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28/Jan/2021

What do Queen Victoria, Jared Leto, Benjamin Franklin, Harry Kewell, Sir Isaac Newton, Michelangelo, Sir Alec Guinness and Jim Belushi have in common?

They all lived (or live) with gout.

Most people don’t realise that gout is the most common form of inflammatory arthritis in the world. According to the Global Burden of Disease Study 2017, there are 41 million adults with gout worldwide; that’s more than twice the number of people living with rheumatoid arthritis.

Gout is characterised by repeated attacks of extreme joint pain, swelling and redness. The most commonly affected joint is the big toe, but gout can affect your feet, ankles, knees, elbows, wrists and fingers.

Historical stereotypes

Gout has always gotten a bad rap. It’s long been associated with kings, lavish living and overindulgence of food and alcohol.

We now know this isn’t the case. It’s a complex, very painful condition that affects many Australians, who deal with stigma based on an out-of-date stereotype.

Women get gout too, as do people who don’t drink or eat meat. Gout is more complex than the historical image. Which is why some rheumatologists have suggested gout be renamed ‘urate crystal arthritis’ to lose the stigma attached to ‘gout’.

So what does cause gout?

Gout occurs when uric acid, a normal waste product, builds up in the bloodstream and forms urate crystals in a joint.

Our body makes uric acid when it breaks down purines, a substance found in our cells and in food.

Uric acid normally dissolves in your blood, is processed by your kidneys and leaves your body in urine.

If your body makes too much uric acid, or your kidneys can’t clear enough of it out, it builds up in your blood. This is called hyperuricaemia.

Having hyperuricaemia doesn’t mean you’ll develop gout. In fact most people with hyperuricaemia don’t go on to develop gout. Because of this it’s thought that other factors such as your genes may be involved.

Find out more about gout, including what you can do in terms of your diet and weight.

Call our Help Line

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.


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28/Jan/2021

We often associate gout with gluttony and enjoying too much alcohol. Historical images of gout include overweight, ruddy faced, aristocratic men or royalty such as Henry VIII.

But this isn’t the case and is too simplistic a view of a complex condition.

To find out more about gout, what causes it and how it’s treated, check out our gout info.

So what causes a gout attack?

If you have gout, you know that an attack happens suddenly, often overnight, and you’ll wake up in a lot of pain.

And it’s more likely to occur if you:

  • are male
  • have a family history of gout
  • are overweight
  • have high levels of uric acid in your blood
  • drink too much alcohol (especially beer)
  • eat a purine-rich diet (including foods such as red meat, offal, shellfish, fructose, beer)
  • use diuretics
  • become dehydrated
  • crash diet or fast.

Managing your weight

While you can’t control some of the risk factors to prevent a gout attack, you can control your weight. If you’re overweight, losing weight gradually and carefully can reduce your risk. However don’t go on a crash diet, skip meals or fast as this can also increase your risk of an attack.

If you need to lose weight, talking with your doctor and/or a dietitian is a really good idea to get the information and support you need to lose weight in a healthy way.

Other dietary changes

It’s believed that lowering uric acid levels through small changes in your diet may help reduce the chance of future gout attacks. These changes include:

  • restricting or avoiding alcohol
  • avoiding binge drinking
  • eating a healthy, well balanced, colourful diet. Research suggests that the DASH diet or Mediterranean diet may be helpful. Read our blog on anti-inflammatory diets for more info.
  • drinking plenty of water
  • avoiding fasting or crash dieting
  • making sure you don’t overeat on a regular basis.

Your doctor or dietitian can help guide you in making healthy changes to your diet.

Keep taking your medication

It’s important to note that dietary changes alone aren’t enough to address the underlying cause of gout – too much uric acid in your blood. For many years there’s been a misconception that simply changing your diet will help keep your gout under control.

However the research clearly shows that medication is needed for most people with gout to manage it effectively. So if you decide to make some dietary changes, discuss this with your doctor and continue to take any medication you’ve been prescribed to manage your gout.

Final word

Gout is a painful, complex condition that affects many Australians. But there are things you can do to take control, including managing your weight, making changes to the things you eat and drink and taking your medication.

Contact our Help Line

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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30/Jul/2020

Looking after your feet

Our feet are amazing ‘feats’ of engineering (sorry, I just couldn’t resist that one).

