Gout is a form of arthritis. Typically, it results in a sudden attack of burning pain, swelling, and stiffness in a joint- most often, the big toe. Unless you get appropriate treatment, these attacks can happen repeatedly.
Over time, your joints, tendons, and other tissues are damaged due to this disorder. Gout is more common in men than it is in women- though women can get it.
Gout is a result of the blood containing too much uric acid. In many people, it’s not a problem to have too much uric acid in the blood.
In fact, there are lots of people who have high levels of uric acid in their blood that never develop gout. On the other hand, if you do have high levels of uric acid in your blood, it is possible for it to form hard crystals in your joints- resulting in gout.
There are a few factors that increase your risk of developing gout. These are: being overweight or obese, drinking too much alcohol, or eating too much meat and/or fish high in a chemical called purines. Additionally, there are some medications, such as diuretics- water pills- that can cause gout.
Some of the most common signs and symptoms of gout is a nocturnal attack of tenderness, swelling, redness, and sharp pains in your big toe.
It is also possible to get attacks in your feet, ankles, knees, or other joints. These attacks can last as short as a few days or as long as several weeks before the signs and symptoms finally dissipate. You may not experience another attack for several months or even years.
Even if the signs and symptoms of your gout have dissipated, you should still continue to see your doctor and be treated for gout. It is possible that the buildup of the uric acid that caused your gout attack can still cause damage to your joints.
To diagnose gout, your physician will ask you some questions about the signs and symptoms you’re experiencing, as well as perform a physical examination. He/she may also want to take a sample of fluid from the affected joint to check for crystals formed by the uric acid. This is the best way to check for gout. Additionally, your physician may wish to do a blood test in order to measure the levels of uric acid in your blood.
In order to stop an attack of gout, your physician will give you a corticosteroid shot or will prescribe a large dosage of one or more medications. As your signs and symptoms begin to dissipate, the dosages of these medications will be reduced. As long as you get treatment right away, you will see relief from an attack within twenty-four hours.
To get pain relief during an attack of gout, you should make sure that you get some rest for the joint that is hurting. Additionally, taking pain relievers such as ibuprofen or other nonsteroidal anti-inflammatory medications can also help. However, you should never take aspirin for pain relief during an attack of gout- it can raise the level of uric acid in the blood and therefore cause the attack of gout to be much worse.
In order to prevent attacks of gout in the future, your physician is likely to prescribe medications to reduce levels of uric acid and keep it from building up and crystalizing in your joints.
One of the best ways to manage your attacks of gout is to pay close attention to what you eat. You should eat a moderate amount of a mixture of healthy foods in order to keep your weight under control and still get the necessary nutrients. You should also limit the amount of meats and seafood you consume as well as the amount of alcohol- especially beer- that you drink. Instead, you should drink more water and other beverages.
Causes of Gout
As mentioned previously, gout is a result of high levels of uric acid in the blood. This is known in the medical world as hyperuricemia. The exact cause of this disorder isn’t always known. However, there are some inherited factors that seem to play a role.
– If you have high levels of uric acid in your blood, this can result in crystals building up on your joints, which results in pain and some other signs and symptoms.
– Gout flare-ups can seem to come on without having a specific cause, or it can be a result of one or more of the following:
– Certain diet and body weight conditions, such as being overweight or obese. Additionally, eating a diet that is packed with meats and seafood, which are high in a chemical known as purines, as well as drinking high amounts of alcohol.
– Some medications could possibly increase the levels of uric acid in the blood, such as aspirin, niacin or other medications known as diuretics, or water pills. Diuretics reduce the amount of water and salt in your body.
– Certain medical conditions or major illnesses, such as high blood pressure or losing weight rapidly.
– Some surgeries can result in gout- check with your physician before undergoing any surgery to make sure you understand all the possible risks and complications.
– Certain conditions that are present from birth such as Lesch-Nyhan Syndrome or Kelley-Seegmiller Syndrome. In both of these syndromes, individuals can have a complete or partial deficiency in the enzyme that controls levels of uric acid, which results in levels being higher than normal.
