Foot Pain
min read

Gout Tophi Symptoms and Removal

Gout tophi develops from a crystallic buildup in joints during a gout attack. Here are the signs, treatments, and prevention options.

Published on
June 15, 2022
A swollen feet next to a healthy one

"lumps" on your toe joints underneath your skin. If so, you may be suffering from gout tophi.

Having gout tophi on toes can be painful and embarrassing. It's important to know what tophi are and how to recognize them for your foot health. 

So what are some common symptoms of tophi gout, and how can you prevent or treat them? You'll find the answers in this article.

Common Tophaceous Gout Symptoms

A swollen feet next to a healthy one

Tophi alone doesn't hurt you, but they can be painful when they swell from being actively inflamed. 

They may also affect the appearance of your toes. They can gradually disintegrate your toe joint tissue, making your joints look bent or twisted — No one wants that!

Because tophi stretch the skin out, they can occasionally cause painful sores. During severely painful episodes of gout attacks, they may even break open and release hardened uric acid, which looks like a soft white material.

Some other common symptoms of tophaceous gout flare-ups include:

  • Severe pain in the joint
  • Tenderness, warmth, and swelling at the tophus
  • Loss of range of motion
  • Discomfort when using the affected joint
  • Difficulty using the affected joint
  • Shiny, red skin over the affected joint

So how do these tophi develop?

Development of Uric Acid Crystals in Joint

Gout is an arthritic condition that arises when monosodium urate (MSU) crystals accumulate in the joint and cause an inflammatory response. MSU crystals form when uric acid — a waste product produced when the body breaks down purines — combines and has reactions with sodium ions.

Gout is the most common type of arthritis. Some common causes of gout include:

  • Kidney problems
  • Obesity
  • High blood pressure
  • Diabetes
  • Diuretic therapy
  • Purine-heavy foods 

You can have acute arthritis, where joint inflammation and pain will strike rapidly and fade over time. You can also have chronic arthritis, where pain and symptoms are ongoing.

Tophi develop when chronic gout is left untreated for an extended period — often ten years or more. The levels of uric acid continue to increase and the gout crystals gradually build up around the joints, causing bulbous, swollen growths to appear.

How To Treat Gouty Tophi

You're probably a little freaked out by now. But don't worry! Thankfully there are several ways to treat gout tophi.

Tophi Removal By Medical Professional

Small tophi often do not require surgery to treat, but a medical professional may recommend gout tophi removal if your tophi are large. In those cases, surgery is best to prevent your joint from losing range of motion or even becoming permanently damaged.

Your doctor may be able to make a small incision above the tophus and remove it by hand. If the affected joint is too damaged, your doctor may recommend joint replacement surgery.

Anti-Inflammatory Drugs or Systemic Steroid Therapy

Management of gout is important to reduce your chance of developing tophi.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Aleve help relieve inflammation and pain from joint damage from tophi and gout attacks. These are the first-line defense for acute arthritis from gout. 

There are also adjunctive therapies available to treat patients with gout. You may go through urate-lowering therapy after multiple gout attacks or tophi development. You will be prescribed medications that directly treat gout and prevent an increase in your levels of uric acid.

Recommendations for Gout Prevention

Prevention is always the best cure. You can use the following methods before you get a gout diagnosis to keep your feet healthy.

Consistently Monitor Uric Acid Levels

A close up of test tubes filled with blood

Regularly visit your health care provider to have a blood sample taken and tested. They may also have you complete a uric acid urine test, during which you will use a provided collection container to collect all your urine passed for 24 hours.

You can also monitor your uric acid levels at home. Purchase a digital uric acid meter, which includes lancelets and test strips to take and read your blood samples. You will get an immediate reading and can monitor your levels of uric acid as often as needed.

Consume Proper Nutrients

a table filled of healthy vegetables

As mentioned above, uric acid is a waste product of your body's purine breakdown. 

Purines are molecules in your cells' DNA and RNA that are made up of nitrogen and carbon. They can also enter the body via food. A high purine dietary intake is one of the primary causes of gout, so you should avoid foods high in purines. 

