Gout. If you’ve experienced 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 may have been your first symptom. Your Nashua chiropractor at Moriarty Chiropractic understands spinal gout, its similarities with other conditions’ symptoms, and the latest recommended assessments to diagnose it sooner than later to direct you to the (appropriate!) 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 tough to diagnose and discrimainate from other inflammatory issues. (1) A new narrative review stated that 94% of spinal gout patients described back or neck pain, 86% displayed neurological symptoms, 72% noted a history of gout, 80% tested for high levels of serum uric acid, and 76% underwent 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 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 of the possibility of gout to request the proper 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 mix of clinical symptoms, lab tests, and DECT may be the answer. (2) Moriarty Chiropractic 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 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 revealedspinal 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 an interesting 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 invalidating an initial diagnosis of vertebral osteomyelitis. Primary treatment often involves symptom management with colchicine, steroids, urate reducing therapy, and NSAIDS. (6) If spinal gout is suspected, Moriarty Chiropractic will get the right tests ordered.
CONTACT Moriarty 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.
Schedule your Nashua chiropractic appointment now. Your Nashua chiropractor will do a thorough examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout.