GOUT

Gout attacks can suddenly strike a joint with intense pain. The skin around the joint may turn red and will be hot to the touch. Said to be one of the most painful conditions someone can experience, gout impacts people of any age or gender. If gout attacks are not managed, individuals may eventually suffer from joint damage, kidney damage and heart attacks or strokes.   Proper management of this condition may include changes to diet and lifestyle as well as using medications to keep the “flare-ups” and disease under control.

Gout occurs when the uric acid levels within the blood stream become excessive.  The high levels of uric acid can produce urate crystals within a joint.  The high levels of uric acid can develop from diet and lifestyle.   When the body breaks down purines uric acid is produced.  Purines are found in red meats, shell fish and organ meats.  Alcoholic beverages (especially beer) and those sweetened with fruit sugar (fructose) can cause uric acid levels to be excessive because purines are present in these drinks.

In someone who does not suffer from gout, their body is capable of dissolving the uric acid that is produced and excreting it through the kidneys.  Unfortunately, for those who suffer from gout, their body is unable to excrete enough uric acid to keep the levels in the blood stream at a safe level.  This can happen when too much uric acid is produced (due to poor diet choices) or the kidneys do not excrete enough from the blood as they filter it.  If the excess uric acid remains in the blood stream, urate crystals can form and lodge in the joint tissue causing severe pain.

Production of uric acid is associated with certain risk factors and if these factors are not controlled, the uric acid levels can be excessive.

Diet:  By far the most important factor to consider.  Reducing or eliminating red meat, shell fish, organ meats, alcohol (especially beer) and fruit drinks with fructose from the diet helps to prevent a flare

Family history:  A genetic component has to be considered.  If someone else in your family has gout, you are more likely to develop it.
Obesity:  Obese people produce more uric acid and the kidneys have greater difficulty filtering it.
Medical conditions:  Certain conditions such as high blood pressure, diabetes, heart and kidney diseases can lead to excessive uric acid production.
Medications:  Some medications that are used to treat hypertension (diuretics) can lead to elevated uric acid production.

Gout, if untreated and not controlled can lead to a host of other, severe problems.  Joint damage can occur and cause destruction of the cartilage surfaces, which leads to the need of joint replacements. Kidney stones which are urate crystals can form and cause all kinds of problems in the urinary tract. There are times that urate crystals can form a deposit in the skin.  These are called tophi and are often times found in the fingers, hands, toes, feet, elbows and Achilles tendon.  These deposits are usually not painful unless there is an active gout flare

Gout must be controlled at all times.  During an acute flare, treating the inflamed joint with NSAIDs, ice and many Physical Therapy modalities can help to reduce the intensity of the symptoms. Medications that help to reduce the level of uric acid need to be taken even when a flare up is not occurring.  Many people who suffer from gout stop taking their medications when they are not experiencing the symptoms of a flare.

Seeking help and treatment for gout from a Physical Therapist can help to reduce the intensity of the symptoms but it cannot control the uric acid levels in the blood stream.  Visiting a Physical Therapist does not require a doctor’s prescription.

Gout is a form of inflammatory arthritis that is associated with many medical conditions.   During an acute flare up the symptoms are server joint pain, limited mobility and swelling.  It is important to control gout with a proper diet, maintaining a healthy body weight and taking medication to reduce the uric acid levels in the blood stream.  Gout must be controlled at all times even when there are no symptoms present.