Some foods to avoid:

  • Seafood: anchovies, scallops, and herring
  • Sugary foods and beverages: sodas and any other foods made with high fructose corn syrup
  • Alcoholic beverages
  • Meat: organ meat and game meats

Instead, you should eat a healthy diet that is lower in purines. Include foods such as: 

  • No-fat or low-fat dairy products
  • Cherries
  • Whole grains
  • Plenty of water
  • Coffee and tea
  • Healthy fats and oils
  • Eggs
  • Nuts and grains, including peanut butter
  • Chicken, fish, and red meat

Some vegetables such as asparagus, peas, and oatmeal are high in purines but do not raise the blood's uric acid levels. Their high fiber content may be beneficial for gout.

It may sound like you can't eat any of the good stuff, but it's worth it for your health. Whole foods and a plant-based diet lower levels of uric acid and inflammation, reduce symptoms of existing chronic arthritis conditions, and reduce the risk of developing other types of arthritis. 

Treat and Ice Joint Pain Early in the Inflammatory Process

A shovel laying down on ice cubes

Don't try to bear the pain when you first notice discomfort in your joint.  Applying an ice pack to the affected joint may help ease the inflammation and pain. You can wrap a bag of frozen peas or crushed ice in a dish cloth and apply it to the area for 20 to 30 minutes several times a day. 

Maintain Foot Health To Help With Your Gouty Arthritis

Close up of foot laying down on a rock

Tophi gout on your feet can lead to painful symptoms such as swelling, severe pain, loss of motion, and even bursting sores if left untreated. 

Thankfully you can prevent tophi by monitoring your uric acid levels, consuming proper nutrients, and treating joint pain early in the process. If you already have developed gout tophi, you can have them professionally removed or try anti-inflammatory drugs or adjunctive therapy.

There are also many products you can use to alleviate painful symptoms, improve the condition of your skin, and maintain your foot health. The Toe Bro offers effective, high-quality foot care products like skin foot foams and foot spray deodorants to improve your foot health. Check us out to get relief from your foot problems today.

Updated on

Related blog post

7 Foot Care Tips for Better Foot Health

Your feet work hard. They take several thousand steps a day to get you from point A to point B — all while bearing the weight of your body. You stand on them a long time and put them into shoes that may not be the best fit. Unfortunately, these conditions can eventually cause a range of foot problems. So how can you take care of your feet and avoid chronic foot issues? This article will cover seven excellent foot care tips to keep your feet healthy.

Foot Care Tips To Keep Your Feet Healthy

It's important to know how to take care of your feet to keep them healthy for years to come. You can implement these seven tips to build a good foot care routine and avoid foot issues.

1. Avoid Wearing Tight Shoes

Shoe fit is very important to your foot health. 

Tight shoes restrict your blood flow, causing poor circulation that damages your feet in the long run. They may also cause foot pain that could become chronic. 

Over time, you may notice calluses, blisters, ingrown toenails, and corns on your feet. They may even deform your feet with conditions like hammertoes and bunions.

2. Wear Shoes With Arch Support

Once you've got comfortable shoes that fit, you need to make sure your arch is adequately supported. Your arch does it all — it supports your body weight, propels you forward when you move, and absorbs shock anytime your foot hits the ground. Over time, your arch can become strained or weakened from the stress.

Arch supports keep your arch in good condition because they:

  • Distribute pressure evenly
  • Support the lower body
  • Help with alignment
  • Prevent arch trauma
  • Provide balance and stability
  • Prevent and lessen foot pain

So really, everyone can benefit from arch supports. Look for shoe brands that are known for providing good arch support. You may benefit from a custom shoe insert if you have shoes that fit well but don't provide enough arch support.

Also, try to avoid wearing flats and flip-flops every day. Although they are comfortable, they don't support your arch enough and may lead to a foot injury down the line.

3. Keep Your Feet Clean and Mostly Dry

Feet often sweat throughout the day, providing a perfect breeding ground for harmful fungi. So pay special attention to your feet when you shower or bathe. Good foot hygiene goes a long way toward eliminating foot odor. 

Be careful! You don't want to soak your feet in hot water or leave them in the water for too long. This may cause dry skin, which leads to skin irritation and flaking. 

After you clean your feet thoroughly, be sure to dry them. Don't be shy — get in between your toes to prevent fungal infections like athlete's foot.

4. Inspect Regularly for Foot Ailments

Practicing a good foot care routine allows you to catch any potential issues before they arise. Inspect your feet for any changes daily, and look out for any sores, cuts, swelling, or infected toenails.

Use antiseptic and healing creams if you notice any cuts, and go to the podiatrist immediately if you have unexpected swelling or infected toenails. 

