Most people think of gout as something that only affects older men or may sound familiar from history books. But gout has actually become fairly common. So what is it? Gout is a type of arthritis that can impact adults of all ages. It causes sudden, intense joint pain that often starts overnight. “Four out of five gout flares will involve one joint, with the most common joints being the base of the big toe or the knee,” says Dr. Corey Pendergraft, Resident Physician at the Family Medicine Residency Center. “That said, other joints may be the location of a gout flare up!” If you've ever woken up with a red, swollen toe that hurts to even touch, gout might be the reason.
Here are four things you may not know about this painful condition:
Unlike some other types of joint pain, gout often shows up very suddenly. You might feel fine at bedtime and then wake up with a throbbing, swollen joint. “Gout pain intensity usually peaks in the first day, this is when the joint will be the warmest and most swollen,” suggests Dr. Pendergraft. “The irritation and swelling can cause the joint to throb and can even irritate nerve fibers resulting in a pain that can radiate away from the joint.” Many people describe the pain as sharp and severe, and even something as light as a bed sheet can feel unbearable.
Gout is caused by a buildup of uric acid in the blood which then deposits in areas like joints. Uric acid is found in certain foods like red meat, shellfish, sugary drinks, and alcohol (especially beer), which can raise your risk. But diet isn’t everything. Dr. Pendergraft says other factors that are associated with an increased risk of elevated uric acid, and therefore an increased risk of gout flares, include some medications (such as loop diuretics), hospitalization, chemotherapy for blood cancers, and environmental conditions (such as high temperatures and with super high or super low relative humidity).
While gout is more common in men over 40 and in women after menopause, it can affect younger adults too. If you have a family history of gout or other risk factors, it’s smart to be aware of the signs no matter your age. “Detecting gout before an acute flare is not quite feasible at this time,” Dr. Pendergraft says. “Checking uric acid levels in an asymptomatic patient is not standard, as most people with elevated serum uric acid don’t develop gout. Also, asymptomatic patients would likely not enjoy having their joint fluid taken to look for uric acid crystals if they weren’t in any pain whatsoever before the needle aspiration. The best prevention is to minimize the provoking factors mentioned above.” However, if you do get joint pain, especially if it comes and goes, you shouldn’t ignore it.
It’s true that the pain from a gout flare can fade after a few days, but that doesn’t mean the problem is gone. Without treatment, uric acid levels can stay high, leading to more flares and long-term joint damage. The good news is that gout is treatable. Dr. Pendergraft suggests that acute gout flares should be treated with medications that target inflammation such as NSAIDs, colchicine, or oral steroids. For chronically elevated uric acid levels that result in gouty symptoms, we would introduce medications that help to lower uric acid levels. The most common medication is allopurinol, but the medication selected can vary and is individualized.
If you’ve experienced sudden joint pain or think you might have gout, it’s a good idea to check in with your Family Doctor or Non Physician Clinician (NPC). A simple test can confirm it, and with the right plan, you can feel better and prevent future flares.
If you don't currently have a Family Doctor or NPC , it's time to establish care! Dr. Pendergraft and the other family medicine physicians at the Family Medicine Residency Center are accepting new patients.
Learn more: pullmanregional.org/residency-center or call the Center at (509) 336-7720.