Gout of the legs is one of the serious diseases of the joints, which is characterized by the deposition of uric acid salts in the joints. This disease cannot be completely cured, but you should not turn a blind eye to this problem. Periods of exacerbation of gout are characterized by very acute symptoms that disrupt human life. Therefore, people with this problem need to know what and how to treat gout on the big toe.
General information
The key reason for the development of gout on the legs is the deposition of uric acid crystals on the surface of the joint structures. In medicine they are called sodium urates. This substance appears as a result of the breakdown of nitrogenous substances - purines, these substances are part of the molecules of protein structures. Uric acid is by its nature a powerful natural antioxidant; under its influence, oxidative processes are inhibited, which negatively affect cells. Uric acid is also a powerful stimulant of brain activity.
Sodium urate deposits can appear in any joint joints, but most often gouty changes are diagnosed in the joints of the lower extremities. Since a person is constantly moving, his lower limbs constantly suffer from high loads. Also in this area there is a slowdown in systemic blood flow. Normally, a small amount of uric acid should be detected in the blood fluid, since if there is an excess, the kidneys actively remove this substance.
Sometimes the concentration of this element in the body rapidly increases, resulting in its crystallization on the surface of the joints. The main provoking factors for the development of gout also include:
- disruptions in metabolic processes;
- various diseases of the urinary system organs of chronic origin, as a result of which their functional activity decreases;
- excess amount of purines that enter the human body along with food. Most often, these are products that contain a large amount of animal proteins and nitrogen: fatty varieties of meat and fish products, seafood, mushrooms, legumes.
Often, specialists diagnose the presence of all of these provoking factors simultaneously, and this is a powerful impetus for gout in the legs to develop much faster. Most often, men undergo such pathological changes, since changes in their hormonal background are observed much more often. In women, this disease is diagnosed much less frequently, its symptoms are less pronounced, the most common manifestation of gouty arthritis is a “bone” on the leg.
Experts have proven that dietary errors are the most common provoking factors in the development of gout. That is why in complex treatment a specially selected diet is mandatory.
Rheumatologists also identify a number of reasons that can provoke gouty changes in the joints:
- genetic predisposition, which is most often associated with metabolic disorders;
- diseases of the urinary system of chronic origin, in which normal kidney function is disrupted and the composition of urine changes;
- prolonged and uncontrolled use of diuretics, without medical supervision, without monitoring health status. The result of long-term use of diuretics is dehydration of the body, blood viscosity increases, and as a result, the concentration of uric acid increases sharply;
- chronic infections and inflammatory processes caused by streptococci. These are tonsillitis, tonsillitis;
- systematic mechanical loads and injuries of articular joints - dislocations, bruises, fractures;
- hypothermia of the lower extremities;
- wearing uncomfortable shoes for a long time, incorrect shoe size.
Gout on the legs is difficult to treat, but if you start taking therapeutic measures in time, you can cure the disease much faster, as well as prevent the development of dangerous health consequences.
Clinical picture
The key clinical manifestation of gouty arthritis is acute pain in the joint. Most often it occurs at night or early in the morning. An attack of pain appears unexpectedly and can be so intense that a person cannot find relief from the pain and tries to relieve it by changing his body position. During the daytime, pain in the joint may decrease slightly, but with the onset of night it becomes severe again. Such symptoms usually last for about three days, then the attack of pain goes away on its own.
Regardless of the location of the pain, the symptoms of gout are the same. When the disease worsens, redness and swelling of the affected joint is noted, its deformation gradually occurs, and it becomes larger in size. At the same time, there is a local increase in body temperature and limited joint mobility. If a person stands on the sore leg, the pain becomes more intense.
Another clinical manifestation of gouty arthritis is tophi. These are painless subcutaneous nodules that form near the affected joint as the disease progresses. Inside these nodules there is a deposit of uric acid salts. Small tophi appear on the surfaces of the joints of the toes; near large joints they can grow the size of a chicken egg. As the disease progresses, painful ulcers appear on the surface of these nodules, and white, pasty contents flow out. When the exacerbation of the disease passes, the ulcers heal.
If gout of the ankle joint develops, the foot becomes bent and the heel turns out. If the hip joint is affected, the leg also becomes bent.
Stages
Experts classify several stages of development of gout on the legs, each of them is characterized by its own clinical picture:
1. At the first stage, there are no pronounced changes in the joints. Any pathological changes are visible in a biochemical blood test, since an increased concentration of uric acid is determined.
2. When the disease passes into the second stage, an acute form of gouty arthritis of the joints develops. This is accompanied by swelling and inflammation. First, the joint of the big toe is affected, then the neighboring joints begin to suffer.
3. At the third stage, attacks of pain occur; they do not last long, but they are intense. The remission period may last several months. As the disease progresses, it decreases, and relapses occur more often.
4. At the fourth stage of gout development, pathological changes in the joints are visible to the naked eye - the joint is deformed, tophi are visible.
Why is gout dangerous?
Without adequate treatment, gout progresses rapidly, especially in mature and elderly patients. Without appropriate therapy, serious complications are possible.
