Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often in the big toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable.
Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.
The signs and symptoms of gout almost always occur suddenly, and often at night. They include:
- Intense joint pain. Gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists, and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.
- Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
- Inflammation and redness. The affected joint or joints become swollen, tender, warm, and red.
- Limited range of motion. As gout progresses, you may not be able to move your joints normally.
Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body.
Purines are also found in certain foods, including red meat and organ meats, such as the liver. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout, and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid.
Normally, uric acid 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 excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation, and swelling.
You’re more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:
- Diet. Eating a diet rich in red meat and shellfish and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increases your risk of gout. Alcohol consumption, especially beer, also increases the risk of gout.
- Weight. If you’re overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid.
- Medical conditions. Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, obesity, metabolic syndrome, and heart and kidney diseases.
- Certain medications. Low-dose aspirin and some medications used to control hypertension — including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta-blockers — also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
- Family history of gout. If other members of your family have had gout, you’re more likely to develop the disease.
- Age and sex. Gout occur more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.
- Recent surgery or trauma. Experiencing recent surgery or trauma can sometimes trigger a gout attack. In some people, receiving a vaccination can trigger a gout flare.
People with gout can develop more severe conditions, such as:
- Recurrent gout. Some people may never experience gout signs and symptoms again. Others may experience gout several times each year. Medications may help prevent gout attacks in people with recurrent gout. If left untreated, gout can cause erosion and destruction of a joint.
- Advanced gout. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fie). Tophi can develop in several areas, such as your fingers, hands, feet, elbows, or Achilles tendons along the backs of your ankles. Tophi usually aren’t painful, but they can become swollen and tender during gout attacks.
- Kidney stones. Urate crystals may collect in the urinary tracts of people with gout, causing kidney stones. Medications can help reduce the risk of kidney stones.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These can quickly relieve the pain and swelling of an acute gout episode. …
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack.
- Limit purine-rich foods. …
- Eat more low-purine foods. …
- Avoid drugs that raise uric acid levels. …
- Maintain healthy body weight. …
- Avoid alcohol and sugary drinks. …
- Drink coffee. …
- Try a vitamin C supplement. …
- Eat cherries.
- Organ and glandular meats. Avoid meats such as liver, kidney, and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.
- Red meat. …
- Seafood. …
- High-purine vegetables. …
- Alcohol. …
- Sugary foods and beverages. …
- Vitamin C. …
- Plus – If you have gout, dishes like chopped liver and liver and onions are the best avoiding, along with other organ meats like kidney, heart, sweetbread, and tripe, since they’re high in purines. (Purines, a common chemical compound found in foods and drinks, are metabolized by the body and turned into uric acid. Uric acid is then filtered out of the bloodstream by the kidneys.)
What exactly are purines?(PYOOR-een) One of two chemical compounds that cells use to make the building blocks of DNA and RNA. Examples of purines are adenine and guanine. Purines are also found in meat and meat products. They are broken down by the body to form uric acid, which is passed in the urine.
Uric acid is a natural waste product from the digestion of foods that contain purines. Purines are found in high levels in some foods such as:
- certain meats
- dried beans
Purines are also formed and broken down in your body.
Normally, your body filters out uric acid through your kidneys and in urine. If you consume too much purine in your diet, or if your body can’t get rid of this by-product fast enough, uric acid can build up in your blood.
A high uric acid level is known as hyperuricemia. This can lead to a disease called gout that causes painful joints that accumulate urate crystals. It can also make your blood and urine too acidic.
Uric acid can collect in your body for many reasons. Some of these are:
- obesity or being overweight
Certain health disorders can also lead to high uric acid levels:
- kidney disease
- diabetes mellitus
- some types of cancers or chemotherapy
Soaking in cold water is most often recommended and considered most effective. Ice packs may also work. Soaking in hot water is typically only recommended when inflammation isn’t as intense. Alternating hot and cold applications may also be helpful.
TREATMENT AND RELIEF
WebMD explains that while gout cannot be cured, it can be controlled with treatment. Anti-inflammatory drugs are one method, but in between gout attacks, it can be helpful to receive massage therapy. First, you should qualify what kind of massage you are talking about. Then you should consider what level of inflammation you are talking about. Severe inflammation related to gout is a medical emergency. If you can’t get your shoes on, go to a doctor, an ER, or Urgent Care. Gout can cause so much inflammation that touching the joint with a feather can be unbearable. But if you have gout don’t apply pressure near the affected joint. Apply pressure to the pressure points that are remotely connected to the inflamed joint.
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*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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