Last year I ran in a couple of charity 10
kilometre runs. I'm not especially sporty
at all, but it seemed a good thing to do.
The second of these was in early October,
and I left my training a little late, so
went at it a little over enthusiastically
from around mid-september. This run was
due to take place on a hilly course, so I
trained on the slopes of the park near my
home.
During training, I began to feel a dull
ache in my right big toe and ball of foot.
Often, after running I would feel an urge
to 'scrunch' my toes to relieve this
nagging toothache-like sensation.
I managed to complete the run, but felt I
was running slightly on the outside of the
affected foot. This altered gait found its
way into my walk and soon I noticed
muscular stress in the right leg caused by
this barely perceptible but unusual way of
walking.
Soon, putting weight on the big toe,
bending it up sharply or pressing into the
side of the ball of the foot would cause
tenderness - not acute but moderately
tender.
I decided to see my doctor, explained all
this, and his first words were "Have you
had gout before?" like it was a foregone
conclusion. None of the training stuff
seemed to interest him.
He diagnosed anti-inflammatories and I had
a blood test for uric acid level. This
came back 'slightly raised'. (THe nurse
quoted a figure of 420 when the normal
band is between 200 and 400, apparently).
In the meantime, I had found reference to
Sesamoiditis on the web which seemed to
match all my symptoms and possible causes.
I brought this up with my doctor but he
showed zero interest (I understand it
could be annoying for a doctor to listen
to a patient's amateur web-based
diagnostic theories, but I wished he'd at
least have listened...)
SO. Slightly raised uric acid. Mild big
toe and ball of foot pain, beginning
during uphill running training and
persisting for 4 months+ with no peaks and
nothing remotely excruciating.
Does this sound like gout to anyone?
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004 Posts: 227
Posted: 01-26-08 15:01pm
May I ask: are you treating it with any
medication? If so, how long you have been
on the med and what's the response?
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Toeache
New User, Becoming EHEALTHy
Joined: 25 Jan 2008 Posts: 3
Posted: 01-27-08 12:08pm
Hi JYY2
My doc prescribed Diclofenac when I first
presented. He didn't actually tell me when
to take it - or how much. I tended to take
one 50ml tablet with breakfast for a while
and then stopped when the toe seemed to
return to near-normality (I wasn't sure if
I was meant to hang on to the meds in
preparation for a REAL gout attack).
Anyway, the problem never really went
away. Being on my feet for long periods or
bending the toe upwards with weight on it
seems to bring the problem back.
I've also tried using orthotic insoles to
take weight off the ball of the foot, and
strapping the big toe to the next toe to
prevent it bending too much. These
measures both seem to help when the
problem is at its worst (although, I
stress again, it's never been too bad) but
I worry that they may contribute to my
change of gait, which I think may have
caused other aches and stresses in the
whole leg.
A fairly important new point to mention is
I'm pretty sure i've got some small
deposits in the helix of my right ear.
(Not the kind of thing I'd ever have
noticed until I saw mention of this on
another gout-related website.) This makes
it look like gout, I guess? Is there such
a thing as 'mild gout' or mild, prolonged
gout attacks?
I guess another possibility is that by
sheer coincidence I have aggravated my
sesamoids at the same time as gout
symptoms were beginning to appear.
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004 Posts: 227
Posted: 01-28-08 11:30am
Hi, Toeache,
Thanks for the reply. It could be the
low-grade gout attack caused by the
over-exercise or injury from running; and,
you did not take enough Diclofenac to lick
the problem.
I would go back to the GP (and a
podiatrist and a rheumatologist if
necessary) for:
1) Colchicine to take by mouth for
gout.-- Colchicine is more specific in
treating gout. If it works, that means
most likely you have gout. It may cause
diarrhea. So ask for some Lomotil to take
by mouth in case the diarrhea is bad.
2) An X-ray to rule out micro-fracture of
the bones, including sesamoid bones of
course.
3) A shot of cortisone in muscle. The
symptoms may disappear quickly.-- This is
a strong medicine. The doctors may not
want to give it to you.
4) Tests to examine the the joint fluid
and the deposits in the helix of your ear,
for monosodium urate crystals. They may
think the symptoms are so obvious that
such tests are unnecessary.
Good luck.
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Toeache
New User, Becoming EHEALTHy
Joined: 25 Jan 2008 Posts: 3
Posted: 01-28-08 12:18pm
Thanks JYY2, you're a star.
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gallego1968
New User, Becoming EHEALTHy
Joined: 24 Jan 2008 Posts: 32 Location: Barnet, England
Posted: 01-31-08 03:16am
I was told when taking Colchicine if you
vomit or get diarrhea you must stop taking
it straight away.
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painfree
Experienced User , Rather EHEALTHy
Joined: 14 Nov 2004 Posts: 77 Location: ,
Thanks: 3
Thanked:0
Posted: 01-31-08 08:56am
Colchicine is used as a gout-specific pain
reliever. It can be toxic, even fatal in a
small number of cases. According to my
former rheumie, diarrhea is almost always
the first sign of its toxicity, so its use
should be stopped if diarrhea develops.
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redngreedy
New User, Becoming EHEALTHy
Joined: 29 Jan 2008 Posts: 3
Posted: 01-31-08 09:09am
How bad should we let the diarrhea get
before we stop? Mine isn't that big of a
deal, just a very loose stool maybe 2-3
times a day.
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runner24601
New User, Becoming EHEALTHy
Joined: 19 May 2008 Posts: 1
see a specialist Posted: 05-19-08 10:17am
My experience is very similar to the
original poster's - particularly the bit
about my GP being convinced from the start
that I had gout (despite my lack of family
history, and the non-gouty pattern of
symptoms). Then this morning, on my own
initiative, I saw a podiatrist, who
listened to my entire story and said "oh,
that's definitely sesamoiditis."
Among the general population, gout is a
much more common diagnosis, so that's what
GPs think of. Try to see a foot doctor,
if you can. Good luck.
