There are two main reasons why gout is thought to strike new patients predominantly in the big toe. The first has to do with temperature. The human foot is on average five degrees Fahrenheit cooler than the rest of the body, and the big toe even a little bit more so, because it sticks out so clearly from the foot mass.
The other has to do with wear and tear. Few parts of the human body get more of a daily workout that the foot – from walking, climbing stairs, running for a bus or taxi, and so on. Experts feel that relative level of wearing down of the big toe joint makes it more susceptible to the onset of gout, than other joints.
Gout is a result of two primary stages. The first is a buildup of uric acid in the bloodstream. When the human metabolism breaks down purines, or DNA blocks, found in other species food like shellfish, meats, and even beer, the result is uric acid.
If that flow of uric acid is not properly filtered by the kidneys, it begins to build up in the bloodstream and leads to the crystallization of its components into salt-like crystals. That crystallization process is temperature triggered, which is why the resulting gout buildup occurs more often in the big toe.
One of the ways to deal with a big toe gout attack is the medicine prednisone. One of several corticosteroid medications, it can be either injected into the toe or taken in the form of a pill. However, such medicines are generally reserved for people who cannot take more standard treatment options like colchicine and non-steroidal anti-inflammatory drugs (NSAIDs).
There are also drugs that can be prescribed specifically to block or remove the buildup of the aforementioned uric acid. These include Zyloprim and Aloprim for example to block uric acid, and Probalan to improve the content ratio of this substance in the blood and urine stream.
Washington Post – “Gout, a Form of Athritist is No Longer Limited to the Well-To-Do”, March 7, 2011, Retrieved April 10, 2011 from http://www.washingtonpost.com/national/gout-a-form-of-arthritis-is-no-longer-limited-to-the-well-to-do/2011/02/22/ABZV2wO_story.html
Mayo Clinic – Gout Treatment and Drugs, Retrieved April 10, 2011 from http://www.mayoclinic.com/health/gout/DS00090/DSECTION=treatments-and-drugs