Gout. If you’ve experienced gout, you
know how uncomfortable it is. You may also know how difficult
it was to identify as the issue, especially if it
was in the spine. Back pain or leg pain might have been your first
symptom. Your Minster chiropractor at Minster Chiropractic Center is aware of
spinal gout, its similarities with other conditions’ symptoms,
and the latest recommended tests to diagnose it
early to help you get 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 stated
that 94% of spinal gout patients experienced back or neck
pain, 86% displayed neurological symptoms, 72% had 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, appropriate
diagnosis of spinal gout can better guide treatment and improve
clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated a
variety of ways to safely and accurately identify gout in
people who have never had gout. They have reviewed
studies going back as far 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 complicate 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 right test. (4) A narrative review of published studies on
spinal gout that was completed by two chiropractors agreed.
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) Minster Chiropractic Center
notes 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 reduced his mobility and with no history of gout wound
up with a diagnosis of spinal gout after an MRI revealed a mass in
his right erector spinae muscles which lead to a biopsy that exposedspinal
gout. 29% of
patients with gout are affected by 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 presented with
severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was
diagnosed negating an initial diagnosis of vertebral
osteomyelitis. Primary treatment often involves
symptom management with colchicine, steroids, urate decreasing
therapy, and NSAIDS. (6) If spinal gout is speculated,
Minster Chiropractic Center will get the right tests ordered.
CONTACT Minster Chiropractic Center
Listen to this PODCAST
with Dr. Joseph Beissel on The
Back Doctors Podcast with Dr. Michael Johnson as he
describes the relief with The Cox® Technic System of Spinal
Pain Management for chronic back pain.
Schedule your Minster chiropractic
appointment now. Your Minster chiropractor will do
a complete examination to determine the best course
to appropriately diagnose, treat, and attain the best relief of
spinal gout.