Gout is a form of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in joints – often starting with your big toe. And though gout may start with your big toe, it can also affect ankles, heels, knees, wrists, fingers, and elbows. At first, gout occurrences usually get better within a few days. As time goes on, the occurrences last longer and happen more often.
In this blog, we’re providing an overview of gout. What is it? How do you know if you are suffering from it? How can it be treated?
What Is Gout?
Gout is a common but complex form of arthritis. It is characterized by sudden attacks of pain, swelling, redness, and tenderness in the joints, often starting initially in the joint at the base of the big toe.
Gout occurs when urate crystals accumulate in your joint, causing the inflammation and pain of a gout attack. Urate crystals form when there are high levels of uric acid in your blood.
Uric acid ordinarily dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys eliminate too little uric acid. When this happens, uric acid can build up, forming sharp urate crystals in a joint or surrounding tissue that then causes pain, inflammation, and swelling.
Gout Risk Factors
You are more likely to have gout if you have high levels of uric acid in your body. Things that increase the uric acid level in your body include:
- Diet. Eating a heavy diet of meat and seafood and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which, in turn, increases your risk of gout. Alcohol consumption, especially beer, also increases your risk of gout.
- Family history of gout. You are more likely to develop gout if other members of your family have had it.
- Obesity. If you are overweight, your body produces more uric acid and your kidneys have a more difficult time excreting uric acid.
- Age and sex. Gout occurs more often in men. Men are more likely to develop gout earlier than women, usually between the ages of 30 and 50.
- Medical conditions. Certain diseases and conditions increase your risk of developing gout. These include untreated high blood pressure, diabetes, metabolic syndrome, and heart and kidney diseases.
- Certain medications. Low-dose aspirin, thiazide diuretics, and anti-rejection drugs can also increase uric acid levels.
The signs and symptoms of gout include:
- Concentrated joint pain. Typically, gout initially affects the large joint of your big toe, but it can occur in any joint including the ankles, knees, elbows, wrists, and fingers. The pain is likely to be most severe within the first hours after it has begun.
- Inflammation and redness. The affected joint becomes swollen, extremely tender, hot to the touch, and red.
- Lingering discomfort. After the most severe pain diminishes, some joint discomfort may linger for a few days to a few weeks. Unfortunately, future gout attacks are likely to last longer and affect more joints.
- Limited range of motion. As gout progresses, your range of motion may become limited and you may not be able to move your joints normally.
Prevention of Gout
Gout symptoms may come and go, but there are ways to manage symptoms and prevent flare-ups. These dietary recommendations may prevent gout attacks:
- Drink plenty of fluids. Stay hydrated by drinking lots of water and limiting beverages sweetened with high-fructose corn syrup.
- Limit your consumption of meat, fish, and poultry. A small amount of meat and seafood may be okay, but pay close attention to the amount and types that seem to cause gout flares for you.
- Maintain an ideal body weight. Choosing appropriate food portions can help you maintain a healthy weight. If currently overweight, steadily losing weight will likely decrease the uric acid levels in your body.
- Get protein from low-fat dairy products. Low-fat dairy products may protect against gout, so they make a great protein source.
- Limit or avoid alcohol. Research has shown that beer in particular is likely to increase gout symptoms. Talk with your physician about whether alcohol is safe for you.
Common tests to help diagnose gout may include:
- Joint fluid test. When a joint fluid test is performed, fluid from your affected joint is removed and then it’s examined for urate crystals.
- Blood test. Your physician may recommend blood tests to measure the levels of uric acid and creatinine in your blood.
- X-ray imaging. X-rays of your affected joints can be helpful to rule out other causes of joint inflammation.
Medications are often the most effective way to treat and prevent gout. Medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDS include ibuprofen and naproxen. Prescription NSAIDs include indomethacin or celecoxib. A higher dose may be prescribed to stop an acute attack, followed by a lower daily dose to prevent future attacks.
- Colchicine. Colchicine is a type of pain reliever that reduces gout pain.
- Corticosteroids. Corticosteroid medications, such as prednisone, may control gout inflammation and pain. Corticosteroids are typically used only in people with gout who cannot take either NSAIDs or colchicine.
- Medications that block uric acid production. Drugs called xanthine oxidase inhibitors (XOIs) limit the amount of uric acid your body makes.
- Medication that improves uric acid removal. Drugs called uricosurics improve your kidneys’ ability to remove uric acid from your body.
Request an Appointment at The Orthopedic Clinic Today
At The Orthopedic Clinic, we want you to live your life in full motion. If you believe you are suffering from gout, let us help you get back to doing the things you love.
Call us at (386) 255-4596 to schedule an appointment.