Gout and plantar fasciitis can both affect the feet. Gout is a type of arthritis that causes joint pain and swelling. Plantar fasciitis is an inflammation of the plantar fascia, a ligament in the sole of the foot.
Gout occurs as a result of high uric acid levels in the body, which can form painful crystals around joints. Plantar fasciitis can develop from an unusual foot arch, overuse, or excess strain on the foot.
In this article, we look at the similarities and differences between gout and plantar fasciitis, including their symptoms, diagnosis, treatment, and outlook.
What is gout?
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Gout is a type of arthritis that can cause pain and swelling in the joints. Gout can occur when excess uric acid builds up in the body and forms sharp crystals around joints.
Risk factors for gout include:
- being male
- having obesity
- drinking alcohol
- having certain health conditions, such as diabetes, poor kidney function, heart failure, and high blood pressure
- taking diuretics
- following a diet high in purine-rich foods, such as red meat, organ meats, and seafood
What is plantar fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia, a ligament that runs along the bottom of the foot from the heel to the start of the toes.
Plantar fasciitis can result from excess strain or pressure on the foot. This may occur due to:
- a sudden increase in physical activity or repetitive impact on the feet, such as when running
- long periods of standing
- unsupportive footwear
- excess body weight or obesity putting extra strain on the feet
- flat feet or a high arch of the foot
Plantar fasciitis can cause pain and swelling around the bottom of the foot and heel.
Similarities
Although plantar fasciitis and gout are different conditions, they share some similarities:
- Both are inflammatory conditions that can cause pain and swelling.
- Obesity is a risk factor for both.
- Both can affect the feet, with gout most commonly starting in the big toe.
- Doctors may use physical examinations and imaging tests to diagnose both conditions.
- Both can involve treatment with ice, anti-inflammatory medications, and pain relievers.
- Treatment can help manage both conditions and relieve symptoms.
Differences
The differences between plantar fasciitis and gout include the following:
- Plantar fasciitis is an inflammation of a ligament in the foot, while gout is a form of arthritis that stems from a buildup of uric acid in the body.
- Plantar fasciitis only affects the feet. By contrast, gout can affect multiple joints throughout the body.
- Doctors may use blood tests and fluid samples to diagnose gout. Diagnosing plantar fasciitis, on the other hand, only requires physical examination and imaging tests.
- Medications, diet, and lifestyle changes may help treat gout. To treat plantar fasciitis, doctors may recommend physical therapy and, in some cases, surgery.
Diagnosis
Doctors diagnose gout and plantar fasciitis differently.
Gout
To diagnose gout, a doctor may first examine any joints displaying symptoms of gout. They may take a sample of fluid from the joint to examine under a microscope in order to check for urate crystals.
A doctor may take a blood test to measure uric acid levels. To confirm a diagnosis, the doctor may also use imaging tests, such as an ultrasound, to check for urate crystals.
Plantar fasciitis
To diagnose plantar fasciitis, doctors may first take a medical history and carry out a physical examination.
To rule out any other possible conditions, a doctor may take imaging tests, such as X-rays.
Treatment and management
Treatment and management are also different for these two conditions.
Gout
Treatment for gout aims to reduce pain, stop flare-ups, and prevent complications.
A treatment plan may include an immediate response to control a gout flare, such as:
- taking nonsteroidal anti-inflammatory drugs (NSAIDs) to help manage pain and swelling
- taking colchicine, a medication to help relieve painful symptoms when they first appear
- applying ice to the affected joint and elevating the joint
- drinking plenty of fluids, making sure to avoid alcohol and any sugary beverages
- trying to lower stress levels, which can worsen a gout flare
- contacting a doctor to inform them of the gout flare-up and to discuss the next steps
A long-term treatment plan may include:
- taking corticosteroids to reduce inflammation, manage pain, and slow down any damage to the joints
- taking xanthine oxidase inhibitors, which are drugs that help prevent the production of uric acid
- taking uricosuric agents, which support the kidneys to remove excess uric acid from the body
- taking uricase, a medication that helps break down uric acid so that the body can remove it more easily
- taking other drugs that lower uric acid levels, such as allopurinol, febuxostat, or pegloticase
- reaching a moderate body weight and engaging in physical activity
- choosing low impact activities, such as swimming or walking, to reduce stress on the joints
- limiting alcohol intake, including beer
- lowering intake of purine-rich foods, such as red meat, organ meats, and seafood
- avoiding or swapping any medications that may cause an increase in uric acid, such as diuretics
Plantar fasciitis
A person may be able to start treating plantar fasciitis at home with the following steps:
- doing gentle exercises to stretch the calf muscle
- wearing supportive shoes with a small heel raise and arch support
- wearing supportive footwear when indoors, as going barefoot can put extra strain on the plantar fascia
- applying ice, wrapped in a cloth, to the heel of the foot for 20 minutes several times per day to reduce inflammation
- reducing physical activity to allow the foot to rest
- taking NSAIDs to help alleviate pain and inflammation
If the pain continues after several weeks, a person can discuss further treatment with a doctor.
The treatment may include:
- applying extra support to shoes, such as padding or orthotic devices, to help reduce strain on the foot and address any structural issues
- receiving corticosteroid injections into the foot to lower inflammation and manage pain
- using a temporary walking cast to keep the foot immobile and allow it to rest for a few weeks
- wearing a splint during sleep to help stretch out the plantar fascia, which may help relieve pain upon waking
- receiving physical therapy to stretch the plantar fascia and strengthen the muscles in the lower leg to provide extra support to the ankle
Most people will not require surgery to treat plantar fasciitis. In severe cases, an individual may need a type of surgery called gastrocnemius release.
Tension in the plantar fascia has a link to tension in the Achilles tendon. Gastrocnemius release lengthens the gastric tendon, which forms part of the Achilles tendon.
Surgery may be suitable for people who have tight calf muscles and tendons or whose plantar fasciitis does not respond to other treatments.
Outlook
Without treatment, gout may progress to form tophi. Tophi are urate crystals that form under the skin and can damage the joints or organs.
Receiving an early diagnosis and following a treatment plan can help a person effectively manage gout symptoms and prevent complications and may even result in treating gout completely.
According to research, in 70–80% of people with plantar fasciitis, symptoms will improve within 9–12 months. Around 5–10% of cases may require surgery to release the plantar fascia.
Plantar fasciitis is common in athletes and may reoccur.
Summary
Gout is a type of inflammatory arthritis that can affect multiple joints in the body, while plantar fasciitis is an inflammation of a ligament in the sole of the foot.
Gout commonly starts in the big toe but can also affect other joints in the body. By contrast, plantar fasciitis causes pain and swelling in the arch of the foot and heel.
Applying ice to the affected areas and taking NSAIDs is the first-line treatment for both conditions.
Medications, diet, and lifestyle changes can help manage gout. Physical therapy, supportive footwear, and, in some cases, surgery can help treat plantar fasciitis.
Last medically reviewed on February 11, 2022
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