Signs and Symptoms of Gout
There are many different signs and symptoms of gout that vary from person to person. Some of the common gout signs and symptoms are as follows:
– Extreme tenderness, pain, swelling, and warmth in the affected joint- typically a big toe joint. This symptom is referred to as podagara. Typically, the pain starts at night and could get worse very quickly and last for several hours. These can be so intense that the individual isn’t able to tolerate any pressure at all on it- even the light touch from the bed sheet.
– The skin around the joint will likely be very red or even nearly purple and looks like it could be infected.
– Individuals will have very limited movement in the joint that is affected.
– The skin around the joint is very itchy and could be peeling as the gout begins to heal.
Variation of Signs and Symptoms
Though the signs and symptoms above are the most common and affect nearly everyone with gout, there are some variations of signs and symptoms from person to person. The variations are as follows:
– In some individuals, gout is not experienced as lots of painful attacks. Instead, they have it almost all of the time. This is known as chronic gout. In older adults, gout could be less painful and can possibly be confused with other forms of arthritis.
– In some cases, gout can cause inflammation of the fluid sacs, known as bursae, which cushion the tissues. This most often happens in the elbow, where it is known as olecranon bursitis, and in the knee, where it is known as prepatellar bursitis.
– Some individuals find that gout affects other joints such as ankles, elbows, feet, fingers, knees, and wrists.
– Sometimes, individuals who may not have had signs and symptoms before, experience gout after a major illness or surgery.
– In some cases, you may not have any classic symptoms, but instead it starts with nodules, known as tophi, on your ears, elbows, and hands.
– You should also know that there are lots of other conditions or disorders that have signs and symptoms that are very similar to those of gout.
The Process of Gout
Typically, gout will develop after several years of uric acid crystals building up on the joints and surrounding tissues. Often, a gout attack will start during the night and you will experience some moderate pain that will get increasingly worse. In addition to the pain, gout is characterized by inflammation, redness, and swelling in a single joint- typically the big toe. Then, these signs and symptoms will gradually improve.
Some things you should know about gout include:
– Typically, attacks of gout will resolve in about a week.
– Mild attacks of gout will stop after several hours, or can last for a few days. In some cases, these attacks of gout are misdiagnosed as a sprain or tendonitis.
– If you have a severe attack of gout, the major symptoms can last for several weeks and you may have some soreness for about a month.
– After the first attack, many people will experience another attack within 6 months to two years. On the other hand, there may be several years between attacks. If gout is not treated properly to begin with, it is possible for the frequency of gout attacks to increase over time.
Stages of Gout
Gout has three stages. However, most of the time, people don’t experience the third stage.
Stage One
Stage one is characterized by high levels of uric acid in your blood. However, there are no symptoms of gout. The levels of uric acid may remain the same for several years and you may never experience any signs and symptoms of gout. In some cases, individuals will have kidney stones before they have their first gout attack.
Stage Two
Stage two is characterized by uric acid crystals beginning to form. Typically, this starts in the big toe. In this stage, you will begin to have attacks of gout. After the attack clears up, the affected joint feels normal. The period of time between attacks may grow shorter and later attacks will be much more severe, will last much longer, and could possibly involve more than one joint.
Stage Three
Stage three is characterized by the symptoms of gout never clearing up. In some cases, more than one joint is affected. You may notice gritty nodules, known as tophi forming under your skin. Without proper treatment, these tophi could form in the external ear or even in the tissues around a joint, including the ligaments, tendons, and bursae. This can result in pain, redness, inflammation and swelling. You may also experience a progressive destruction of bone and cartilage.
As mentioned, most people never reach stage three of gout. This is due to the many advances in the early intervention treatment of gout.
Factors that Increase Risk of Gout
There are several things that can either cause or contribute to gout. Some of these, you can control- others you can’t.
The things that you have no control over include the following:
- Being a man
- Family history of gout
- Having Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome, which cause high levels of uric acid in the blood due to a deficiency of a specific enzyme.
Medications that increase the levels of uric acid in the blood:
- Using more than 1 to 2 aspirin per day or taking niacin
- Using diuretics, which decrease the levels of water and salt in your body
- Chemotherapy medications to treat cancer
- Medications such as cyclosporine, which is used to suppress the immune system. This medication is most often used after an organ transplant, to prevent rejection of the new organ.
