The accumulation of uric acid in the body leads to its deposition in the joints and the occurrence of gout. The disease is characterized by severe pain in the area of the damaged joint, redness of the skin, and swelling at the site of inflammation. If you suspect such a disease, you should consult several doctors. The pathology is mainly rheumatic in nature, so you need to visit a rheumatologist. If this is not possible, then you need a therapist who is available in any hospital or a general practitioner, surgeon, or orthopedist.
It is a mistaken belief that women who wear uncomfortable high-heeled shoes suffer from gout. People at risk include people who are overweight, have high blood pressure or have joint injuries. The disease begins unnoticed; in the early stages, the likelihood of its diagnosis is low. As the disease progresses, the person suffers from attacks of aching pain in the affected joint at night and in the morning. Such pain syndrome is a reason to go to the doctor. The following symptoms of gout are distinguished:
The disease has negative consequences, so at the first signs of gout you should consult a doctor.
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Gout is caused by metabolic disorders in the body. Therapy to alleviate the symptoms of the disease requires an integrated approach. The correct choice of which doctor to see depends on the signs of the disease and the availability of specialists in the clinic. A rheumatologist, therapist, orthopedist or surgeon will help solve the problem of gout. Depending on the presence of other health problems, other doctors are involved in complex therapy: nutritionist, gastroenterologist, nephrologist. During the first examination, any doctor finds out the peculiarities of the patient’s lifestyle. The patient must describe the symptoms of the disease as accurately as possible. Complex therapy consists not only of prescribing medications, but also of following a special diet.
A specialist doctor who treats arthritis, arthrosis and other diseases of the joints and connective tissue. During the first appointment, the rheumatologist establishes a preliminary diagnosis and prescribes a set of diagnostic measures:
Collecting examination results gives a complete picture of the extent of the disease, helps prescribe effective therapy and develop movement exercises. Patients with acute gout are admitted to the hospital until their condition improves. At the remission stage, treatment is carried out at home under the supervision of a rheumatologist.
This is a generalist who conducts a comprehensive examination of the patient’s body. It is important to contact him immediately after the first gout attack. The doctor orders an examination, and if the diagnosis is gout, he may refer you to a rheumatologist or other specialist, depending on the characteristics of the disease. Therapy for gout consists of drug treatment with drugs to reduce the amount of uric acid in the body and following a strict diet. To do this, the therapist refers the patient to a nutritionist.
Gout is characterized by a change in the shape of the foot. A characteristic bump grows on the leg, and the gait changes. With such a pathology, the therapist writes a referral to an orthopedist. He prescribes an additional examination to determine other signs of diseases of the musculoskeletal system. In severe cases, gout on the legs is treated with joint replacement.
The therapist and rheumatologist interact with the surgeon in their practice. This is a specialist who deals with treatment through surgical operations. If the patient did not consult a doctor in time and allowed accumulations of uric acid in the joint - tophi, they are removed from the soft tissues surgically. This is a drastic measure that is accompanied by a long recovery process.
Timely diagnosis of gout prevents the development of complications. At the first signs of the disease, you should consult a doctor to establish a diagnosis and prescribe therapy. The specialist profile should be chosen depending on the symptoms, but at the beginning of the disease, a therapist or rheumatologist will help to conduct a comprehensive examination.
To answer the question of which doctor treats gout, you must first determine what kind of disease it is. Gout is a chronic disease that occurs as a result of metabolic disorders. It is characterized by insufficient excretion of uric acid by the kidneys or its excessive formation in the body, which ultimately leads to the deposition of so-called urates in the tissues - crystals of sodium or potassium salts of this acid.
Typically, gout manifests itself as painful inflammation of the joints and the formation of growths on them, and over time, the duration of periods of remission between exacerbations of the disease decreases.
Doctors are increasingly diagnosing people with gout on their legs. In women, this is often associated with wearing narrow shoes with high heels and uncomfortable lasts. In men, this is due to the consumption of food rich in water-soluble organic compounds - purines (there are a lot of them in red meat, coffee, etc.), which are converted into uric acid in the human body. Since the disease chronically recurs and requires constant supervision by a specialist, you need to know which doctor to see for gout.
If you suspect it, you can contact several doctors. Since this disease is rheumatic in nature, i.e. it mainly affects connective tissue and joints, it is best to visit a rheumatologist who deals with such diseases in his field. However, it happens that for some reason it is difficult to find such a doctor or it is impossible to get to him at the moment. Then you should go to see a therapist, which is available in any medical facility, or a general practitioner.
The patient should describe his condition to the attending physician in as much detail as possible so that the diagnosis can be made faster. Both the therapist and the general practitioner generally have sufficiently broad competencies to conduct an initial examination of the patient, assess the general picture of the disease and identify gout, and, if necessary, refer the person to a rheumatologist in a larger regional center if this doctor is not available at the local health care facility .
