Gout. If you’ve had gout, you
know how uncomfortable it is. You may also know how difficult
it was to diagnose, particularly if it
was in the spine. Back pain or leg pain might have been your first
symptom. Your Severna Park chiropractor at Back And Neck Care Center understands
spinal gout, its similarities with other conditions’ symptoms,
and the latest advised assessments 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 difficult 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% had a
history of gout, 80% had elevated levels of serum
uric acid, and 76% underwent surgery. Though an infrequent
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, appropriate
diagnosis of spinal gout can better guide treatment and enhance
clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated various ways to safely and accurately identify gout in
people who have never experienced gout. They have analyzed
studies going back as far 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 confuse 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 request
the proper test. (4) A narrative review of published studies on
spinal gout that was done by two chiropractors concurred.
To make better 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) Back And Neck Care Center
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 wound
up with a diagnosis of spinal gout after an MRI showed a mass in
his right erector spinae muscles which lead to a biopsy that divulgedspinal
gout. 29% of
patients with gout are affected by spinal gout, too,
which didn’t 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 presented 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 lowering
therapy, and NSAIDS. (6) If spinal gout is speculated,
Back And Neck Care Center will get the right tests ordered.
CONTACT Back And Neck Care Center
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 Severna Park chiropractic
appointment now. Your Severna Park chiropractor will do
a thorough examination to figure out the best course
to properly diagnose, treat, and attain the best relief of
spinal gout.