What Is Gout?
Gout is one of the most common and most painful forms of inflammatory arthritis. It occurs when uric acid levels in the blood become elevated (a condition called hyperuricaemia), causing microscopic uric acid crystals to deposit in the joints. These crystals trigger acute inflammation, resulting in sudden, severe joint pain that often comes on overnight with little warning.
The most commonly affected site is the big toe joint (first metatarsophalangeal joint), though gout can affect the ankle, heel, instep and metatarsals. Attacks typically subside within one to two weeks without treatment but recur more frequently and with greater severity over time if the underlying cause isn’t addressed.
What Causes Gout?
Gout develops when the body produces more uric acid than the kidneys can efficiently excrete. Contributing factors include:
- A diet high in purines — red meat, shellfish, offal, and alcohol (particularly beer)
- Obesity and excess weight
- High blood pressure and certain blood pressure medications
- Kidney disease or reduced kidney function
- Hereditary predisposition — gout runs in families
- Dehydration, which concentrates uric acid in the blood
- Sudden illness, surgery or crash dieting — all of which can trigger a flare
Gout predominantly affects men and is rare in women until after menopause, when rates become more comparable.
Signs of a Gout Attack
- Sudden, severe pain in the big toe, ankle, heel or midfoot (often starting overnight)
- Intense swelling, redness and warmth at the affected joint
- Skin that appears shiny or glossy over the joint
- Extreme tenderness (even light contact from bedding can be unbearable)
- Pain that peaks within 12–24 hours and gradually subsides over days to weeks
Gout typically affects one joint at a time. If you’re experiencing recurring acute attacks or pain spreading to multiple joints, it’s important to seek assessment. Untreated gout can lead to permanent joint damage and the formation of tophi (uric acid crystal deposits) around the joints.
How We Treat Gout
Gout management involves both addressing the acute attack and reducing the risk of future flares.
A podiatrist’s role is to manage the foot and ankle manifestations (the pain, swelling, joint function and footwear impact) while working alongside your GP, who manages uric acid levels and any medication.
At Highett Podiatry, our approach may include:
- Diagnosis and assessment — confirming gout as the cause of joint pain and ruling out other conditions such as infection, bunion flare-up or stress fracture, which can present similarly
- Acute attack management — advice on rest, elevation and offloading the affected joint
- Footwear assessment — identifying footwear that accommodates swelling and reduces joint irritation, particularly around the big toe and ankle
- Custom orthotics — to redistribute load away from affected joints and improve long-term foot mechanics, particularly where gout has caused ongoing joint changes
- Dietary and lifestyle guidance — practical advice on purine restriction, hydration and weight management to reduce uric acid levels over time
- GP referral and co-management — your GP prescribes anti-inflammatory medication and uric acid-lowering drugs. We work alongside your GP to ensure foot-specific care is coordinated with systemic management
Why Choose Highett Podiatry?
Gout can be mistaken for other causes of foot and ankle joint pain, including bunions, stress fractures and joint infections, and an accurate diagnosis matters before any treatment begins.
Our podiatrists are experienced in assessing acute and chronic gout presentations across the foot and ankle and work in conjunction with GPs to ensure both the immediate flare and the longer-term management plan are addressed.
We offer appointments at our Highett and Mentone clinics. No referral required.