Although a rheumatologist is a more specialized specialist than the above-mentioned doctors, he also considers requests from patients with completely different complaints. Because joint pain can occur for various reasons and be a manifestation of several ailments.
Some symptoms that patients complain to a rheumatologist are directly related to any previous illnesses, congenital malformations or injuries. For example, a patient who comes in with joint discomfort and malaise may suffer from:
Thus, a rheumatologist has extensive knowledge for a comprehensive differential diagnosis of a wide range of diseases that manifest as inflammation or degeneration of the joints, connective tissue or heart. He often collaborates with other specialists when caring for a patient:
Large medical centers employ highly qualified rheumatologists who combine several medical specialties.
These include a rheumatologist-orthopedist, who treats rheumatic diseases with complications in the musculoskeletal system, and a rheumatologist-arthrologist, who combines therapeutic and surgical methods for treating joints.
Since the course of gout is influenced by the food a person eats, the patient may need to consult a doctor about prescribing an adequate diet. Any of the above specialists can talk about this, but a more detailed consultation with a nutritionist is also possible.
Patients with newly diagnosed gout or during its exacerbation are usually admitted to a hospital or specialized department of multidisciplinary medical centers. And if the disease is in remission, it is possible to observe the patient in a medical institution at the place of residence, but only if effective therapy is prescribed and the disease progresses positively.
Treatment for gout is vital, and you should see a doctor as soon as possible.
For rheumatic diseases, potent drugs are often prescribed that can only be prescribed by an experienced specialist, so at the first signs of discomfort in the joints you should go to the doctor and follow all his instructions.
You cannot self-medicate so as not to aggravate the course of the disease.
The development of gout is caused by an increased level of uric acid in the body. A typical manifestation of this disease is specific arthritis. In this case, it is mainly the joints of the lower extremities that are affected - the first metatarsophalangeal, ankle, knee, and the joints of the small bones of the foot. It’s not without reason that gout, translated from ancient Greek, means a foot trap.
Effective treatment of gout in the legs involves not only eliminating the arthritis itself, but also the causes that led to it. In this regard, it is important to combat hyperuricemia - increased levels of uric acid in the body. In the treatment of this pathology they use:
Before treating gout on the legs with medications, the patient should be provided with an appropriate protective regime. Motor activity is limited as much as possible, and sometimes completely eliminated, and the affected limb itself is brought into an elevated position. NSAIDs are effective for any arthritis, incl. and with gout. However, not all drugs from this group can be used in this case. For example, Acetylsalicylic acid and its derivatives increase the content of uric acid in the body. Therefore, salicylates are contraindicated in gout.
But Indomethacin is quite suitable. This drug is the drug of choice in the treatment of gout. Other remedies are also suitable - Naproxen, Ibuprofen, Diclofenac. When starting to treat gout with NSAIDs, do not forget about their negative effects on the gastrointestinal tract, liver and blood clotting. Steroid hormones (Kenalog, Diprospan) are most effective when administered intra-articularly. Taking these medications orally is also accompanied by side effects.
But the most effective remedy for exacerbation of gouty arthritis is Colchicine. After taking Colchicine tablets orally, inflammation in the joints immediately subsides. However, this drug is contraindicated in renal failure. And the latter, as you know, is a common complication of gout.
Gout on the toes is manifested not only by arthritis, but also by tophi - subcutaneous deposits of uric acid salts. By causing inflammation of the joint capsules and tendons, tophi complicate the course of arthritis. As the level of uric acid in the body decreases, tophi decrease in size and sometimes disappear altogether. At the same time, inflammation in the joints of the legs is stopped. For this purpose, drugs are used that inhibit the synthesis of uric acid (Allopurinol) and promote its excretion in the urine (Etamide, Urodan, Sulfinpyrazone). After the exacerbation is relieved, the drug effect is consolidated by physical procedures - UHF, electrophoresis, magnetotherapy.
As Hippocrates, who first described gout, said, let your food be your medicine and your medicine your food. It is hardly possible to cure gout on the legs with diet alone, since it is a chronic disease. However, some dietary restrictions will help improve the patient's well-being.
First of all, you should give up alcohol, strong tea, coffee and fatty foods. There are some foods whose consumption leads to the accumulation of uric acid. These are meat, fish, liver, brains, peas, soybeans, beans, mushrooms, eggs, carrots, lettuce. These products should be limited as much as possible. Meat and fish dishes should be consumed boiled without spices and herbs. The diet should contain fresh fruits and vegetables. It is important to maintain optimal water regime. The amount of water you drink per day should be at least 2-2.5 liters. It is advisable to drink alkaline non-carbonated drinks.
