OK - this is my third gout attack in my life. I am a 41 year old male, 6'2", 225lbs. I thought I could recognize an attack coming on but this one really threw me. I was wondering if others had this happen or if someone could explain what is going on.
I was playing basketball and a large guy landed his weight right on my right foot. It stung a little right then but I kept playing and even forgot about it. The next morning I felt some pain in the upper top-part of the middle of my right foot - kind of felt "sprained". So I figured I would just walk it off and it would go away.
My previous two gout attacks started off really painful and right in a joint (big toe and knee) and I had not had one in over 2 years (lost some weight, exercising more). So... when this pain came on I completely missed it as a gout thing.
For the next few days the pain got progressively worse but still did not feel like a joint pain like the gout I had before. Also there was no tell-tale swelling, redness, or high heat area on my foot.
BUT- Day 5 woke up with an inflamed joint above my big toe in the right foot - GOUT. It was here. The pain, throbbing, redness, inflamation, swelling, etc. But... not as painful as previous attacks, i.e., I could still manage to put on a shoe and walk and go to work. My last two flare ups required an immediate trip to urgent care. I can't remember the drugs they gave me but I was able to recover completely in about 5-7 days each time.
I generally hate taking drugs and worry about the side-effects. So when this flare up happened but I could still walk, I figured I would wait it out, try some chery juice,etc. After two weeks I caved and got a prescription for Colchicine. .6mg a day for 5 days. Worked great but did not totally remove swelling.
Bottom line, I am 4 weeks into this attack and while the pain is not terrible, I can't walk without a limp and the left side of my right foot continues to swell to different sizes every day.
1) How does injury trigger gout attack? I tought it was all diet, weight, consumption related.
2) Does waiting too long into an attack mean that the prescription meds won't work? And why?
3) What the heck can I do now? Am I at risk for permanent damage due to the length of this flare up?
Hi there! Lets see if I can help you with some insights.
1) One thing you should realize; gout loves injuries! If you have had gout before chances are that an injury would trigger a gout attack. As we know by know gout is very specific to each individual. What usually triggers an attack in other (diet, weight, consumption)does not necessarily mean that will be so in your case. And of course gout is not limited to the usual joints. Your foot is full of little joints that could also be affected. But the possibility that you might have fractured one of those little foot bones also exist. You might consider going for an X-ray just to rule this out.
2) Waiting into an attack obviously is never a good idea. It just elevates the risk for damage to joints and tissues which you do not want. The prescription meds should still do its job though it might take a bit longer or you might need to increase the dose a little (but please not without your doctors knowledge).
Colchicine has a dual purpose: it helps prevent attacks and helps end them when they do occur but it is not an anti-inflammatory. Ibuprofen or Diclofenac would help get the swelling down. I have to tell you that this sounds like an injury to one of the little bones in your foot which THEN triggered a gout attack in the joint of you toe. I would have that checked out if I where you.
3) Your doctor would be the best one to help you here. The risk is always there. Again, if you have an X-ray taken your doctor will be able to see if there was damage done to the joint and then you can take it from there. Hope this helps!