Q: Is it possible my painful joints are caused by gout?
Gout may be a condition that’s straight out of a Dickens novel. However, it’s also a real and painful problem that people still experience today. Fortunately, there’s much rheumatology doctors can do to provide relief.
Gout is a type of arthritis. Patients who have it endure episodes of red, hot, swollen joints. Generally it’s the big toes that are affected. The pain can be so intense that it can hurt to have a bedsheet touch them.
In some cases, the rest of the foot, the ankle, and the knee may be involved. Individuals who have had gout for a long time may experience symptoms in the hands and elbows. However, it’s rare for gout to affect the hip or back. Gout can also cause chronic joint pain and kidney problems, including kidney stones. Most gout episodes last between a couple days and several weeks, with patients being pain-free between flares.
Monosodium urate is the crystal that causes gout. In men, urate levels increase at puberty. In women, this occurs after menopause. High levels of uric acid increase the risk of gout. Particularly in severe, long-standing gout, patients can also get tophi, which are soft-tissue deposits of monosodium urate crystals.
Gout is most common in middle-aged and older men and older women. However, gout can occur at younger ages. Risk factors include:
- Having a family history of gout
- Consuming alcohol
- Having kidney disease
- Being diagnosed with certain cancers
- Taking certain medications—particularly diuretics (water pills) like furosemide and hydrochlorothiazide.
Several things can trigger gout, including medication changes, a surgery, a minor injury, an infection, and a change in kidney function. Foods such as red meat and shellfish, and drinks such as beer and hard liquor can also trigger gout.
If you are suffering from gout, talk to a rheumatologist. Some episodes resolve on their own. In patients who have had gout for a longer period of time, anti-inflammatories, steroids, and drugs that lower uric acid can help reduce pain and speed up recovery.
—Esther Hwang, MD
Dr. Esther Hwang is a rheumatologist at Vancouver Clinic. She enjoys educating patients so that they can make informed decisions about their health. As one of the doctors in the only rheumatology group in Clark County, Dr. Hwang is honored to be able to provide rheumatology care close to her patients’ homes.