Gout

November 22, 2011

In the winter of 2000-2001 I developed a heel spur on my left heel. Over the course of the spring and early summer, though a series of ultrasound treatments, the calcification was reduced. Almost immediately I developed similar pain on my right heel, and had it treated the same way.

My Left Foot Heel Spur

In late 2005 I started to develop pain my in right big toe and, when I complained to my chiropractor, she pointed out that I have fallen arches. The plantar fascia, the connective tissue connecting the heel and toes, is under different tension as a result of the fallen arch and she felt this was the cause of my pain. It also seemed to explain the earlier heel spurs.

Two primary care physicians and a second chiropractor have not bee successful in finding a solution to the near daily pain this joint experiences. I liken it to have just smacked my toe into a wall, or maybe dropping a sledge hammer on it. There have been times at night when the pain has woken me up. Nighttime seems to be the worst time for my toe, even the weight of the sheet on it is uncomfortable. I've learned to sleep with my foot partial extended over the side of the bed so as to suspend my toe in the air with nothing against it.

As a result of our primary care physician moving away I saw a new doctor today, ostensibly about my right knee, I was given a new diagnosis for my toe: gout. In collecting information about my overall health the doctor zeroed in on several things I said about my toe and how it reacts to different situations. She x-rayed it, along with my knee, and said there were some odd calcifications present, that, along with the pain I described, point to gout as the cause. I'm signed up for a well-man physical at the end of December, which includes a blood test. This test will include a test for uric acid, which will help to determine for certain that I have this form of inflammatory arthritis. Historically gout was known as the "disease of kings" or a "rich man's disease" - I guess due to the diet or lifestyle which can cause the condition.

Once I've had the blood work completed I suspect there will be some dietary suggestions made and maybe some medicine to correct or combat the uric acid levels in my body.

As for my knee, which is been creaky for years and twinging at times, the doctor feels that an MRI to better see what shape the soft tissues of that joint are in, is called for. I'm waiting for that exam to be scheduled. If there is enough damaged tissue, she'll recommend I see and orthopedist for further treatment and or surgery. If the damage doesn't warrant something invasive, we'll try some physical therapy.

While I was still actively pursuing martial arts I managed to tear the upper anchor of my medial collateral ligament (MCL), which heals itself. On the x-ray there is a calcification where the bone and ligament meet. She see some slight indications of arthritis in my knee, but nothing significant. The MRI will allow better imaging of the tendons and ligaments, as well as the meniscus in that joint.

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Mark H. Nichols

I am a husband, cellist, code prole, nerd, technologist, and all around good guy living and working in fly-over country. You should follow me on Twitter.