Bout With Gout

12 03 2020

12 March 2020, By Marc Woodard

The most common signs of gout are sudden (acute) redness and inflammation around joints with intense pain. Most often people’s bout with gout occurs at the first joint attacked, with arthritis like symptoms at the big toe. Once gout forms, due to the nature of inflammatory properties it can spread throughout the body (medically referred to as poly-articular gout).

Patients initial symptoms include – an intense throbbing pain, whereas the big toe and/or foot is reddened and swollen beyond belief. These signs and symptoms may occur infrequently, then become chronic if not treated by a medical doctor.

Gout in foot

Gout and Arthritic-Like Conditions – Although there is much similarity in osteoarthritis and rheumatoid arthritis (RA) the difference is RA afflicts up to several joints at a time, where gout usually impacts one joint at a time and typically starts in the feet.

Once gout sets in it can be so painful one can hardly bare to stand, walk or have a bed sheet touch the toe. A chronic gout situation can also occur within other joints of the body, i.e., ankles, knees, fingers, hands, elbows and wrists… whereas – Tophi – “Uric acid crystallization” spreads to other part of the body.

Ten Foods to Avoid to Decrease Gout Risk

Purines are a part of our biology and introduced into the body through diet. The by-product of Purines is uric acid. Purines are part of human tissue. A diet high in Purines are known to increase gout risk. Those high Purine-Rich foods are:

Alchohol is high in purines; Certain fish: herring, tuna, mackerel, sardines, codfish, trout, and haddock and anchovies [Salmon is a low purine alternative]; Wild Game; especially rabbit, venison, quail, pheasant, and goose – Tip, white meats [turkey, chicken] rarely cause gout attack; Sea foods: avoid scallops – Tip, Low purine sea foods are lobster, shrimp, salmon, and crab (6-8oz). Organ Meats; tongue, liver, brains, kidney, heart and sweetbreads, etc. Beer; wine in moderation is allowable. Sugar Drinks; avoid all foods with high-fructose corn syrup. It’s best to stay with natural fruit juices. Certain vegetables; plant foods like dried fava and garbanzo beans are high in purines, also: cauliflower, mushrooms, asparagus, peas, spinach, and cauliflower.  Certain Fruits: pears, dates, lychees, prunes, plums, cherries, and pears – it is suggested if eaten in moderation, may not cause a gout attack. But if they do, avoid consuming them. High-Fat Dairy Products; Those with gout should avoid consuming too much ice cream and milk. Various studies suggest contradictory evidence – whereas the following dairy products may decrease gout risk: cheeses, yogurt, and ice cream [consume in moderation].

Ten Most Common Symptoms of Gout

Diets with high purines and protein have long have been suspected of causing gout. Uric acid crystals can be transported by blood circulation and deposited within targeted joints that breach the bursa sacs throughout the body. Bursa sacs are our fluid protective cushions around body joints that protect joint tissues. They can become breached by elevated uric acid levels that form crystals within certain joints of the body. Gout can lead to a chronic bursitis [swollen bursa sacs]. A condition where surgery may be required. Gout is considered one of the most painful forms of Rheumatic conditions and afflicts an estimated 840 out of 100,000 people in this US. Gout accounts for approximately 5% of all cases of arthritis.

Pain in big toe – whereas uric crystals form in joint; and make it incredibly sore to walk on; Tenderness – after chronic toe pain condition subsides, or prior to another gout episode; Swelling – to decrease swelling and inflammation and pain once gout symptom occurs, use cold compresses and see a doctor for medically prescribed drugs. Pain Attacks – sudden pain distant from the toe, often occurs simultaneously in the feet, or legs lower extremities. Felt mostly during standing or walking. Night Pain – Any pressure on big toe or foot, even a bed sheet can exasperate the pain condition once gout has set in. Redness – A red bloated skin condition on or near the gout site is a common. Kidney Stones – The build up of uric acid is also a cause of kidney stone formation which leads to very painful urination and bloody stream. Other secondary symptoms: low back and abdominal pain, nausea and vomiting. Tophi – Uric acid crystallization in other parts of body joints. Check for crystallization nodules to confirm on the ears, hands, ankles or elbows. Biopsy of the nodule can confirm a gout diagnosis. Fever – Gout can also cause nausea, fatigue and flue and fever-like symptoms. Peeling Skin – With swelling comes inflammation and damage to skin cells: itching, cracking, dry and bleeding skin surface.

