As one grows older body starts to show symptoms of wear and tear by way of pains and aches. While these pains and aches can be very bothering, timely action by way of accurate diagnosis and treatment goes a long way in helping the body recover and stay healthy. Most often we treat pains of muscles and joints as casual sprains and try to get relief by either consuming painkillers or applying pain-relieving topical ointments. But what happens if the pain is a symptom of an underlying serious medical ailment. Hence, if the pain is unusual and long driven, timely medical intervention is extremely crucial to treat it. (1)
What is Gout?
A disease that is characterized by pains and aches of muscles and joints; Gout is a disease that is very similar to arthritis. Gout is a disease commonly diagnosed among men and generally involves sudden spurs of burning pains, muscle stiffness, and joint swellings. These painful spurs are recurring in nature unless the disease is treated completely. When left untreated for long, Gout can result in harming the joints, tissues and ligaments making even basic day to day activities seem painful.
Can Gout strike you?
Check out the common causes of the disease:
The presence of excessive Uric acid in the blood can lead to Gout. It is usually common to find high uric levels in the bloodstream of individuals but for some individuals, the Uric acid levels increase beyond control. Extremely high levels of uric acid in the blood can lead to the uric acid components formation of hard crystals in the joints which in turn causes gout. Individuals eating excessive amounts of meat, consuming too much alcohol or those who are obese; stand higher risks of being diagnosed with Gout. Meat and particularly plates of seafood like fishes are high on a chemical compound is known as purines which is one of the major factors resulting in Gout. Medications such as water pills or diuretics can also lead to gout.
What happens to the body when Gout strikes?
Gout though shows up suddenly in most cases, it is a result of prolonged reasons. It takes years for the uric acid to build up as crystals around the joints and tissues thereby causing Gout. Typically, a gout attack begins at night with some pain that grows into acute pain as the symptoms progress. A usual gout attack involves symptoms like swelling, excessive pain, redness around the affected skin area and inflammation around the joint affected. Most often the symptoms are seen around the big toe. In most cases, Gout symptoms will last for a specific period of time and then recur. Mostly gout symptoms are known to settle down in a week’s time. The milder painful episodes may last up to one or two days and are hence often misconstrued and a sprain or a muscular catch. In severe cases of Gout, the muscle soreness and tenderness can last up to a month. The reoccurrence of gout symptoms can be anywhere between 6 months up to 2 years. The intervals between attacks could also extend up to a year. When left untreated, the frequency of gout episodes could be higher.
The Gout disease progresses in an individual’s body in three steps:
Step 1: In the first step of this disease, the body has high levels of uric acid but does not show any symptoms of the same. The levels may continue to remain high without showing the physical symptoms. The crystals could in some cases also result in kidney stones before triggering the first episode of a gout attack. (2)
Step 2: In the second step of gout the attacks begin as the uric acid crystals form, generally seen around the big toe. After the first attack settles the patient may feel normal. The time between the episodes of gout may be short or long and the severity of each gout episode may also vary. The attacks may either be concentrated around one area involving any one particular joint or may involve more than one joint.
Step 3: In this step, the symptoms of the attack may either last longer or just stay on. The effect could be seen on more than one joint. This stage of gout is rather serious, but most people never get there due to advanced treatment options that are available. There are unpleasant nodules that appear under the skin in this stage. They are called Tophi. In case not treated on time, these tophi could spread to the external ear or to the tissues around the joints. This can lead to pain, swelling, redness of the skin and inflammation. This can further advance to the destruction of the bone tissues, impairing them permanently. (3)
Risk factors associated with Gout
There are a number of factors that may result in Gout disease or increase one’s chances of acquiring this disease. Some of the known associated risks of gout are:
- Men are more likely to be affected by the gout disease
- In many cases, gout is seen to be a hereditary disease affecting those with a family history of gout
- In some individuals, there is a birth defect whereby the body automatically is prone to high uric acid in the bloodstream. Such people by default fall under the risk zone of acquiring gout disease
- Certain medications such as aspirin, diuretic medicines, chemotherapy medicines or immune suppressants such as cyclosporine are known to cause gout in some cases
Symptoms of Gout
The common symptoms associated with gout include:
- The first part of the body that starts showing symptoms of gout is generally the big toe. The patient can feel a warm, painful sensation around the joints. Most patients face these symptoms at night and they can get worse rather quickly. The pain could be so intense that any pressure that the patient feels can be very painful and difficult to manage.
