Surprisingly, gout (podagra) affects about 1 in 40 individuals. It is a form of arthritis that causes stiffness, tenderness, and pain in the joints. It can make movement difficult and very painful. Luckily, gout treatment can help you manage your symptoms. Orthopaedic care offers a holistic approach to treating gout.
At the Singapore Sports and Orthopaedic Clinic, our qualified experts can help find the best solution and gout treatment in Singapore, for you and your lifestyle.
What is Gout?
Gout (podagra) is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints.
When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones (nephrolithiasis).
What Causes Gout?
- Intake of alcholic beverages
- Increase in level of uric acid
- Starvation and dehydration
Thousands of years ago, gout was considered the ‘disease of kings.’ Why? Certain foods with a high purine content, such as shellfish and red meat, and alcohol trigger gout attacks. During this era, these foods and alcohol were limited to royalty and the extremely wealthy. Thus, middle and lower class civilians rarely experienced the disease.
Today, the prevalence and incidences of gout have steadily increased. Our diets have changed. And with technology, we can detect and diagnose gout much easier than ever before.
Gout is caused by a buildup of uric acid in the body. Usually, the kidneys filter and then excrete uric acid through the urine. In certain circumstances, the body may produce uric acid at a higher rate than it can expel it. When uric acid levels in the blood become too high, the body deposits monosodium urate crystals in the joints. These crystals irritate our joints, and cause the symptoms commonly associated with gout including:
The body may be unable to keep up with uric acid levels for a number of reasons. Our body breaks purine down into uric acid. Purine is found in alcohol beverages, various meats, and seafood. When we consume foods high in purine, our bodies may lack the ability to keep up with the production of uric acid. This results in hyperuricemia, or high uric acid levels, in the blood.
In other cases, kidney impairment may cause higher uric acid levels. If the kidneys are unable to excrete uric acid, it builds in the blood. Impaired kidney function may occur due to diabetes, cancer, high blood pressure, thyroid disorders, or kidney failure.
Genetics and certain medications are also thought to play a role in the development of gout. For example, diuretic medication used to treat high blood pressure can lead to gout. Diuretics increase your fluid output. Yet, the fluid left in the body may become highly concentrated with uric acid. Doctors advise drinking plenty of fluids when taking diuretics and avoiding foods high in purine to reduce the risk of gout.
How is Gout Diagnosed?
Prior to gout treatment in Singapore, a proper diagnosis must be made by a physician. Your doctor may take into account a number of factors. They may assess and ask questions relating to the following:
- Are you overweight?
- Do you consume a diet high in purine foods?
- Do you regularly consume alcoholic beverages in high amounts?
- Are you on certain medications, such as diuretics?
A joint fluid test and blood test will confirm a gout diagnosis.
In a joint fluid test, fluid is taken from the inflamed and painful joint via a needle. If crystals are present in the fluid, a gout diagnosis is made. Your doctor may further order an x-ray to ensure the pain is not caused by other problems.
Exploring the Relationship Between Gout & Joint Pain
Gout can cause sudden intense painful attacks at the joints, causing swelling and redness of the joint tissues. It usually attacks the joint of the big toe but this does not rule out the attacks on other joints. Gout usually affects men with 9 out of 10 patients being men. Once gout starts to attack other joints, it leads to inflammatory arthritis. Let’s look at the relationship between Gout and Joint pain here.
Gout happens due to an excessive accumulation of uric acid. Uric acid is formed when the body breaks down an aromatic organic compound called purines. Purines are found in foods such as livers, beans, mackerel and beer. Overconsumption of such foods will lead to a high level of purines, resulting in too much uric acid. The body’s natural mechanism of dealing with uric acid is by passing them out through urination but when this urination process is less efficient, hyperuricemia occurs, leading to gout.
Gout happens through 3 basic stages:
This is the onset of gout. In this first stage, the patient starts to have an excessive accumulation of uric acid in the body but no other symptoms or problems are present. It is also in this stage that the problem can easily be reversed by significantly reducing the amount of purine-rich foods.
