So you went out for St. Patrick's day, drank large amounts of green beer, and now you have a splitting headache and your big toe is warm, red, swollen and so painful you can't even bear to have your bedsheets touch it. After a couple powerades, your head is better, but your toe is still killing you! You don't remember kicking anything or getting your toe stomped on while river dancing, so what gives?
Barring any traumatic event or infection, the presentation of these symptoms is consistent with a diagnosis of gout. Hereditary factors often play a role in having gout, but it is not uncommon that a person with no family history of gout or elevated uric acid will have a flare up.
Uric acid is a naturally occurring compound in the body that is a product of the metabolic breakdown of purines, which are found in high concentrations in meat and meat products, anchovies, mackerel, scallops, game meats and beer. At high levels, uric acid crystalizes and gets deposited in joints, tendons and the surrounding tissues causing a localized inflammatory reaction. It also may cause kidney stones, additional kidney issues and arthritis.
While a gouty attack can occur in any joint in the body, for some reason, over half the cases involve the joint of the big toe. The first step (which is excruciating if you have gout) is evaluation by a podiatrist. Your podiatrist will order some blood work, offer a range of treatments from oral medications to injectable steroids, and have you follow up with your internist or an endocrinologist. As a sufferer of gout, I can tell you, the sooner you see your podiatrist, the sooner you will get relief.