9 Pictures of the Gout: Symptoms, Food to avoid, other tips

Last updated on August 24th, 2022 at 09:44 am

9 Pictures of the gout for better understanding

Here are a few pictures of gout!

If you have pain, swelling and redness at the base of the great toe then most likely it is due to gout. It not only affects this joint but initially it may affect small joints of fingers of hand and leg, in the later stage, it may also affect large joints such as the ankle, knee wrist and elbow joint. It is a type of arthritis which is quite different from rheumatoid arthritis & osteoarthritis.

Gout happens due to increased blood uric acid levels. Pharmacological management focuses on controlling the blood uric acid level but being a physiotherapist I will also suggest a few home tips and exercises that will prevent joint swelling, pain and most important is joint stiffness.

So, let’s get started.

What is gout, its causes

Gout is actually a type is arthritis that happens due to hyperuricemia, a condition where blood uric acid level increases more than the normal level. So, what happens when uric acid increases in our bodies?

Uric acid present in the blood gets ionized into Monosodium Urate Crystal. Normally these urate crystal gets dissolved and its solubility is affected by:

• Synovial fluid pH,
• Water concentration,
• Electrolytes level, and
• Other synovial components such as proteoglycans and collagen.

But, when the level of uric acid increases the urate crystal starts deposition gets starts in the tissue around the joints leading to gout. There are two factors that cause the increase in the uric acid level one is overproduction of uric acid and the second condition is when there is decreased excretion of uric acid from the body.

1) Overproduction of uric acid

One of the most common reasons for overproduction is when we increasingly intake food rich in purines. These foods are processed foods like cookies, bread, and ice cream, it also includes food from animal sources like red meat especially seafood.

Alcohol consumption also increases the risk of gout.

2) Decreased excretion of uric acid

Two thirds of urate excretion occurs in the kidneys while the rest is excreted through the gastrointestinal tract (GIT). Reduced secretory function of the transporter ABCG2 leads to decreased excretion of uric acid through the GIT resulting in rise of serum levels of uric acid and enhanced renal excretion¹.

Clinical feature of gout

Gout can affect any joint but it commonly affects the small joints of our body, like joints of fingers of hand and leg. But, the most common joint to affect is the PIP of the great toe where there occurs the formation of gout nodules. We can understand the clinical features of gout in 4 different stages².

• Stage 1, Asymptomatic hyperuricemia: It is a preliminary stage of gout when there is an elevated level of blood uric acid level. However, many hyperuricemic patients never develop clinical manifestations of gout.
• Stage 2, Acute gout: It is also termed as a gouty attack when the patient complains of acute pain in the affected joint. However, classically it affects the first metatarsal joint of the great toe. It commonly presents as an abrupt onset of an erythematous, warm, swollen, and exquisitely sensitive joint. The pain is so severe that the sufferer complains of terrible burning pain even when a bed sheet rubs against the swollen joint. Morning pain with burning is typical at this stage.
• Stage 3, Intercritical or interval gout: It is the stage when acuteness subsides leaving a low-grade inflammation within the joint, causing unnoticed damage. It is during this phase the continuous monosodium urate crystal deposition results in the development of tophi, causing erosive changes to the bone, which may be seen radiographically in patients with chronic gout.
• Stage 4, Chronic gout: (refer to pictures of gout in slides above)It is presented with repeated episodes of acute gout, usually complicated by tophi formation. Acute gout symptoms often are not well recognized in patients with chronic gout because of a lack of intensity or soft tissue swelling; in these cases, the patient presentation may simply mimic osteoarthritis.

Management of gout

Initial medical management is very important, you must visit a good gout doctor who would prescribe you the appropriate NSAID to manage acute gouty pain. In some cases, it is even prescribed with steroids. For herbal management, you may try Gout 911 or it is also marketed as GR 911 which contains natural supplements.

In physiotherapy, acute pain which is also termed the gouty attack is aimed at reducing pain swelling, and redness. This can be achieved by cryotherapy or regular application of a cold gel pack over the painful joint.

Once the acute pain subsides the exercise of joints is very important to manage joint stiffness. The exercises include a joint range of motion exercises and stretching exercises.

Foods to avoid when gout & recommended diet

Gout sufferers should strictly restrict the intake of food rich in purine as purine promotes the production of purine in the body. Broadly it includes processed food and food from animal sources, especially seafood. So, here is the list of food you should avoid and recommended food. For more details on other effective natural ways to reduce serum uric acid level I highly recommend reading one of my articles Uric Acid, How to Reduce by Food? Other lifestyle modifications to consider.

What uric acid food to avoid:

• Red meat
• Fast food like, pizza, burger
• Processed food like bread, cookies
• Seafoods like fish and others.

Recommended food

• Milk and dairy products
• Green leafy vegetable
• fruits
• green salad

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