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Non-sudden slow-build-up gout?

Posted , 5 users are following.

matt14241
matt14241

Hi there. About 9 months ago I had a swollen how knee. The doctor decided it was most likely to be cellulitis, bursitis or possibly gout, so arranged for me to have a uric acid test, which came back high. They warned me to be on the lookout for the usual symptoms.

I'm a little confused as everything I've been told/read says that gout attacks come on very suddenly. However, for the last 4 months I have had some pain (aching) in and around my big toe. Mostly it's around the joint but it does sometimes stretch up the toe itself, particularly towards the opposite edge.

It's fairly low-level, and on its own doesn't feel like much to be concerned about. It doesn't noticeably affect my walking (the pain is generally as I am lifting my foot). Occasionally (once or twice a day perhaps, mostly late in the day) I will have a twinge of sharper pain - generally whilst it's at rest. This will last a few seconds and then go away.

Like I say, on its own it doesn't seem a problem, but I'm concerned about whether it's a sign that sometime soon I'm going to wake up in agony. Are these normal symptoms?

1 like, 13 replies

13 Replies

  • ChrisW
    ChrisW matt14241

    Posted

    Hi

    If your uric acid levels are high have they put you on Allopurinol or something similar like Febuxostat or Sulfinpyrazone?

    The problem with high uric acid levels is that after time the acid crystalises into sodium urate which forms in and around the joints, this may explain why you are experiencing continual pain

    Thanks

    • matt14241
      matt14241 ChrisW

      Posted

      Thanks for the reply ChrisW.

      No, they didn't put me on anything, just told me to keep an eye out for symptoms, which I it would seem misinterpreted to just mean the sudden night-time attacks.

      Interestingly, after reading your reply I googled sodium urate and the wikipedia article which came up (http://en.wikipedia.org/wiki/Uric_acid#Gout) also mentioned kidney stones. I woke up three consecutive mornings last week with pain in my right side and also had a bit of discomfort weeing. It passed (no pun intended) and again, wasn't like the nightmarish descriptions I've heard, so didn't think too much of it.

      Sounds like I should go back to the doctor.

  • keith48631
    keith48631 matt14241

    Posted

    Very strange Matt the usual onset of a gout attack is to be awakened by intense pain in the early hours of the morning. Although this is not always the case, having suffered gout for over fortyfive years a gout attack can come on at any time of the day with an unpresented vengence.

     

    • matt14241
      matt14241 keith48631

      Posted

      Thanks Keith.

      Based on what I've read, it does make sense that the knee issue may have been gout. I forgot to put further details but it was hot, swollen and  very painful and I could barely bend it for 2 days. I did feel a bit of discomfort the first evening but it really got started overnight.

      The toe thing does seem very different - it's a much lower level achey pain, and has been continuous for months now. It does sometimes feel warm "itself", but when I touch it with my hand the temperature seems normal. I do sometimes feel similar symptoms in the other big toe, but that comes and goes and is less painful. There are spells where the toe seems a bit itchy but it's mostly ache. It's not swollen, although it does look quite dark around the joint.

      I have read things about sprains etc, but they all seem to suggest that they would recover much more quickly than this.

  • timothy12884
    timothy12884 matt14241

    Posted

    The build up may be slow, but the result is some real pain. That is unless you change your life style. Eating, drinking, exercising loseing weight is what you need to be concerned with before it's too late. See a diatician,  google gout diet, gout foods, alkaline foods, purines ( from organ meats, sausage, beef or beer etc. ). 

        Your body is becoming toxic to the point crystals are forming in your blood as your kidneys can not get rid of the over abundance of purines and acid. Those crystals will form in your joints, swelling, and feel like glass shards as you move the joints with the crystals in them. You could damage your kidneys or joints, not a good choice. 

        I had it for a year and just thought I was getting old. The pain was there one morning when I woke up. Yes it was pain I woke up with my big toe on the left foot was red, swollen and real pain that made me limp. Then someone said it may be gout. At age 57 some of my friends had it also. So I learned all about it from the internet. I had it and ate better choices until it went away. But it came back worse each time. Now I'm real careful what I eat and stay alkaline rather than acidic. I don't do burgers very much any more but I still have a steak now and then (once a month). By the way I am not on any meds and staying alkaline.

    I don't like the pills and damage they may do to liver and kidneys. You have to make the choice to do it with meds. or diet. By eating right I've brought my acid level down from 13.4 to 4 but not its back ot 6 which is normal.

    Good Luck take action before the pain get to be too much.

  • matt14241
    matt14241

    Posted

    Just to give a bit of an update...