It is highly recommended if you experience any of the signs or symptoms listed above, avoid high purine foods and seek medical treatment right away to keep your bout with gout at bay.

Marc T. Woodard, MBA, BS Exercise Science, ARNG, CPT, RET. 2020 Copyright. All rights reserved, Mirror Athlete Inc., http://www.mirrorathlete.com, Sign up for your free monthly newsletter.





Sciatica Pain Gone through Military Experience Knowledge

5 02 2020

5 February 2020 by Marc Woodard

[Marc is the soldier in the featured image overlooking Camp San Louis Obispo, CA – during active duty training, 2002]

What is sciatica and what is the best way to manage, alleviate or remove it?

Through my military experience I found a treatment path which led to complete reversal of my sciatic pain problem. A pain problem that afflicted me throughout my 20 year military career. Below under “Sciatica Pain Experience During My Military Career,” I detail my experience and findings and treatment course once I connected all the dots. Possibly these pain alleviation modalities could work to relieve and/or reverse your sciatica problem without surgery.

Sciatica in short, refers to back pain caused by a problem with the sciatic nerve [webmd 2020]. Sciatica (nerve pain) can be caused through numerous factors: incorrect posture, genetic deformities, injury or overuse of back muscles, or when the vertebra discs become defective or inefficient at absorbing vertebrae structural stress, or the bone itself is compromised then impinge upon the sciatic nerve. Sciatica isn’t actually a condition, but instead a medical term used to describe symptoms, such as tingling, numbness, prickly sensation and shooting pain down the leg to foot. The cause of sciatica varies in pathology but can be effectively alleviated without surgery, or non-intrusive surgery in many cases… such as mine was the case.

Skeletal compression, or impingement often occurs at vertebra’s L4-5 (lumbar) to S1-2 (Sacrum).

Sciatica pain in the lower back and extremities are often caused by injury, over-stressed muscular skeletal system, poor postural alignment and bad genetics; whereas soft tissue and/or skeletal compression, or impingement often occurs at vertebra’s L4-5 (lumbar) to S1-2 (Sacrum). Pain and swelling events can be isolated in the lower back and/or felt anywhere down the lower extremities at various frequency, duration and intensity throughout the day once aggravated by any number of postural load imbalances.

The six most common spinal disorders that cause spinal nerve compression and sciatica lumbar radiculopathy (radiating pain) are

1) Bulging or herniated disc (The gel-like center of the disc mal-forms creating nerve compression and swelling around the sciatica nerve). 2) Spinal stenosis (nerve compression through narrowing or clogged nerve pathway – brought about by standing or walking and relieved by sitting down). 3) Spondylolisthesis (Characterized by slipping and displaced vertebrae – acquired at birth and developed through childhood, trauma or physical stress. 4) Trauma (accident injury, sports, weight lifting, etc.). 5) Piriformis syndrome (named for the low back piriformis muscle impinging and irritating the sciatic nerve. This condition is also very difficult to diagnose and treat due to lack of findings through x-ray and MRI findings). 6) Spinal tumors (although tumors are rare in the lumbar region, benign or cancerous (malignant) tumors can develop creating nerve compression. Fortunately, this is a rare.

Those who suffer from sciatica should also be aware of the term radiculopathy

Radiculopathy is a term often used to describe radiating pain from its origin. In the case of sciatic nerve and radiating pain problems, this pain origin occurs at L5-S1 vertebrae [refer to images above]. When there is a low back nerve impingement, or compression condition on the right side of the lower back for example, and it causes pain and/or numbness down one side of the buttocks and/or thigh-to-foot-to-toe… This is a radiating or radiculopathy neural pain symptom. The pain travels distant from the lower back pain origin. Many patients who experience radiculopathy symptoms absent of low back pain don’t relate the pain stemming from a low back problem. For others the low back symptoms may be a feeling of achenes and stiffness, but not produce radiating pain. At this point in time, the low back is likely stressed and requires early medical diagnosis and treatment to avoid future episodes and worsening a low back condition.

Although symptoms of radiculopathy pain in the low back may occur at the same time as a burning and/or prickly sensation down the leg and toes – patients “at first” rarely associate this pain originating from the low back. Unless pain in the low back occurs simultaneously at the same time it is felt in the lower extremities.

