Gout. If you’ve had gout, you
know how painful it is. You may also know how tough
it was to identify as the issue, especially if it
was in the spine. Back pain or leg pain may have been your first
symptom. Your Auburn chiropractor at Dr. Le's Chiropractic & Wellness, L.L.C. is aware of
spinal gout, its resemblance to other conditions’ symptoms,
and the latest recommended tests to diagnose it
early to direct you to the (proper!)
care you need.
PREVALENCE OF SPINAL GOUT
Arthritis is an inflammatory condition impacting
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 discrimainate
from other inflammatory issues. (1) A recent narrative review reported
that 94% of spinal gout patients described 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% underwent surgery. Though an uncommon
cause of spine pain, gout’s inflammatory arthritis stems 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 enhance
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 better
than 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. Fortunately, dual energy computed tomography (DECT)
shows the crystals. However, healthcare providers must be
aware that gout is a possible cause to request
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 combination of clinical symptoms, lab tests, and DECT may hold
the key. (2) Dr. Le's Chiropractic & Wellness, L.L.C.
documents that cases of spinal gout are appearing 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 revealed a mass in
his right erector spinae muscles which lead to a pathological exam revealed spinal gout. 29% of
patients with gout have spinal gout, too,
which didn’t help in this case of a patient without gout but is an interesting stat to consider in the next case. (5) A 41-year-old
male who did have a 7-year history of gout presented with
severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was
diagnosed invalidating an initial diagnosis of vertebral
osteomyelitis. Initial treatment often involves
symptom management with colchicine, steroids, urate reducing
therapy, and NSAIDS. (6) If spinal gout is suspected,
Dr. Le's Chiropractic & Wellness, L.L.C. will get the right tests ordered.
CONTACT Dr. Le's Chiropractic & Wellness, L.L.C.
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.
Schedule your Auburn chiropractic
appointment now. Your Auburn chiropractor will do
a thorough examination to determine the best course
to appropriately diagnose, treat, and attain the best relief of
spinal gout.