    About four weeks ago, I starts to get an increase in the frequency and intensity of the sudden short twinges, and also warmth in both toes on a couple of evenings. This finally made me go back to the doctor, who told me that it seemed like I was on the cusp of having a gout flare-up. She suggested I take ibuprofen four-hourly, which I did for a few days. I also immediately cut-out marmite and pate from my diet, and ensuring I was getting a proper amount of water. The symptoms subsided a great deal and I switched to only taking ibuprofen when I felt them coming back.

    However, something very interesting happened at the weekend, which was that the pain when walking came back, but this time it was stretching from the joint into the arch of my foot. It felt rather like plantar fasciitis, which I've suffered from before, but obviously in a different location and later in the day. I googled toe pain and foot arch and found loads of results about sesamoiditis, which I'd never heard of before. The symptoms seem much more of a good fit than gout ever did, and I have flat feet which is apparently presents a higher risk. So I suspect much of what I've experienced has been that, with possibly a bit of borderline gout for a couple of days before I went to the doctor.

  • W-H
    W-H matt14241

    Posted

    My gout built up over a period of one year. I had CONSTANT low intensity pain in my toe. It screwed with my head for a year then on top usless docs screwed me even more by coming out with silly diagnosis.

    After which I got my 1st traditional full blown gout attack. Nothing since last 5-7 years.

  • matt14241
    matt14241

    Posted

    The saga just gets weirder and weirder.

    I went to the doctor about a stubborn cough last week, and she, having looked through my recent notes, asked me about the gout thing. I explained that the symptoms had mostly calmed down, and mentioned the semasoiditis, which she'd never heard of and didn't seem very fussed about finding out about. She did decide to prescribe allopurinol (300mg, which from what I've since read seems strangely high for someone who's never had a confirmed gout attack) - she explained that whatever the symptoms were, the high uric acid result I'd had was a concern and that either way I would not want a gout attack. So I've now been taking that for 8 days.

    Yesterday, during the day I noticed a continual increasingly strong, dull ache in both big toe joints - if anything worse in the left, which up to now has been the less bad one. Unlike most of the dull pain, it was worse when my feet were at rest.

    After I went to bed, I woke after a couple of hours and it had got worse, but there were also sharper pains further up my big toes. It felt like they were starting to swell but there was no visible change and no warmth. I had some ibuprofen, did a lot of panicking but eventually fell asleep and woke up fine. Now I'm getting a repeat of yesterday's aches.

     

  • ChrisW
    ChrisW matt14241

    Posted

    Allopurinol can actually kick off a gout attack before it gets the uric acid levels under control

    I would ask for some colchicine which can be nasty if you take too much, but should sort the attack out

     

    • matt14241
      matt14241 ChrisW

      Posted

      Thanks Chris. I've just had a look at the NHS page on gout and it explains that and it all makes sense. It's been quite eye-opening, and actually fairly encouraging, as the weirdness it's causing would suggest that these crystals are really there, and that the allopurinol is presumably dealing with them pretty effectively.

      I've made a phone appointment, so I'll ask about the colchicine. Of the many times when I've falsely been convinced that I would wake up with an attack, last night was definitely the worst, as both my toes, both knees and to a lesser degree pretty much all my other joints were all feeling like they were about to explode, and they all felt exactly like my knee did when it first swelled up with the then-suspected cellulitis/bursitis.

      What was perhaps most interesting was that my finger joints were pretty bad, and one particular the inside of one of my middle finger joints. About two years ago I ended up at A and E because that joint swelled up and eventually went pus-y and had to be drained. I'd decided at the time that it must have been a splinter, since that was what it had originally felt like, but based on what happened last night I'm guessing that might have been my first attack.

    • matt14241
      matt14241

      Posted

      Just spoken to the doctor who was very apologetic about not having told me to expect this and prescribed the colchicine. She helpfully described the likely side-effects of that and quipped "with gout we make you run before you can walk" lol
    • ChrisW
      ChrisW matt14241

      Posted

      good luck

      I tend to take about 6 tablets maximum in a day then give my system a day off to recover

  • frances58388
    frances58388 matt14241

    Posted

    I have just been diagnosed with gout.  I was recently in New York visiting my son and his family.  They have a new puppy who I took for a walk wearing flip flops (of course I had other clothing on).  The following day the base of my toe was swollen and painful and I swore that the puppy had yanked the lead and I must of twisted my foot.  I spent the rest of my trip hobbling around, needed assistance at the airport as I was unable to walk and hold my hand luggage, needed a fit to fly certificate before they let me on the plane and was met with a wheelchair the other end. 

    I went to see my doctor the following day who diagnosed goat sent me home with anti-inflamatorys and said to come back in a fortnight.  30mins after taking the meds I could put my foot down and walk without limping.  This is the third day and the foot is almost back to normal, still a bit swollen. I don;t know where I go from here.  Will it come back? Will I have to take meds for the rest of my life? Perhaps someone else can let me know their story

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