Diagnosis is key to Relief of Richmond Spinal Gout
Gout. If you have had gout, you know how unpleasant 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 Richmond chiropractor at Johnson Chiropractic understands spinal gout, its resemblance to other conditions’ symptoms, and the latest advised 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 difficult 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% showed neurological symptoms, 72% noted 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 guide treatment and improve clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated various ways to safely and accurately diagnose gout in people who have never experienced 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 cloud the diagnostic process for spinal gout. Fortunately, dual energy computed tomography (DECT) shows the crystals. However, healthcare providers must be aware that gout is a possible cause to order the right test. (4) A narrative review of published studies on spinal gout that was done 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 mix of clinical symptoms, lab tests, and DECT may be the answer. (2) Johnson Chiropractic documents 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 ended up with a diagnosis of spinal gout after an MRI revealed a mass in his right erector spinae muscles which lead to a pathological exam showed spinal gout. 29% of patients with gout are affected by 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 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 reducing therapy, and NSAIDS. (6) If spinal gout is supposed, 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 thorough examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout.
