From the Guidelines
A gout patient who is not wearing shoes should find appropriate footwear immediately to reduce the risk of injury and exacerbation of pain. When selecting shoes, it is essential to choose ones that are comfortable, provide good support, and have a wide toe box to accommodate any swelling or tophi, as recommended for managing gout symptoms 1. Open-toed sandals or adjustable footwear may be helpful during acute flares when the foot is particularly painful and swollen. Avoid tight, narrow, or high-heeled shoes as these can increase pressure on affected joints and worsen pain. Proper footwear is essential for gout patients because it helps distribute pressure evenly across the foot, reducing stress on painful joints, particularly in the big toe where gout commonly affects. Going barefoot can increase the risk of injury to already sensitive joints and may exacerbate pain when walking on hard surfaces. Additionally, supportive shoes can help with mobility during gout flares when movement is difficult. Some key lifestyle advice for gout patients includes weight loss if appropriate, avoidance of alcohol (especially beer and spirits) and sugar-sweetened drinks, heavy meals, and excessive intake of meat and seafood, as outlined in the 2016 updated EULAR evidence-based recommendations for the management of gout 1. For immediate gout pain relief, patients should continue taking prescribed medications as directed by their healthcare provider, rest the affected foot, apply ice to reduce inflammation, and elevate the limb when possible. Regular exercise and low-fat dairy products are also encouraged for overall health and management of gout symptoms 1.
From the Research
Gout Patient Not Wearing Shoes
- A gout patient not wearing shoes may be at risk of further irritating their affected joints, particularly the first metatarsophalangeal joint 2.
- Wearing comfortable and supportive shoes can help reduce foot pain and disability in people with gout 2.
- Patients with gout should be advised to wear shoes that have good cushioning and motion control, as these may be an effective non-pharmacological intervention 2.
Footwear Recommendations
- People with gout need comfortable shoes that conform to the foot, have a wide opening, and are made from pliable materials with adjustable straps 2.
- Closed-in athletic shoes, sturdy walking shoes, and casual closed-in slip-on shoes are commonly worn by people with gout, while orthopaedic shoes are worn less often 2.
- Comfort, fit, support, and ease to put on/take off are the features most often rated as important or very important when choosing footwear 2.
Management of Gout
- Gout is a chronic inflammatory condition that requires individualized treatment, and a healthy lifestyle is always recommended 3.
- Patient education is critical to support self-management and long-term adherence to treatment 3.
- Anti-inflammatory therapy, typically colchicine or an NSAID, is recommended for management of an acute gout flare, while urate-lowering therapy (ULT) may be used in patients with frequent or severe acute gout, tophi, urolithiasis, renal function impairment, or other complications of gout 4, 5, 3, 6.