After all, prevention is always the best cure.

5. Use Nail Clippers Correctly

We may tend to use nail clippers to clip and shape our toenails. But this can cause damage to the tender skin of your nail bed. 

It's important to use nail clippers correctly. Make sure they're stainless steel, so the blades stay sharp for longer. A dull blade is more dangerous than a sharp one. 

Use the nail clippers only to trim the toenail straight across. You then want to use a nail file or emery board to gently smooth and round the corners. 

You can also use the nail file or emery board to push your cuticles back. However, you want to avoid cutting them, so they don't split or bleed.

6. Use Moisturizing Cream at Night

Chronic dry skin can cause skin irritation and flakiness. To avoid this, use moisturizing cream every night right after you dry your feet off. 

You can use creams, lotions, or even petroleum jelly. These are all nourishing emollients that sink into the skin and create a barrier to protect it. Your feet will be noticeably softer and well-hydrated. 

You can even give your feet a gentle massage as you apply your moisturizer, which can help stretch the tendons and contribute to your foot's muscular health. 

Afterward, you can put on socks or wrap your feet in plastic wrap for at least an hour for better lotion absorption, especially if you have dry skin.

But don't put any moisturizer between your toes to prevent a fungal or bacterial infection. Remember, you want to keep that area dry.

7. Don't Perform DIY Surgery on Ingrown Nails

We all know that ingrown toenails are annoying and even downright painful, and it's tempting to do a little DIY surgery to get rid of them. However, this is dangerous. 

Many people dig out ingrown nails with nail clippers or use floss to "splint" the toenail. These home remedies create a wide opening for harmful bacteria to get into the skin and develop into a nasty infection.

Go see your podiatrist instead. They are experts in all things feet and will safely get rid of your ingrown toenail in sanitary conditions. They can also prevent ingrown nails from regrowing and causing issues in the future.

Schedule Periodic Foot Exams and Invest in Advanced Foot Products

It's important to practice proper foot care. This includes wearing comfortable shoes, practicing good foot hygiene, and using the proper tools and creams.

You also want to visit your podiatrist for periodic foot exams to prevent the development of foot problems. They can also improve your foot health by performing procedures like ingrown toenail removal. These steps will ensure that your feet stay healthy and happy for many years.

Make sure you use products made for your feet. Here at The Toe Bro, we know how important it is for you to take care of your feet. That's why we provide high-quality advanced foot products to tackle and prevent a host of foot problems afflicting people today. Feel free to visit our website and add products to your routine today. You won't regret investing in your foot health.

The Signs of a Foot Corn and What To Do About It

What comes to mind when you hear the word corn? You may think of that delicious golden vegetable that tastes amazing on the grill, or maybe a joke that's not too funny. But there is another kind of corn that can affect your foot health: a foot corn.

What is a foot corn, and what can you do if you've got one? This article will discuss the signs of a foot corn and how you can treat it.

Foot Corn Common Symptoms

A foot corn is a type of callus made from dead skin that develops when the foot experiences excessive pressure or friction. Layers of skin build and harden in response as a protective measure. 

Foot corns can develop between your toes, below your toenail bed, and on the sides or bottoms of your feet. They often appear as small, hard, raised knobs with thin skin over the top. The skin may appear white or become yellow and flaky if left unattended for too long.

There are several types of corns:

  • Seed corns: Small corns that form on the bottom of the foot.
  • Soft corns: Corns that appear between the toes. They are a whitish or gray color and have a semi-soft, rubbery texture. 
  • Hard corns: Small areas of hard skin underneath larger areas of thickened skin. These form on the tops of the toes, typically right above bone joints.

Common symptoms include skin irritation, discomfort/pain, blisters, and redness. If left untreated, they can become infected, affect your ability to walk, and require surgery.

So how can you prevent the development of corns? Several health tips will help you:

  • Avoid ill-fitting or tight shoes, and wear comfortable shoes with a soft cushion. 
  • Wear thick socks when breaking in new shoes.
  • Cover the sides of your feet and the tops of your toes with breathable bandages when engaging in physical activity.
  • Keep your toenails trimmed to the edge of your toe.

But what can you do if you already have foot corns? Let's look at four options for foot corn removal.

Treatment for Corns

There's no reason to despair if you have corns on your feet. There are several foot health tips that you can follow to treat corns and enjoy healthy skin again:

Soak Hardened Skin in Warm Water

Corns can be treated at home if they are adequately softened and prepped.

