Why does gout often start in the feet?

Gout is a common form of arthritis, causing sudden and intense pain in the joints, accompanied by redness and swelling, making it difficult for the patient to walk.

The blood uric acid index for men is at a fixed level of 210-420 umol/L and 150-350 umol/L for women. The amount of uric acid in the body that exceeds the safe level will precipitate into urate crystals in the joints. These crystals have a small, hard, sharp structure that can rub against the synovial membrane, causing swelling, pain and inflammation, creating acute gout attacks.

Gout can occur in all joints in the body but often starts in the toe joints for the following two reasons:

Temperature changes : Uric acid is very sensitive to changes in temperature. At low temperatures, the saturation of urate salts decreases, leading to the formation of urate salt crystals deposited in the joints. The foot, especially the big toe, is the part furthest from the heart, so blood circulation here is less than other organs in the body, causing them to have a lower temperature. Therefore, the big toe is often prone to depositing urate salt crystals, causing the onset of gout and the strongest inflammatory reaction.

The big toe joint is the most common location of damage during an acute gout attack.  Photo: Freepik

Microtrauma : The foot is one of the most active parts of the lower limb, so it can easily lead to injury. Even a minor injury can change the biological properties of the joint, including the pH, creating conditions for increased uric acid deposition in the joint.

Depending on the severity of the disease, the frequency of acute gout flare-ups can range from every few months to every few years. If not well controlled, when acute gout attacks occur frequently, the range of affected joints increases. From there, there is a risk of dangerous complications such as osteoarthritis, joint necrosis and disability; kidney stones, impaired kidney function, urinary tract infections; narrowed arteries can lead to stroke, heart attack, or other cardiovascular problems; depression; erectile dysfunction...

However, patients can still live with gout by maintaining the amount of uric acid in the blood at a stable level, thereby reducing symptoms and preventing the disease from developing. Patients should follow the doctor's instructions and have regular check-ups and pay attention in daily activities.

Follow a healthy diet , limit foods with high purine content such as animal organs, seafood, some beans, meat... Quit smoking, abstain from alcohol and stimulants. Patients should drink plenty of water to help eliminate excess uric acid from the kidneys and reduce symptoms of inflammation.

Regular exercise helps reduce uric acid levels in the blood and restore joint flexibility after acute pain. Exercise has been shown to reduce inflammation. However, patients should not exercise during an outbreak.

Reduce stress and get enough rest to prevent flare-ups.

Cold compresses are effective in reducing swelling, pain and inflammation, but should only be used when the patient has an acute gout attack.