Understanding and Managing Gout

Arthritis can take many forms, including the buildup of urate crystals commonly known as gout. According to the Partnership to Fight Chronic Disease, this condition currently affects almost four million Americans and produces severe, sometimes debilitating pain.

Fortunately, you can improve your quality of life when you recognize a potential gout problem, receive the correct care from a rheumatologist, and learn how to minimize future flareups. Start by examining the following key points.

Gout Symptoms
According to the Arthritis Foundation, gout represents just one of the 100-plus forms that arthritis can take. However, unlike degenerative arthritis that causes a slow but progressive increase in pain, gout can attack suddenly and with great intensity. It commonly makes its first appearance in the first joint of the big toe, but it also strikes knees, elbows, and other joints.

You may suffer agonizing attacks of gout surrounded by periods in which your symptoms seem to vanish. Gout often produces sharp pain at night. Acute pain may last for 4 to 12 hours, with some discomfort lingering for days or weeks. Redness, inflammation, and swelling of the joint may also occur.

You may notice the appearance of lumps just under the skin, not just around affected joints but also at the tops of the ears or in other locations. These lumps, known as tophi, can result in disfigurement, nerve compression, or joint damage if they go untreated.

Gout Causes
Gout occurs due to unusually high levels of uric acid in the blood, or hyperuricemia. In some cases, an underlying condition may prevent the kidneys from removing uric acid normally. In others, high consumption of foods rich in purines can lead to an excess of uric acid, which then forms urate crystals in the joints.

About 20 percent of individuals who have hyperuricemia will go on to develop gout, with the condition affecting men more often than women. Other risk factors include alcohol abuse, obesity, diuretic drugs, diabetes, kidney disease, and heavy consumption of purine-rich foods such as red meats, sweets, organ meats, and sardines.

Gout Treatment
Primary care physicians can diagnose hyperuricemia and gout through a combination of x-rays, laboratory tests, discussions of your symptoms, and evaluation of your medical history. They may also prescribe treatment for mild cases. However, if your gout causes severe symptoms or threatens joint damage, you need a rheumatologist.

Hyperuricemia may not call for treatment unless the condition actually causes gout, although you may still need treatment for a related underlying condition. Medications to treat acute gout attacks include non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and a drug called colchicine.

If you suffer an acute gout attack but can’t see your rheumatologist immediately, you may manage to reduce your pain by elevating the affected joint, applying ice, and minimizing stress (including physical stress on the joint). However, the sooner you get proper medical attention, the more effectively you can get the flareup under control.

Gout Prevention
Healthy lifestyle choices can go a long way toward minimizing your overall gout risk. Diet plays an especially critical role in managing this form of arthritis. Restrict your consumption of alcohol, avoid the purine-rich foods that boost uric acid levels, and follow a safe, doctor-recommended weight loss program to reverse obesity if needed.

You may also need to work with your primary care physician to combat other contributing chronic ailments such as diabetes or kidney disease. If you currently take diuretics for a medical condition, find out whether you can swap those drugs out for non-diuretic alternatives.

If you find yourself facing the challenges of gout, contact Sarasota Arthritis Center for an evaluation. We can determine the proper course of treatment for your condition and help you get this painful form of arthritis under control.