What to know about gout in the heel

Gout is a type of inflammatory arthritis. If gout affects your heel, it may make walking, running, or being active difficult. You may notice your heel is discolored, swollen, or painful to touch.

Gout is caused by an increase in uric acid or creatinine in your blood. It can affect any joint but typically involves those furthest away from your heart. This includes joints like toes, ankles, knees, fingers, and hands.

Even though the heel is not the most common place to experience gout, it can make daily activities very painful and difficult.

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What are the symptoms of gout in the heel?

Symptoms of gout in the heel can include:

• pain
• redness or discoloration
• a joint that feels hot
• swelling

Gout pain typically affects one joint at a time, and it may feel intense. Symptoms can last from a few days to a few weeks.

Although the heel isn’t the most common location for gout, it is possible. You might be more likely to notice it in your toes, fingers, or knees. The symptoms will be similar regardless of the joint they affect.

What causes gout in the heel?

A buildup of uric acid in the blood causes gout in the heel. This can happen if you produce too much uric acid or if the kidneys are unable to filter out enough uric acid. Crystals can then form around the joints, causing symptoms of gout.

Certain factors may increase a person’s likelihood of developing gout. These include:

• chronic kidney disease
• obesity
• high blood pressure
• diabetes
• family history of gout
• consuming a diet high in red meat, offal, or seafood
• consuming excess amounts of beer or spirits

It is best to contact a doctor if you have concerns about the risk factors for gout.

What are the treatments for gout in the heel?

While there is no cure for gout, several treatment options can reduce the number of flare-ups and shorten their duration. Your doctor may prescribe medication and lifestyle strategies to improve your overall health and reduce symptoms.

Urate-lowering therapies

Urate-lowering therapy (ULT) medications help manage hyperuricemia, or high uric acid in the blood, to help reduce the incidence of gout.

Examples of oral ULT medications include:

• allopurinol (Zyloprim)
• febuxostat (Uloric)
• colchicine (Colcrys)
• pegloticase (Krystexxa)
• canakinumab (Ilaris)

Allopurinol is the primary urate-lowering treatment. A doctor may recommend other oral ULT medications if you do not respond well to it.

Canakinumab is an injectable ULT medication. They may be suitable if oral treatments are not effective.

Anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be suitable during flare-ups to reduce pain and inflammation in the joint.

Some NSAIDs are available over the counter. These include ibuprofen (Advil) and naproxen (Aleve).  

A doctor may prescribe stronger NSAIDs, such as indomethacin (Indocin, Tivorbex) and sulindac.

They may also prescribe corticosteroids to help manage inflammation during a flare-up. These include prednisone (Prelone) or prednisolone (Orapred). They might involve oral medication or an injection directly into your joint.

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Dietary changes

According to a 2022 study, obesity may play a prominent role in hyperuricemia. Maintaining a moderate weight and consuming a low fat diet may help reduce gout.

The Arthritis Foundation also recommends consuming:

• at least 8 glasses of water per day, or up to 16 glasses during a flare
• low fat milk and other low fat dairy products
• fruits high in vitamin C but low in fructose, such as:
  • strawberries
  • oranges
  • pineapples
  • grapefruit
• vegetable proteins, such as:
  • leafy greens
  • lentils
  • tofu
  • peas
  • beans

It may be beneficial to avoid consuming large quantities of the following:

• beer, as it has a high purine content, which the body converts into uric acid
• other alcoholic drinks, as they can slow down the excretion of uric acid in urine
• foods or drinks containing fructose corn syrup, such as soda and fruit juice
• organ meats and other red meats, such as beef, bison, and venison
• certain seafood, such as mussels, shrimp, and lobster

Physical activity

Getting enough regular physical activity can help treat joint damage associated with gout.

Exercise is important to maintaining a healthy lifestyle. The Centers for Disease Control and Prevention (CDC) recommends getting 30 minutes of exercise a day, 5 days a week.

If gout in your heel is making it difficult to walk or stand, try an alternative exercise such as swimming.

What are the possible complications of gout on the heel?

Gout occurs when an increased level of monosodium urate crystals builds up inside joints. When there is a buildup of these crystals, it causes inflammation and joint damage.

Over time, these cells can deteriorate and die, which may lead to arthritic damage without treatment. This can subsequently cause difficulties with mobility, the ability to wear some shoes, and a reduced activity level.

Beginning treatment as early as possible may help reduce the risk of complications.

Is it possible to prevent gout in the heel?

A person can help reduce the risk of developing gout in various ways.

Protect your joints

Injuries can make gout worse. The CDC recommends trying activities that are typically easier on your joints, like biking, walking, or swimming.

These do not put as much pressure on your joints and can reduce your chance of injury.

Maintain a moderate weight

Maintaining a moderate weight can reduce pressure and strain on your joints. It may also help slow the progression of the condition, ease pain, and improve overall function.

Contact a doctor

Speak with a doctor if you have concerns about the risk factors for gout or a family history of the condition. If you have a family history of gout, a blood test can help determine whether you have elevated uric acid levels.

The doctor can also advise on more ways to help prevent gout or manage a flare-up of symptoms.

Summary

Gout in the heel happens when uric acid builds up in the blood and crystals form in the joint. This can cause symptoms such as pain and swelling.

There are various ways to alleviate symptoms and help reduce flare-ups. These include taking medication, maintaining a moderate weight, and making dietary changes, if necessary.

It’s best to contact a doctor for advice if you have concerns about gout. Your doctor can order tests to confirm the diagnosis and help you create a suitable treatment plan.

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