Gout Specialists in Downtown & Midtown, NY

Gotham Footcare

Podiatrists located in New York, NY

Foot care is important. Gout is a well-known and common problem that affects the first metatarsophalangeal joint of the feet. Miguel Cunha, DPM, and the physicians at Gotham Footcare offer treatment for gout at their offices in Downtown and Midtown Manhattan, New York.

Gout Q & A

What is Gout? 

Gout is a common and complex form of arthritis that is caused by the accumulation of uric acid crystals in a joint, typically the great toe joint.  Uric acid is formed from the breakdown of purines, substances that are naturally found in the body.  Purines are also found in certain foods that are high in protein such as meat and seafood, as well as sweetened drinks, and alcoholic beverages, especially beer.  Normally, uric acid dissolves in your blood and gets filtered by your kidneys into your urine.  Sometimes, uric acid is either overproduced by the body or under-excreted by our kidneys.  When this happens, uric acid can accumulate in your blood and crystallize in your joint, causing a sudden gout attack which presents with a joint that is severely painful, red, hot, and swollen.  This attack often occurs in the middle of the night giving you the sensation that the affected joint is on fire and can be so severe that even the weight of your bed sheet on it may seem intolerable.

What are the risk factors of Gout?

  • Family history of Gout.
  • Diet. Foods rich in protein such as meat and seafood, sweetened drinks, and alcohol beverages, especially beer.
  • Obesity.
  • Medical Conditions: Certain medical conditions such as hypertension, diabetes, heart and kidney diseases.
  • Medications: Certain medications such as Thiazide diuretics for hypertension, low-dose aspirin, and organ transplant anti-rejection drugs.
  • Age and sex. Gout occurs more commonly in men usually between the ages of 30 and 50, because men are more likely to consume a diet that produces elevated levels of uric acid.  Women typically develop gout signs and symptoms after menopause, when their uric acid levels approach those of men.  
  • Recent surgery or trauma. Surgery or damage to a joint increases the likelihood that uric acid will accumulate in that joint, which increases the risk of developing a gout attack.

How is Gout diagnosed?

At Gotham Footcare, your doctor may perform the following tests to help diagnose gout:

  • Joint Aspiration. Your doctor may use a needle to withdraw fluid from your affected joint that will be examined under a microscope for the presence of Urate crystals.
  • Blood test. Your doctor may perform a blood test to measure the levels of uric acid in your blood. 
  • X-ray imaging. X-rays of the joint may show the deposition of uric acid crystals.
  • Ultrasound. Musculoskeletal ultrasound can also be used to visualize urate crystals in a joint.

How is Gout Treated?

At Gotham Footcare, the first step in acute treatment of gout is to eliminate or reduce the pain by decreasing inflammation of the joint. Your doctor will prescribe pain-relieving medications, which may include:

  • (NSAID’s) Nonsteroidal anti-inflammatory drugs . NSAIDs such as over-the-counter ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can be taken or your doctor will prescribe a  more-powerful NSAID such as celecoxib (Celebrex) or indomethacin (Indocin), which is the traditional drug of choice for Gout.
  • Colchicine. Your doctor may prescribe Colchicine (Colcrys, Mitigare), a type of pain reliever that effectively reduces gout pain by inhibiting the immunological response of white blood cells that cause the symptoms of Gout.
  • Corticosteroids. Corticosteroid medications, such as the drug prednisone, are generally used in patients with gout who cannot take either NSAIDs or colchicine. Corticosteroids may be in pill form, or they can be injected into your joint.

The second part of acute gout treatment consists of taking prescription medication to lower the levels of uric acid in your body.  At Gotham Footcare, your doctor will explain the various medications available, how they differ, and their potential side effects.  The medication that you and your doctor will choose will be based on what is the most appropriate in consideration of your lifestyle and current health status.  Some medications may be used to treat acute Gout and others will be used to prevent chronic Gout. 

Last but not least, at Gotham Footcare, your doctor will have a thorough discussion with you on the necessary lifestyle changes that you will need to make including increased exercise, weight loss,  and modifications in your diet to help prevent future gout attacks.

 

In an effort to minimize out-of-pocket expenses, we accept most managed care plans and insurance providers. For any questions regarding insurance, please contact our offices.

Aetna
Allied Benefit Systems
Blue Cross Blue Shield
Cigna
Empire Plan
Harvard Pilgrim Health Care
Humana
MagnaCare
Medicare
Meritain Health
Oxford United Healthcare
United Healthcare
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