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Diagnosis is key to Relief of Richmond Spinal Gout

Gout. If you have had gout, you know how uncomfortable it is. You may also know how tough it was to diagnose, particularly if it was in the spine. Back pain or leg pain may have been your first symptom. Your Richmond chiropractor at Johnson Chiropractic understands spinal gout, its similarities with other conditions’ symptoms, and the latest recommended assessments to diagnose it sooner than later 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 difficult to diagnose and differentiate from other inflammatory issues. (1) A new narrative review stated that 94% of spinal gout patients had back or neck pain, 86% showed neurological symptoms, 72% had a history of gout, 80% tested for elevated levels of serum uric acid, and 76% underwent surgery. Though an infrequent 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, suitable diagnosis of spinal gout can better direct treatment and improve clinical outcomes.

DIAGNOSIS OF SPINAL GOUT

Researchers have explored a variety of ways to safely and accurately diagnose 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 complicate the diagnostic process for spinal gout. Fortunately, dual energy computed tomography (DECT) illustrates the crystals. However, healthcare providers must be aware of the possibility of gout to order the right test. (4) A narrative review of published studies on spinal gout that was undertaken by two chiropractors concurred. To improve 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 key. (2) Johnson Chiropractic 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 ended 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 have 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 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 speculated, Johnson Chiropractic will get the right tests ordered.

CONTACT Johnson 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 Richmond chiropractic appointment soon. Your Richmond chiropractor will do a complete examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout. 

 
Johnson Chiropractic is aware that inflammatory spinal gout is a differential diagnosis to consider for patients who present with back pain and other spine related symptoms. 
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."