Try soaking your feet every day. Fill a basin with hot soapy water and add a cup of apple cider vinegar. Ensuring that the patch of skin with the corn is fully immersed, soak your feet in the water for at least 15 minutes.

This soaking process will soften your corns, preparing them to be filed away or readied for the use of castor oil and corn pads.

File with a Foot File

It may be possible for you to remove foot corns with a foot file. A foot file is a pedicure tool with a pumice surface designed to grate dead skin off your feet. Once the dead skin is gone, fresh, healthy, and smooth skin is exposed.

There are several steps you can follow daily to remove layers of hard, dead skin:

  1. Soak your feet in warm water with Epsom salt. 
  1. Use a clean towel to pat your feet dry.
  1. Moisturize your feet with lotion or cocoa butter.
  1. Gently rub the corn with the foot file after it's soft and does not hurt. Use an emery board if the corn is in between the toes.
  1. Repeat these steps every day until the corn disappears.

This process may take several weeks, but it is a gentle way to remove corns physically.

Apply Castor Oil and Corn Pads

Castor oil and corn pads are a great option if you don't want to file away your foot corn. 

Castor oil is a thick, vegetable-based oil that is an excellent emollient for the skin. Corn pads are small pads specially designed to cover the affected area and help relieve pressure so it can heal. Both items are over-the-counter products that can be purchased online or at your local pharmacy. 

This method also includes several steps:

  1. Soak your feet in warm water.
  1. Use a clean towel to pat your feet dry.
  1. Apply castor oil to your corn.
  1. Place the corn pad on the corn.

Your socks and shoes mustn't be too tight after you apply the corn pad. You also want to pick spare socks since castor oil can stain the fabric. This method may take ten days to several weeks, but the foot corn should peel away.

Meet With a Foot Specialist

Allowing corns to remain on your feet for too long can lead to painful corns and foot complications. So if your home treatments don't work after several weeks, you should visit your doctor. Your doctor may refer you to a podiatrist — a doctor that specializes in foot conditions.

Your foot specialist may use specialized tools to shave, scrape, or cut away the hardened skin layers. Depending on the size of the corn, this foot corn removal process may take a few appointments before the corn completely disappears. They may also opt for laser treatment instead. 

Your podiatrist may prescribe topical medications to help soften the corns and slough away dead skin. Topical medications may include pads or a solution with a high concentration of salicylic acid, urea, or silver nitrate. Another option to use is hydrocolloid dressings.

Stop The Formation of Corns and Keep Your Foot Pain at Bay

Foot corns can be painful and embarrassing, but there are ways to treat them. If you notice a foot corn, you can soak it in warm soapy water, file it with a foot file, use castor oil and corn pads, or meet with a podiatrist if it is too severe for home treatment. These steps will help you treat existing foot corns and prevent new ones from developing.

As you can see, a good foot care routine is essential to the health of your feet. The Toe Bro provides high-quality advanced foot care products to prevent and treat symptoms of foot problems like foot corns and athlete's foot. Visit our website today to begin your journey to healthy feet. Your feet will thank you.

Chiropodist vs Podiatrist: Key Differences

If you've visited your general doctor about a foot problem, they've probably recommended that you visit a foot specialist. You may have heard of both chiropodists and podiatrists. But what are they, and is there a difference between the two? In this article, we'll compare a chiropodist vs. a podiatrist and evaluate any differences.

Comparing Foot Care Specialists

A foot specialist discusses the patient's results

You need to know which foot doctor to contact when you have a foot problem. So what is a chiropodist, and what is a podiatrist? 

To put it simply, there is no real difference when you compare a podiatrist vs. a chiropodist. Both are feet doctors — primary healthcare professionals that specialize in the well-being and health of your feet.

The term chiropody can be called podiatry's ancestor. How so?

The term chiropody was first used in the U.S. in the late 19th century. A group of foot doctors established the first recognized medical organization for foot specialists in New York in 1895. This organization was known as the first society of chiropodists. 

The first chiropody school was established nearly 20 years later in 1911. All practitioners in the United States received a Doctor of Surgical Chiropody degree from the beginning of WWII. 

All schools in the United States changed the name of the profession to podiatry by the late 1960s. Practitioners have been awarded a Doctor of Podiatric Medicine (DPM) degree and called podiatrists since then.

