gout,attacking my plantar fascia

[thefridge]

hi everyone

i’m male, 31, weight:95 kgs, height: 175 cms, i have a history of LBP
two weeks ago my right ankle swollen,and my plantar fascia on my both feet hurts like hell whenever i stand and walking, pain also rise on my left knee, low back,right shoulder and right neck,jeez….i can’t sleep at night,feels like hell when moving even a bit movement

then i went to see an internist doctor,i was diagnosed with GOUT,only by seeing my swollen right ankle,but gave me only some pain killers (forgot the name..), the next day i was testing my blood, found that my total chlosterol level is very high (370 mg/dl) trigliserida (normal) and UA level normal (4.5 mg/dl)

i didn’t start gout diet immediately because i still didn’t believe i have gout,went back to my internist doctor and he only gave me stator for my cholesterol, a week going without meat but i still consumed fish and chicken (how foolish..) and the pain still rising up on my feet specially in the morning

i was curious, and began searching for gout diet, now it’s been a week without meat, fish,chicken and i’m on a water treatment. i’m starting taking allupurinol 3 x 100 mg /day. the second day i consumed allupurinol my feet feels like hell.

i’m planning to check for blood level again in 2 weeks, i haven’t read here gout attack plantar fascia, anyone ?
i feel hell when i have to work and standing 1 hours on my train, thankfully i don’t have to work everyday.

help please…. -hadi, jakarta-indonesia-

[Keith Taylor (GoutPal Admin)]

Hi @thefridge, you have made some interesting points.

First, I’m puzzled by your blood test result. Uric acid can fall during a gout attack, but 4.5mg/dL is quite low. Do you have earlier test results with higher values? I am very critical of a sight-only examination of your ankle coupled with a 4.5 reading. That should have prompted the doctor to refer you to a rheumatologist for joint fluid analysis. It is a painless process that rules out conditions that mimic gout.

If it is gout, allopurinol is a good idea, but it needs good pain relief support for the first few months. Colchicine is the obvious choice, but other options are usually OK. A combination of pain killers is usually best, with something to reduce inflammation, and something to block pain.

Again, if it is gout, the uric acid crystals can grow anywhere in the body. Plantar fascia is involved in less than 5% of gout cases. With such low frequency, I did not specifically include it in Running On Gouty Feet. Without a thorough medical examination, we will never know if it is gout or something else.

If you cannot get a proper medical examination, the only other thing I can suggest is to proceed as if you do have gout. That means:
1. Monthly uric acid tests to make sure uric acid is as low as possible, but definitely below 5mg/dL
2. Pain relief for up to 6 months, as required
3. After 6 months, review progress.

If pain and swelling is gone you are OK, if not, you need a specialist examination.

[thefridge]

hi keith, thanks for your instant reply

i never test blood level before, so i think when my internist doctor saw my 4.5 mg/dl he didn’t prescribed me with allopurinol, only some pain killers. FYI when i take the blood test the swollen on my right ankle is already down in size (4 days before the test, i use Thrombophob ointment).

but until now i still cant move my ankle in fully operational as before when i’m healthy

i starting allopurinol on my own 4 days ago, and will have a test blood 2 weeks from now, but is it safe to consume pain killer staright to 6 months ?

how about “mefenamic acid” pain killers ? i usually take this to ease pain on my LBP, is it safe for gout ?

[Keith Taylor (GoutPal Admin)]

I should explain that point 2 better. I don’t mean take pain relief for 6 months constantly. I mean take it as required. After 6 months you should not need it any more, because gout should be controlled by allopurinol.

I have to say that from everything you have said, I do not believe you have gout. I strongly recommend seeing a rheumatologist.

[thefridge]

thanks keith, will see one after i have my blood test

“two weeks ago my right ankle swollen,and my plantar fascia on my both feet hurts like hell whenever i stand and walking, pain also rise on my left knee, low back,right shoulder and right neck,jeez?.i can?t sleep at night,feels like hell when moving even a bit movement” –>> so are u saying this is RA symptom keith ?

[Keith Taylor (GoutPal Admin)]

I wouldn’t know an RA symptom if I fell over it. I know gout from personal experience and research. What you have described is outside either of those. In cases of unclear diagnosis where gout is suspected, the best way forward is to see a rheumatologist. They can rule gout in or out, and arrange treatment or further investigation as appropriate. If you do go to a rheumy, please let us know what is said and done.

[thefridge]

hi keith, just went back from blood test yesterday
my UA level is 4.1 mg/dl, and Rhematoid factor: non reactif, so i guess my doctor has missdiagnosed me with GOUT
both my feet still hurt when walking, i guess due to plantar fascitis, and my right ankle still swollen a little bit

anyway keith, thanks for your support…

[Keith Taylor]

Thanks @thefridge for the update. I’m still unsure where the allopurinol comes in with respect to blood test results.

However, if you are down at 4.1mg/dL without any allopurinol (it takes up to 2 weeks to stop affecting blood tests), then gout is highly unlikely unless you are exposed to prolonged low temperatures.

I hope you can find the cause of your pain and find a way to treat it.

Good Luck
Keith

[Sandra]

Hello and really interested in this forum. You have the same thing I do. My plantar fascia is also a problem for about a year now or more. Recently the foot doctor told me I have gout in my left big toe for certain, tests etc. No medicine so far. She told me to continue the Omega 3 fish oil, I take two a day, 500mg, and my foot exercise, foot against the wall and leaning forward . I so appreciate all this information. Sandy in Washington DC Metro Area… THANK YOU KEITH TAYLOR FOR THIS FORUM. YOUR MENTIONED MR TAYLOR THAT ONLY ABOUT 5 % OF GOUT PEOPLE HAVE THIS CONDITION TOO. TELL ME MORE PLEASE.

[Keith Taylor (GoutPal Admin)]

Hello @sandra-boletchek. Thank you for joining the forum.

I do not have much more to say about plantar fascia than I’ve already said. I linked to my article Running On Gouty Feet, above. In that report is a DECT scan of a foot, and if you click on that image, it gives more information. The quick way to get there is: Gouty Foot DECT Image.

The most important thing to remember is that, left untreated, uric acid crystals will spread everywhere, and affect more joints every day. It is not enough to control pain – you have to get uric acid below 5mg/dL. Gout does not go away when the pain stops. Uric acid crystals continue to grow and spread. They weaken bone, cartilage, ligaments and tendons. This is a very slow process, but the longer you leave it, the worse it gets.

The most important information we get from this new technology is that we can now see very early damage to joints in places where we never noticed a gout attack. Our bodies are very good at repairing themselves, but we have to allow them to do so by getting rid of the uric acid crystals. The longer you leave this, the harder it is to get rid of the crystals, and the less chance your body has of repairing any damage caused.

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