One reason is because the crimping, pinching and pressure caused by tight fitting footwear can impede blood circulation around the toes and feet. Sluggish flowing blood is more likely to form and deposit crystals. A gout attack begins because needle shaped crystals form. And the toes are the number 1 recurring gout attacks location by far. Gout in the foot attacks, and more specifically in the ankles, are in the top five.
Can tight fitting shoes actually trigger gout attacks? Yes they can. Especially if you walk too far in them. Many gout sufferers know this from bitter experience.
Some kinds of shoes, specially designed for gout sufferers, also allow maximum air circulation around the feet.
A second consideration is that it is especially important to avoid pressure on the crucial big toe joint (where the big toe meets the main body of the foot) aka the 1st metatarsophalangeal joint of the big toe. If you are not particularly aware of it, have a look at this joint. It is gout’s favourite (favorite) location, so treat it well.
Not light and tight In the study the worse their footwear, the worse their foot impairment. These findings are in tune with what many gouty folk say. Lightweight, over-worn, tight footwear will not give your feet a comfortable enough ride, and protection. When there’s no protection, if you get a bash, twist or bump…… that shock can set off a gout flare in people living with gout, and in those close to a first gout attack.
Also consider wearing shoes that are sufficiently wide to allow for some increased swelling and avoid crimping. Shoes which narrow at the front, in the style of the Winkle Pickers of the 1960’s, or Chisel Toe (the front narrows to a chisel shape), and Pointy shoes today, are unfriendly to gout sufferers. They’ll crimp and push the big toe towards the others, and maybe bend it. Insoles boost the padding and comfort, but watch for them eating up too much space in the crucial big toe shoe area.
Gout sufferers often recommend 4x wide shoes, and shoes that are wide at the front, (square or round) to avoid pressuring the big toes.
Good gout shoes choices Sneakers (trainers); walking shoes; Oxfords (aka Balmorals); thick sole sandals. Things to look for - good cushioning and insoles (knocks are less likely to trigger attacks); space for air circulation; no pressure points; thick soles; and the shoes should have a large front box for the toes’ area.
Poor gout shoes choices Thin sole sandals, flip-flops, slippers, moccasins; any tight-fitting shoes, including narrow toed shoes such as chisel toe shoes, and women’s high-heeled shoes. As far as high-heeled shoes are concerned, shoes should not be tight-fitting (for the reasons explained above) and it’s doubtful that stretching the ankle is a good idea. It might be, or become, the shock that triggers gout. Gout often spreads from the big toe to the ankle. Stretching the ankle might encourage that.
Avoid shoes with thin soles – you want protection from what’s on the ground. If high heels, or other shoes, puts pressure on the knee or other joints, the same could happen.