Gout

At Masterton Foot Clinic, we assess and manage gout alongside your GP and other healthcare professionals. Our role is to help identify the condition, reduce its impact on your mobility, and support your recovery while helping prevent future problems.

What is gout?

Gout is a type of inflammatory arthritis caused by the build-up of uric acid crystals within a joint.

When uric acid levels in the blood become high enough, crystals can form inside joints. The body's immune system recognises these crystals as foreign, triggering an intense inflammatory response that results in pain, swelling, redness, and warmth.

At the time of writing, gout is considered one of the most treatable forms of arthritis when appropriately diagnosed and managed.

While gout commonly affects the big toe joint, it may also occur in the midfoot, ankle, heel, or other joints throughout the body.

Symptoms

Common symptoms include:

• Sudden onset of severe joint pain.
• Redness and warmth around the affected joint.
• Swelling.
• Extreme tenderness, even to light touch.
• Difficulty walking or bearing weight.
• Episodes that develop rapidly, often overnight.
• Symptoms that gradually settle over several days or weeks.

Some people experience occasional attacks, while others may develop more frequent episodes if uric acid levels remain elevated.

Causes

Gout develops when uric acid levels remain high enough for crystals to form within a joint.

Contributing factors may include:

• Genetics.
• Kidney disease.
• Certain medications.
• High alcohol intake.
• Obesity.
• Diet.
• Dehydration.
• Other medical conditions affecting uric acid metabolism.

Many people with gout have more than one contributing factor.

When should you see a podiatrist?

We recommend an assessment if:

• You develop sudden pain, swelling, or redness in your foot.
• You have repeated attacks of gout.
• Foot pain is affecting your walking or work.
• You are unsure whether your symptoms are caused by gout or another condition.
• You have ongoing foot pain following a previous gout attack.

If this is your first suspected attack or the diagnosis is uncertain, further medical assessment is important to confirm the diagnosis and exclude other serious conditions, such as infection.

How gout affects movement

Your feet and legs work as one connected system.

Almost every muscle in the lower leg attaches to the foot, helping to control walking, balance, and stability. During a gout flare, the affected joint often becomes so painful that people instinctively alter their gait to avoid loading it.

Although this protects the painful joint in the short term, altered walking patterns can place additional stress on other joints, muscles, and tendons throughout the foot and lower limb.

Once the acute attack has settled, our focus shifts towards restoring comfortable movement, improving function, and reducing unnecessary loading through the affected joint.

How we treat gout

Our role is to work alongside your GP to support both the short-term management of painful gout attacks and the long-term health of your feet.

Depending on your presentation, treatment may include:

• Clinical assessment.
• Advice regarding temporary activity modification.
• Footwear advice.
• Pressure reduction strategies.
• Custom Foot Orthoses where appropriate.
• Foot Mobilisation Therapy (FMT), once acute inflammation has resolved, where appropriate.
• Management of ongoing joint stiffness or secondary biomechanical problems.
• Referral to your GP for investigation and, where appropriate, ongoing medical management.

Our goal is to help reduce pain, restore mobility, and minimise the long-term impact gout may have on your feet.