What Is the Difference Between Gout and Bunion?

17th Dec 2024

What Is Gout?

Gout is a condition that occurs due to increased uric acid level in bloods, which may result in inflammation of joints, in particular around the foot. It affects the big toe joints. The big toe joint becomes swollen, inflamed and painful during an acute gout attack. Most people complain that they wake up in the middle of the night with lots of pain and swelling. The underlying pure cause is generally that the increased uric acid levels cause crystal deposition inside the joint synovium or the surrounding of the joint, and the body reacts as if it has a foreign body reaction and therefore causes a significant amount of inflammation and a lot of pain. 

How Is Gout Diagnosed?

Gout diagnosis can be clinically made where you note swelling and redness of the joint, but this can also mimic other conditions like infection and just inflammation, or trauma, and therefore certain tests can be performed to ascertain the diagnosis.

Your podiatrist or foot surgeon may recommend that you have a uric acid blood test as well as check for inflammatory markers such as CRP which could be raised. A sample of fluid from the joint could also be taken to check for any crystallisation.

Sometimes specialist scans such as X-rays may show erosions especially gout has been present for a number of years. These erosive changes are around the outside of the joint margins. Ultrasound may show inflammation of the joint capsule and synovitis as well as MRI showing a significant amount of swelling of soft tissue and joint.

How Do You Treat Gout?

The treatment for gout depends on the severity and the longevity. In the first instance, anti-inflammatories such as naproxen could be used but occasionally specialist medications such as colchicine for three days. Long-term management to prevent further attacks of gout would require specialist medications such as allopurinol. In some cases, you can also inject steroid to calm down the inflammation.

Dietary changes and lifestyle modification could also be used as a long-term treatment plan.

What Is a Bunion?

A bunion is a deformity which is mostly of genetic disposition where you get inflammation and pain in the big toe joint but this is different to gout in that it is not due to uric acid levels but a physical widening of the forefoot due to displacement of the metatarsal and toe. This results in increased pain around the big toe joint due to footwear irritation mainly or displacement to the joint. For more detailed information about the causes, diagnosis, and treatments of bunions, you can visit this link.

When To Speak to A Specialist?

Once it is established that you have pain that is not managed by anti-inflammatory and that you are concerned as to underlying diagnosis, then you should see a specialist who can have the necessary tests from X-rays to blood tests and scans to diagnose the problem. They will be able to differentiate the symptoms due to gout or bunion.

How Will I Know That It Is Gout or Bunion?

Typically, if the blood test shows normal uric acid levels and there is only deformity of the big toe then you have a bunion rather than gout. However, if the toe is generally well aligned and you have inflammation, then it will be obvious that there is another condition, and hence why you test for gout.

What Does the Toe Look Like with Gout?

The toe is very inflamed, red and stiff if you have gout. It is painful even on light touch and even on placing bed clothing over it at night.

What Is the Fastest Way to Flush The Gout?

If you have been diagnosed with gout, you have to keep hydrated and drink approximately three litres of water a day. You should take anti-inflammatories such as naproxen or colchicine prescribed by your specialist.

Can A Person Have Both Gout and Bunion Simultaneously?

Yes, it is possible to have an underlying bunion deformity where gout has a different mechanism of action, and therefore can result on top of the bunion deformity itself.

What Is the Difference Between a Bone Spur And A Bunion?

A bone spur is a growth of bone usually on top of the joint due to osteoarthritis or a condition known as hallux rigidus. It causes stiffness in the joint due to cartilage wear. The bunion has healthy joint cartilage but displacement of the big toe. For more information on bunion surgery, visit this link.