Conditions related to body and weight:
These are areas that you do have control of. You can make sure that you take good care of yourself and you’ll be less likely to develop gout. Following are the conditions that are related to body and weight:
- Being overweight or obese
- Drinking lots of alcohol, especially beer, on a regular basis
- Eating lots of meats and seafood that contain high levels of purines.
- Frequently becoming dehydrated
- Consuming very low calorie diets
Other conditions related to gout:
There are certain other conditions and diseases/disorders that occur more often in individuals who have gout than those who don’t. However, studies have not revealed a clear-cut relationship between these. It is possible that gout has some shared risk factors, such as obesity, high levels of triglycerides, and hypertension, with specific diseases, such as the following:
- Diabetes
- Kidney Disease
- Lead Poisoning
- High Blood Pressure
- Heart Disease
- Hardening of the arteries
- Joint injury
- Rapid weight loss due to change in diet and/or medications
- Acute infection/illness
- Surgery
- Conditions such as: multiple myeloma, hemolytic anemia, psoriasis, or tumors
Reasons to Visit Your Physician
If you experience any of the following symptoms, you should contact your physician immediately to get a proper diagnosis and treatment.
– Severe pain that comes on quickly in a specific, single joint
– Swelling, tenderness, and inflammation in the joints (including redness of skin)
– Even if the pain from your gout has subsided, it is still vital that you continue to see your physician. The uric acid buildup that resulted in the attack of gout could possibly still be irritating your joints and eventually could result in serious, irreversible damage. Your physician will be able to prescribe some medications for you that will prevent and reverse the buildup of uric acid in the blood.
What Type of Physician Should You See?
Following is a list of healthcare professionals that will be able to diagnose gout and prescribe a treatment program for it.
- Family Medicine
- Orthopedist
- Rheumatologist
- Physician Assistant
- Internist
- Nurse Practitioner
Exams and Tests to Diagnose Gout
There are several different examinations and tests that can help with diagnosing and treating gout. These include the following:
– Joint Fluid Analysis, known as arthrocentesis. This will reveal whether there are uric acid crystals present in the joint. This particular procedure is the only certain way to diagnose gout.
– Complete medical history and physical examination
– Blood test to measure the levels of uric acid. Your physician will likely use this test if he/she is unable to safely take fluid from the joint that is affected.
– Urinalysis to measure the levels of uric acid in the urine.
– In later stages of gout, x-rays of the hands and feet can be useful to diagnose, but these are not typically used in the earlier stages. Often, pain causes individuals to visit their physician and seek treatment before any long-term changes will be visible on an x-ray. However, on the other hand, x-rays can be quite useful to rule out other possible causes of arthritis.
If you have been exposed to lead through your hobbies or in your job, your physician will most likely have you evaluated for lead poisoning.
Treating Gout
The main goals for gout treatment are to provide fast relief of the pain, and to prevent gout attacks in the future, as well as prevent any long-term complications such as kidney damage and destruction of the joints. Treatment for gout includes medications and some steps you can take on your own at home to prevent attacks from occurring in the future.
The specific course of treatment will depend upon whether you are experiencing an acute attack or you are trying to manage gout over the long-term and prevent attacks in the future.
Acute Attack Treatments
If your physician is treating you for an acute attack of gout, he/she will recommend the following:
– Rest for the joints that are affected joint
– Oral corticosteroids
– Medications at the first signs of a gout attack (short-term)
– Corticosteroid injection
– Ice packs to reduce swelling
– NSAIDs (nonsteroidal anti-inflammatory drugs)
– Colchicine
Managing and Preventing Gout Attacks in the Future
If you have had signs and symptoms of gout off and on for years without seeking treatment, it could become chronic, and could possibly affect more than one joint at a time. In order to treat chronic gout, you should do the following:
– Medications to control pain
– Specific steps to prevent attacks in the future
– Discuss with your physician all of the medications you’re currently taking- both prescription and OTC. Some of these could be causing an increase in the levels of uric acid in your blood.
– Make sure to keep your weight under control
– Get plenty of exercise
– Limit the amount of meat, alcohol, and seafood you’re consuming
– Medications to reduce the levels of uric acid in the blood
If your physician prescribes them, make sure that you take all medications. Some medications that he/she may use to treat your gout are: xanthine oxidase inhibitors, Colchicine, Pegloticase, or Uricosuric agents. Studies have shown that these are effective for treating chronic gout.
