Spinal Gout Symptoms, Causes, Treatment and Prevention


Gout is a type of inflammatory arthritis that affects more than 8000000 people in the United States.

It is caused by the buildup of a substance called uric acid in your joints. The The most common location of gout development is your big toe. Other common places are your other toes, ankles or knees.

If gout is left untreated, uric acid crystals may begin to accumulate in other areas, such as the spine, rib cage, or skull.

Spinal gout is considered rare. From 2000 to 2014, only 68 case reports have been published in the medical literature. However, it is difficult to know exactly how common it is because its symptoms are non-specific and it is thought to often go undiagnosed. Some studies estimate that it can affect up to 22-35% of people with gout.

Read on as we take a deeper look at spinal gout, including symptoms, causes, and treatment.

Symptoms of spinal gout are not specific and can mimic many other conditions.

Potential symptoms include:

Gout symptoms alternate between flare-ups and symptom-free periods.

In a study 2016, researchers found that 69.1% of 68 people with spinal gout had back or neck pain. The lower spine was the most common place where gout developed and the upper spine was the least common area.

Gout is caused by a buildup of uric acid in your body. This condition is called hyperuricemia. However, not everyone with hyperuricemia develops gout.

Your body produces uric acid when it breaks down chemicals called purines found in certain foods. Too much uric acid creates crystals that build up in your joints, fluids, and tissues. Whether left untreatedmasses of these crystals called tophi can form outside your joints in places such as your spine.

Some people are more likely to develop hyperuricemia and gout. Risk factors to understand:

  • to be born male
  • obesity
  • certain medications, such as diuretics
  • eat many foods high in fructose sugar
  • eating a diet rich in foods containing purines
  • certain health conditions, such as:

Spinal gout is managed with a combination of medications and home management strategies. The same drugs are used to treat spinal gout and gout that affects your joints.

A doctor or healthcare professional can recommend the best way to manage your condition. Common treatment options include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as naproxen, ibuprofen, or indomethacin, are commonly used to treat pain and inflammation during flare-ups.
  • Colchicine. Colchicine is an alternative to NSAIDs for people with NSAID allergies, chronic kidney disease, or other conditions that make them ineligible for NSAIDs.
  • Lifestyle changes to prevent future flare-ups. Lifestyle changes, such as eating a balanced diet, limiting alcohol and purine-rich foods, and maintaining a moderate weight, can help prevent future flare-ups.
  • Preventive therapy. Doctors may recommend medications, such as allopurinolfebuxostat or pegloticase, to prevent tophi and kidney stones.

Flares should be treated first 24 hours reduce their severity and duration. Gout flare-ups usually last 5-7 days. If left untreated, spinal gout can cause permanent spinal cord damage.

It’s important to see a doctor if you have unidentified back pain or other potentially concerning symptoms, such as muscle numbness and weakness.

The British National Health Service recommends seeking urgent attention if you have symptoms that could indicate an infection, such as:

  • you feel sick and cannot eat
  • you have a high fever
  • your pain is getting worse

Diagnosing spinal gout can be tricky because it doesn’t cause any specific symptoms.

A doctor called a rheumatologist, who specializes in arthritis and diseases of the joints, bones, and muscles, can diagnose gout.

The gout can only to be diagnosed during flare-ups when lab tests may find uric acid crystals.

A doctor can measure your uric acid level using a blood test. Higher uric acid levels 7 milligrams per deciliter are indicative of hyperuricaemia.

A doctor may order imaging tests, such as an MRI, CT scan, or X-ray, to look for signs of spinal compression or other abnormalities.

A biopsy or surgical removal of uric acid crystals is necessary to confirm a diagnosis. Another imaging test, dual-energy computed tomography, specifically finds uric acid deposits. A doctor may recommend this test if a biopsy fails.

In a study 2020, researchers estimated that 77% of gout cases could have been prevented in a group of 44,654 men followed for 26 years. They felt that gout could have been prevented if all men had:

  • maintained a healthy weight
  • avoided alcohol
  • diuretics avoided
  • followed a diet similar to the DASH diet (a diet based on dietary approaches to stop hypertension), developed to prevent high blood pressure

A doctor can give you specific strategies to prevent future gout flare-ups. Some changes you can make include:

  • have a balanced diet
  • minimize your purine intake
  • limit alcohol
  • become or remain physically active
  • maintain a healthy weight if you are overweight or obese
  • taking care to prevent joint injury

Foods high or moderately high in purines that you may want to avoid include:

  • Red meat
  • organ meat
  • game meat
  • certain fish and seafood, such as:

Learn more about the best diet for gout.

Gout is a type of inflammatory arthritis caused by the buildup of uric acid. The most common place where gout develops is the big toe. Spinal gout is considered rare, but is thought to be underdiagnosed because it causes no specific symptoms.

It is important to see a doctor as soon as possible if you think you are having a gout flare. Prompt treatment can minimize the severity and duration of your symptoms.

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