Gout is a painful inflammatory arthritis. It is caused by an over production of uric acid crystals depositing in joint, skin (tophi) or kidney tissue (uric acid kidney stones). As a result, the body reacts with an immune response, causing subsequent inflammation.
What are the symptoms of Gout?
Symptoms of gout include the abrupt onset of a hot, red, and swollen joint. Generally it manifests in the great toe at some time in the course of a patients disease. Typically, gout is characterized by an abrupt onset of disease affecting one joint. It is often described as occurring overnight with such severe pain; even the bed sheet is too heavy of a weight on the affected area. Gout is actually considered one of the most painful afflictions known to man.
Gout classically involves the great toe (podagra). It may affect any joint, but initially seems to affect one joint at a time. With time however, gout left untreated may mimic Rheumatoid Arthritis (RA), with numerous joints affected simultaneously.
What are risk factors for Gout?
Gout is most commonly seen in men prior to age 50, but becomes increasingly more common in females after menopause. Gout is associated with elevated blood uric acid levels (hyperuricemia).
Risk factors for elevated uric acid levels include:
- Advancing age
- Male sex (gout is the most common inflammatory arthritis in males older than 40 years old)
- Obesity
- Alcohol use
- Co-morbid conditions; including the metabolic syndrome, heart disease, kidney disease, and certain medications (diuretics, aspirin)
What should I do if I notice symptoms?
If you notice symptoms of joint pain or swelling, you should be evaluated by your primary care provider. This is especially important with a sudden and/or severe onset of symptoms. The diagnosis of Gout consists of a thorough history and physical exam. This may include lab work, X-ray, CT, or MRI based on your clinical symptoms and exam results.
Your doctor may recommend additional studies, referral for additional care, and/or further testing (rheumatology, physical therapy, or orthopedics).
Once diagnosed, what are my options?
With an inflammatory arthritis like Gout, the sooner you seek care and initiate therapy, the better the outcome. Gout is not curable, but is often very manageable with appropriate medication and lifestyle modifications. Talk to your doctor about specific options that would be best for you.
What can I do at home?
Taking good care of your health in general is important. Pay attention to your physical, mental, emotional and spiritual health every day. In general, inflammatory arthritis requires prescription therapy to slow the progression of disease and prevent deformities.
Primary aspects of home therapy would include:
- Staying active with daily exercise (often under the guidance of a trainer or therapist)
- Proper diet
- Losing excess weight
- Maintaining your healthy body weight
- Quit smoking
Depending on the type of arthritis, the following may also be helpful:
- Creams
- Heat/cold therapy
- OTC pain medications