Sore toe: Physical injury - or gout?

[SumGuy]

Ok, gout is the last thing that I ever thought that I might get, but the more I read, the more I wonder.

I'm an active 45 year-old male. I was doing some yard work yesterday, and that involved lifting some heavy objects. Normally when I over-do some strenuous activity, any joint or muscle or tendon pain that might result will usually not happen for a day or two after the activity.

So between about 9:30 and 11:30 last night, my big toe on my right foot starts to bother me. Sort of felt like it was a little out of joint, like a sprain when I walk on it. But by midnight, the pain is really bad, and I have to walk on the side of my foot, can't put any force on my big toe. The knuckle of the big toe is the problem, and specifically the top-side of the knuckle. Touching or rubbing the top side of the knuckle is painful. I go to sleep, but I'm pretty much in constant pain. This morning, I still have pain. I can bend my big toe down, but it only goes about half way compared to my other foot. Bending it up, even a little, results in massive pain. The knuckle looks bigger than my other foot, and the big toe is bent a little towards the other toes. But it's not red, there's no bruising, maybe a little warm to the touch.

I can squeeze my big toe, and the bone between the toe-nail and the knuckle, and there's no pain. I can push and prod the bottom of the toe-knuckle, and there's no pain. The pain is all on the top side of the knuckle, maybe a bit towards the front (towards the toe).

So I'm thinking that maybe I sprained my toe, and it just took 3 or 4 hours for the pain and injury to kick in.

But then I'm reading about gout, and now I'm not sure. I also have a history of kidney stones.

So my questions are:

a) how do I know if I have gout? Is there a blood test for it?

b) if there's a blood test for gout, do I have to have the blood drawn while my toe-pain is active for the test to be useful?

c) can gout also cause elbow pain - like tennis elbow or chronic forarm pain?

[siteburn]

Go get your blood tested. They can test for Uric Acid levels. In my case, I had an attack about 2 weeks ago and just went to the doctor today for my followup. He doesn't want to re-test my blood for another month (after taking Allopurinol during that time). My uric acid levels were at 11.5% then and he said that they were still going to be high.

The toe is a common place for gout and it usually starts toward / during the night. I would for sure go in and tell your doctor about what happened and tell him/her that you want to get your uric acid level checked. If your acid levels are indeed high, start making lifestyle/diet changes to prevent it because it sounds like it can only get worse if nothing is done. The fact that you have kidney stones says that you may just had your first known gout attack since the two seem to be somewhat cousins.

Not sure about tennis elbow/for-arm pain but I wouldn't be at all surprised if you would get similar symptoms with a Gout attack in that area.

[thurstonb]

With gout, you can usually expect the whole toe area to be sore, rather than just the top side. And when you say "knuckle" are you talking about the joint in the middle of the toe, rather than the one where it attaches to your foot? Normally gout will be in that joint (the one on the foot)

However the symptoms do sound as if they could be gout and it would be worth seeing the doctor. Even if the pain subsides quickly which gout usually does, getting your uric acid levels tested would definitely be a wise idea. Left unchecked gout will actually be doing you damage even when you aren't having the pain symptoms.

You definitely can get gout in the elbows. Same symptoms - redness, swelling, pain.

Cheers
Brett