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What Causes Gout of the Foot?

By Laura Evans
Updated Mar 03, 2024
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Gout of the foot is a type of arthritis that often affects the joint at the bottom of the big toe, causing severe pain even when there is no pressure on the foot. This condition is caused when uric acid builds up in the body. If uric acid accumulates in the fluids that surround a joint and forms crystals, the crystals aggravate the joint, causing pain and swelling.

In the past, gout was called the "disease of kings" because it seemed that only royal or noble families were wealthy enough to afford the types foods and amounts of alcohol that were thought to cause it. In fact, during certain time periods, and as recently as the turn of the 20th century, having gout added to a person's social prestige. Today, while changes in diet may be part of the treatment recommended for gout, medications are also used treat it. In addition, having gout does not have the prestige that it did in the past.

Although the mechanics of how gout of the foot develops are known, the exact causes are less understood. It occurs more commonly in men than in women, although the odds of a woman developing gout increase after she becomes postmenopausal. There is evidence that the condition may have a genetic factor and run in families. Drinking alcohol and taking certain types of water pills may also increase the risks of developing gout.

The way gout develops involves uric acid. Uric acid is a naturally occurring substance that develops in the body as foods are digested. The body normally regulates the amount of uric acid by excreting excess in the form of urine. Uric acid can build up in the bloodstream either because the body produces too much uric acid or the body is not able to dispose of as much as it should. Just having excessive uric acid in the bloodstream does not guarantee that a person will develop gout, however.

Gout of the foot develops when uric acid increases in the synovial fluid, or the fluid that surrounds a joint. In this case, this fluid would surround the joint at the base of the big toe. The uric acid forms sharp uric acid crystals. These crystals ultimately cause the pain associated with gout. In addition to the big toe, gout can occur in other joints in the foot as well as in the knees or hands.

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Discussion Comments
By anon160981 — On Mar 17, 2011

thanks for the information.

By anon148538 — On Feb 01, 2011

I have tophic gout, where the tophi are located under and around the ball of the foot, in big toe and other toes and in the heel.

My gout was caused by the following:

I used caffeine daily, which accumulates in the body in active uric acid form. Caffeine and its active metabolites elevate the levels of adrenaline and noradrenaline around the clock.

Adrenaline and noradrenaline constrict the blood-vessels of the kidneys, thus decreasing their blood-flow, which inhibits the secretion of uric acids from blood to urine. Caffeine stores itself and all other uric acids from the food to your body and prevent them from leaving it.

When uric acids are directed to tissues, the body tries to extract them through the skin, which causes acceleration of apoptosis of skin cells with psoriasis as one consequence.

Uric acids seem to gather in the extremities, maybe because palms and feet sweat easily and extract acids efficiently.

Crystallization of acids is caused by cold temperatures and slowed blood circulation in the foot. Acids leak from joints and start to build a vein of tophi. I had one that started from the second joint of big toe and rounded the tip of the toe all the way to the other side. When I emptied it, it left a groove in the toe for a couple of days. The groove was about 2-3mm wide and deep.

I have studied this phenomena and how to treat it best.

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