Other countries such as South Africa, the United Kingdom, and Australia gradually adopted the term podiatrist to refer to a foot doctor, and their scope of practice remained the same.

However, the term chiropodist is still used in one place in the world today.

Location: Ontario vs the World

A skyline of Toronto in Canada

The difference in foot doctors' titles is determined by which country they received their degree. The province of Ontario in Canada is the only place that still uses the term chiropodist.

All specialists who graduated outside Ontario and moved there before 1993 are referred to as podiatrists. Specialists who moved to Ontario after 1993 are registered as chiropodists. The College of Chiropodists of Ontario regulates both professions. 

Since specialists who moved there after 1993 are called chiropodists, the term is still used to promote the profession of chiropody in Ontario. A new podiatrist hasn't been registered in Ontario for the last 29 years!

But what about other countries?

The rest of the world has completely replaced the term "chiropodist" with the term "podiatrist". Sometimes older patients may use the term chiropodist, but the terms are used interchangeably.

Education: Doctors vs Foot Health Professionals

Both chiropodists and podiatrists must pass provincial licensing exams and comprehensive board exams to obtain licensure to practice. Both must also complete university-level schooling.

Podiatrists must attain a Doctor of Podiatric Medicine (DPM) degree — a four-year, post-bachelor's degree. Both podiatrists and chiropodists can take additional courses to expand their knowledge of certain foot conditions.

The majority of chiropodists in Ontario have a bachelor's degree in the sciences or other fields. They must also have a post-secondary diploma in chiropody.

However, it's important to note that neither podiatrists nor chiropodists are medical doctors. They are highly skilled and knowledgeable health physicians that specialize in disorders and conditions of the foot.

Scope of Practice: Surgical Procedures vs Basic Foot Care

Chiropodist doing basic foot care treatment

Both podiatrists and chiropodists provide foot care services for patients with foot disorders or foot pain. However, there are some differences in their level and scope of practice depending on where they are located.

Podiatrists around the world can carry out both basic foot and nail care as well as advanced surgical procedures. Their scope of practice includes:

  • Perform physical examinations
  • Complete and study medical histories
  • Take and interpret MRIs, ultrasounds, X-rays, and other imaging studies
  • Diagnose and treat foot conditions like flat feet, athlete's foot, and ingrown toenails
  • Prescribe podiatric medicine, including oral, topical, and injectable forms of medicine
  • Administer anesthetics and sedation
  • Prescribe, order, and fit insoles, custom foot orthodontics, prosthetics, and casts
  • Order and perform physical therapy
  • Treat sports-related injuries and set fractures
  • Perform surgical management and procedures
  • Perform reconstructive surgeries and microsurgeries

Chiropodists in Ontario can also carry out most of these duties, but they can not perform surgical procedures on foot bones, communicate a diagnosis, or order diagnostic X-rays. Most patients will see orthopedic surgeons or podiatric surgeons for these procedures.

What does that mean for you? Both chiropodists and podiatrists can treat a host of foot conditions, including:

So you don't need to worry. Both a podiatrist and chiropodist are fully qualified and able to treat your foot problems with no issue.

Is the Chiropody Profession Going Away?

Even though most countries have adopted the podiatry model, the chiropody profession remains strong in Ontario. 

In response to the pandemic, the scope of drugs that chiropodists can prescribe has been widened to provide more comprehensive care to their patients.

Furthermore, requests for new podiatrists to be registered in Ontario were recently denied. The Minister of Health and Long-Term Care determined that the public needs access to the more affordable, routine, basic foot care that chiropodists provide. Chiropody remains an important medical science for Ontario residents because it gives them access to holistic foot care services.

Are Podiatry or Chiropody Services Right for You?

Close up of a foot massage

Both podiatry and chiropody are important professions when it comes to your foot health. While the term chiropodist is only used in Canada, both podiatrists and chiropodists specialize in the care and treatment of the ankles and feet.

So if you are in Ontario and need preventive care, therapy, or surgical treatment, you will benefit from visiting your local chiropodist. If you live anywhere else in the world, you will visit a podiatrist at a foot clinic. Both doctors will take care of your foot care needs and get you back to health.

In addition to visiting your local chiropodist or podiatrist regularly, you also need to use proper tools and materials to take care of your feet. The Toe Bro offers many specialized foot care products to enhance your foot care routine. Take a look at what we offer and see how you can enjoy happy, healthy feet today.