Treatment at home for gout of the legs is carried out using folk remedies in the form of compresses, lotions, homemade ointments and other external remedies. The simplest way to treat arthritis flare-ups at home is to apply ice to the affected joint. The next day, on the contrary, warming is carried out. This is done using an alcohol compress. A napkin soaked in alcohol or vodka or a piece of clean cloth is applied to the affected joint. The napkin is covered with polyethylene, and the polyethylene with cotton wool. All this is fixed with a bandage or thick woolen cloth.
Another effective remedy is to mix butter with the same volume of powdered hop heads. Heat the mixture in a water bath and rub into the affected joints. You can also use an infusion of elderberry and chamomile flowers as compresses. To prepare it, flowers taken in equal quantities are poured with boiling water and infused for 2 hours. Then the infusion is filtered and applied to the sore joints. Baths of chamomile decoction with the addition of sea salt crystals are also shown.
The removal of uric acid is facilitated by the ingestion of herbal infusions and decoctions, and berries. The most useful berry for gout is strawberries, which can be eaten in their natural form. The intake of strawberries can be combined with the use of birch sap - 1 glass three times a day. A decoction of celery roots (1 tbsp in 2 cups of boiling water) is taken 2 tbsp. spoons three times a day 3 hours before meals. Traditional medicine for gout recommends tea from the trifid series, which is drunk hot.
Unfortunately, folk remedies, as well as a diet with medications for gout of the legs, do not always provide the desired result. Sometimes the accumulation of uric acid leads to irreversible changes in the joints of the lower extremities. In such situations, they resort to surgical intervention - plastic surgery or joint replacement.
Gouty arthritis is a serious disease that limits joint mobility and leads to joint deformation. The symptoms of this disease are extremely unpleasant, and the consequences are very sad. That is why it is worth learning everything about this disease in order to be fully armed.
Gouty arthritis or gout is an unpleasant disease characterized by degenerative changes that occur in the joint tissues. Such changes occur in humans as a result of serious metabolic disorders. In particular, the exchange of uric acid and purine bases is disrupted. And if the products of purine metabolism are not excreted from the body for some reason or are excreted too slowly, then the concentration of uric acid increases sharply, which is not normal. Yes, such a substance must be contained in the body, but its excess is normally eliminated.
Unremoved excess uric acid begins to be deposited in various tissues of the body, which leads to serious deviations in the functioning of certain systems. And if this substance is deposited in the joints, they become inflamed, deformed and gradually destroyed. This is called gout.
Most often, the disease affects the feet, namely the fingers. Quite often the arms (hands and fingers) are affected. Gouty arthritis of the ankle, elbow or knee occurs rarely, and the disease practically does not affect the shoulders and pelvis.
It is worth mentioning separately the causes of this disease. They have not been fully clarified. But it has already been proven that the hereditary factor has a fairly significant influence on the development and course. In addition, metabolic processes also play an important role. But there are several negative factors that can be called unique triggers:
The disease has a paroxysmal character. The frequency of exacerbations depends on the person’s lifestyle and the effectiveness of treatment. It can range from 1-3 attacks per year to monthly or even weekly occurrences. In most cases, exacerbation occurs after consuming alcoholic beverages or meat in large quantities. Most often, attacks occur at night or in the morning. Some people experience them after physical exertion or hypothermia.
During an exacerbation, the patient feels sharp pain. The joint is almost completely immobilized, the mobility of the entire limb (usually the foot) is limited. Severe swelling occurs (outwardly it looks like a lump of quite impressive size). The skin in the affected area becomes hot and severe redness appears. On palpation, the pain intensifies. An increase in the patient's body temperature (up to 38-39 degrees) may also be observed. On average, an exacerbation can last from a day to several days and even a week. It all depends on the measures taken and their effectiveness. But after a few days, all symptoms will go away in any case, even without treatment.
The further course of the disease will depend on the patient’s lifestyle and compliance with medical prescriptions. For some, remission (a period of complete absence of symptoms) can last several years. For others, attacks occur quite frequently. During the period of remission, absolutely no signs may be observed; at this stage, the disease is difficult to detect.
If gout treatment is not effective, the disease can become chronic, in which changes affect not only the joints. So, there will be problems with the kidneys, accompanied by swelling. After 2-3 years, salt deposits may form on the joints, which will take on a characteristic appearance (bumps will appear). In addition, tophi occur (single accumulations of urate salts, spreading throughout all tissues of the body). Externally, they look like small whitish seals.
To identify the disease, you need to undergo some examinations and take certain tests:
Only after an examination can a doctor make an accurate diagnosis.
Your doctor should tell you how to treat gouty arthritis. Specific measures will depend on the severity of the disease, characteristics of the body and other factors. In case of exacerbation, therapy should be carried out in several directions:
During the period of remission, the doctor may prescribe some physiotherapeutic procedures, special therapeutic exercises or massage.