You may develop tophi, which are chalky nodules that result from uric acid crystals. You can have these treated through surgical removal of the larger ones that are causing deformities, or taking Xanthine Oxidase Inhibitors
Things to Consider
If an individual has high levels of uric acid in their blood, but they have never experienced an attack, they most likely do not require treatment. However, these individuals- especially if the levels are extremely elevated- must go for regular testing in order to check for signs of kidney damage. Additionally, they may require treatment to reduce the levels of uric acid in their blood. Your physician will most likely want to monitor the levels of uric acid in your blood until it has been reduced to normal levels.
Treatment over the long-term to reduce levels of uric acid and prevent gout depends on the current level of uric acid and how likely you are to have attacks of gout in the future.
It is necessary that you speak with your physician after an acute attack of gout about what could be causing your elevated levels of uric acid in your blood. Your doctor may wish to do some testing and a physical examination to get an idea of your overall health. This could reveal medications, diseases/disorders, or even habits that could be causing high levels of uric acid. Typically, most physicians want to wait for several days or even weeks after an attack of gout to begin treatments to lower levels of uric acid in the blood. You should be aware that these medications can result in the uric acid located in other areas of the body to move through the bloodstream, and can cause symptoms to be worse if treatment is started in the middle of an attack.
If you have swelling that is causing pressure in a large joint such as your ankle or knee, your physician may wish to relieve the pressure and pain by a procedure called aspiration. In this procedure, a needle is inserted into the joint and the fluid is pulled out with a syringe connected to the needle.
Preventing Gout
In most cases, gout develops after several years of uric acid crystal buildup in the joints and surrounding tissues. Most likely, you will not be aware of elevated levels of uric acid in your blood until you’ve experienced your first attack of gout.
However, it is possible to prevent or at least reduce the severity of gout attacks in the future by making sure to follow specific steps at home.
Treating Gout at Home
If your physician has diagnosed you with the condition of gout, there are many things you can do on your own in order to treat your condition.
Tips to Decrease Pain Associated with an Acute Attack
- Rest the joint until the attack has dissipated and then for twenty-four hours after
- Elevate the joints that are painful
- To reduce swelling, use ice packs- don’t use heat
- Take NSAIDs to reduce inflammation. However, avoid taking aspirin because this can change levels of uric acid and cause symptoms to be much worse
Tips to Prevent Attacks in the Future
- Keep control of your weight. Being overweight or obese increases your risk of developing gout. If you’re overweight, a low-fat diet could help to facilitate your weight loss. However, you should not fast or consume low-calorie diets. The diets that are low in calories actually contribute to an increase in the amount of uric acid produced by the body and could cause or contribute to an attack of gout.
- Follow an exercise program to keep yourself in shape.
- Limit your alcohol consumption- especially beer. Alcohol reduces the amount of uric acid that is released in your urine, which causes levels of uric acid to build up in your body. Beer contains high levels of purines, seemingly higher than other alcoholic beverages.
- Limit consumption of meat and seafood. Diets that are very high in these things can cause a rise in levels of uric acid in your body.
- Discuss any medications you’re taking with your physician, as some have been proven to raise levels of uric acid. Check with your physician about ways to counteract this or possibly changing your medications.
- Keep taking medications that your physician prescribed for your gout. However, if you were not taking medications to lower uric acid such as probenecid or allopurinol before your attack of gout, you should not start after the attack has started. These medications won’t relieve the acute symptoms of gout and in fact, could cause them to be much worse.
In the past, researchers thought that gout was a result of drinking too much alcohol and eating too many extremely rich foods. Though it is true that certain foods and alcohol consumption could trigger a rise in uric acid levels in the body, these habits do not cause gout by themselves. Gout is a result of increased levels of uric acid in the body, due to problems with metabolism, or a decrease in elimination of uric acid by your kidneys.
Medications for Gout Treatment and Prevention
There are medications available for the treatment and prevention of gout. It is possible to treat your gout and to reduce the levels of uric acid in your blood. By reducing the levels of uric acid in your blood, you are able to prevent attacks of gout in the future.
Typically, medication choices for treating gout involves both short and long term medications. Following is an explanation of both short- and long-term medications.
