June 19, 2018 at 11:15 pm #7201
Calum ConnorParticipantŦallars: Ŧ 3.34Rank: Carer
Last month i woke up with a severely swollen left ankle, which was that painful that i couldn’t bare any weight on it.
I had worked 5×12 hour shifts(the days leading up to the incident) but i couldn’t remember going over on my ankle or being in pain the day before, which left me confused to why i woke up in such pain. I was literally having to crawl to get around my house.
The swelling was in my tendons around my ankle rather than in the joints which made me think that gout was out of the question.
I tried treating my ankle like it was a sprain, using the P.R.I.C.E method (Protection, Rest, Ice, Compressions and Elevation) and also taking pain killers and ibuprofen to bring down the swelling. Eventually after several days the swelling subsided but then after a few days at work the pain and swelling was back.
I went to see my doctors about it and he recommended that i have a blood test to check my Uric Acid level, although he did mention that i need to wait until the pain and swelling had completely gone. Due to it starting to affect my work and me needing answers, i ended up going for a blood test last Tuesday when i was still limping around in pain. My results came back today and my Uric Acid level was nearly 600umol/L. My doctor is suggesting that i have gout, but i am not fully convinced as i have no redness to the swelling and also it feels like it is more in my tendons around my ankle rather than in my joints.
Please if anyone can help it will be much appreciated.
Thanks in advance,
June 20, 2018 at 12:02 am #7202
Yeah, that diagnosis was kinda quick if no other tests were done. If you have gout, you’ll probably know before very long as your symptoms become more obvious.
But in my modest experience, ankle symptoms are more like you describe than the classic gout symptoms in the toe. Then again, I’ve never had very bad ankle symptoms.
When you talk about the tendons around the ankle, was that more up the leg, towards the foot or both? How did it feel when you pushed on the area next to the tendons or when you tried to move your foot in a sort of circle around your ankle? Would simply lying down in the wrong position cause serious pain?
Any gout in the family?
If the pain and swelling have gone, it might also be worth re-testing uric acid. The result might be even higher now (which would be another clue).
Do get ahold of a pair of crutches. That will save your from crawling next time.
And ask the doctor how much ibuprofen you might take exactly, considering that you wouldn’t take that much every day. A green light to take a higher dose might come in handy next time as well.
June 20, 2018 at 1:36 am #7203
Calum ConnorParticipantŦallars: Ŧ 3.34Rank: Carer
Thanks for getting back to me, yeah i also thought it was a rather quick diagnosis.
When i pushed on my tendons around the ankle it hurt on both the tendon going up and the tendon going down my foot and it felt like it would if you pushed on your ankle if it was sprained, very sore and tender. The tendons that hurt more specifically:
External View(looking from the outside):
-Common tendinous sheath of fibularis (peroneus) longus and brevis.
-Fibularis (peroneus) longus tendon.
-Fibularis (peroneus) brevis tendon.
-Tendinous sheath of extensor digitorum longus and peroneus tertius.
-Fibularis (peroneus) tertius tendon.
Internal View(Looking from the inside):
-Posterior tibial tendon.
(I only know this as i looked at a diagram on google images).
I literally couldn’t move my foot in a circular motion as my foot/ankles flexibility was severely restricted and yes it did hurt when i slept in certain positions.
My Uncle has been diagnosed with gout but none of my parents have it.
The pain and swelling have almost gone but it is still slightly there so going to get my bloods done again when it fully subsides. If i get my bloods taken when i have fully recovered from the pain and swelling would that not mean that the uric acid levels will have decreased anyway?
Thanks for your help, much appreciated!
June 20, 2018 at 1:12 pm #7206
Your ankle problem affected a more extensive area than mine. You seem to have had more swelling but less pain in response to pressure. Possibly someone who had more uric acid than I did (my tests were never anywhere near 600) would find your description more familiar.
With a test reading as high as yours and gout in your family, it certainly ought to be suspected in any joint pain.
The interaction between uric acid in the blood and gout is complicated.
When you go from being symptom-free to experiencing serious gouty inflammation, the immune system can contribute to uric acid going out of solution. This could turn into a bit of a chain reaction and the process can end up significantly lowering the amount of uric acid in the blood. Likewise, the blood of people who never had gout can sustain more uric acid in solution.
On the other hand, if the gout flareup is caused by a largish deposit of uric acid being activated, dissolved uric acid may cause the amount in the blood to rise.
June 28, 2018 at 12:54 pm #7219
Fred DeerParticipantŦallars: Ŧ 6.28Rank: Detective
My gout started in my ankle. I tripped and it didn’t seem to severe and had a slight pain but the next day it got worse and I was unable to walk. I went to the doctor and they treated me for a sprain like you. Making me walk on it.
I spent 3 months in a foot cast not able to climb stairs. Looking back I went to the hospital 3 times at about 3am because the pain was so bad. I showed all the symptoms of gout but because it was in my ankle and it happened after a trip it was never considered as gout by anyone least of all me as I’d never had any signs of gout before.
I had ibuprofen to reduce the sprain inflammation and went to a consultant every week but nothing helped. Not surprising if I was being treated for a sprain which involved me walking on it as much as possible.
I was lucky because a practice nurse at the doctors stepped in on one occasion when they were busy. She asked if I suffered from gout. I said no but and suggested I try Sodium diclofenac and gave me a prescription. Within 2 days it was gone!!))) Three months of unbearable pain disappeared in 48 hours.
The next attack was in my toe about 6 months later but this time they realised it was gout. The diclofenac worked in a few days once again.
Since then I have had other attacks. It is my knee joints and ankle joints on both sides that get it never my toe. Again it was not recognised as gout and I was simply told i was getting old and it was arthritis. It took the 5th attack for me to put 2 and 2 together and then suggest it might be gout to them. A quick blood test and they knew I was right.
After a few attacks you get of recognise the feel of a gout attack. It’s a hot and very painful feeling that feel half inflammation and half like a joint sprain.
Now I am aware that gout can occur around any joint. Now I simply take a single diclofenac pill when i feel an onset and it subsides.
Rest assured gout can attack any joint and not only the toe.
For me the signs are the following
It comes on in the night for no reason (Just as you stated)
The pain is worst during the night at around 1-4am
It feels hot and cooling soothes it
It is not directly in the joint but in the tissues around it. It moves around the knee/ankle over period of a few days and doesn’t stay in the same place.
It hurts like hell especially at night,
Whilst not a be all or end all for gout symptoms these are my personal clues.
Diclofenac is my saviour but I’m sure it does not work for all. I have a supply at hand at all times and take one pill (sometime a follow up) and its gone really quickly. Normally in an hour or 2 but sometimes takes 24 hrs.
Find what works for you and if you get joint pain anywhere and are prone to gout do not think it simply lives in the toe. I’ve only had one toe attack and every other one has been around my knee and ankle joints.
Sounds like you have gout to me.
June 28, 2018 at 1:36 pm #7222
Diclofenac should help all gout sufferers but how much it helps would depend on the dose. So it would be helpful if you specified the doses you’re talking about when comparing its efficacy to similar drugs such as ibuprofen.
Gout in the ankle or knee is supposed to be pretty common. Certainly it didn’t take long for me to get gout-like symptoms there after getting them in the toe. But there are other joints which are normally not affected by gout.
Finally, in case you weren’t aware… diclofenac will not stop the progress of gout and only prevents part of the damage it does to your joints. If you don’t do something about your uric acid, your gout is likely to get worse over time.
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