Gout is a type of arthritis that causes sudden and intense pain, usually in one joint at a time. In most cases, gout attacks the big toe, but it can also affect other joints in the foot, like the ankle or the small joints of the toes. Gout happens when there’s a buildup of a substance called uric acid in the body. Uric acid usually dissolves in the blood and leaves the body through urine. However, sometimes, the body makes too much uric acid or the kidneys can’t get rid of enough of it. When that happens, the extra uric acid forms crystals, which get stuck in joints and cause swelling, pain and redness.

Gout is fairly common, affecting over 8.3 million people in the U.S. It tends to affect men more than women. While there isn’t currently a cure for gout, with the right treatment and some lifestyle changes, you can manage your symptoms and reduce the chances of future attacks. So if you’re feeling a sharp, sudden pain in your big toe or other parts of your foot, it may be worth taking a trip to your doctor to see if it could be gout and figure out a treatment plan to help you find relief, which may include physical therapy.

What causes gout?

As mentioned earlier, gout is caused by a buildup of uric acid in the bloodstream. Uric acid is a waste product produced when the body breaks down purines, which are found in certain foods and drinks. Normally, uric acid is dissolved in the blood and passes through the kidneys into the urine. However, if there’s too much uric acid in your blood, it can form sharp crystals in your joints, leading to painful gout attacks. Some common causes and risk factors of gout in the foot include:

• Diet — Eating foods high in purines can raise uric acid production. Purines can be found in:
• Red meat
• Shellfish
• Organ meats 
• Alcohol — Drinking alcohol, especially beer, can increase uric acid production. Alcohol slows down how the body gets rid of uric acid.
• Genetics — If someone in your family has gout, you may have a higher chance of getting it too. Genes play a role in how the body processes uric acid, so family history can be a big factor.
• Health conditions — Other health issues like high blood pressure, diabetes, obesity and kidney problems can increase the chances of getting gout. When your kidneys aren’t working well, they can’t remove uric acid as well, causing a buildup.
• Medications — Certain medications, such as diuretics and aspirin, can raise uric acid levels in the body. If you’re taking these, it may increase your chances of a gout attack.
• Dehydration — Not drinking enough water makes it harder for your kidneys to flush out uric acid, allowing it to build up and form crystals in the joints.

Understanding what causes gout in the foot can help in making choices to prevent it. 

What are the symptoms of gout in the foot?

Gout in the foot can be extremely painful, especially if it affects the big toe, which is a common spot for gout to strike. Symptoms of gout in the foot can include:

• Severe pain — You may experience sudden, intense pain, often described as debilitating.
• Swelling — The affected joint becomes tender and swollen.
• Redness — The skin over the affected joint turns red.
• Warmth — The affected joint may feel warm to the touch.
• Limited range of motion — You may have difficulty moving the affected joint. 
• Sensitivity — Even the slightest touch, like a sock or sheet, can feel unbearable on the affected joint.
• Discomfort lingering — After the worst pain passes, the affected joint may still feel sore and uncomfortable.

Gout attacks happen quickly and can last for several days or weeks. It’s important to treat these symptoms early, as repeated gout attacks can damage joints over time.

Diagnosing gout in the foot

If you think you have gout, a health care provider will need to do a few things to confirm the diagnosis, including:

• Medical history and symptoms
• Physical exam
• Blood test
• Joint fluid test
• Imaging tests

By using a combination of these methods, your doctor can determine if you have gout and help you find the right treatment to relieve the pain and prevent future attacks.

