At first glance, it may not seem like gout and Achilles tendonitis would be related. Gout involves issues with bones and Achilles tendonitis deals with a specific tendon. However, according to the Seton Family of Hospitals, gout is a risk factor for Achilles tendonitis.
Gout attacks occur when uric acid in your blood crystallizes in your joints. This happens when the uric acid level in your blood gets too high either because your body can’t get rid of it through the urine or you are consuming foods that are too high in purines.
Signs and Symptoms
A gout attack is usually marked by sharp pain that can become excruciating within a day. The painful area will feel warm to the touch and will look red and swollen. It will also be very tender. About 90 percent of the attacks are in the joints of the big toes, but other joints, such as the ankle, knee, wrist and fingers, can also experience gout. Attacks last anywhere from three to 10 days with irregular periods between attacks. Over time, the attacks can occur more often and with greater intensity.
The Achilles tendon helps with walking, running and maintaining balance. Though it is the strongest tendon in the body, it can fatigue, become inflamed and develop into tendonitis. Acute Achilles tendonitis comes quickly and causes pain in the heel where the tendon attaches. Chronic Achilles tendonitis can cause enlargement of the heel and tendon.
Gout in the Achilles Tendon
As gout becomes a chronic condition, it can eventually attack other joints besides the site of the original attack. This secondary gout attack can also occur in the Achilles tendon, although it is not a joint. The gout can even leave tophi (large crystallized uric acid deposits) on the tendon that can cause the heel to become enlarged. The gout pain may be mistaken for Achilles tendonitis at this point.
At its worst, gout can cause a spontaneous rupture of the Achilles tendon, according to a National Institutes of Health case report. This is a rare condition. Gout was discovered as the cause when gouty tophi were found at the end of the ruptured tendons.