Short-Term Medications to Treat Gout
Short-term medications are meant to relieve pain and reduce inflammation during an attack or to prevent an acute attack from recurring. Some choices for short-term medications are as follows:
- NSAIDs such as naproxen, ibuprofen, or indomethacin. However, be sure to avoid taking aspirin as a pain reliever during an attack of gout, as this can increase levels of uric acid in the blood and could actually cause the attack to be much worse.
- Colchicine- though this is not classified as a pain reliever, it does help to reduce the pain and inflammation of gout.
- Corticosteroids, which can be given orally or injected. These are used in cases where an attack of gout has not responded to colchicine or NSAIDs.
As long as treatment is started immediately, individuals will see that their symptoms will begin to subside within twenty-four hours.
During an attack of gout, your physician will prescribe the maximum daily dose of one or more of the above medications in order to treat the attack. As the symptoms begin to subside, your physician will gradually decrease the dosages of these medications.
Long-Term Medications to Treat Gout
In some cases, individuals may require long-term treatment. In these cases, the medications are meant to reduce the levels of uric acid in the blood. By reducing uric acid levels, you can effectively reduce how often your attacks of gout occur, as well as the severity of the attacks when they do occur. Some of the medication choices for long-term treatment of gout include:
- Uricosuric Agents, which increase the amount of uric acid that is eliminated by the kidneys
- Xanthine Oxidase inhibitors, which decreases the amount of uric acid that is produced by the body
- Colchicine, which helps to prevent flare-ups of gout during the first few months that you’re taking medications to lower levels of uric acid in your blood.
- Pegloticase, which works well for cases of gout that have lasted for a long period of time and has not responded to other methods of treatment.
You should know that if your physician prescribes one of the above medications, you should make sure that you take it as directed. If you have any questions regarding any medication your physician prescribes you, make sure that you get clarification so that you can be sure it will work like it is meant to.
If you are taking one of the above medications to treat or prevent gout, you should keep taking it during the attack of gout. However, on the other hand, if you were prescribed one of these medications, but you have not been taking it as directed, now is definitely not the time to start. Starting to take it in the midst of an attack can cause the signs and symptoms to be much worse.
Things to Consider about Gout Medications
Treatment using long-term medications depends entirely on how high your levels of uric acid are and how likely you are to experience attacks of gout in the future. In general, the higher your levels of uric acid, and the more often you experience attacks of gout, the more likely the long-term medications will help your situation.
In some cases, individuals continue to have problems with gout because they simply don’t take their medications as directed- or at all. Many times, people will need to take these medications every day in order to keep the levels or uric acid in their blood normal. However, when these levels do get regulated, and they feel healthy, they wonder what the point is in continuing their medications- so they stop. Of course, stopping medications doesn’t mean that an attack will happen immediately. However, after a while, an attack of gout is likely to happen. Without properly treating gout and regulating levels of uric acid, attacks of gout in the future are likely to be much worse and occur much more often- possibly leading to chronic gout at some point.
Surgery for Gout
If you have been experiencing signs and symptoms of gout off and for ten years or more, it is possible that uric acid crystals have built up on your joints and formed gritty, chalky nodules. These nodules are known as tophi. If you are experiencing pain, infection, pressure, and/or deformed joints, your doctor may be able to treat using medications. However, in some cases, the medications will not work and you will need to have surgery to remove them.
Homeopathic Gout Remedies
Homeopathic medicine, or homeopathy for short is a medical philosophy as well as a practice that is based upon the idea that the body can heal itself. This philosophy and practice came about in Germany in the 1700s and since then, has been very widely practiced in Europe. Homeopathic medicine believes that symptoms of an illness are part of the normal response of the body as it tries to regain optimal health. Homeopathic medicine is very different from natural treatments, though it typically does use natural substances.
The idea that homeopathy is based upon is that “like cures like.” This means, that if there is a specific substance that causes a healthy person to exhibit a certain symptom, then giving someone who is sick a very small amount of this particular substance could actually cure the sickness. Basically, it is the thought process that giving a dose of this substance will actually enhance the normal self-regulatory and normal healing processes.
What is Homeopathic Medicine Used For?