Acute Gouty Arthritis
When no actions were performed to limit the consumption of purine-rich foods, the uric acid levels will increased and lead to the formation of uric crystals in the spaces between the joint. Due to the crystals and high acidity, sudden onset of intense pain will occur and this can lead to swelling in the joints. Attacks will be infrequent and can be spaced weeks or even months apart from each, but as time passes, the attacks will become more and more common.
Chronic Tophaceous Gout
This stage is the most serious and will only happen after 10 years. A patient will only reach this stage when he makes no attempt to seek treatment and gout has caused a permanent damage to the joints and kidneys.
There is an exponential relationship between gout and joint pain, leading to sudden onsets of pain attack and swelling. However, reaching from one stage to the other takes time and during the periods, it can be treated by medication and reduction in consumption of purine-rich foods. Gout will cause a lot of trauma and severely affect patients.
How is Gout Treated?
In some cases, gout is very dehabiliting. It can happen suddenly and be very painful. The most common spot for gout to occur is in the big toe. Although, it may spread to the ankles, feet, and knees.
Fortunately, gout is a very treatable condition. And we offer a variety of ways to treat the disease. When a gout attack occurs, it will often resolve on its own in about a week. Thus, many health professions focus on relieving the symptoms and preventing future incidents.
Medications are the most common go-to. NSAIDs, nonsteroidal anti-inflammatory drugs, may alleviate swelling and pain. Your doctor may also prescribe stronger pain medication if over-the-counter drugs aren’t helping. Medications that help lower uric acid levels may also be considered. These type of medications help to prevent attacks by reducing the production of uric acid.
However, long-term use of most of these drugs is not recommended. Surprisingly, NSAIDs can have fairly dangerous side effects. With chronic use, heart problems may arise. Prescription NSAIDs are particularly problematic for this. You may experience gastro-intestinal issues. These medications may cause bleeding and ulcers when used for long-periods or at high dosages. Such medication may also lead to further impaired kidney function, which not only doesn’t help the problem but can amplify gout occurrences and symptoms. When using any medication, make sure to follow the direction on the label and read the warnings prior to consumption.
Your healthcare provider may also consider the medication you are currently taking and make modifications where it is necessary.
If your diet is the main problem, your healthcare provider may discuss other dietary options that do not increase your risk of gout. They will advise you to avoid foods high in purine and to drink plenty of water throughout your day.
The treatment of an acute attack of gouty arthritis involves measures and medications that reduce inflammation. Preventing future acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to lower the uric acid level in the blood.
Maintaining adequate fluid intake helps prevent acute gout attacks. Adequate fluid intake also decreases the risk of kidney stone formation in patients with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism to cause hyperuricemia. Therefore, alcohol has two major effects that worsen gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, both of which contribute to the precipitation of uric acid crystals in the joints.
Orthopaedic Care & Gout Treatment in Singapore
At the Singapore Sports and Orthopaedic Clinic, our experts can diagnose, treat, and prevent joint, neuro, and muscular disorders, such as gout. They can provide exercise and nutritional advice to help treat gout.
Your doctor will address your nutritional and lifestyle choices, in combination with manual manipulation of the joints to eliminate your pain, improve mobility, reduce the incidences of gout attacks, and help increase your overall quality of life.
Your healthcare provider may recommend the following foods to replace high-purine content foods in your diet:
- Low fat dairy products
- Whole grains
Surgery is a rare option for treating gout. However, in cases where there is a lack of draining, the area has become infected, or movement is severely impacted, surgery may provide the best option.
Your healthcare provider may also recommend specific exercises to reduce joint pain and increase support to the commonly affected areas. Weaknesses in the body may lead to pain and conditions such as gout. Strengthening around these areas can lessen the pain symptoms associated with the condition. Weight management is also important to limit the stress placed on the joints that are prone to gout attacks. Your treatment will likely involve an exercise program tailored to your specific needs, including strengthening exercises and possible weight loss strategies.
Get the advice you need and the proper care and treatment for your condition. Frequent and painful gout attacks do not have to be your normal.
At the Singapore Sports and Orthopaedic Clinic, our qualified doctors will find the appropriate gout treatment in Singapore for you. Our team of doctors are experienced in treating orthopaedic problems, sport injuries, and degenerative changes. Start your life free of pain. Get back to the activities you know and love. Call and book your appointment, today.