To get treatment for low back sciatica and radiculopathy pain, see your primary care physician and ask to be referred to a physiatrist. This is a medical doctor who specializes in Physical Medicine and Rehabilitation [also called PM&R physicians]. A Physiatrist is a pain specialist doctor who diagnoses and treats both acute and chronic pain in a wide variety of nonsurgical treatments for the Neuromusculoskeletal system” (google 2020); and can refer surgical intervention if determined the best treatment course. The sciatic problem can be diagnosed through use of x-rays, CAT Scan (Computerized Axial Tomography – 3 dimensional, multiple cross-sectional picture technology) and MRI (Magnetic Resonance Imaging – Magnetism produces images of body structure).

Sciatica Pain Experience During My Military Career

When I was younger, I associated the numbness in my right calf and foot with military issued boots at the beginning of my 20 year military service. Foot discomfort and back pain seemed to go along with the territory. There was much conversation between soldiers regarding military issued boots also suspected of causing knee, hip and lower back pain. Foot pain was a given in the military. Everyone I knew during basic and advanced soldier training had foot problems as a result of wearing those boots.

Military issued boots in the 80’s and 90’s had no posture corrective insoles. And the exterior leather required a lot of wear and tear treatment/ conditioning to make it comfortable to wear around the foot all day long. Although a pre-wear and tear treatment process helped condition to break in the boot… imbalanced pressures on the soul and side of foot and toes often caused painful hot spots, even after the boots were broke in.

I like many other soldiers began limping acutely during basic training… I also continued wearing those basic boots for the first 5 years of service limping at various times. I had no ideal through this time they were the cause of my low back pain. The postural imbalances were further aggravated by intense occupational work load [field training] on my body, which further compromised the lower back alignment and weakened the area – causing swelling around the sciatic nerve. In time, pain was felt from the lower back, buttocks, leg and foot [radiculopathy].

It only took 5 years of improper foot wear to permanently put me in a hurt locker. Ultimately my back problems became chronic for 3 years of my last years of service. I did purchase boots approved by the military with proper insoles… about my 6th year of service which alleviated the radiculopathy but not my back problems. Regardless I did complete 20 years of combined military service. However the damage was done and that was not the end of my physical pain challenge. My pain challenge is fully covered within Ageless MirrorAthlete “Overweight and Unfit No More.” The pain challenge is a continuing story at the end of each chapter that connects well with “how to live life to the fullest” regardless of mental, physical or spiritual pain challenges. Click on the link below to read the free preview at Amazon.com and please provide a rating review after you’ve read the book. Thank you for your support.

I’ve written articles on acupuncture and how it helped alleviate my sciatic pain. And ultimately led to complete remission of sciatica pain. Maybe it will work for you like it did for me. Just search under acupuncture in MirrorAthlete archives and you’ll find other articles.

I highly recommend if you are serving in the military or an avid hiker

Invest in a pair of Danner, or Bates boots of good thermal water resistant and good insole quality. Then throw those basic military issued, or over worn boots in the trash.

Basic Issued Military Boots were the the cause of my postural weight bearing load misalignment and cause of acute foot and back and neck pain for years. And thereafter chronic pain problems occurred in the lower back, worsened and radiated downward. I had no ideal in my twenties how important proper foot ware and customized and corrective insoles were to Neuromusculoskeletal health of the feet and the rest of my bodily alignment.

One would think with the science behind many foot related back and neck pain problems – the feet would be of great pain prevention interest and at a minimum the military would invest in proper weight bearing boots with foot analysis that custom fit proper insoles to be place within the boot. This foot pain prevention process would have a return on tax paid investment – i.e., reduced sick call incidents, higher soldier productivity and fewer disability claims that retire trained soldiers early on…, etc. Until any boot or “almost any” shoe is broken in, or has bad insoles, or none at all… this creates hot spots and/or blisters everyone can relate too. And when the feet don’t get relief, limping occurs. If something doesn’t change, pain can be felt in other weight bearing joints. I believe military issued boots should be of the highest postural and corrective weight load bearing quality, Solders work their bodies hard in the field and put their lives on the line and deserve the best gear money can buy and this includes foot wear. They also deserve to end their service commitment without pain and injury caused by inferior foot wear that also causes harm to other parts of the body.

