Gout Symptoms and Treatments: How to Deal with Intense Pain on Your Swollen Big Toe Joint

Agonising. Excruciating. Tormenting. These are several words we use to describe gout symptoms like pain and swelling of the big toe joint. Usually, you can treat these symptoms with painkillers and anti-inflammation medication. However, gout can cause a more debilitating form of both symptoms and impair your mobility and overall quality of life.

Here’s a breakdown of how gout develops and a few prevention and treatment measures to consider.

Understanding How Gout Symptoms Develop 

Gout — a severe form of arthritis — usually occurs when an excess of uric acid, called crystals, accumulate in the body. The consumption of alcohol, seafood and meat products is the most common cause of a gout attack. Referring to meals that contain seafood or meat, Eu Yan Sang TCM physician Ng Qing Xiang says, “Both contain elevated levels of purine, which breaks down to form uric acid.” 

The disease typically attacks one joint at a time. However, it can affect two or more joints simultaneously if it becomes chronic. Apart from the big toe, gout can also cause redness, swelling and sensitivity to touch in the ankle, heel, instep, elbows, fingers, knees, and wrists. Uncontrolled chronic gout can also present with tophi — firm lumps that appear under the skin — which can become infected, cause pain and lead to impaired function. Tophi, or uric acid deposits, look like lumps on the skin. 

Western and Traditional Chinese Medicine (TCM) share the belief that gout is more common in men and post-menopausal women. Certain TCM practitioners describe the ratio of men and women with gout as 3 to 1 – which is rather alarming. According to physician Ng, the main reason for gout in middle-aged men is a reduced ability to metabolise purine. Pre-menopausal women have high oestrogen levels, which encourages more effective processing and excreting of uric acid by the kidneys.

However, TCM generally believes that a set of internal and external factors causes gout. These include pathogens like cold (寒), dampness (湿), heat (热) and wind (风). A combination of these pathogens can disrupt qi (vital life energy) and blood flow in the body’s meridians, causing other classic gout symptoms.

Different Ways to Prevent a Flare-up of Gout Symptoms 

To diagnose gout, a TCM practitioner will determine which pathogen or combination of pathogens causes the condition. The practitioner will prescribe herbal medication or treatments based on the diagnosis which also takes a person’s body constitution, condition severity, and lifestyle into consideration.

Consume a customised diet  

To ensure that you do not suffer a disease flare-up, a TCM practitioner may recommend foods like Chinese pearl barley, cucumber, winter melon and green beans as part of a gout diet to eliminate internal heat and dampness. Foods that are high in saturated fats, such as fried foods and ice cream, should be eaten in moderation. 

Also, consume asparagus, cauliflower, legumes, mushroom, spinach, or foods and beverages derived from soybean sparingly. Avoid foods like edible viscera (or internal organs) — kidney, liver, and sweetbread — and certain types of seafood. Conversely, a TCM practitioner may also suggest the use of herbs like lycopodii (伸筋草), achyranthes root (牛膝), plantago seed (车前子), and fish poison yam (萆薢).

Undergo acupuncture treatment 

Acupuncture can be an excellent long-term treatment for gout. Data analysis of 28 randomised, controlled trials (RCTs) involving 2237 people diagnosed with the disease indicates that acupuncture is more capable of reducing pain intensity and uric acid. It also improves the clinical efficacy of gout treatment compared to Western medicine.

The risk of adverse events was also significantly lower in people who did acupuncture treatment. It is worth noting that you may consider acupuncture for gout at non-acute phase or for management of chronic joint pain.

Keep the body warm 

If you have gout, always keep your body warm. Drying your feet and hands after you wash them can also help to prevent wind and dampness from penetrating the body. Extreme humidity, too, can trigger gout flare-ups.

A 2014 American Journal of Epidemiology study also learnt that extreme humidity and high ambient temperature could also increase the risk of a gout attack. 

Ultimately, preventing a flare-up of gout symptoms always starts with a controlled lifestyle and adherence to a physician’s recommendations. “While gout is difficult to cure, it can be managed, including with TCM. But the patient must play his part to keep the condition under control,” reminds physician Ng. 

This is an adaptation of an article, “Keeping Gout at Bay,” which first appeared on Eu Yan Sang website.