Gout. If you have experienced gout, you know how uncomfortable it is. You may also know how tough it was to identify as the issue, particularly if it was in the spine. Back pain or leg pain might have been your first symptom. Your Easley chiropractor at Young Chiropractic is aware of spinal gout, its similarities with other conditions’ symptoms, and the latest recommended tests to diagnose it early to direct you to the (appropriate!) care you need.
PREVALENCE OF SPINAL GOUT
Arthritis is an inflammatory condition affecting people around the world - 47.8 million US sufferers, 8 million UK sufferers, 108 million European sufferers - with osteoarthritis being the most common affecting joints in the knee, hands, etc. Gout is just such an inflammatory cause of pain in similar areas, making it a challenge to diagnose and differentiate from other inflammatory issues. (1) A new narrative review reported that 94% of spinal gout patients had back or neck pain, 86% displayed neurological symptoms, 72% noted a history of gout, 80% tested for elevated levels of serum uric acid, and 76% went through a surgery. Though an uncommon cause of spine pain, gout’s inflammatory arthritis results from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, suitable diagnosis of spinal gout can better direct treatment and improve clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated various ways to safely and accurately diagnose gout in people who have never had gout. They have reviewed studies from as far back as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were superior to a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can muddle the diagnostic process for spinal gout. Luckily, dual energy computed tomography (DECT) illustrates the crystals. However, healthcare providers must be aware that gout is a possible cause to order the proper test. (4) A narrative review of published studies on spinal gout that was completed by two chiropractors concurred. To enhanced the quality of life of spinal gout sufferers as well as the diagnosis, treatment planning and prevention of surgery, a mix of clinical symptoms, lab tests, and DECT may hold the key. (2) Young Chiropractic notes that cases of spinal gout are emerging in the medical literature.
CASES OF SPINAL GOUT and TREATMENT
One case of a 48-year-old man with sudden, severe, sharp low back pain that limited his mobility and with no history of gout ended up with a diagnosis of spinal gout after an MRI showed a mass in his right erector spinae muscles which lead to a pathological exam revealed spinal gout. 29% of patients with gout experience spinal gout, too, which did not help in this case of a patient without gout but is a noteworthy stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout came for help with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed negating an initial diagnosis of vertebral osteomyelitis. Initial treatment often involves symptom management with colchicine, steroids, urate decreasing therapy, and NSAIDS. (6) If spinal gout is supposed, Young Chiropractic will get the right tests ordered.
CONTACT Young Chiropractic
Listen to this PODCAST with Dr. Joseph Beissel on The Back Doctors Podcast with Dr. Michael Johnson as he illustrates the relief with The Cox® Technic System of Spinal Pain Management for chronic back pain.
Make your Easley chiropractic appointment soon. Your Easley chiropractor will do a thorough examination to figure out the best course to properly diagnose, treat, and attain the best relief of spinal gout.