…is an experience not to be recommended, but which frequently affects older people between the ages of 40 and 60, most often men, particularly those who are overweight or have a diet that is high in protein. During the 17th to 19th centuries the links with rich living were a target for laughter, caricature and cartoons. The great Dr Johnson suffered acutely from it. Even the public perception of gout today is not dissimilar – yet nobody who has suffered from this extremely painful condition finds it the least bit amusing. It is only rarely seen in pre-menopausal women and men under the age of 30, and rarely occurs in children.
It usually occurs as a persistent ache, often developing in a few hours and causing severe pain, typically but not exclusively in the big toe or other parts of the foot. A form of rheumatics, it may last several days, the joint extremely tender to the touch. Bed clothes at night can feel heavy and increase the pain, It is caused by an excess of uric acid, forming tiny grit-like crystals that irritate the tissues in the effected area.
Normally the uric acid is removed when urinating, but among patients with a predisposition for gout, the uric acid accumulates in the blood. Among some of these patients, the concentration in the blood is so high that the uric acid ‘overflows’ and settles in the joints.
It may help to ease the pain if you raise your leg and use an ice pack (frozen peas can have a new use!) for about 20 minutes. Doctors often recommend anti-inflammatory painkillers which may reduce the swelling and ease the pain, although if you are regularly taking a low dose of aspirin every day this may not be a good idea. Drinking lots of water helps.
What causes it? Too much alcohol may result in the otherwise harmless uric acid to build up, as can sugar sweetened soft drinks.
Obesity, high blood pressure, vascular disease and kidney damage can also be contributory factors. A blood specimen can confirm what may be happening and how serious it is. It is sometimes a recurring problem, although most people who are subject to gout may only have an attack now and then.
The UK Gout Society has an excellent website which contains much more specific medical information than I am equipped to provide. But back to my first sentence – Gout, I do not recommend it!