Gout has been historically known as the “disease of kings”, stemming from its association with rich foods and excessive drinking in medieval times. Despite this, gout still affects millions of people today and is a condition which can cause debilitating pain in the joints.
What is Gout?
Gout is a form of arthritis caused by the build up of uric acid in the blood, which can crystallise in your joints, leading to sudden, severe pain and inflammation. Uric acid is a waste product that the body normally eliminates through urine, but when there is excess in the body it forms sharp crystals in the joints. While gout typically affects the big toe, it can also impact other joints such as the ankle, knee, elbow, wrist, and fingers.
How Do You Develop Gout?
Gout develops when the body is unable to adequately process uric acid. This could be due to:
- Excessive uric acid production: Some people naturally produce too much uric acid, which can overwhelm the kidneys’ ability to filter it out.
- Poor kidney function: Conditions like kidney disease can reduce the kidneys’ efficiency in clearing uric acid.
- Dietary factors: Foods high in purines (like red meats, shellfish, and alcohol, particularly beer) can increase uric acid levels.
- Obesity: Being overweight increases the production of uric acid and reduces the ability of the kidneys to excrete it.
- Genetics: Family history plays a significant role—if your relatives had gout, you’re at higher risk of developing it.
Symptoms of Gout
The symptoms of gout often appear suddenly and can be very intense:
- Severe joint pain: The pain usually starts suddenly, often at night
- Swelling and redness: The affected joint may become hot, swollen, and visibly inflamed.
- Tenderness: Even the lightest touch on the affected joint can be extremely painful.
- Limited range of motion: As the joint becomes more swollen and painful, movement can become restricted.
Gout attacks typically last from a few days to a week but can become more frequent and severe over time if left untreated.
Groups Susceptible to Gout
- Men: Gout is much more common in men, especially those between the ages of 30 and 50. However women are at increased risk post menopause
- Middle-aged individuals: Gout is often diagnosed in middle age, as uric acid levels tend to rise with age.
- Overweight individuals: Excess weight can contribute to the development of gout due to increased uric acid production.
- Those with a family history: Genetics plays a strong role in susceptibility—if your parents or siblings had gout, you’re at greater risk.
What to Do During a Gout Attack
- Take Medication
- Use ibuprofen or naproxen (Advil, Aleve) for pain relief. Avoid aspirin, as it can worsen gout. If prescribed, take colchicine or other anti-inflammatory meds as directed by your doctor.
- Ice the Joint
- Apply an ice pack or frozen peas wrapped in a cloth for 20 minutes several times a day to reduce swelling and pain.
- Stay Hydrated
- Drink 8-16 cups of fluids a day, mostly water, to help flush out uric acid.
- Avoid Alcohol
- Stay away from alcohol, especially beer, which can increase uric acid levels and worsen the flare-up.
- Elevate and Rest the Affected Area
- Elevate the painful joint with pillows to reduce swelling, and use a walking stick if needed to avoid putting pressure on the affected joint.
How to Prevent Gout Flare-Ups
- Maintain a Healthy Weight
- Being overweight raises uric acid levels. Aim for a balanced diet and regular exercise to manage your weight.
- Stay Hydrated
- Drink plenty of water (at least 8-10 cups a day) to help flush out uric acid and prevent kidney stones.
- Limit Purine-Rich Foods
- Avoid foods high in purines, like red meat, shellfish, and organ meats, which can raise uric acid levels.
- Cut Back on Alcohol
- Especially beer and spirits, which can trigger flare-ups by increasing uric acid levels.
- Take Uric Acid-Lowering Medications
- If prescribed, continue taking medications like allopurinol or febuxostat to lower uric acid levels and reduce the risk of future attacks.
- Exercise Regularly
- Engage in low-impact exercises, such as walking or swimming, to keep your joints healthy and improve circulation.
How Physiotherapy Can Help
While there’s no cure for gout, physiotherapy can play a crucial role in managing the condition, especially after a flare-up or in cases of chronic gout.
- Pain management
- Joint mobilisation: Gentle mobilisations and stretching exercises can help maintain joint flexibility and reduce stiffness during and after flare-ups.
- Strengthening exercises: After the acute pain of gout subsides, physiotherapists can guide you through strengthening exercises to protect the affected joints and prevent future injuries.
Gout is more common than most people realise, affecting millions globally. By understanding what gout is, how it develops, and how you can manage it, you can reduce your risk of flare-ups and lead a more comfortable life.
If you have gout, lifestyle changes, medications, and physiotherapy can help you manage the condition effectively. While recovery from an acute flare-up can take a few days to a week, long-term management is crucial to preventing future attacks.
Click here to book a physio appointment at either our Woking or Egham clinics.