In the chronic form, to reduce the level of uric acid in the body, the doctor may prescribe special drugs: “Allopurinol”, “Allomaron” and others like that.
Nutrition for gouty arthritis is adjusted by the attending physician, but usually the diet involves limiting the amount of meat and meat products (including semi-finished products), certain types of fish (for example, cod, pike perch, sprat, sprats), mushrooms, spinach, beans, peas, broccoli , asparagus, strong coffee or tea, sorrel, figs and other products. You will have to completely give up alcohol.
You can eat nuts, fruits and vegetables (excluding those listed above), cereals, dairy products, baked goods, grains and some types of fish (infrequently).
Treatment with folk remedies can only be carried out along with the main therapy. Here are some recipes:
Remember that gout requires treatment, as this disease has dangerous consequences and can lead to complete immobilization of the limbs.
When a person is worried about something in terms of health, he should immediately consult a doctor. But it is not always clear who to go to with this or that problem. The specialty of a doctor speaks about the range of diseases that he deals with, namely diagnosis, treatment and prevention. For example, not everyone knows which doctor can help if the first symptoms of gout appear.
Which specialist should I go to?
The first signs are a reason to immediately seek qualified medical help in order to undergo a full examination and begin treatment. Gout is considered a disease for which it is impossible to postpone a visit to the doctor. There is a risk of complications.
Which doctor treats gout? This question arises for good reason, because the disease affects several systems in the human body at the same time. Therefore, there is no clear answer. As a rule, the patient should first visit a general practitioner. The doctor will examine the patient and analyze all the symptoms. Sometimes it happens that a person who goes to the doctor confuses the signs of gout with pain resulting from a joint injury. The therapist will be able to understand the situation and prescribe the necessary examination. If the diagnosis is confirmed, the doctor will write a referral to a rheumatologist.
A rheumatologist is a doctor who treats diseases of the joints, connective tissues, and rheumatic diseases of the heart muscle. This doctor will help you cope with your illness. Treatment of gout requires a lot of time and patience, both on the part of the patient and the doctor. There is a practice where gout, which is in the initial stages of development, is treated by two doctors at once: a rheumatologist and a therapist. Doctors consult with each other about medications and methods of therapy that are suitable in a particular case.
Diet is an integral part of the comprehensive treatment of gout. Therefore, a physician or rheumatologist may advise the patient to seek advice from a nutritionist. It will help you create an individual diet depending on the severity of the disease.
Gout is a chronic disease associated with a violation of the metabolism of uric acid, the level of which in the blood increases, and crystals begin to accumulate in the tissues. It is considered very ancient and widespread. In recent years, medical statistics indicate that the diagnosis of gout is being made more and more often. In most cases, this is due to the fact that people do not notice the first, still mild, symptoms and diagnose the disease already at an advanced stage. If every person regularly underwent preventive medical examinations, then this situation would not arise.
As mentioned above, the cause is an increased level of uric acid in the blood, the crystals of which gradually begin to be deposited in the joints. They are partially or completely destroyed. The level of uric acid in the blood increases due to:
1. healthy kidneys cannot cope with such a large amount of it;
2. the kidneys (due to certain problems) cannot cope with the normal volume of acid.
People themselves provoke the development of the disease. They eat foods with a lot of purines and drink alcoholic beverages.
Gout on the legs is diagnosed much more often. An inflamed joint provokes unexpected severe pain in the mornings and nights. Such attacks are accompanied by:
2. increased temperature at the site of the lesion;
3. hyperemia of the skin;
4. slight increase in body temperature;
6. loss of appetite;
7. decreased physical activity.
A growth appears on the diseased joint, which is commonly called tophi. It causes severe pain, can burst, and significantly impairs a person’s life.
The doctor will find out from the patient all the symptoms that worry him: the intensity of the attacks, how long ago they occurred, and others. After this, he studies the medical history and finds out what kind of life the patient leads.
To make an accurate diagnosis, it is necessary to undergo a complete examination:
After a full examination and diagnosis, the doctor treats gout. First of all, the patient must radically change his lifestyle and diet.
Treatment includes:
As a rule, the patient has to take the following medications:
If the tophi reaches a large size, becomes infected, and interferes with the person, then in such cases surgical intervention is indicated. When the joint is significantly damaged, it is replaced.
If treatment is not started on time, or the patient does not follow all the recommendations and regularly take the necessary medications, then he faces dangerous complications:
1. chronic gout;
2. tophi (sometimes they reach the size of a golf ball);
3. kidney stones;
5. heart disease;
6. lung problems;
7. cataract, dry eye syndrome.
If a person engages in activities that require a lot of energy, the metabolism of purines will increase.