Major complications
Gouty arthritis Uric acid, in the form of crystals (tophi) is deposited in all parts of the body. When such deposits become lodged in joints or periarticular tissues, severe inflammation occurs. This leads to severe pain and fever
Urolithiasis Crystals that occur with gout often form in the kidneys. They become the main cause of kidney failure and ultimately lead to the death of the patient.
With gout, kidney stones can form at all stages of the disease, excluding the first
Diagnosis of gout on the legs
Diagnostic measures begin with an external examination by a specialist. The doctor collects anamnestic data and conducts a survey regarding complaints. It is important to find out how severe the pain syndrome is, determine the intensity of joint swelling, and detect whether there are tophi. Next, the doctor refers the patient to the following types of diagnostics:
- general blood analysis;
- general urine analysis;
- synovial fluid samples;
- radiography;
- scintigraphy;
- computed tomography or magnetic resonance imaging;
- blood chemistry.
In the general blood test, if there is gout, there is an increase in the concentration of leukocytes, the leukocyte formula changes, and an increase in the level of uric acid is visible. Any changes in the urine are diagnosed only if the inflammatory process has affected the organs of the urinary system.
When puncturing the synovial fluid, specialists find urate crystals in it. These deposits are also visible on X-ray images.
Causes and symptoms of the disease
Most often, this inflammation of the big toe is diagnosed in men after 40 years of age, although it can appear earlier. The cause of the development of pathology is an increased level of uric acid, which is converted into salt and deposited between the bones of the joints. It is these deposits that provoke the development of the disease process.
Acid production is stimulated by excessive alcohol consumption, smoking, and unhealthy diet (eating foods that are difficult to digest, as well as foods high in purines).
As for the symptoms, they are as follows: severe pain, which manifests itself mainly at night; the appearance of swelling and an increase in local temperature in the affected area. In addition, your overall body temperature may increase.
Gout is a chronic disease that will accompany a person throughout his life. However, proper therapy will help to significantly reduce the frequency of acute gout attacks and enable a person to lead a full life.
Gout on the legs: treatment
With the development of gouty arthritis, hospitalization of the patient in a hospital is required in extremely rare cases, if pathological changes have affected the kidneys. With the development of the articular form of pathology, outpatient treatment of gout on the legs is recommended.
Conservative treatment of gout on the legs is prescribed with the help of non-steroidal anti-inflammatory drugs - Butadione, Reopirin, Indomentacin. They are produced in the form of tablets, ointments, and injections for intramuscular administration. These drugs effectively relieve the inflammatory process and reduce the severity of pain.
Among the specific drugs for the treatment of gout on the legs, due to which it is possible to stop attacks of gout on the legs and have a positive effect on metabolic processes, one can highlight: Allopurinol, Allomeron, Colchicine, Urodane. Colchicine is administered intravenously. This drug is very effective during an attack of illness.
During complex treatment of gout on the legs, in addition to medications, physiotherapeutic procedures are indicated. Thanks to such procedures, it is possible to improve blood circulation and metabolic processes in pathologically modified joints. The following physiotherapeutic procedures are prescribed by doctors:
- irradiation with ultraviolet light;
- ultra-high frequency currents;
- shock wave therapy;
- balneology;
- use of paraffin applications;
- ozokerite applications;
- electrophoresis.
When the inflammatory process is stopped and pain is eliminated, the patient is indicated for massage and physical therapy. Such procedures contribute to the normal restoration of joint mobility. Massage of the foot, knees, and hip joint helps improve microcirculation of blood fluid, helps reduce the size of tophi, accelerates the removal of uric acid salts from the body, eliminates muscle spasms, and prevents the development of muscle contracture.
It is recommended that you learn foot massage under the guidance of a physical therapist so that you can perform this procedure yourself at home. Therapeutic exercise can also be performed at home after prior consultation with a physiotherapist.
Treatment
Features of drug treatment of the disease
The basis of gout treatment is taking medications. Therapy is divided into two stages: elimination of the acute period of the disease and basic treatment, which is carried out while the intensity of symptoms decreases.
Read more: Medicines for gout.
So, drug therapy involves taking the following medications:
- Non-steroidal anti-inflammatory drugs - Nimulid, Ibuprofen, Voltaren. These medications help relieve inflammation and pain in the big toe joint. In addition, they can reduce the intensity of pain. If gout occurs in attacks, the doctor has the right to prescribe a one-time injection of an anesthetic, which is injected directly into the joint.
- Local compresses and non-hormonal ointments for the treatment of joints - for example, Diclofenac. These remedies make it possible to eliminate swelling, redness and pain. If not one joint is affected, but several, then you will have to take non-hormonal antibiotics.
- Diuretics. To successfully treat gout in your toes, you need to get rid of too much uric acid in your blood.
Physiotherapeutic treatment
The disease must be treated comprehensively, using not only medications, but also physiotherapeutic agents. The patient is offered the following procedures:
- Magnetic therapy.
- Compresses with Dimexide or applications with paraffin. They warm up the joints well.