Treatment options available to help gout in the foot

Treatment options for gout in the foot focus on relieving pain and inflammation during an acute attack and preventing future attacks. Treatment options for acute gout attacks include:

• Pain relieving medication — When you have a gout attack, the pain can be intense. Your doctor may recommend taking a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen to help reduce pain and swelling. If the pain is severe, they may prescribe colchicine, a medication that helps ease inflammation. 
• RICE method — The RICE method is a classic treatment approach for a wide variety of conditions, including gout in the foot. It stands for:
• Rest — When you’re having a gout flare-up, it helps to rest the affected foot.
• Ice — Applying ice to the affected area can help ease the pain and swelling. Ask your doctor how long to ice and how frequently you should repeat the process for best results.
• Compression — Using a compression bandage can also help support your affected foot and reduce inflammation.
• Elevation — Elevating your affected foot while you rest can help reduce swelling and allow the joint to heal faster.
• Uric acid lowering medication — Since gout happens because of too much uric acid in the body, one of the goals of treatment is to lower those levels. Your doctor may prescribe medications to help prevent future gout attacks by reducing uric acid production. These medicines can help keep uric acid levels in a safer range. 
• Lifestyle changes — Once the flare-up is under control, your doctor will likely suggest some lifestyle changes to help prevent future gout attacks, including:
• Make dietary changes.
• Drink plenty of water.
• Maintain a healthy weight.
• Physical therapy — A physical therapist can create a personalized treatment plan designed to help manage pain, reduce inflammation and improve joint function. 
• Corticosteroids — In some cases, if NSAIDs and colchicine aren’t fully effective, your doctor may prescribe corticosteroids. These strong medications can be taken orally or injected directly into the joint to reduce swelling and pain. 
• Regular checkups — If you’re experiencing recurrent gout attacks, your doctor will monitor your uric acid levels and may adjust your treatment plan to keep the condition under control.

With the right treatment and lifestyle changes, many people with gout can manage their symptoms and live comfortably without frequent flare-ups.

Physical therapy for gout in the foot

While physical therapy isn’t a cure for gout, it can play a significant role in managing symptoms, improving joint function and preventing future flare-ups. Your physical therapist will do a thorough exam to assess your condition and create a detailed, customized plan designed to meet your unique needs and concerns. This treatment plan may include physical therapy techniques such as:

• Manual therapy — Manual therapy techniques are hands-on techniques that can help relieve pain, reduce inflammation and improve joint function. These techniques include:
• Soft tissue manipulation — Gout can cause swelling and tightness in the muscles around the affected joint. Soft tissue manipulation involves your physical therapist using gentle pressure to loosen tight muscles and improve blood flow. This can help reduce inflammation and make your foot feel less stiff, allowing for better movement.
• Joint mobilization — Joint mobilization involves your physical therapist using slow, controlled movements to gently move your foot in different directions. It can help reduce stiffness in the joint, improve its range of motion and make it easier to walk without pain. It can be especially useful if your foot joint is hard to move due to swelling and discomfort.
• Therapeutic exercises — Once the acute inflammation has subsided, your physical therapist may create a therapeutic exercise program using a variety of exercises to help improve joint function and prevent flare-ups. These exercises may include:
• Range-of-motion exercises
• Strengthening exercises 
• Stretching exercises
• Balance exercises
• Electrical stimulation — Your physical therapist may place small electrodes around your affected joint. These electrodes deliver low-level electrical currents to stimulate the muscles and nerves around the area. Electrical stimulation can help reduce pain, ease muscle spasms and promote healing. It can be helpful during the early stages of a gout flare-up when pain is high and movement is limited.
• Therapeutic ultrasound — Therapeutic ultrasound uses sound waves to penetrate deep into the tissue of your foot, promoting healing and reducing inflammation. The heat generated by the ultrasound can help boost blood flow, reduce swelling and relieve pain. It can be a great tool for calming the flare-up and speeding up recovery.

By using these techniques and others, physical therapy can help ease the discomfort of gout, improve your foot’s movement and prevent future flare-ups, allowing you to get back to doing the things you enjoy.

You don’t have to face gout alone; Lattimore Physical Therapy is here to support you

At Lattimore PT, our skilled physical therapists are here to help you every step of the way of your journey in managing gout in your foot. We will create a personalized treatment plan that can improve your mobility, relieve pain and strengthen the foot to reduce future flare-ups. We focus on every aspect of your recovery and aim to empower you to live comfortably and confidently.

Contact our team today for more information or to schedule an initial appointment.