Diagnosis is key to Relief of Williamson Spinal Gout
Gout. If you’ve experienced gout, you know how painful it is. You may also know how difficult it was to diagnose, especially if it was in the spine. Back pain or leg pain may have been your first symptom. Your Williamson chiropractor at Apple Country Chiropractic is aware of spinal gout, its resemblance to other conditions’ symptoms, and the latest recommended assessments to diagnose it sooner than later 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 tough to diagnose and differentiate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients described back or neck pain, 86% showed neurological symptoms, 72% had a history of gout, 80% had elevated levels of serum uric acid, and 76% went through a 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 direct treatment and enhance 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 analyzed 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 cloud the diagnostic process for spinal gout. Luckily, 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 agreed. 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 be the answer. (2) Apple Country 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 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 experience 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 lowering therapy, and NSAIDS. (6) If spinal gout is supposed, Apple Country Chiropractic will get the right tests ordered.
CONTACT Apple Country Chiropractic
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 Williamson chiropractic appointment today. Your Williamson chiropractor will do a complete examination to determine the best course to properly diagnose, treat, and attain the best relief of spinal gout.
