Should You Stay Off Your Feet with Gout

Gout, a common type of arthritis that has to do with excess uric acid in the body, usually affects the joints of the feet. The affected joint can be painful and stiff, which sometimes could be severe enough to interfere with your daily activities. Lifestyle measures, changes in diet for example, are required to help soothe the flare-up. How about exercise? Should you keep active or stay off your feet with gout?

Gout often affects the feet, especially the big toe

The story starts when you have too much uric acid in your bloodstream. Uric acid is a waste byproduct from (1) your own body mechanism (the destruction of old, damaged cells) and (2) the metabolism of purines, a substance found in foods.

Over time excess uric acid may form deposits of microscopic, needle-like urate crystals that accumulate in the body somewhere. The body marks these crystals as a foreign subject. As a result, infection fighting cells like white blood cells are sent to the affected area, and inflammation occurs. The inflammation is usually also followed with swelling, redness, tenderness, and warmth (heat).

Mostly, gout affects the feet. Excess uric acid from the bloodstream is likely to accumulate in the feet, especially in the joint of the big toe. This is not always easy to explain, but gravity may have a role. Gout is also quite common to be found in the knee and ankles. Sometimes it may affect fingers, elbows, hip, and heels (see also gout in the heel).

This suggests that gout is not only about swelling in the big toe. It can also affect many other joints of the body. At its advanced stage, it can affect more than one joint at a time.

Your diet is important, but it’s not everything!

Diet plays a key role to control your uric acid level. A number of foods are high in purines, for examples; saturated fats (e.g. red meat, organ & glandular meats), alcohol, shellfish, and a few vegetables (e.g. spinach and asparagus). If you eat them a lot, this will boost your number much higher than normal.

Changes in diet can help control the uric acid production in the body. But other lifestyle measures are also important! Exercise, for example, is also vital. It is one of other important pillars to deal with arthritis, including gout.

But it’s also important to understand when and how to exercise with gout. It’d better to work with your doctor for more guidance. Sometimes medication is necessary if lifestyle measures are not enough to treat and control the disease.

A few medications for treating another condition may also have an effect on your flare-up. For instance, diuretics for treating hypertension! Diuretics can reduce the amount of fluid in the body, causing the buildup of uric acid crystals more likely [1].

It seems that a number of factors can affect your treatment plan. With the combination of appropriate strategies — diet low in purines, maintain a healthy weight, regular exercise, and medications (if necessary) — your gout is likely more controllable instead of relying on diet alone.

So, should you keep off your feet with gout?

During flare-up, the affected joint can be so painful. It usually also become swollen, red, tender, and very stiff in the morning. In such case, you’d be willing to do anything to get rid of the flare-up quickly. How about exercise?

This depends on your situation. If there is a gout inflammation in your feet, excess physical activity with the affected joint could be counterproductive. Exercising an inflamed joint would prolong the inflammation, worsen your gout symptoms, and make the flare-up take longer to go away. In such case, all of your efforts should be focused toward soothing the inflammation, take a rest! Meanwhile, ice/cold applications may help. You may also need anti-inflammatory medications to get rid of the inflammation more quickly.

How long it takes for the inflammation to relieve can vary. But in general, it lasts for several days, probably about 3 to 14 days.

In this period of recovery, you need to take good care of the affected joint. But gently moving it through its full range of motion, do this carefully, would sometimes be effective to prevent stiffness.

Once the inflammation has quieted down, your body probably is ready for exercise. Just listen to your body signals, you’re the only one who knows your condition most. But to keep safe, discus with your doctor!

Gradual exercise is recommended to help re-establish the affected joint and restore the strength of the muscles around the joint. Start with easy & low-impact, range-of-motion exercises. Progress slowly and gradually to allow your body get used to the program.

In long term, regular exercise would provide lots of benefits. These include increasing muscle strength, improving your joint flexibility, good for your cardiac fitness, and important for your endurance. What’s more, it is a good way to keep your weight healthy and promote an improved sense of well-being.

But, it’s also important to understand what ‘good’ and ‘bad’ things when you exercise with arthritis. Here are few things to remember:

  1. You can still participate in a variety of exercise programs, but ‘Not all’. Typically, any exercises or sports that involve high-impact /pressure on your joints are not recommended.
  2. Your exercise would give a big impact on your gout prognosis in long term. So do it regularly, choose exercise program you love most so you can make it a habit.
  3. Make sure it’s not too much, avoid strenuous exercise! If you experience pain, swelling, or other negative effects – stop your exercise, and see a doctor for guidance!

If necessary, ask your doctor whether you need a physical therapist. A professional, physical therapist who has experience training people with arthritis, would design an exercise program that you can enjoy most.

Gout is incurable, but it’s very manageable. With appropriate strategies, it’s possible to stay in remission for years. On the other hand, if the disease is left untreated (poorly controlled), you’re at high risk of serious complications which some could be life-threatening.

It usually takes months or years before other attacks return after the first gout attacks. Without preventive strategies, the next attack would come back more quickly. And later attacks would be more severe. Over time, the flare-ups may become more frequent [2]. So if you have gout, never ignore it – controlling its progression is a must!

Resources:
  1. Diuretics and gout, April Chang-Miller, M.D. Published on Mayo Clinic
  2. Gout, published on the American Academy of Orthopaedic Surgeons (AAOS). Retrieved from here!