Gouty Arthritis

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission.

Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis.

Gout can effectively treat and manage the condition with medication and self-management strategies.

signs and symptoms

Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins.

Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

Symptoms in the affected joint may include:

• Pain, usually intense
• Swelling
• Redness
• Heat

Causes of gout

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated.

The following make it more likely that you will develop hyperuricemia, which causes gout:

• Male gender
• obesity
• certain health conditions, including:
  • Congestive heart failure
  • Hypertension (high blood pressure)
  • Insulin resistance
  • Metabolic syndrome
  • Diabetes
  • Poor kidney function
• Using certain medications, such as diuretics (water pills).
• Drinking alcohol.

Diagnosis

Diagnosis can be made up by physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.

How is gout treated?

Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to

• Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
• Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food (like red meat or organ meat), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
• Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.

In addition to medical treatment, you can manage your gout with self-management strategies. .

• Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines (like a diet rich in red meat, organ meat, and seafood), and limit alcohol intake (particularly beer and hard liquor).

• Get physically active. Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking.
• Go to effective physical activity programs.  participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move.
• Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.