If your feet have little to no arch, it would be wise to invest in good foot insole orthodics to provide a supportive arch and alleviate foot pain and calf cramps. Improper foot ware “when not corrected” will cause further breakdown of the foots mechanical-muscular structural integrity and then work that aggravation upward – putting pressure on other weight bearing joints. The bodies posture works to re-align itself around an articulating joint pain center. Better known as guarding. This is why you see people limping. E.g., the compromised [pain problem] side is guarded by the side not experiencing pain. Therefore it takes on an additional load burden moving the body forward, putting additional stress on the non-compromised side.

I have corrective insole in every shoe I wear. Simply rip out the manufacturers flat insole and replace it with a corrective insole – purchase them in pharmacies with free foot analysis equipment. Stand on the foot analysis machine. It analysis foot pressure points and refers an insole for less than 1/2 price of podiatrist prescribed orthodic.

When limping continues too long without correction the body adapts to compensate and create a new gait norm to alleviate pain. Realignment during guarding puts more stress on other weight bearing joints and causes an imbalanced mechanical disadvantage during the gait. When this is the case the weight bearing joints are susceptible to aggravation and injury because the anatomical posture is imbalanced and eventually becomes compromised.

Dr. Bernard Filner, MD, says, a significant number of people, including many of his patients, contemplate surgery because they hurt so badly – but most of the time, by using a Posture Control Insole can alleviate the pain and avoid surgery. … Your feet play an integral role in maintaining a pain free posture, including proper curvature of the spine. Modest changes in your posture provide the potential for complete relief of low-back pain. If you are in pain, even if you have tried custom orthotics without success, please try Posture Control Insoles before you try surgery, said Dr. Filner.

As previously mentioned – most who suffer acute to chronic sciatic symptoms experience numbness, tingly to prickly sensation to excruciating sharp – jolting pain from the buttocks down the leg and foot. … I experienced radiating pain at times as an achy to chronic electrical pain sensation which was horrible and nearly knocked my off my feet at times when it struck.

For me acute sciatica feels like short bouts of being zapped by electricity and a burning , or tingling/prickly sensation when it occurred. One way to know when the worse case pain scenario will occur… you’ll experience a numbness and swelling in your lower back and loss of sensation in parts of your leg/calf/big toe with prickly sensations. At least for me that’s how my acute converted to chronic pain episodes. When a chronic episode occurred, the pain and swelling afterwords was so severe, I stayed off my feet for a couple of days. Only anti-inflammatory, ice, physical therapy and bed rest helped get back on my feet.

I’ve known many people – including myself go years suffering with low back sciatic pain and use prescription pain killers, muscle relaxants and anti-inflammatory to treat the symptoms with rest. Other outpatient treatments include steroid injections, chiropractic and physical therapy sessions and acupuncture, etc., that work temporarily, or permanently but may/may not fix the underlying weight bearing integrity problems without surgery. Patients who ignore infrequent episodes of back pain, or sciatic symptoms… without proper diagnosis can unknowingly create an irreversible pain condition that may have been preventable and without need of surgical intervention.

Foot insoles may be the cure to remove a sciatic Pain Problem

I chose not to go through surgery. After years of working with specialists, I learned what worked for me. It was a combination of acupuncture and corrective insoles that abated my sciatic pain. I only wish I could have had someone tell me the exact treatment course that would work for me after experiencing 20 years of sciatic and radiating pain. Will this treatment course work for you? That’s hard to say. Everyone is so different. But until you make the time to get a physiatrist referral from your primary care physician you’ll likely continue the fast track pain alleviation plan like I did… pain pills, anti-inflammatory and muscle relaxants… “which won’t fix you, and your pain episodes and weight bearing bodily damage will likely worsen.”

Correcting posture at the feet first – in “most cases” when foot, knee and back problems first occur, including sciatic pain … corrective insoles are often the pain relief solution! However with this being said, there is no guarantee as you age a sciatic problem with radiating symptoms “will not” become worse. We are talking about pain alleviation through proper anatomical foot insole alignment that will not worsen a back-pain condition. But its good to know nearly all back problems can be corrected and/or alleviated without surgery when proper postural foot alignment “at the sole” is made in a timely manner.

Most back pain can be resolved without surgery if both doctors and patients are willing to try other treatments that basically help the back to heal itself (Dr. Richard Deyo, University of Washington, and Consumer Health Interactive Magazine).

Author:  Marc T. Woodard, MBA, BS Exercise Science, Captain ARNG Retired. 2009-2020 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com, Sign up for your Free eNewsletter.