma also are possible causes. Drinking 6-8 glasses of water each day, eating an appropriate diet, and evaluating current medications will reduce the likelihood of an attack or lessen the severity should it occur.
Rheumatoid arthritis and osteoarthritis are two common forms of arthritis that affect millions of Canadians and Americans, especially those over the age of 45. The cause of rheumatoid arthritis, a ‘systemic’ disease that can affect the entire body, is unclear. It is believed to result when the body produces enzymes that inflame the joints and other tissues.
Osteoarthritis, sometimes called degenerative arthritis or referred to as joint “wear and tear”, is isolated to the joints only and does not systematically affect the body. Pain and stiffness caused by cartilage destruction in osteoarthritis develop slowly as a result of years of everyday living.
Joint stiffness, pain, tenderness, swelling and/or redness that lasts for more than two weeks may signal arthritis. Any of the 100 forms of arthritis can damage our bodies, especially the joints, gradually wearing away protective cartilage where the bones meet to make a joint. As cartilage erodes and bone rubs against bone, the joint becomes painful. Movement may become limited as bone ends erode or thicken, sometimes developing painful outgrowths or spurs. If left untreated, cartilage damage can seriously weaken the joints, often leading to pain and deformities.
Surgery to reconstruct the joint may be needed if arthritis causes chronic problems that cannot be controlled by medications, orthotics or physical therapy. In the vast majority of cases, reconstructive surgery can bring improvement. Pain relief and increased joint motion are benefits of surgery. While surgical care will not cure arthritis or completely restore the joint to its natural health, it will ease pain and make daily activities more manageable.
Appropriate surgical corrections are conducted at the West Vancouver Foot Clinic outpatient surgical suite.
Therapeutic injections are also helpful at alleviating chronic joint pain.