foot pain

[rucyrius]

I have been on allopurinol since january and my UA is around 4.7 -5.0 … i have been really well for the most part , but do get pain in my big toe joint once in a  while… i have very little room between my bones in that joint, not from gout , i dont think , but from my arch sort of breaking down .. i use to be an 11 size foot in my 20's and 30's now in my 50's my feet are a size 13 …. so i believe this is mechanical pain ,that in the past would have blown up into a gout attack, from the inflammation… now its a pain but not nearly as bad and doesnt blow up and hang in there for 2 weeks or so… i have insoles from a podiatrist , but it doesnt quite do the trick… any body have this also?

john

[rucyrius]

actually i take it back… this is a gout attack … how is that possible … my UA level has been 4.8 or so for months… whats the deal  i have to call my rhuematologist on monday … i have had little twinges before while on  allopurinol , but this is swollen and everything … i'm depressed…

john

[odo]

Sorry to hear you're having a flare up John, especially at low SUA levels, but take comfort in the probability that it is old crystals dissolving as the Allo does its work, which is beneficial in the long run. I'm no meds expert, but it might be worth getting hold of some Colchicine or Naproxen to nip things in the bud in future or why don't you give the Black bean broth a try? Many have found it to be highly effective and fast acting on pain.

Also, it's worth analysing whether you did anything to aggravate it recently. One of my biggest triggers of joint pain is cold, which is very easy to overlook if one's attention is focused on diet etc.

[davidk]

Hi John.  Not sure how long you had gout before getting on Allopurinol and getting your levels below 6 a few months ago, but it can take many months to clear everything out.  I've been below 6 for 2.5 months now, but a few weeks ago, my rheumatologist upped my dose of Uloric (I take Uloric because I can't take Allopurinol, but the concepts are the same).  My levels had actually been below 5 and I thought fine, but he said he wanted me even lower because I was still having flare ups (and I have a kidney transplant so my body has a really hard time excreting UA).  He also has me taking 5 mg prednisone and .3 mg colchicine once or twice a day.  I go back this week (or next?) to see what my UA levels are now, but I have not had any more flare ups since increasing the dosage and am doing better than in months.

So, not sure if too much of htis is similar to you, but a) you can still get flare ups while clearing out old crystals; b) it can take months depending on how long you were building up UA and how low you get your UA, etc; c) ask your rheumatologist if you should be increasing your allopurinol or supplementing with any nsaids or colchicine or anything.

One other note; I find drinking plenty of water is critical.   We all know that, but I really find a difference if I slack off a little bit. I assume its because it is so critical to be able to clear out the crystals being broken down. 

[zip2play]

rucyrius,

If you settle things down with this attack, make sure you watch vigilantly for another. What you do in the first couple hours of an attack is SO much more important than what you do in day 2 or day 3.

A bottleful of colchicine in your medicine chest will give you YEARS of insurance at a rate of 2 or 4 pills with each threat of an attack, but it's got to be fast action to be effective at such a low dose…don't delay.

Yep,

The 10 1/2 D's of my twenties are now the 13 EE's of maturity. Seem to be spreading like pizzas.

[rucyrius]

thanks for your help guys… so this doesnt sound out of the realm of possibility ? 3 months of allopurinol isn't long enough to get all the old junk in the tissue out… i thought i was cruising pretty well . till now .. zip2play .. is that 2-4 .6 mg pills a day when i have a twinge? man i cant even get on my shoe…

john

[rucyrius]

i've been having gout attacks for about 7-8 years … so thats a bit of build up i guess … in fact what made me decide to go on allopurinol was that since last summer i was constantly having pain in both feet .. and it would never go away completely so by dec i figured it was time to go on allopurinol..

[zip2play]

yep,

2-4 of the .6mg (or the .5 mg.) colchicine.

Three months is probably not long enough to get rid of all the urate deposits and even 3 YEARS might not be long enough. Some urates are probably so well hidden by the body that they may NEVER surface. But out of sight out of mind because these permanent deposits will not trigger attacks.

[Author]

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