CONDITIONS

What Is Gout

Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, most often affecting the big toe, knee, and wrist joints. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.

Osteoarthritis and gout are sometimes mistaken for one another, as both diseases are characterized by swelling and inflammation, Gout, however, is different because it occurs when the body can’t get rid of a natural substance called uric acid, which is composed of of carbon, nitrogen, oxygen, and hydrogen. The excess uric acid forms needle – like crystals in the joints that cause swelling and severe pain. This does not occur in typical osteoarthritis. While some treatments for gout and osteoarthritis are similar, gout requires specific medications in order to decrease uric acid build up in the body.

What Causes Gout

 

Gout is caused by having too much uric acid in your blood. Having high levels of uric acid is not harmful in and of itself, and many people who do have high levels of uric acid in their blood will never get gout. When uric acid levels are very high, however, the uric acid can form into hard crystals in your joints, which is the defining feature of gout.

Risk Factors For Gout

According to the Centers for Disease Control (CDC) some arthritis risk factors you can’t change, and others you have control over:

What you can’t change:

  • Age. The risk of developing most types of arthritis increases with age.
  • Gender. Most types of arthritis are more common in women; 60% of all people with arthritis are women. Gout is more common in men.
  • Genetics. Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis.

What you can change:

  • Overweight and Obesity. Excess weight can contribute to both the onset and progression of arthritis.
  • Joint stress. Damage to a joint can contribute to the development of arthritis in that joint.
  • Occupation. Certain occupations involving repetitive movements are associated with arthritis.

Diagnosing Gout

In most cases, arthritis is diagnosed with:

  • A physical examination. Your doctor will assess your pain levels, range of motion of your joints, muscle strength n the affected area, presence of swelling or tenderness in the joint and the way you walk (gait)
  • X – rays
  • Routine tests such as complete blood counts, urinalysis, biochemistries, and specialized tests such as rheumatoid factor and antinuclear antibody (ANA), may be given in order to rule out other diseases that can cause joint pain and swelling.
  • Arthroscopy. In some cases, your doctor may look for damage by inserting a tiny, flexible tube (arthroscope) through an incision near your joint. The arthroscope transmits images from inside the joint to a video screen.

Symptoms of Gout

Symptoms of gout include:

  • Hyperuricemia (an excess of uric acid in the blood)
  • Presence of uric acid crystals in joint fluid
  • More than one attack of acute arthritis
  • Arthritis that develops in a day, producing a swollen, red, and warm joint
  • Flare-ups of arthritis in only one joint, often the toe, ankle, or knee.

Prognosis

The severity of gout attacks and the rate of their recurrence can be suppressed with appropriate treatment. In doing so, the long-term consequences of the disease can most often be prevented.

Living With Gout

The following lifestyle changes can help you deal with gout:

  • Moderate exercise. Will help to lubricate joints and strengthen your muscles. Gentle low-impact exercises like swimming, yoga and walking are best. Excessive exercise can damage your joints.
  • Lose extra weight. By maintaining a healthy weight you’ll put less stress on joints. Just 10 extra pounds puts stress on your knee joints by the equivalent of 30 to 60 pounds.
  • Make adjustments. People in occupations with repetitive and stressful movement should find ways to reduce trauma by adjusting the work area or substituting tasks that produce less stress on joints.
  • Mechanical aids: Splints, braces, shoe inserts, orthopedic shoes, and knee braces are available to limit stress on the joint.
  • OTC pain creams. Creams and gels may provide temporary relief from pain. They work best on joints that are close to the surface of the skin, such as knees and fingers.
  • Rest. If there’s pain or inflammation in your joint, rest it for 12 to 24 hours.
  • Eat a healthy diet with an emphasis on fresh vegetables and complex carbohydrates. Drink plenty of water.
  • Take medications as prescribed.
  • Keep stress at bay. Try mindfulness exercises, deep breathing, relaxing yoga.

