Gout in the feet: symptoms and care

Urate crystals can trigger inflammation in a toe or another foot joint. The area may become so sensitive that footwear or a bedsheet feels uncomfortable. Gout commonly affects the big-toe joint, but the midfoot and smaller joints can also be involved. Repeated inflammation may leave stiffness or firm deposits called tophi. A painful swollen foot is not automatically gout: injury, skin infection, cellulitis and other arthritis can produce similar signs. Examination and, when needed, joint-fluid testing help separate these causes.

Reduce walking and pressure while the foot is painful, elevate it when resting and choose loose footwear. A cloth-wrapped cold pack used briefly may soothe swelling. Take the flare medicine prescribed for you and check before using an over-the-counter anti-inflammatory, especially with kidney disease, stomach conditions, pregnancy or blood-thinning medicine. Keep any preventive gout treatment consistent unless your clinician gives different instructions. Once the flare settles, review triggers and prevention with a clinician.

Seek prompt advice for a first episode, a newly hot swollen foot or pain that prevents normal walking. Get urgent care if fever, chills, spreading redness, a wound, pus or severe illness accompanies the swelling; infection can need rapid treatment. Arrange follow-up for repeated attacks, persistent stiffness, visible lumps or symptoms that are not improving with your treatment plan.

Which joint is affected? Do I need testing to distinguish gout from infection? What can I take safely with my current medicines? Should I use preventive treatment between flares?