Gout is an inflammatory condition that is characterized by uric acid disturbance and presents, clinically, with sudden and severe joint pain, joint swelling, stiffness, and possible fever. Gout most commonly affects the big toe, although, it may affect larger joints as well. It occurs in 1-4% of the general population, however, is increasing in incidence due to rising obesity, poor diets and lack of exercise.
How do I know if I have gout?
Gout is categorized by 4 major stages:
1. Asymptomatic gout – elevated levels of uric acid with no clinical symptoms
2. Acute gouty Arthritis - sudden onset of severe pain and inflammation from urate crystal phagocytosis
3. Intercritical gout – Interval between flares
4. Chronic gout – uncontrolled hyperuricemia resulting in long term gout complications
If your healthcare provider suspects gout, your physician may order a serum uric acid test (normal levels fall within 2.4 - 6.0 mg/dL), however the gold standard for detecting this is detection of monosodium urate crystals in synovial fluid aspirate using polarized light microscopy. The most common diagnosis method is by conventional radiography (x-ray) and is an effective tool in determining outcomes.
What are the treatments for gout?
Your physician may prescribe medications such as Colchicine, NSAIDs, and/or steroids. In addition, physical therapy is beneficial for reducing inflammation, restoring range of motion and improving functional capacity necessary for everyday activities. In more severe cases, arthroscopic surgery, joint replacement or joint fusion may be indicated to reduce the pain.
If you are in the Mission Viejo area and think you, or someone you know, might benefit from some physical therapy, please don’t hesitate to reach out!
1. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective - A review. J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008
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