Screening

In general a doctor screens for arthritis by looking at symptoms such as pain, swelling and stiffness in the joint. Blood tests can help diagnose arthritis, monitor treatments, track disease activity and eliminate the possibility of other diseases. X-rays and other imaging tests can see if the painful joint is narrowed or has bone spurs.

Prevention

Some forms of arthritis such as RA can’t be prevented. The Arthritis Foundation (AF) makes the following recommendations to protect joints:

  • Maintain your ideal body weight
  • Don’t sit for long periods of time – stay active
  • Maintain good posture
  • Do a variety of physical activities to avoid injuries
  • Pay attention to pain; don’t push through it
  • A gout diet helps to control the production and elimination of uric acid, which may help prevent gout attacks or reduce their severity. The diet suggests limiting meat, poultry and fish, cutting back on fat, limiting or avoiding alcohol, limiting or avoiding sweet foods, and eating complex carbohydrates, low fat foods and drinking plenty of water

Medication And Treatment

The following medications can be used to control the severity and frequency of gout attacks:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, indomethacin, or naproxen
  • Colchicine
  • Corticosteroids, which may be given in pills or as a shot for cases of gout that don’t respond to NSAIDs or colchicine.

DO NOT TAKE ASPRIN DURING A GOUT ATTACK. Aspirin changes uric acid levels in the blood and may make the attack worse.

Complementary and Alternative Treatment

According to the National Center for Complementary and Alternative Medicine (NCCAM) researchers have found little conclusive evidence that any dietary supplements including the much touted Glucosamine and Chondroitin Sulfate Dimethyl Sulfoxide (DMSO), Methylsulfonylmethane (MSM) – as well as any herbal remedies – help with OA, RA, or gout symptoms or the underlying course of arthritis. If you are taking any supplements, tell your doctor

  • Some research has shown that acupuncture may help to reduce pain and improve joint mobility, and a small number of studies on massage and tai chi for OA symptoms suggest that both practices may help to reduce pain and improve physical function.
  • Mind/Body therapies. These include meditation, deep breathing, progressive muscle relaxation, visualization, tai chi, biofeedback and acupuncture. Studies show these methods can relieve stress, and in some instances reduce pain.
  • Heat and Cold. Most doctors recommend cold compresses to reduce joint swelling and inflammation and heat to relax your muscles and stimulate blood flow.

Care Guide

You can take steps to care for your body if you have gout. These self-care measures may help you manage your symptoms

  • Stay active but don’t try to work “through” pain
  • Eat a healthy diet
  • Lose extra pounds
  • Stick to a regular sleep schedule
  • Manage your pain with medications
  • Speak to your doctor if you’re taking any supplements
  • Use devices that support painful joints
  • Consider joining a support group

Speak with your doctor about surgical options

When To Contact A Doctor

If you have the following symptoms, be sure to contact your doctor:

  • Severe pain in a single joint that comes on abruptly
  • Swollen and tender joints with warm, red skin over them

Questions For Your Doctor

Your primary physician may refer you to a rheumatologist, a doctor who specializes in arthritis and other inflammatory conditions of the joints. You’ll also likely be referred to a radiologist, a doctor that uses imaging technologies such as X-ray, CT scans, and MRIs. If your doctor or specialist determines that surgery is needed you will be referred to an orthopedic surgeon. Orthopedic surgeons are trained in surgery connected to conditions of the musculoskeletal system

Questions For A Doctor

If your doctor has diagnosed arthritis, these questions can help you understand your condition:

  • What type of arthritis do I have? Does it affect only my joints, or can it affect other parts of my body? What joints are affected? What is the severity?
  • What caused my arthritic condition?
  • What is the best treatment for this type of arthritis?
  • What are the risks of not treating this type of arthritis?
  • How will this type of arthritis affect me over the long term?
  • What is the rate of progression of my arthritis likely to be?
  • How much joint damage do I have?
  • Do I need surgery? Will I need surgery in the future?
  • What should I do if my symptoms get worse?