- Electrophoresis. This procedure makes it possible to destroy salt deposits and also helps remove uric acid from the body.
- Mud therapy.
- Ultrasound.
- Pulse currents.
Treatment with physiotherapeutic agents should be carried out only if the patient has no contraindications.
A good effect is ensured by manual therapy and physical therapy. However, these procedures must be carried out by an experienced specialist. For example, massage is done only after the acute period of illness has passed. Treatment of the disease with the help of special exercises for the legs allows you to develop diseased joints, improve blood microcirculation and metabolism, and also prevent further inflammation.
Another important procedure that can help treat gout is blood cleansing. It helps eliminate excess uric acid and prevents the formation of salts.
Features of surgery
In some cases, surgery may be necessary to treat gout of the big toe. But this procedure is used only if conservative treatment has not given a positive result, and the functions of the joint are limited due to osteophytes (bone growths).
The operation involves cutting out the growth or removing the affected joint.
In some cases, foot mobility becomes impaired after surgery, so this procedure should only be done as a last resort.
Diet
Gout of the leg joints is an insidious disease that requires an integrated approach to treatment. An important stage of therapy is changing the diet. To begin with, the patient will have to completely abandon those foods that the body does not digest well. That is, you need to exclude fatty meat and fish dishes, smoked meats, sausages, and canned food from the menu.
It is better for a patient with gout to forget about strong tea, coffee and alcoholic drinks. They help increase the concentration of uric acid in the body, which provokes inflammation of the joints. The disease requires an increase in daily fluid intake (juices, compotes, still mineral water) to 2.5 liters. However, this can be done if there are no contraindications from the cardiovascular system and kidneys.
For gout patients who have a lot of weight, it is advisable to try to lose it. It is better to eat more fruits and vegetables, cereals and soups. You need to forget about meat and fish broths, as they contain a large amount of purines.
Traditional treatment
The disease can be treated using folk remedies. The following recipes may be useful in treatment:
- Honey and salt compress. To prepare it, you need to thoroughly mix both components - honey and salt - in equal proportions. The mixture is placed on clean gauze and applied to the area of the leg where the inflammation is localized. It is better to leave the compress overnight. The procedure is repeated exactly as long as necessary to eliminate the symptoms of the disease.
- Lingonberry decoction. This folk remedy has a diuretic effect. The decoction should be taken at least 250 ml per day. You can add birch sap to this decoction, which will increase its effect several times.
Other folk remedies will be useful in the fight against disease and salt deposition in joints: decoction of chamomile, sage, pine cones, which are added to foot baths. They perfectly relieve inflammation and help quickly get rid of unpleasant symptoms. In pharmacies you can find a lot of homeopathic remedies or folk herbs that help fight the symptoms of gout in the joints.
Radical methods
If the conservative treatment of gout on the legs prescribed by the doctor does not bring results, the disease is diagnosed in an advanced form, there are complications, doctors consider the advisability of radical treatment of gout on the legs. Minimally invasive and invasive techniques can be used. A minimally invasive technique allows you to remove tophi, open the joint cavities in order to remove purulent contents from them if an acute inflammatory process develops. This operation is performed using local anesthesia.
In advanced situations, the patient is indicated for endoprosthetics, which involves removing the joint affected by the disease. A prosthesis is installed instead. But in the majority of cases, gout on the legs can be treated with conservative methods, and it is possible to extend the period of remission for a long time.
Disease prevention
So, inflammation of the joints cannot be completely cured, however, you can try to reduce the number of relapses. To do this, you should follow some rules of prevention:
- It is necessary to wear comfortable shoes that will not deform the joints and cause inflammation in them.
- It is also important to do a light foot massage yourself.
- Daily gymnastics will keep your joints in shape.
If you follow the doctor's instructions and diet, then gout may not make itself felt for a long time. Taking care of your health will make it possible to prolong the normal functioning of the joint. However, self-medication is in any case unacceptable.
Read the article about the role of hirudotherapy in the treatment of gout.
Unconventional methods
Any alternative medicine can only be used in combination with conservative therapy prescribed by a doctor. The following means are used:
- ointment based on poplar buds;
- St. John's wort decoction;
- larkspur ointment;
- cinquefoil decoction;
- propolis ointment;
- lubricate damaged joints with a mixture of iodine and crushed aspirin tablets;
- ointment based on red pepper.
Proper nutrition is required; the diet should contain a low amount of purines. Those patients diagnosed with gout on the legs are not allowed to eat mushrooms, legumes, fatty fish and meats, offal, fried, salty and spicy foods. It is recommended to consume large amounts of fermented milk products, cereals, vegetables and fruits.
These foods contain low levels of purines. It is not recommended to consume any oil - butter, sunflower, so as not to burden the kidneys and organs of the digestive system.
With complex treatment of gout on the legs, with the help of medication, folk treatment, physiotherapeutic procedures and proper nutrition, you can achieve a quick recovery, reduce the number of attacks, reduce the severity of their symptoms, and achieve stable and long-term remission.