Heel pain in the morning affects 26% of people over 40 years of age. The disease is detected in 88% of patients over 70 years of age. The most common cause of pain is plantar fasciitis or heel spurs. The disease appears from overload of the tendons with excess weight and flat feet, after a heel injury. Foot pain also accompanies gout, diabetes, and certain neurological and systemic diseases.
Which doctor should you contact for your first appointment for heel pain? What examinations does the doctor perform at the initial stage and what kind of foot diseases can he identify? What specialized specialists will need to be involved in the treatment of heel spurs? Let's find out.
If you suspect a heel spur, it is important to know which doctor you should see first. If you have heel pain, first make an appointment with your surgeon. The doctor finds out the history of the disease - the nature and duration of pain, profession, concomitant diseases. After this, he conducts a physical examination - examination and palpation of the foot.
The surgeon, if there is a suspicion of plantar fasciitis, refers the patient to an x-ray of the foot. The presence of a heel spur on the image confirms the diagnosis of plantar fasciitis. But the absence of a bone growth does not exclude the disease, since a heel spur is detected only in 10% of patients with plantar fasciitis. An X-ray examination is carried out to exclude a malignant disease, gout or other foot pathology.
What other doctor diagnoses heel spurs? Not every clinic has an orthopedic doctor, but if such a specialist is on staff, then it makes sense to initially make an appointment with him. An orthopedic doctor is a specialist who deals with the pathology of the human musculoskeletal system. The orthopedic doctor’s tactics during examination are the same as those of a surgeon. Therefore, he will also refer the patient for an x-ray of the foot.
It is difficult to recognize foot diseases, since many of them present with similar symptoms. If necessary, to clarify the diagnosis, the surgeon or orthopedic doctor refers the patient to an ultrasound examination (ultrasound).
If the diagnosis of plantar fasciitis is in doubt, the doctor will refer the patient for magnetic resonance imaging (MRI) of the foot. This method allows you to detect changes not only in bones and joints. The tomogram shows pathological deviations of muscles, ligaments and soft tissues. MRI reveals the thickness and nature of changes in the fascia - its inflammatory and degenerative changes are visible in the image. With plantar fasciitis, an MRI image shows an accumulation of fluid along the anteromedial side of the aponeurosis. MRI also reveals other changes in the foot - Baxter's neuroma and occult stress fractures of the calcaneus.
For the purpose of differential diagnosis, the doctor gives a referral for a biochemical blood test. Why is this analysis necessary?
Biochemical blood test
When examining patients with inflammatory diseases of the joints, specific disease markers of ankylosing spondylitis or psoriatic arthritis are detected in the blood.
That is, each disease is characterized by specific markers in the blood.
What diseases can be detected during the examination?
If neurological or systemic diseases are diagnosed, the orthopedist or surgeon refers the patient to a specialized doctor. For example, in the case of rheumatoid arthritis, ankylosing spondylitis and Reiter's syndrome, the patient is observed by a rheumatologist. Patients suffering from these systemic diseases first undergo an inpatient examination in a specialized clinic and only after that continue specific treatment under the supervision of a rheumatologist at the clinic.
If Baxter's nerve compression syndrome (tunnel syndrome) is diagnosed, patients are treated by a neurologist.
If you complain of pain in the heel and foot, a neurologist can detect painful polyneuropathy, which develops in alcoholics due to vitamin B12 deficiency. A neurologist eliminates such foot pain in 1 week by replenishing this vitamin in the body.
If you have pain in the foot, a neurologist can diagnose the disease - funicular myelosis. The disease is also caused by a deficiency of vitamin B12, but due to impaired absorption in the stomach. The cause of foot pain in this disease is a disorder of nerve conduction in the spinal cord. The pathogenetic factor of the disease is chronic autoimmune gastritis with dyspeptic syndrome. It is precisely because of this disease that the absorption of vitamin B12 in the stomach is impaired. In case of funicular myelosis, the neurologist refers the patient for examination to a gastroenterologist.
Patients with heel pain may have diabetic polyneuropathy. The disease develops in patients with latent (latent) diabetes mellitus, sometimes suddenly. With diabetic polyneuropathy, foot pain appears at the earliest stage of the disease, when blood sugar rises inconsistently. An endocrinologist and neurologist examines and treats patients with diabetes. To establish a diagnosis, blood is examined for the content of glycohemoglobin and insulin.
So, which doctor treats heel spurs? An orthopedic doctor or surgeon makes a primary diagnosis based on examination data. If a heel spur is identified, then it is the surgeon or orthopedist who prescribes treatment, during which you will need to visit more specialized specialists.
