Bunions Vs Gout

What's the difference: Bunions vs gout

Bunions vs gout are both ailments of the foot that share some similarities but they are significantly different disorders. The timing of the onset of symptoms is a notable difference. Bunions take time to form and the pain they cause is gradual.

They are generally the result of long-term wear and tear on the feet. By contrast, gout pain comes on suddenly and is often the result of an imbalanced diet.

What are bunions and gout?

A bunion is formed at the base of the big toe where the metatarsophalangeal (MTP) joint is located. The big toe is pushed toward the second toe and the joint begins to protrude. All of this is a mechanical process and does not appear overnight. By contrast, gout is a metabolic process and symptoms appear rapidly. Gout results from the buildup of uric acid in the blood. When uric acid crystals form in the joints, the result can be a sudden onset of pain in those joints.

Both bunions and gout are forms of arthritis, which is a painful swelling or stiffness in the joints. A bunion—from the Latin "bunio," meaning enlargement is not limited to the big toe but can also occur on the little toe, where it is called a "bunionette" or "tailor's bunion."

Likewise, gout is not limited to the large joint in the big toe. It can occur in insteps, ankles, heels, knees, wrists, fingers, and elbows.

How bunions form over time

In addition, to varying in the time in which symptoms develop, the causes of bunions and gout are also significantly different. Bunions can form when ill-fitting shoes are worn over lengthy periods of time. This includes shoes that compress the toes together like pointy toed styles or high heels that force toes downward and together.

In both of these examples, the toes are forced into an unhealthy position stressing the MTP joint and turning the top of the big toe toward the outside of the foot. The joint is more prone to stiffness and irritation.

The shoes that cause bunions are most often worn by women making bunions more commonly seen in women. However, the choice of style over good foot health is not the singular determinant leading to the formation of bunions. People with flat feet or low arches are more prone to bunion formation. The lack of arches in the foot causes a poor distribution of body weight and can contribute to the contortion of the toes leading to the formation of a bunion.

How gout appears quickly

One might argue that gout is also a gradually developing ailment as the uric acid builds in the blood over time. Also, this buildup is the long term result of poor eating habits with an emphasis on rich foods and alcohol. Gout may be the result of long-standing health concerns but many sufferers describe the onset of gout as an attack. The pain generated from the accumulation of uric acid crystals is intense, immediate and generally happens at night. Gout is more prevalent in men and in postmenopausal women. Like bunions, gout most often occurs in the big toe.

Gout is more often diagnosed in people who are overweight and eat diets rich in meat and fish containing purines. Organ meats contain high levels of purines as do anchovies, scallops, and tuna. Purines are naturally broken down in the body to uric acid. The problem arises where there is too much uric acid for the body to dispose of in the urine.

Disease Progression and Treatment

Bunions vs gout: Without significant intervention, like surgery, bunions are forever. Once the metatarsophalangeal (MTP) joint has been compromised it pretty much remains in an awkward position. Shoes should be worn that don’t add to the pressure on the joint and cause further structural problems. Persons with low arches are encouraged to wear inserts that help bring the feet into a better position.

On the opposite side of the coin, the acute attacks associated with gout may come and go every few months or even years. The pain can be managed with over the counter medications like ibuprofen and naproxen. Avoid aspirin as it may increase uric acid buildup. Doctors may prescribe additional medications depending on the intensity of the pain. In some people, the flairs can be managed with a change in diet, increased exercise and weight management.

Bunions vs gout have in common the ability to generate pain in the large joint at the base of the foot. However, the underlying cause of the pain is quite different as is the treatment.

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Last Reviewed:
August 21, 2017
Last Updated:
October 18, 2017
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