At the five offices of Long Island Spine Rehabilitation Medicine, our physiatrists deal with a broad spectrum of musculoskeletal injuries and disorders, including gout. If you are troubled by pain of unknown origin, or if you have been diagnosed, our specialists can help you recover and assist you in avoiding a recurrence. Our approach is holistic and we always make our first priority to relieve your pain and restore your mobility. Contact us for an accurate diagnosis and personalized treatment.
What is gout?
Gout, in spite of the cultural reputation that links it to European royalty with indulgent habits, is relatively common almost everywhere. It is characterized by sudden, severe pain associated with swelling, redness, and soreness in one or more joints. Most frequently, gout manifests in the big toe. The best first-aid treatment is applying ice.
Symptoms
In many instances, an attack of gout occurs suddenly, perhaps awakening the patient with an acute burning sensation in the big toe (or other affected joint) that is hot, swollen and so sensitive that the weight of a bedsheet is unbearable. The pain of gout is typically worst within the first 4 to 12 hours after onset.
- The symptoms come in waves, known as flare-ups, but our pain management physicians have the medical knowledge and experience to help you manage and get through the ordeal.
- As noted, gout can affect other joints besides the big toes, such as ankles, elbows, knees, wrists, hands, and fingers. After a flare-up, when the most severe pain has subsided, patients are likely to continue to feel joint discomfort and limited range of motion for days or weeks.
- Unless treated properly, each episode may last longer, affect more joints, and increase in intensity. Patients should be aware that when a joint is especially hot and inflamed, there may be an infection at the site that requires urgent treatment.
Causes
The causes of gout, like the causes of many medical problems, are not always immediately apparent. It has now been proven that gout occurs when urate crystals accumulate in the joint. These crystals form when the patient has an elevated level of uric acid in the blood, precipitating the inflammation and intense pain characteristic of a gout attack.
Because the body produces uric acid when it breaks down purines — substances that are found naturally in your body but also contained in certain foods — eating too much of these foods can put you at increased risk of developing this condition. Purine-rich foods include:
- Red meat and organ meat (e.g. liver)
- Anchovies, mussels, scallops, trout, and tuna
- Alcoholic beverages, especially beer & fructose-sweetened alcoholic drinks
This is why you can reduce the risk of gout attacks by changing your dietary habits.
Other Risk Factors for Gout
Other factors that increase your risk of developing gout include:
- Being overweight
- Having certain medical conditions (obesity, high blood pressure, diabetes, metabolic syndrome, heart disease, kidney disease)
- Taking certain medications (low-dose aspirin, medications to control hypertension, anti-rejection drugs prescribed for those who have undergone organ transplants
- Family history of gout
- Age and sex (gout occurs more often in men, especially those between the ages of 30 and 50; in women, it is more likely to develop after menopause)
- Recent surgery, trauma, or receiving a vaccination can also trigger a gout flare-up
Gout should be treated promptly to avoid complications, such as recurrent gout, advanced gout in which skin nodules (tophi) can appear and become swollen and painful, and kidney stones.
How Our Doctors Diagnose
The physiatrists of Long Island Spine Rehabilitation Medicine are very familiar with the symptoms of gout and may give a preliminary diagnosis after a physical examination. Since it is always important to confirm any diagnosis with precise testing, we may also administer one or more of the following:
- Joint fluid test that may show urate crystals under a microscope
- Blood test to measure the level of uric acid in your blood*
- X-rays can help to rule out other causes of joint inflammation.
- Ultrasound imaging can detect urate crystals in joints or in tophi.
*Blood test results can be misleading since you may have gout in spite of low uric acid levels and others don’t have gout in spite of high levels.
We Use a Variety of Methods to Treat Gout
Our doctors have various treatment methods for gout. Depending on the frequency and severity of your symptoms, we will determine which type of treatment is best in your particular case.
Ways to treat include:
- Medications that may either help reduce the associated pain and inflammation (e.g. NSAIDs and corticosteroids), lower the amount of uric acid in the blood or decrease immune response (e.g. Colchicine)
- Acupuncture to reduce inflammation, unwanted immune responses, and pain
- Physical therapy to stabilize affected joints and strengthen the surrounding muscles
- Occupational therapy to retrain stiff joints to perform everyday tasks more easily
- PRP (platelet-rich plasma) therapy to inhibit inflammation, stimulate the formation of new cartilage, and increase the natural lubrication at the joints
- PEMF (pulsed electromagnetic field) therapy to alleviate pain and accelerate healing by significantly reducing inflammation
- Injections of hyaluronic acid to lubricate the affected joint
- Injections of corticosteroid and analgesics to greatly reduce pain and inflammation
There are advantages to coming to Long Island Spine Rehabilitation Medicine for treatment of symptoms of gout. For one thing, we are quite familiar with the awful pain of gout and have had success treating it with a variety of methods. For another, we are able to differentiate what may seem to be gout from other conditions through precise diagnosis. If it turns out that you are suffering from another problem, our physiatrists are still well-prepared to treat you.
Contact Our Pain Management Specialists for Prompt Relief of Gout
If you experience the searing pain of gout, you certainly will want to make it go away as quickly as possible. Our doctors have access to both traditional and cutting-edge means of making you more comfortable and preventing a recurrence. Contact us soon so we can relieve your suffering.