Heel spur block
What other treatment methods, and therefore doctors, will be needed to treat heel spurs? When possible methods of treating fasciitis have been exhausted, and pain continues to torment the patient, a drug blockade is often prescribed - an injection in the heel. The advantage of this method is that medications are injected directly into the site of inflammation of the fascia. This increases the therapeutic effect of the drug. For blockade, drugs with different deposition times in tissues are used. The most commonly prescribed steroid drugs are Kenalog or Diprospan. Which doctor performs a heel spur block? The manipulation is performed by a surgeon or orthopedist with experience. The injection is given at the most painful point on the heel. To reduce pain during the procedure, the drug is mixed in one syringe with the anesthetic Novocaine or Lidocaine. The use of ultrasound for control facilitates the blockade technique. Heel spur blockade has not become widespread due to the short duration of therapeutic action and contraindications. The main negative consequence of the block is the potential for fascial rupture. Therefore, the blockade is done in case of severe pain that cannot be relieved by other means.
Let's summarize. If you have heel pain, you should initially visit a surgeon or orthopedist. At the diagnostic stage, the patient undergoes a number of examinations, including x-rays, ultrasound, MRI and blood tests. During the examination, the patient may need consultations with other doctors, including a neurologist, rheumatologist, and even an endocrinologist and gastroenterologist. If a diagnosis of heel spur is made, then treatment is carried out under the supervision of a surgeon or orthopedist, during which the services of an exercise therapy instructor, massage therapist, and physiotherapist will be needed.
Gout is an inflammatory process in the joint associated with salt deposition. An imbalance of uric acid, an increase in its levels in the urine and blood leads to the development of gout - that is, the accumulation of crystals of sodium salts.
The appearance of gout and its causes are often associated with heredity, which is why a family tendency to gout is widespread among men. However, the factors leading to the development of gout are very diverse. These include: obesity, increased levels of triglycerides in the blood, abuse of protein in food, addiction to alcohol. feel the signs of gout by taking diuretics, nicotinic acid or riboxin for a long time.
Inflammation and pain due to gout occur when neutrophils (cells of the immune system) begin to attack the salts deposited on the joints. A gout attack also has another name - gouty arthritis . It appears suddenly and usually at night.
A gout attack is a sharp, throbbing pain in one or more joints. Most often, signs of gout affect the big toes. Pain from gout is accompanied by redness and swelling of the joint. The affected area becomes hot, and the pain increases with a light touch.
A gout attack lasts several days. It can return to a sick person after drinking alcohol, physical exhaustion, hypothermia, surgery, injury, or through the abuse of certain foods.
Chronic gout is manifested not only by pain, but also by the accumulation of uric acid in the tissues. For example, signs of gout include the appearance of yellow-gray deposits in the folds of the ears, as well as over the joints.
Exacerbation of gout can be avoided by changing lifestyle and not starting the disease after the first attack of gout.
To diagnose gout, the doctor prescribes: a general and biochemical blood test, a urine test. An X-ray examination of the joints or an MRI is also necessary to detect the accumulation of uric acid in the tissues.
Treatment methods for gout vary. These include medications for gout , prescribed to relieve pain and inflammation, and a special menu for gout, which reduces the risk of new attacks, and removal of gout if the process has gone too far.
In any case, you need to pay special attention to your lifestyle and eliminate factors that provoke gout (its causes).
Firstly, after testing your blood for cholesterol and your urine for acid levels, the doctor will advise you to lose excess weight and offer a special diet for gout . It is necessary to completely abandon meat and offal, meat and fish broths. Limit the content of legumes, radishes, cauliflower, mushrooms, asparagus, and fish in the menu for gout.
Nutrition for gout should be based on carbohydrates. The menu for gout can freely include: milk and dairy products, vegetables (except those listed above), fruits and berries.
Sometimes eggs, cereals and even flour products are allowed. Meat can be consumed boiled, but not more than twice a week and in small quantities. During an attack of gout, all meats should be eliminated immediately.
Cherries, currants, and strawberries are suitable as tasty remedies for gout
Prevention of gout and its exacerbations includes: taking activated carbon, and a mixture of ground flaxseed and mixed with activated carbon is applied to the joints (hold for 30-60 minutes).
An attack of gout can be alleviated by: raising the affected leg to an elevated position, drinking frequently (rosehip decoction, for example), taking non-steroidal anti-inflammatory drugs (diclofenac, naproxen). Aspirin does not adequately relieve gout pain, making it difficult for the body to eliminate uric acid.
When gout worsens, doctors prescribe:
- glucocorticosteroids (these are synthesized hormones that relieve inflammation) - in the form of tablets or injections into the affected joint;
- colchicine is used to prevent gout (it reduces the flow of certain substances into the joints);
- in some cases, plasmapheresis is prescribed - purification of blood from uric acid.
A rheumatologist diagnoses and treats gout.
