#803 How can gout lead to hallux rigidus? - DOC

#803 How can gout lead to hallux rigidus?

How can gout lead to hallux rigidus? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



One of the problems with being a runner is that you have a higher pain threshold. So, if you have a minor attack of gout, it may not bother you as much as it would other people. And what Gout is, is that you get painful crystals forming within a joint like the big toe joint.

If you have what we call sub-acute gout, meaning it’s not really killing you, it’s just kind of a minor thing that’s building up gradually, then the condition might actually sort of fly under the radar. And you might be gradually building up crystals in the joint that you’re not really aware of at all.

What happens is that within the big toe joint, you get these little needle shaped crystals that are building up while they poke the inside of the joint and it hurts. So, what happens? Well, even if you’re not really aware of it, if you have sub-acute gout, you have a really minor sort of low-level attack of gout. Your brain knows that that’s a problem.

Even if you’re not consciously aware of it, then you’re going to basically be splinting, meaning that you’re trying to hold the big toe still, while you run. You’re going to be compensating, meaning that you’re limping in ways to not move the joint. And over time, what happens is that, that compensation to protect the joint and hold it still leads to contraction of the joint of the soft tissues around the joint that protect, prevent it from moving normally.

In a simplest sense, hallux rigidus, all it means is that the joint that normally glides and moves gets restricted and instead of gliding and moving, it turns into a strict hinge joint and when you get a straight hinge joint in the big toe, the bone in the base of the toe slams into the bone in the foot, the metatarsal, and starts to compress and damage the cartilage and then you get bone spring and all kinds of other things that we start to see later on the X-ray.

So, if you have gout that’s not really diagnosed, it can actually overtime lead to this condition called hallux rigidus, but that’s basically how it happens.

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