For many centuries, people have used homeopathic medicine to help in maintaining overall health as well as treatment of a wide variety of long term illnesses, such as allergies, rheumatoid arthritis, IBS, and atopic dermatitis. In addition, it has been used to treat minor injuries such as sprains and/or strains as well as scrapes and/or cuts.
On the other hand, homeopathic medicine is not used for illnesses such as major infections, heart disease, cancer, or emergency situations.
Homeopathic medicine is very popular in European countries, as well as India.
Is Homeopathic Medicine Truly Safe?
Since 1938, homeopathic medicine has been used and regulated in the United States of America and is considered to be very safe.
There are some critics of homeopathic medicine that truly believe that there is so little of an active substance in these homeopathic treatments, that any benefits of the particular treatment are not really because of the substance, but because the individual holds the belief that it will be effective. This is known as a placebo effect.
If you choose to use homeopathic medicine to treat your illnesses, you should speak with your physician. As long as you have been totally honest, he/she will have full knowledge of your health and will therefore be able to help you make wise decisions regarding where to purchase your homeopathic solutions, as well as which homeopathic practitioner you should go see. Keep in mind, if you have a very serious health concern, you should not use homeopathic medicine.
You can purchase homeopathic treatments at most health food stores without having a prescription from a physician. However, homeopathic preparations vary according to the practitioner and supplier that you obtain it from.
As mentioned, you should always speak with your physician if you choose to use an alternative therapy in conjunction with or in place of any conventional treatments he/she may prescribe. There may be some interactions that make it unsafe to use a particular homeopathic treatment with your conventional treatment, or it may not be advisable to quit your conventional treatment and use only alternative therapies.
Using Homeopathic Medicine to Treat Gout
Following are some substances that have been used to treat gout using homeopathic medicine.
The first homeopathic treatment we will discuss for the treatment of gout is, Aconite, also known as Aconitum. It is a substance that is created from a plant that typically grows in the mountain regions of Europe. Though in its herbal state, aconite is actually a deadly poison, when used in a homeopathic solution, it has been proven safe- even for infants. The name of this plant comes from a Greek word that means, “rocky”- which is a description of the native habitat of the plant.
The symptoms will have a very sudden onset, especially after being exposed to a really cold wind. In addition, gout pain that could effectively be treated with this substance might possibly also include symptoms such as extreme anxiety. Additionally, Aconite has been used to effectively treat gout in the feet and is most effective when used at the onset of the symptoms.
The second homeopathic substance that has been effective for treating gout is known as Nux Vomica. This substance comes from seeds of a plant called Strychnos, which grows in the country of Asia, mostly in the areas of China and India. In traditional Chinese Medicine, it is typically used as a botanical. Nux Vomica is especially effective at treating gout that is accompanied by chronic indigestion and stomach distress.
The third homeopathic substance that has been very effective at the treatment of gout is referred to as Colchicum- and is very common. Colchicum is extremely effective at treating gout that causes the joints to become red and extremely sensitive to the touch. Additionally, this gout will be much less painful when lying still and becomes much worse when n motion.
The fourth and final homeopathic substance that will be discussed in this article for the effective treatment of gout is Ledum. This substance is especially useful for treating gout in the big toe. It is very effective after using Colchicum, or possibly an overuse of Colchicine, which is a traditional medical treatment for gout, and comes from the Colchicum plant. When the individual suffering from gout feels chilled and the joint is cold, Ledum is an effective treatment.
Risks of Using Homeopathic Medicine
For the most part, homeopathic medicine is very safe and does not bring with it harmful side effects. However, when it comes to homeopathic medicine, if there are other therapies or diagnoses needed, there is a bit of a risk. If this is the case, it is possible that both conventional treatments and homeopathic medicine can be used together.
There are two things that increase the risks of homeopathic medicine:
- You must have patience and be willing to spend the time necessary to find an appropriate treatment. Using homeopathic medicine generally takes longer than conventional medicine.
- You must be sure that the remedy you’re using matches up with your particular symptom, including things such as what causes the symptom, where it happens, what seems to make it worse, and any other symptoms you may be experiencing.
Please understand if it is not a common and readily available treatment, it could possibly be hard to find. You may feel much worse after starting the therapy, but this will be a short term feeling. When your symptoms clear up, you should stop the treatment.