The question of which doctor treats gout arises in almost every person who is faced with this kind of problem. And if previously people with the disease in question turned primarily to a therapist and, together with this specialist, figured out which doctors would be advisable to turn to next, now the situation has changed a little.
Gout is a chronic disease that occurs due to disruptions in the normal course of metabolic processes. The disease is characterized by the occurrence of deposits of uric acid salts in various places: mainly the joints of the thumbs, as well as the wrist, ankle and knee joints.
The risk group for this disease includes men who have crossed the 40-year age limit. In addition, gout is increasingly being diagnosed in older women.
As a result of the deposition of salt crystals in the affected area, inflammation begins to develop, causing the patient great inconvenience and a lot of unpleasant sensations. In order to at least a little imagine the patient’s condition, it should be remembered that from Greek the name of the disease in question can be translated as “foot trap.”
In the old days, gouty arthritis was a “signature” disease of aristocrats. The bottom line is that the disease is most often diagnosed in patients who drink alcoholic beverages and include large amounts of protein and fatty foods in their diet. In addition, people with diabetes, hypertension and obesity are at risk.
Acute gout is characterized by a sudden onset and rapid progression. If a patient discovers symptoms of the disease, and after some time they disappear without treatment, it means that after 6 - 12 months the disease will make itself felt again, but in this case its nature will be chronic and it will be much more difficult to get rid of the problem.
Typical signs of gouty arthritis include:
The duration of attacks of gouty arthritis can range from several hours to several weeks (prolonged in the absence of appropriate treatment).
In this case, even minor touches to the affected joint provoke the occurrence of very severe pain.
The occurrence of the disease in question is caused by 2 main factors: heredity and dietary habits. Heredity is laid down at the genetic level, but the disease does not always pass from parents to children. Even if both adults suffer from a similar disease, the development of gout in a child is not necessary.
Among the dietary features that provoke the occurrence of gout, it should be noted that the menu contains a large amount of meat, alcoholic beverages, and chocolate.
That is why diet must be included in a comprehensive gout treatment program.
Feeling severe pain, many patients rush to consult a traumatologist, surgeon or therapist. At the same time, doctors of other specializations are also authorized to treat the disease in question.
The key cause of gout comes down to disruption of metabolic processes in the body, and pain in the joints is already a consequence of the described failures. Because of this, the best treatment option for gout is to work with a rheumatologist. However, an experienced therapist can also help solve the problem. A single examination is usually sufficient to make a diagnosis, after which treatment can begin.
In most cases, patients think about the need to treat gout only during an exacerbation. The first sensations arising from the disease in question are remembered for a long time: burning pain in the joints is a pleasure for few people.
As a rule, the big toe suffers, but salt deposits in other places cannot be ruled out. The treatment program is compiled exclusively by a qualified specialist. The list of drugs is standard for arthritis, arthrosis and other joint pathologies.
The basis of therapy is non-steroidal anti-inflammatory drugs. The use of corticosteroids is not excluded. The primary task is to eliminate inflammation.
As a rule, doctors prescribe colchicine to patients with gout - this drug has a selective effect on the body, defeating inflammation at the site of localization of the pathology in question. When used, the duration of the acute period is reduced to 2 - 3 days.
Having eliminated the inflammation, the specialist prescribes the main treatment. And although gout is most often localized on the legs, a comprehensive approach is taken to designing therapy under any circumstances.
Drugs of 2 key groups are used: uricodepressants and uricosurics. Under their influence, the concentration of uric acid in the body decreases, the salts of which are the main link in pathogenesis.
The most popular uricodepressant (inhibits the formation of acid) is the drug Allopurinol. The dosage and frequency of administration are prescribed by the doctor. Even if the specialist’s recommendations differ from those indicated in the instructions, there are objective reasons for this, based primarily on the individual characteristics of the patient’s condition.
Uricosuric drugs are prescribed selectively. Under the influence of such drugs, there is an increase in the clearance of urate in the kidneys, which represents the main danger. It has been established that gout causes problems not only to the joints, but also to the kidneys. As a result, gouty nephropathy can develop, often leading to death. If signs of nephropathy are detected in a patient, treatment with drugs from the group of uricosuric drugs is not used.
Treatment is not limited to just visits to a rheumatologist. Additionally, the patient is recommended sanatorium treatment, physiotherapeutic procedures, therapeutic massage, physical education, diet, etc.
The point regarding diet is especially important. Firstly, the patient is recommended to maintain a water regime by drinking at least 2 - 3 liters of high-quality mineral water per day. Secondly, an important component of therapy is diet correction. The diet should contain a large amount of plant and dairy foods. The consumption of meat, especially fried and fatty meat, is kept to a minimum. Chocolate products, cocoa, tea, coffee and alcoholic drinks are excluded from the diet.
