Is this Gout or a bad shoe?

[Luke S]

I had my middle toe swell up a couple times this year. First couple times were after rigorous hiking in shoes that weren't my normal barefoot style shoes.

This is the latest flare up. Any ideas what this is? A friend thinks gout. I'm not so sure.
The first couple times I had this happen when I was hunting or backing. I could not change shoes or stop walking. Those times it was bad. This time I felt the soreness start in the middle of a road trip. I was wearing boots that felt a bit snug. Once I felt the swelling I immediately switched to Merrell Trail Gloves (soft soles, lots of root).
So the problem does respond to footwear. But I've switched back and forth between barefoot shoes and stiffer boots fir a while before this.

 

[pacoalcracker]

just swelling or with some pain/discomfort? i had gout in my right shoulder, right out of the blue. extremely painful at times. changed the diet and take a daily pill...no more pain. must keep venison to a minimum...it has a lot of purine which brings gout on, as well as a "rich" diet.....

 

[Luke S]

Not really painfully unless I walked on it or messed with it.

 

[pacoalcracker]

well, eat a diet less "rich" and see if it goes away....thats why they call it the rich man's disease. i take a 1x/day 300mg of allopurinol tablet to keep the gout away because i like eating good food, but did cut back a good bit. like i said, venison is really high in purine so i don't eat much of it...same with turkey meat.

for most people gout starts in the feet or knees and it can worsen over time to be a crippling disease so get ahead of it. however, it can start in any joint in your body. in the beginning i could not even lift my right arm for weeks....but a cleaner diet and the pills helped and after about a month it was just 1/10th as bad. after about 4 months it was gone. it's a lactic acid that builds up in the joints and then crystalizes creating a grinding away of the cartlidge. that causes the pain/discomfort but over time it destroys the joint.

your dr can test your urine to see if it is in fact the gout.

 

[Luke S]

Well I need to cut sugar and red bulls anyway. I can wear Mukluks and barefoot style shoes pretty much all winter so I'll see how that goes. I used to hike and run exclusively in barefoot style shoes. Worked great. When I moved to Alaska I started wearing hiking boots because trail runners got cold. But with the new options out there I might be able to go minimalist again.

 

[pacoalcracker]

well, if you continue to have an issue with it get the urine tested and if it is gout and diet changes don't remedy it you have the option of the tablet. living with gout isn't an option as it will get worse and potentially spread to other joints. as the old cowboy saying goes....no hoof, no horse.

not just sugar, rich foods in general...but that's a start. it isn't easy to give up or even cut back on your favorite dishes.

 

[Axlrod]

well, if you continue to have an issue with it get the urine tested and if it is gout and diet changes don't remedy it you have the option of the tablet. living with gout isn't an option as it will get worse and potentially spread to other joints. as the old cowboy saying goes....no hoof, no horse.

They check your uric acid level with a blood test, not a urine test. There is also pseudogout, caused by calcium crystals in the joints.

 

[mt100gr.]

Look up "Capsulitis"

Cutting a hole out of your insole may relieve pressure on the balls of your feet.

 

[Luke S]

The ball of my foot seems fine. It's the actual toe that is the problem

 

[Valumpessa]

Gotta be gout. I had it in my big toe earlier this year and it looked exactly like that. Hurt like hell to the touch or when I walked on it. Took a couple months to fully recover.

 

[mt100gr.]

I had some miserable inflammation in my toe joints - from the "root/web" thru the first knuckle - and started trying to rule things out. The ball of my foot felt fine but the flexing of my toes and the linkage there on the bottom of my foot somehow played a role.

I cut about 1.5-2 inch ovals out of my insoles and it helped immediately. The cutouts were right behind my toes and gave that area on the ball/pad of my foot that little bit of space/ clearance /relief.

I've used those insoles a couple times since then when it seemed to be flaring up.

 

[mt100gr.]

And I admittedly know exactly nothing about gout. Hope you find some relief.

 

[Luke S]

Gotta be gout. I had it in my big toe earlier this year and it looked exactly like that. Hurt like hell to the touch or when I walked on it. Took a couple months to fully recover.

Hum. Mine has never lasted for more than a couple days.

 

[wyosam]

Looks a little like gout (aka too much bacon toe), but not really a slam dunk based on presentation.


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[Pdrechsler]

Usually gout is really painful to the touch. Based on what you’re describing, seems to be more irritation

 

[OrthoNPBeau]

Could be gout but I doubt it. That location would be an unusual presentation. I think of cellulitis when I see that. Does it itch? Sometimes a stress fracture will present as focal redness like that. A frequent thing I hear with gout is it hurts for the sheets to touch it.

Do not take allopurinol during an acute attack. It will make the attack worse.

Contrary to popular belief- acute gout does not mean an elevated uric acid level. I can't begin to tell you how many people I have seen with acute gout flare ups and normal uric acid levels.

It it looks like gout- treat it like gout. You will know pretty quick if you are treating the right thing or not.

 

[CRJR45]

I had my middle toe swell up a couple times this year. First couple times were after rigorous hiking in shoes that weren't my normal barefoot style shoes.
View attachment 813146
This is the latest flare up. Any ideas what this is? A friend thinks gout. I'm not so sure.
The first couple times I had this happen when I was hunting or backing. I could not change shoes or stop walking. Those times it was bad. This time I felt the soreness start in the middle of a road trip. I was wearing boots that felt a bit snug. Once I felt the swelling I immediately switched to Merrell Trail Gloves (soft soles, lots of root).
So the problem does respond to footwear. But I've switched back and forth between barefoot shoes and stiffer boots fir a while before this.

I had the same thing , the Dr said Neuroma , sent me to podiatrist , he said it some kind of cyst , Morton Cyst I think .
Do toe yoga for it , it helps .

 

[CRJR45]

Morton's neuroma is a noncancerous thickening of the tissue around the nerve that runs between the metatarsal bones in the foot. It's also known as an interdigital neuroma.

Symptoms include: Sharp pain between the toes, Burning pain while walking or standing, Inflammation between the toes, Numbness and tingling between the toes, and Pain and swelling under the balls of the

 

[Luke S]

No sharp pain between toes
No itching or burning type pain. Feels more like a jammed finger or toe.
Nothing under the ball of the foot.

Those would seem to rule out Mortons Neuroma.

Sounds like gout is possible but less likely. I'm leaning towards a jammed toe that may be getting re injured when I wear shoes that put it in bad positions.

 

[CRJR45]

I wouldn’t rule out Morton’s yet . That how my foot feels now , as you described, but I’ve had it flair up and be very painful.
I would show you my feet , but nobody wants to see that , trust me.
But my second toe is much bigger on my right foot , looks like your picture.