If you have unexplained foot pain and you’ve been researching your symptoms, you may be wondering if you have gout or plantar fasciitis. They’re quite different conditions, but both can cause foot pain that can interfere with your daily life.
Knowing which one you’re struggling with is important. The two conditions require quite different treatment and management, so figuring out which one to treat is the first step to improving your pain and mobility.
Thankfully, it’s fairly easy to tell which one you have by comparing the two. Let’s have a look at each condition separately to understand the differences.
We’ll end off with a quick symptom checker so you can figure out which one you’re dealing with!
Gout is a common type of painful, inflammatory arthritis that affects one joint at a time. It most often affects the joint of your big toe, but you can also develop gout in your fingers, wrists, elbows, knees, ankles, and midfoot.
When there’s too much uric acid in your body—a condition known as hyperuricemia—tiny sharp crystals form in your joints. As these crystals build up, they begin to rub against the soft tissue lining of the joint, known as the synovium.
This rubbing causes pain and inflammation in and around the joint, known as a gout attack or flare. You’ll find that the gout attack is followed by a period of remission and you may not experience your next gout attack for weeks, months, or even years later.
Unfortunately, there’s no cure for gout. But it can be effectively managed and treated with medication and some careful lifestyle changes.
In most cases, there aren’t any noticeable symptoms until you’re having a gout attack. These attacks come on suddenly and you may be woken up in the middle of the night with intense pain in the joint.
Gout attacks can last five to seven days, but are often at their worst within the first 12 to 24 hours.
You may experience intense pain around the affected joint, while the skin over the joint is red and appears shiny.
The area around the joint will be sensitive and anything that comes into contact with it will be painful. Shoes, socks, and even the weight of a bedsheet will be unbearable.
The area around the affected joint will be noticeably warm. You may also find that the joint is swollen and you have a limited range of motion.
If left untreated, gout attacks can become more frequent, they may spread to other joints in the body, and they can cause long-term damage to cartilage and the bone.
Although gout is more common in men over the age of 30 years old, anyone can develop it due to high levels of uric acid in the blood. Several factors can increase your risk of developing gout. These include:
Some alcoholic drinks—like beer—are higher in purines than others and these drinks can increase the production of uric acid in your body.
Aside from the high levels of purines, alcoholic drinks can negatively affect the processes of the kidneys.
The impact on the kidneys may then affect how much uric acid is eliminated through your urine, which can increase your risk of developing a gout attack.
You may be at an increased risk of a gout attack if your diet contains a lot of:
- Processed food
- Refined carbohydrates
- High-fat foods
- Foods high in purines, like red meat, seafood, and shellfish
While it’s essential to maintain a healthy weight, it’s also important to notice where you tend to put on the extra pounds.
If you’re prone to gaining weight on your stomach, then you may be at a higher risk of developing gout.
This is because belly fat produces and releases more inflammatory chemicals than the visible fat—subcutaneous fat—under the skin on your arms and legs.
Some medications can increase your risk of a gout attack. These include:
- Diuretics—known as water tablets
- ACE inhibitors—used in the treatment for high blood pressure
- Low-dose aspirin—especially if they’re made from salicylic acid
If you’re taking any medication, you should speak to your doctor or pharmacist to see if it could increase your risk of developing gout.
Several medical conditions can increase your risk of gout. They include the following:
- Metabolic syndrome
- Heart attack or stroke
- Kidney disease
- Rheumatoid arthritis
You may be prone to gout attacks if other members of your family have had it, as it could be passed down through the genes you’ve inherited.
These genes could influence the way your gut and kidneys function, and that may cause your body to accumulate uric acid. This would make you more likely to develop gout.
The most common reason for pain on the bottom of your heel is plantar fasciitis. Your plantar fascia is a thick band of tissue that runs across the bottom of the foot, connecting your heel bone to your toes.
When the plantar fascia becomes irritated and inflamed, you’ll experience pain in your heel.
Often, the pain is at its worst first thing in the morning or when you get up after being seated or lying down for an extended period.
The main symptom of plantar fasciitis is pain on the bottom of your heel. At first, it may be a dull ache that becomes a sharp, stabbing pain after some time. You may also experience pain in the arch of your foot, as well as your heel.
The pain is at its worst first thing in the morning when you get out of bed. In most cases, the pain usually subsides during the day but can be felt after you have been inactive or sitting for a long time.
You may notice that the pain improves when you’re active or exercising, but it returns when you’ve finished your activity.
Anybody can develop plantar fasciitis. However, there are some risk factors that make you more susceptible to developing the condition. These include:
Spending Time on Your Feet
You may be at an increased risk of developing plantar fasciitis if you spend most of your work day standing, walking, or working on hard surfaces.
This can be aggravated by other factors, like wearing shoes that don’t have enough cushioning or support.
Tight Calf Muscles
Tight calf muscles can reduce the amount of flexibility in the ankle joint, and this places extra strain on your fascia.
As you go about your daily activities, the muscles and tendons that run down the back of your legs pull on the plantar fascia. This can lead to overstretching of the tissue, which causes irritation, inflammation, and pain.
Your plantar fascia supports the arch of your foot and acts as a shock absorber as you walk, run, or jump. If you’re obese, this will place excessive strain on the fascia and over time, your fascia becomes stretched.
This leads to the tendons and ligaments in your foot weakening, which affects how your foot distributes your body weight. Over time, this results in tenderness, swelling, and pain.
Wearing shoes that don’t provide adequate arch support for your foot shape can lead to uneven weight distribution. Shoes that don’t provide adequate cushioning won’t absorb shock effectively.
A lack of support and cushioning puts your plantar fascia under excessive pressure. It will aggravate the fascia with every step you take and increase your risk of developing this condition.
Aside from having flat feet or high arches, your feet will change shape as you get older. You’ll find that your feet may widen or flatten, and you might notice that your fat pad on your heel has become thinner.
Your plantar fascia won’t be able to effectively withstand the strain of each step, while supporting the arch and distributing your body weight. This will place the plantar fascia under added stress, where it becomes inflamed and irritated.
In most cases, plantar fasciitis is caused by overuse that causes micro-tears in the fascia. Over time, the repetitive stress causes constant irritation when you go about your daily activities, leading to heel pain.
Differences Between Gout and Plantar Fasciitis: Quick Symptom Checker
Fortunately, there are several differences between gout and plantar fasciitis that will help you determine what you may be experiencing.
It’s important to note that plantar fasciitis is inflammation of a ligament—soft tissue—in the foot, while gout affects the joints throughout the body.
Where Is Your Pain?
- Big Toe/Ankle: Gout
- Bottom of heel: Plantar fasciitis
Type of Pain?
- Gout: Intense, sudden pain that lasts throughout the day for up to seven days
- Plantar fasciitis: Dull ache or sharp, stabbing pain that goes away throughout the day or during activity
Is It Noticeably Warm?
- Yes: Gout
- No: Plantar fasciitis
Is the Pain Worse At Night?
- Yes: Gout
- No: Plantar fasciitis
Is the Pain Worse On Your First Steps In the Morning?
- No: Gout
- Yes: Plantar fasciitis
Do You Have Arch Pain?
- No: Gout
- Yes: Plantar fasciitis