- Discoloured skin (mainly reddish or purple) around the joints that are most affected by the gout pain
- Restricted movement of the joints or feeling intense pain when trying to move at all
- The skin may feel itchy or scaly as the condition improves.
An important thing to remember about gout is that people feel varied symptoms of the disease at different points.
- In some cases of gout, instead of gout attacks, patients may feel the pain due to gout all the time. In the case of older adults, it becomes difficult to classify gout as it is often confused with arthritis.
- The gout disease can spread to cause discomfort and pain around the feet joints, ankles, knees, fingers, wrists and elbows. (4)
Diagnosing the symptoms of gout
To diagnose gout, the onus first lies on the patient to understand the pain of gout is different from a normal muscular pull or sprain. The patient must visit the doctor as soon as the severe pain is felt in any one particular joint that can come and go very quickly. Also, a visit to the doctor is necessary where the joints feel swollen and tender and there is slight redness around the skin. If the pain subsides also, the patient must visit the doctor for a complete analysis of the condition as the uric acid buildup which results in gout can cause serious complications eventually. When diagnosed and treated on time, the uric acid buildup can be corrected through medications and the symptoms of the disease can be reversed.
Following tests may be recommended by the doctor for a complete diagnosis of the disease:
- A test that involves examining the joint fluid (arthrocentesis) is recommended to confirm gout. This test confirms the presence of uric acid crystals present in the bloodstream.
- The doctor obtains a complete medical history (including the family history of the patient) followed by a physical examination before confirming gout.
- In the case for any reason if the doctor is not able to obtain the joint fluids, then the uric acid levels are tested for in the bloodstream by means of a blood test.
- Urine tests are also recommended to measure the uric acid levels present in the body.
Treatment and Medications
The good news as far as gout disease goes is that it can very much be treated and managed under medical supervision. The treatment aims at managing the pain and preventing further gout attacks. The mode of treatment is largely through medications and certain home measures that help in effectively managing the pain and other symptoms.
In the case of acute and severe gout attacks, medications such as Non-steroidal anti-inflammatory drugs (NSAIDs), Colchicine and Oral corticosteroids are prescribed by the doctor. These medications are usually temporary and recommended to manage the first signs of gout. Resting the joint that has felt the impact of gout is also very crucial in managing gout. Patients are advised to refrain from indulging in high-intensity activities such as running, gaming etc that can put pressure on the affected joints thereby causing pain and discomfort. Ice packs and cold packs are recommended to soothe skin inflammations. Painkillers are usually recommended to bring about relief from the pain and aches.
If Gout is not treated on time, it can continue as a long-term disease that can cause immense discomfort due to the pain and other symptoms. It can also become chronic affecting more than one joint. To manage the symptoms of gout one must complete the medication prescribed. If there are long-term drugs indicated by the healthcare practitioner that can effectively reduce the reoccurrence of the attacks, then the patient must complete the entire course. Further medication with regards to controlling uric acid in the blood may also be required to be consumed for the long term.
Although gout is a disease that put a persona through a lot of pain and discomfort it is not really a life-threatening disease. However, ignored symptoms can lead to quality of life getting affected. Hence, to manage the disease and from preventing it one must make an early diagnosis and take the treatment to get relief from the disease at the earliest.
Ana Miller is a creative writer. Her topics of interest and expertise range from psychology to all sorts of disciplines such as science and news.