In Canada alone gout, or “gouty arthritis,” afflicts an estimated 1.5 million people. It is caused by the buildup of uric acid in the blood and can lead to painful episodes known as “attacks,” most commonly concentrated in the big toe. In some cases the attack may spread to the ankles, knees, elbows and wrists as well. It is predominantly a male affliction usually striking men between the age of 40 and 50. If left untreated it can lead to potentially serious long-term complications.
- Intense pain in the big toe that may last several days.
- Pain which spreads to other joints in the lower arms and legs.
- Red skin, tender to the touch in the afflicted areas.
Causes of Gout
The cause of gout is well understood to be the buildup of uric acid in the blood. Normally a benign chemical, when uric acid reaches abnormal levels in the blood it can form crystals which collect in the joints at the body’s extremities. The hard crystals irritate the sensitive tissue of the joint causing inflammation and pain. Why uric acid accumulates to unhealthy levels in some people and not in others is not entirely clear but certain conditions and behaviours are known to contribute, such as:
- Excessive alcohol consumption.
- Vitamin C deficiency.
- A diet rich in certain seafoods or yeast.
- High doses of aspirin.
- Severe cases of psoriasis.
The condition is typically diagnosed by examination of symptoms manifested during an attack. The doctor will do a physical exam and perhaps check the level of uric acid in the patient’s blood. If diagnosis is in doubt the doctor may choose to examine the fluid in the swollen joint and test it for crystals of uric acid.
A range of treatments exist to help the sufferer deal with the acute pain of an attack. These include:
- Rest – Raise the leg to alleviate downward pressure and apply an ice pack. If there is no ice pack available, a bag of frozen vegetables will do. Keep the afflicted joint wrapped for about 20 minutes and then remove the ice pack to avoid damaging the skin.
- NSAIDs – NSAIDs such as ibuprofen are the most commonly recommended medication for treating attacks. This type of medication can be bought over the counter in any drugstore, is inexpensive and, when combined with ice pack therapy, is generally all that is needed to help the patient get through an attack.
- Corticosteroids – In severe cases the doctor may prescribe the use of corticosteroids for relief of symptoms. This type of medication, while effective, carries the risk of more severe side effects than NSAIDs. Corticosteroids should only be prescribed if the patient does not respond to other types of treatment.
Medications used to lower uric acid levels have proven effective in reducing the condition’s impact if taken over the long term. Declining to seek treatment for gout however, can lead to potentially serious long term complications including destruction of affected joints, hypertension, heart disease and kidney failure.