Can Vaccines Contribute To Gout Flares?

I received an inquiry recently on my website from someone suffering from debilitating pain in the right great toe that he feels stemmed from a recent shingles vaccine. This person first noticed swelling and discomfort nine days after the second dose of the vaccine. Despite rest, ice and ibuprofen, the person said his pain worsened significantly over the course of a week and even interfered with his sleep. He says the range of motion in the toe is intact but notes that pressure of any kind causes burning, radiating pain. 

He recalled no trauma or change in his exercise regimen, and is puzzled by the correlation with the vaccine along with the sudden onset of symptoms. While awaiting a scheduled appointment with a podiatrist, he wondered if I had seen such reactions in others. 

Actually, I have. I am seeing a lot of symptoms similar to these after patients receive the COVID-19 vaccine, regardless of which dose or brand. I treat these instances like a gout attack, which it may be. Gout attacks occur due to changes in metabolism that in my experience can occur dramatically with vaccine administration. 

When I see cases like this In my office, I start with an initial X-ray although this is usually inconclusive. I recommend these patients aggressively hydrate for five days, drinking at least four, but up to eight, eight-ounce glasses of water minimum each day. Additionally, 600 mg of ibuprofen four times daily for five days is helpful in my experience treating possible gout attacks I also importantly recommend a 10-minute ice soak (cold water with ice cubes) of the affected area three times daily. Additionally, applying a dancer’s pad to float the great toe joint in a removable cast boot allows the patient to get around. 

If the patient does not feel significantly better within about a week, I order serum uric acid levels and magnetic resonance imaging (MRI). This imaging may help rule out a sesamoid stress fracture or some joint pathology. 

The first five patients I have seen who presented with these symptoms post-COVID-19 vaccine immediately got better with the aforementioned treatment approach. The sixth patient is awaiting X-rays, uric acid levels, MRI and probably a corticosteroid injection. 

Dr. Blake is in practice at the Center for Sports Medicine, which is affiliated with St. Francis Memorial Hospital in San Francisco. He is a past president of the American Academy of Podiatric Sports Medicine. Dr. Blake is the author of the recently published book, “The Inverted Orthotic Technique: A Process Of Foot Stabilization For Pronated Feet,” which is available at www.bookbaby.com. 

Editor’s note: This blog originally appeared at www.drblakeshealingsole.com. It is adapted with permission from the author.