Each foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. They support us through thick and thin – whether we’re walking, running, jumping, dancing, skipping or hopping. We cram them into ill-fitting shoes, torture them in high heels and stub them against the bedside table in the middle of the night (or is that just me?).

As well as the many injuries and calamities that befall our feet, many musculoskeletal conditions, such as osteoarthritis, rheumatoid arthritis and gout can affect the feet.

They’re the unsung heroes of this pandemic as we hit the streets, parks and trails for exercise. Walking has become the exercise of choice for people at the moment. Many of us can’t – or don’t feel safe to – return to gyms or exercises classes. And lots of people are walking instead of catching public transport to avoid being in close contact with others. As a result we’re all walking many more steps than we did pre-COVID.

So we need to stop taking our feet for granted. We need to look after them so we can continue to do the things we want and need to do as pain-free as possible.

So what can we do?

Give your feet the TLC they deserve. It’s really important to look after your feet. Wash and dry them regularly. Inspect them for anything unusual such as cuts, blisters, changes to the nails and skin. By being aware of your feet and any changes that occur, you can seek advice sooner. And if they’re sore after a day of walking, maybe give them a warm soak in the bath, or in a bucket or a foot spa (if you have one) while you watch TV. Then dry them thoroughly and rub a moisturising foot cream into your skin. Take your time and give your feet a nice massage. Better yet, see if you can talk someone else into giving them a massage while you relax on the couch.

Manage your condition. If you have a musculoskeletal condition that affects your feet, it’s important that you work with your doctor and healthcare team to look after your feet and manage your condition effectively. The treatments used for foot conditions will vary from person to person, depending on your condition and how it’s affecting you. And this may change over time as your condition and your feet change.

See a podiatrist. If you have foot pain, or a condition that affects your feet, visit a podiatrist. They’re feet experts and can assess, diagnose and treat foot and lower limb problem, including skin and nail problems, foot and ankle injuries, foot complications related to medical conditions and problems with your gait or walking. Podiatrists can also give you advice on appropriate footwear, and can prescribe custom foot orthotics.

Consider orthotics. Orthotics are corrective insoles that can help alleviate pain by redistributing pressure away from the painful area and support your arches. You can buy off-the-shelf orthotics or you can have orthotics made that are specifically fitted to your feet by a podiatrist.

Fit your feet with appropriate footwear. With our worlds turned upside down due to COVID, and many of us having to stay home, it’s tempting to stay in our slippers all day. There’s something so comforting about warm, fluffy slippers. However our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

If you’re buying new shoes, make sure they fit properly, support your feet and are comfortable. Look for shoes that are light, flexible at the toe joints and are hard wearing. Shoes made of leather are preferable over synthetic materials as they breathe better. Avoid slip-on shoes and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces may be an option.

Let them breathe. Did you know you have about 250,000 sweat glands in each foot? That’s a lot of sweat! So let your feet breathe to avoid smelly feet and fungal infections. Change your socks and shoes at least once a day. Wear shoes that allow air flow around your feet: leather, canvas, and mesh are good options, avoid nylon and plastic. And avoid wearing the same shoes two days in a row. Give your shoes time (at least a day) to dry and air out. And if the weather’s warm, set your feet free and let them go au naturale. There’s nothing better than walking barefoot on warm grass on a sunny day.

Exercise your feet. I’m not talking about walking here…but other exercises that keep your joints moving. Try non-weight-bearing exercises such as swimming, especially if you have foot pain, as they take the pressure away from the painful areas. You can also do exercises while sitting in a chair. NHS Inform (Scotland) has some foot exercise videos you can try. If you want exercises tailored specifically for you, visit a podiatrist or physiotherapist.

Medications might help. If you’re having a lot of foot pain, speak with your doctor about whether medications may be an option. Depending on the underlying condition causing the problem, your doctor may prescribe a short-term course of pain relievers or anti-inflammatory medications, or they may prescribe other medications, such as a cortisone injection into a joint for rheumatoid arthritis or medication for acute attacks of gout.

Diabetes and feet. Many people with musculoskeletal conditions also have diabetes. So it’s really important if you have diabetes that you take care of your feet every day because of the increased risk of developing nerve damage, ulcers and infections. Talk with doctor about how to look after your feet properly if you have diabetes.

Surgery may be required. For some people, surgery may be needed if other conservative treatments haven’t helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

Contact our free national Help Line

If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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