Thus, only a timely, competent and comprehensive approach to the treatment of gout allows one to expect good results and a reduction in the frequency of recurrent exacerbations.
Be attentive to the condition of your body, seek medical help in a timely manner, follow the recommendations of a specialist and be healthy!
Gout is a chronic disease caused by metabolic disorders. Gout occurs in people with persistently elevated levels of uric acid in the blood. With gout, crystals of a derivative of uric acid, sodium urate, are deposited in the joints and some other organs and systems. Sodium urate is deposited in the joints in the form of small crystals, which causes joint damage , which is why such arthritis is called microcrystalline. Read more about arthritis.
Uric acid deposition and arthritis in gout
Most often, gout affects the big toes , less often - the wrists and joints of the hands. But gout can also begin in the knee or ankle joints. The possibility of deposition of uric acid salts in other joints cannot be ruled out.
1. Complete rest. During an acute attack, keep the sore joint elevated and place pads under it. This advice is easy to follow because the pain is very severe.
2. Drink plenty of water , 5 - 6 glasses a day. Drinking plenty of fluids will help speed up the removal of uric acid from your body. It is better to prepare herbal tea, rosehip infusion or lingonberry juice. Do not add sugar.
3. Avoid aspirin and drugs containing it. Painkillers work in different ways. Aspirin can actually make gout worse by slowing down the release of uric acid.
4. If the affected joint allows you to touch it, try applying an ice pack to it for ten minutes . Ice will have an analgesic effect.
5. Avoid foods that increase the concentration of uric acid in the blood. These are high protein animal products with a high purine content. In the first days, meat and fish are limited or even completely excluded, and every other day they arrange fasting days (vegetables, fruits, juices, dairy). Diet for gout - see below. You can't drink alcohol.
6. And most importantly. Excess uric acid and its derivatives damage joints, kidneys, blood vessels and other organs. Therefore, it is urgent to remove excess uric acid from the body and avoid its re-accumulation. To select treatment, consult a rheumatologist.
The development of gout is associated with an increase in uric acid levels in the body. The reason for the increase in uric acid levels can be both an increase in formation and a slowdown in its removal from the body. Constant overeating plays a role, especially eating large amounts of meat and other foods containing so-called purine bases (see diet for gout). Hereditary predisposition and sedentary lifestyle matter.
The needle-sharp crystals are absorbed by blood cells called neutrophils. Needle urates injure cells, resulting in their destruction. The contents of the cells are released into the joint tissue, causing an acute inflammatory reaction and unbearable pain.
Along with acute attacks of pain in the joints, gout is characterized by the deposition of uric acid salts in the tissues, resulting in the formation of gouty nodules - tophi. The favorite places for tophi to appear are the ears, hands, feet, and elbow area. Gout nodes without treatment can enlarge over time and change the shape of the joint.
The disease is more common in middle-aged men (40 - 50 years old). Gout may occur in women after menopause. A predisposition to metabolic disorders is inherited.
The key to treating gout is uric acid control. Uric acid is a breakdown product of substances called purines found in a number of foods. Therefore, treatment of gout is aimed at suppressing the production of uric acid and accelerating its elimination from the body.
Treatment of gout: at an appointment with a rheumatologist
The development of gout is facilitated by excessive consumption of alcoholic beverages (especially beer, cognac, sparkling and dessert wines), meat dishes and excess nutrition in general.
Sometimes “gout” refers to a specific deformity in the area of the big toe, the so-called “bunion of the big toe.” These changes are manifestations of subluxation, deformation of the big toe joint (Hallux Valgus, subluxation of the 1st metatarsophalangeal joint of the foot). This orthopedic disease often occurs in women; from time to time the joint may become painful and deformed; The cause of arthritis is not associated with the deposition of uric acid salts.
There is an opinion that beer helps to “flush the kidneys” for gout. Beer is strictly prohibited for gout patients, since it contains a significant amount of purine (more than wine or other alcoholic beverages), and, like any alcohol, enhances the production and delays the excretion of uric acid from the body.
To treat gift, make an outpatient appointment with a rheumatologist. The doctor will examine you and, if necessary, perform an ultrasound of the joint. The doctor will then discuss and agree on a treatment plan with you. Please allow yourself some time: the examination and consultation can take up to 1.5 hours. As your treatment progresses, you will be able to keep in touch with your doctor in person, by email and by phone.
Our clinic phone number: +7 (495) 649-68-68 .
The clinic consultant will select a convenient day and time for you to visit the doctor.
The clinic is open 7 days a week from 9:00 to 21:00.
If you are unable to come to the clinic for a second consultation, you can get a doctor’s consultation via Skype for the same cost.
If any studies have been previously performed, be sure to bring their results for consultation. If studies have not been performed, we recommend and will perform them based on the results of the inspection, which will avoid unnecessary studies and save money.